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It’s Hard Out Here for a Prospective Home-Birth Midwife


Sometimes, I completely hate the media. It endorses common fears women have about natural birth and birthing at home, when there truly should not be anything to fear. As I’ve said before, birth is natural. Our bodies were made to do it. In a normal pregnancy, birth with a midwife is the best option, no matter where you give birth, because the midwife will give you the most all-around care and usually be at your side for most of the birth, unlike OBs who let nurses check on the laboring mama and report back, not arriving in the delivery room permanently until the last few minutes of birth.  But instead of seeing these facts, people only see the horror stories in the media about home birth midwives who lost baby or mom or both in their birth.  Infant and maternal mortality are risks attributed to BOTH hospital and home births.  The problem is that there are midwives out there who have little training and experience under their belts, and they are missing important warning signs, both before and during labor, that should trigger them to advise birth in a hospital. I, myself, am going through an EIGHT YEAR program through the University of Midwives. It is insane to me to think that there are midwives out there who are licensed and certified with less than one year of training and experience.  The doctors and women out there who are fearful of home birth certainly have every right to be, with such lax training protocols!  An obstetrician can not practice without going through medical school. I think the same amount of training should be the norm for midwives, as well! We are holding at least two precious lives in our hands every time we attend a birth.  I know that personally, I would rather die myself than be responsible for a mother or child’s death because I was not adequately trained to recognize and treat potentially deadly complications.  I will rest easy knowing that I am never going to stop training, even after I go into practice. That I will do my best to memorize every affliction a birthing mother is at risk for. That I will learn the early warning signs that would make me recommend a hospital birth and not offer services at home.  That I will never be reckless in my education, so I will not be reckless during a birth.  How is it that some women who aspire to be midwives do not feel the same way? What could possibly possess a woman (or man) to begin practicing midwifery after only ONE YEAR of training, and no formal education?  I think they are insane, and they hurt my odds of being a successful midwife because they (rightfully) scare women away from our profession. 

So here’s my advice to all you mommas out there.  If you are going the home birth route, do your research!  Find out if your midwife has any malpractice suits. If she does, find out the circumstances.  Find out how long your midwife has been practicing.  Ask what training she went through to be a midwife, and how long she studied before practicing on her own.  Ask her for statistics on how many babies she has transferred to a hospital and what the reasoning for some of those instances were.  Ask to speak to former patients who will vouch for her.  Ask if she has had any infant or maternal deaths, and, if so, what the circumstances were.  If you feel like your midwife isn’t honest with you about any of the above, find someone else!  The most important part of a midwife-patient relationship is trust!  So make sure your midwife deserves yours.

 
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Posted by on July 6, 2012 in My Story

 

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Too Posh To Push? Then Don’t Get Pregnant.


Cesarean sections are a hot-button topic for me, and when someone has one electively and plans it months in advance it makes me so angry at them.  I have nothing against C-sections when they are used for the purpose they were designed for – to save a baby who is in distress during labor – but otherwise the practice completely repulses me.  These days, you hear supporters of women’s rights, feminists, celebrities, and plenty of other women going on about how we are strong, and we can do anything.  But I call BS on it.

There are very few women who consider themselves to be strong enough to take the childbearing plunge without the help of drugs or scalpels.  And for some reason, everyone sees it as normal, and safe.  News flash, ladies: a cesarean section is a highly invasive surgery with many possible complications and a long recovery time.  We, as women, are willing to put up with that (and with a cranky newborn in the house no less!), but why?  Every woman has her reasons.  Some are completely justified: if you have an STD that could potentially be passed to your baby, a c-section may be a good option.  Others are not: if you are scared of your hoo-ha being stretched and not returning to it’s previous tightness, a c-section is just selfish.  But women tell themselves it’s for the baby’s health, that they won’t get their heads misshapen by going through the birth canal, that the baby is breech and couldn’t possibly travel through the birth canal safely that way, that it takes less time to have a c-section.

For a list of things women tell themselves (and apparently women’s WEBSITES tell women), check out this horrifying slideshow from iVillage.  Please read the whole thing, then read what I have to say about it.  I had a lot of issues with this article, so I want to address each of the excuses presented in it.  They made a lot of false claims and claims that aren’t supported by good evidence.  So here’s the real story:

1. You’ll Know Exactly When Your Baby Will Arrive.  So having a baby makes your life a little unpredictable for a few months at the end there.  The reason there’s not an EXACT amount of time every baby spends in the womb is that every baby needs a slightly different amount of time to get ready to join the rest of us out here.  Just like they develop at different rates after being born, babies may fluctuate in the amount of time necessary before being born.  Scheduling your c-section may deprive your baby of the extra week he or she needed to develop fully. That can cause all sorts of complications, such as minor social and learning disabilities and difficulty breathing when first born, among many other things.  Is it really worth knowing the exact day and time you’ll meet your child if the consequences last a lifetime?

2. Your Baby Will Be Camera Ready. This is a dumb excuse.  Babies were meant to travel the birth canal.  That’s why their heads are soft, so they can fit.  It’s not bad for them, so the only reason this excuse is valid is cosmetic.  And are you really that shallow?  Also, even if the baby’s head comes out a little squished, it returns to normal adorable roundness after a few days.

3. Operating Rooms Have Gotten Cozier. There is nothing cozy about an operating room.  People die in operating rooms, and yes, that is a risk of cesarean section.  And yeah, your partner can stay with you now!  They can stay during vaginal birth, too.  Many doctors skim over the risks of a cesarean section, which is totally unfair to the woman going through the procedure.  Here’s a link to check out the risks yourself.  It’s not a pretty picture.

4. You Get A Little More Privacy.  Yeah, you don’t have 6 people staring at your hoo-ha. You do have someone’s hands buried inside your internal organs, though!  It’s silly to be self-concious about people seeing your intimate parts during labor – they’re all professionals, unless you’re at a teaching hospital where they let students watch, and even then you can tell those students to get out.  That’s your right as a patient.  If privacy is what you seek, though, think about looking into a birth center or even a home birth – us midwives try to be very discreet during birth, and are more open to having less people in the room if it makes you uncomfortable.

5. Extra Hospital Time Has It’s Perks. Really, who likes being in a hospital?  The food is horrible, your partner can’t stay the night with you (unless he’s willing to take on a very uncomfortable couch and/or chair), and you are in recovery from major surgery, meaning you will probably be on pain meds and have a more difficult time bonding with your baby and breastfeeding.  The reason you’re required to stay longer for a c-section is because you literally would not be able to care for yourself or your newborn in the first couple days without a support staff.  Vaginal births get to go home faster because they are already feeling like they can get up and do things, not to mention take care of their own baby.  And if you have a vaginal birth and don’t feel 100% after you go home, that’s what your PERSONAL support team is there for.  You just had a baby!!  You are the queen.  Ask your husband to take on a few extra things like cooking and cleaning while you’re recovering.  Ask some good friends and family if they want to come see the baby, and when they ask if there’s anything they can do to make your life easier when they come to check out the little ball of joy, don’t lie!  Let them know you’re too tired to stand at the sink and do dishes.  Tell them you’re craving a home-cooked meal but baby starts crying as soon as you set him down.  I guarantee that they will be all too happy to help – if they can hold the baby for a few minutes! 😉

6. You Get Treated Like A Queen. This should be a given whether you get sliced open or not.  After a c-section, you will almost definitely be unable to perform simple daily tasks.  After vaginal delivery, you can do what you’re comfortable with, and see my response to number 5 for the things you don’t want to do.

7. Everyone Will Take Your Pain Seriously.  You really do need painkillers after surgery.  If you have a c-section, take them.  However, you aren’t prescribed prescription painkillers after natural birth because you don’t need them, and they can interfere with the care of your newborn.  Are you really going to pick up your baby while you’re on Vicodin?  Some people would call that irresponsible.  Yes, you can have pain after natural birth.  It’s a given.  But those remedies that doctors recommend, such as warm compresses and sitz baths, are usually plenty to ease the discomfort.  And when they’re not, you can always call your doctor and ask what else you can do, or consult a naturopath who may have natural remedies that will eliminate your pain.

8. You’ll Get Extra Help With Breastfeeding. Whether or not you have a c-section, there are always options for getting help with breastfeeding.  Most cities have lots of support groups, if the problems you’re experiencing aren’t serious, and lactation consultants you can hire by the hour for more difficult cases.  They’re probably less expensive than the thousands you’re going to spend if you stay extra time in the hospital.  Also, the claim about the drugs here is wrong.  If you are given Percocet, Morphine, Oxycodone, or Vicodin, these can certainly be transmitted to your breast milk and do harm to your baby.  Most doctors will tell you it’s ok to take them, but there haven’t been many studies on the actual long term effects of these drugs on newborn children. There are theories that they can effect their ability to learn later in life, that they can make babies more susceptible to drug and/or alcohol addiction later in life, and even that it could cause minor social and learning disabilities.  None of these have been proven, yet, but correlations have been noted.

9. Everything Will Be The Same Down There. If you do your research, you’ll find that there are many ways to return your vagina to awesomeness after natural birth.  First of all, DON’T let the doctors slice open your perineum during birth.  Episiostomies aren’t necessary if you employ perineal massage before and during labor.  That muscle will never heal to the way it was if it’s sliced.  If it tears, it will heal properly but will take time.  I’ve seen two births so far, both pretty large baby boys, delivered naturally.  With massage, there was zero tearing for both women.  I’m not saying you will magically regain your previous vagina.  It takes work.  You have to be willing to do kegels and squats (squats strengthen your pelvic floor), and you have to accept that it will be a little wonky for about six months.  But your vagina is meant to have a baby pass through it, and it does eventually return to normal.  Many mothers actually report better sex after their vagina has fully healed.  This book may be of some help to you if you want that old sex life back after baby!  It’s also good if you’ve been having trouble with “leaking”.

10. You May Actually Like Your Scar.  Really?  Yes, it’s a visual representations of the life you created.  So is the actual baby.  Most women who have c-section scars are self-concious about them.  It can be difficult to come to terms with having a line across your stomach forever.  If you have to have a c-section for health reasons, then yes, the scar is something you can be proud of, because you went to great lengths for the health of your baby.  If you have a c-section because you’re scared of natural birth, it’s just a reminder of your cowardice.  If you have a c-section because a slippery slope of interventions put you there at doctors orders, it can actually be a reminder of a very traumatic, scary experience.  It’s generally hard for women to feel good about their scar, though.

11. You’ll Embrace Your Inner Tough Chick. I can name something harder than caring for a newborn.  Birthing said newborn naturally.  You want to be a tough chick?  Go through 3 – 48 hours of excruciating contractions and pop a bowling ball out of yourself- without painkillers.  Caring for a newborn while recovering from surgery is NOT a good situation.  And it lasts a lot longer than natural birth.  it takes 4-6 weeks to fully recover from c-section if there are no complications, much longer if you get an infection or another complication arises.  4 – 6 weeks of terrible pain while attempting to care for a bawling, screaming, breastfeeding baby sounds like a much more sadistic kind of hell than natural birth, in my opinion.

12. You Can Probably Try For Vaginal Childbirth Next Time. THIS is true.  And should be very much taken to heart!  If you have your heart set on natural childbirth for your next baby after a c-section, but can’t find an obstetrician willing to attend, seek out your city’s birth centers and midwives.  VBAC is possible!!!  Never lose hope in it.

13. You’ll Be Putting Your Baby’s Safety First.  This is total propaganda against vaginal birth.  C-section poses a much higher risk of complications.  The American Journal of Obstetrics & Gynecology published a study which concludes: “A planned cesarean delivery doubled both the rate of transfer to the neonatal inten- sive care unit and the risk for pulmonary disorders, compared with a planned vaginal delivery.”  How is this safer for the baby?  And the higher c-section rate hasn’t created a drop in infant mortality rates, either.

All in all, this article really struck a nerve for me.  Women should be provided the whole story in articles such as these.  Yes, vaginal birth is difficult!  There’s no argument from me here.  But Cesarean delivery has its own difficulties, and I personally think the risks outweigh the benefits unless there is a good reason behind the choice.  I’ll do a post sometime in the near future about the acceptable medical reasons for cesarean section, but it’s going to require a lot of research so it gets its own post.  For now, remember that you are a woman, and you are strong, and your vagina was built for having babies.  Don’t forget it.  And before you go to the hospital, for vaginal or cesarean birth, do your research on c-section.  Educate yourself about the risks, and good reasons a doctor can give you for a c-section.  Sadly, some doctors will recommend a c-section to a laboring mother simply because they’re going to be late to dinner.  They’ll give you an explanation which sounds reasonable, but if you’ve educated yourself you’ll be able to tell if there really is a problem or not.  I hope this is helpful to women who are on the fence.  It’s a very tough decision, and has a lot of implications.  I hope that I can prevent at least a couple women from making a decision they may regret.

 
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Posted by on January 26, 2012 in Rants

 

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