Soapboxing: Birth, etc.

I have a number of soapboxes on which I like to stand.  Well, not really.  I don’t like to think of them as soapboxes, because I don’t think street preachers with a megaphone on a soapbox really get listened to all that much.  I’d like to think of myself at least slightly more influential than that.

Still.

The topic of birthing has always been close to my heart.  I’ve learned much more about it in the last, oh, 13 years.  But even before I ever gave birth, I had some opinions that seem like they shouldn’t be all that controversial, but it turns out they are, like:

  • Women can birth babies with no medication, just the way God created ’em to.
  • Breastmilk is the best food for a baby.

Whoda thunk that such things would be frought with controversy, politics, and vitriol?  I’m a simple gal at heart, really.  It seems to me that those topics SHOULD be simple, end of story.  But, they’re not.

Some of my recent thoughts on birthing:

  • My sister, for various and important reasons, recently decided to move from Tennessee and her government job, to Texas to work for my Dad’s company.  The first place of employment had fabulous insurance.  Our Dad’s company:  None.  The “problem” is that when she moved, she was newly pregnant.  She is now 24ish weeks along.  This is problematic because a) she makes too much money to qualify for state aid, and b) she has a condition that places her in the “high risk” category for pregnancy and birth, so even though she would rather birth at home with midwife (which she could easily afford), no midwives will take her because of the potential risk.  So, it looks like she’s stuck with a hospital birth.  BUT, since she doesn’t have insurance, she is required to pay out of pocket, up-front, which is $6-8 THOUSAND DOLLARS, which, um, she doesn’t have, before a doctor will even see her for prenatal care.  Total rock and hard place kinda situation, don’t you think??  (BTW, I do have her permission to share this.  She said:  “I knew our health system had problems, but I didn’t understand that you could actually be in a position where you couldn’t get care.”)  Any ideas, anyone???
  • Stand and Deliver is by far my favorite birthing blog.  It just seems that nearly everything Rixa posts resonates with me, and I find extremely relevant.  Though I don’t see eye-to-eye with all of her opinions, I hold her in high esteem, as she is learned, kind, thorough, and humble.  In one of her recent posts, a statement caught my eye:  “if 80 to 90 percent of women exclusively breastfed for as little as four months and if 90 percent of women would breastfeed some times until six months, the US would save $13 billion in excess costs annually and avert 911 preventable deaths per year”  Yes, you read that right.  And, unbelievably enough, the study which came to those conclusions wasn’t published in some neo-hippie publication, but Pediatrics An article from CNN, which summarizes the findings of the study is well-worth reading.  The entire original article is available by subscription only, but you can read the abstract here.  By the way, the costs mentioned do NOT include the cost of formula itself, which would certainly add millions, if not billions, to the associated cost;  they are only the costs associated with premature death from conditions medically linked to formula-feeding, and the costs of parents’ missed time from work.
  • Another good post is from Midwifery Ramblings, entitled What Pitocin Does to Your Baby.  I have become increasingly alarmed about the blasé attitude women have towards pitocin.  It has become standard in hospital births (I read somewhere semi-recently that pitocin is used in 90% of U.S. hospital vaginal births… gotta find that source…) instead of the last-ditch effort that it is supposed to be for, or for other situations of true medical necessity and emergency (normal giving of birth is not an “emergency” even if it doesn’t proceed at a pace according to hospital protocol, the doctor’s personal schedule, et al).  Pitocin is pretty much evil in an IV bag, in my opinion, often the first step in the “cascade of interventions” that lead to our nation’s shameful, staggering, needlessly-inflated 31% c-section rate.  Pitocin is NOT good for you, and it is NOT good for your birthing baby.  The only person that pitocin is good for is the OB, who wants you to just hurry up and have that baby so he can make it to his dinner party.  (I don’t believe that all OBs are evil and chiefly motivated by self-serving interests, but I do believe that they — with virtually no exception — out of habit, convenience, or whatever the reason, overuse pitocin in their patients, and not in the patients’ best interest.)  And/or, pitocin is good for the hospital, whose protocols are usually prioritized with its profitability in mind, thus, protocol is formed to maximize turnaround rate in the L&D ward.  The quote in her post which stuck out to me in Midwifery Ramblings’ post was this:  “Consider this: in nearly half of malpractice suits involving damage to the baby, synthetic oxytocin is cited as the culprit.”  (MW was quoting Jennifer Block on that.  And, pitocin is synthetic oxytocin.)  JUST SAY NO TO PITOCIN!!!!!!! You have the RIGHT TO REFUSE IT!!!!!  The best way to go about that is:  Don’t schedule an induction.  If you’re already in spontaneous labor, and the staff determines that your labor is not proceeding according to their protocol, STILL refuse it.  Do your research before you go into labor, and let your doctor know that you will NOT agree to pitocin.  (By the way, I did agree to pitocin once.  It was after the 100% unmedicated, slow birth of my fifth baby.  I went nearly six hours with **NO** dilation, “stuck” at 7 cm, refusing pitocin all the while, and went from about 7 cm to 10 cm and safe, healthy birth in literally 10 minutes.  My doctor supported me in my NO INTERVENTION goal of birth, but I guess understandably, started to waver five hours or so, asking if he couldn’t at least do an amniotomy — breaking my water.  I agreed to pitocin in an IV because, post-birth, I was hemorrhaging.  It did — painfully — cause my uterus to clamp down and more forcefully and quickly expel the afterbirth, and surely saved me from losing more blood.  However, in retrospect, I still wonder if even THAT was necessary.)
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About Karen Joy

I'm a partially-homeschooling mother of six -- 3 boys ages 19, 17 and 15 years old, and three girls: 11, 8, and 3. I like birding, reading, writing, organic gardening, singing, playing guitar, hiking, the outdoors, and books. I very casually lead a very large group of homeschooling families in the Phoenix area. I have a dear hubby who designs homes for a local home builder and who is the worship pastor of our church. I live in the desert, which I used to hate, but now appreciate.

Posted on April 13, 2010, in Babies, Birth, Family, Medical Stuff. Bookmark the permalink. 19 Comments.

  1. Lioness had to do a short research paper on abortion for her awana class (keep in mind she is in the 6th grade and it will only be shared with her teachers) and other 6th grade girls). Anyway she was so horrified at all of it (and I chose the sites and shielded her from the worse) that she said she wanted to have her babies no matter what the situation was.

    When she is older I certainly plan on sharing these sites with her. I was shocked at all the misinfo on the sites that we looked at. Particularly the medical reasons. I would say 90% were ludicrous. OK so stepping off my soapbox. hehehe

    BTW I had hemorraghing after #4 and I passed out from the loss of blood. They did the pitocin with me too (midwife at birthing center). Ironically this wasn’t an issue with 5 and 6 although they kept telling me it would be. hmmm……

  2. My heart really goes out to your sister! There really aren’t as many options for birth as they try to make it seem. After moving to the south (Louisiana, number one in the country for number of c-sections performed, number two for infant mortality, and only 2 practicing home birth midwifes in the state!) from the northwest, having a baby at home is ALOT more tricky over here than it is over there, and you have to be in tip-top shape or else they really won’t take you on. I would recommend a Naturopathic physician be seen for the high-risk issues. They are certified doctors back home, I’m not sure what the deal is with Tennessee, but they really do get to the bottom of the problem and fix it, not try to mask it with synthetic medications. How wonderful it would be if it has an easy fix (which can be the case for some seemingly complex issues). I very much enjoyed your post, and I pray your sister has a healthy, wonderful, non stressful pregnancy and birth!

  3. Any out of hospital birth centers around where she is? Could be a cheaper option–a half-way point between home and hospital.

    And I don’t know what her high-risk condition is, but sometimes Direct Entry or Lay Midwives will take conditions that CNM’s cannot take because of their malpractice insurance. Such things as age, position of baby, twinning, etc. are often rejected by CNM for homebirth, but DEM or LM will take.

    Just a thought.

  4. DAJA! You rock. I will suggest that (about DEM or LMs) immediately. Because of her health, I thought a CNM might be more able to care for her, but I hadn’t thought of the whole malpractice insurance thing… and Texas really does have a stellar program for DEMs… There are quite a few in the Austin area.

    She has Marfan Syndrome, which, among other things, affects the blood vessels. The aorta is of special concern, as it can become enlarged (even w/o the stress of pregnancy), and it can dissect with the increased blood flow & physical strain of birth, and the mother can bleed out within minutes. It’s a true high risk. Some OBs schedule Marfan’s patients with a de facto c-section, because the risk is so high. (Not all docs are of the same mind on that, though.) HOWEVER, at her last cardiac u/s, her aorta was in fabulous condition, but it’s been about 3 years (I think) since that was checked. Also, my mom has the same condition, and while it has very much endangered her health in many ways, her own aorta is in solid shape, which bodes well for Robin’s…. My mom also birthed four kids v@ginally.

    Rather than spending lots of $$ on getting prenatal care with an OB, I suggested to Robin that her first step might be allocating funds to getting a cardiac u/s to assess the health of her aorta. If it’s normal, that would make her home delivery a lot safer, and expand her options, even though she would still technically be a high risk pregnancy.

  5. My thoughts are also with your sister. Thanks for the enlightening info, too, on pitocin. I have had inductions with all three of my kids…the first one because of my doctor’s recommendation at 41 weeks. She went into fetal distress, had nuchal cord 3x, had to be vacuumed out and her apgars were 1,5,& 7. It was so traumatizing & we’ve always attributed it to her being too big for my body. Because of that, we’ve elected inductions for baby 2 & 3 @ 39 weeks, thinking we were being “safe.” All this to find out that perhaps the pitocin was partly to blame for the birth “trauma” with baby 1 and perhaps we’ve been taking risks rather than playing it safe with our other babies. God is good and everyone is healthy, thankfully, but if we’re blessed with a 4th, I’m going to have a completely different perspective on birth and my body’s ability to deliver. Thanks so much for sharing!

    • Sarah, you’re second-to-last sentence is EXACTLY my heart in posting this. I had some response (on my Facebook account) to this post that made me… well, I’m thinking about posting something new addressing it: It is NOT my heart to make mothers feel badly about previous birth outcomes; it’s to, especially if they plan on having more children, compel them to consider that there might be a better way for future births… turning good prior experiences into EXCELLENT future experiences. (And, for the ladies who have not yet had children, open the door to the possibility that there might be a better way to birth their children than what the standard of maternity “care” in the US has been dishing to them for at least the last 50 years.)

  6. I think your sister should fly to the UK for the remainder of her pregnancy – sounds like it would be cheaper for her to come here and rent a house for a few months, deliver here and then go home than it would be to stay home to have the baby! Crazy thought! I simply can’t imagine how I would have coped had I been presented with that sort of a bill when I was expecting my first! At the time we only had an income of about £10,500 a year (what’s that, about $15,000??) so there’s no way I could have considered paying more than half of that out.

    • Jennie, you might be right!!!

      Though the UK medical system has its own struggles, one thing that I do think it has (mostly) right is maternal care: From what I understand, low-risk women are attended by midwives with homebirthing being fairly standard, and it is covered by the nationwide system. High-risk patients see the OB for hospital deliveries. It’s better for mothers & babies, and lower in cost, system-wide, and just makes more sense.

      • I have delivered two children v@ginally in the UK, and have had nothing but praise for the system (except for the odd less than useful nurse, but you get them everywhere, right?!). My first child was a low risk pregnancy, and noticeable for the lack of intervention. I don’t think I saw a doctor throughout, until my 6 week postpartum check up with my GP. And I only had the pain relief I wanted, which was in no way pushed on me. My second child was classed as slightly higher risk as I had SPD and developed higher blood pressure. Still, I only had a midwife attending the birth, in a very relaxed room, and only gas and air (again through choice). I felt very much in control of my own destiny, if you like! although I was happy enough each time to be in hospital. In fact, I could have (had I not been developing chickenpox) left the hospital within a couple of hours of the birth of my second child, which I think is fabulous. I’ve known women who’ve gone into hospital toward the end of their labour, had the baby, been checked over and been home in time for the next meal!

        • Jennie, you bring up an interesting bit to the conversation: Time spent in the hospital. I read something recently (can’t recall where), where a woman who was a surgeon gave birth in a hospital, and her father (also a doctor) was the only other attendant — no nurses, no doctors — and she went home only about 60 minutes after the baby was born. Oddly enough, she said it took TWO YEARS to straighten out with the insurance company, because they couldn’t figure out how to bill/charge for ONLY about 2 hours’ “rental” of a labor & delivery room. I thought that was hilarious/ironic/sad.

          Although all five of my children were born in a hospital with no medication whatsoever (and no interventions at all, other than an unconsented episiotomy with my first, and a with-consent episiotomy with my 2nd, as he had let go of his meconium, and truly had a HUGE head, and we had to get him out ASAP)… I was very happy when then-president Bill Clinton signed into law the requirement that insurance companies HAD to pay for 48 hrs of hospital stay, post-birth. With my first four, I didn’t want to go home early, largely because of lack of support at home… partly because that’s just the way my extended family is — unavailable and/or unable to help — and partly due to my own over-independence, which manifests in not wanting to “trouble” friends for assistance after the birth… so, those 48 hours were very much like a babymoon for me: I could just enjoy my eensy baby, have my meals brought to me, and not worry about whether or not dishes and laundry were getting done.

          If there is a next time, though, I will almost certainly have a home birth, and humble myself to request help from others so that my other children and home be cared for adequately during the birth and afterward. In the past, we’ve had extended family members be able to take turns at least part of the time, so that my husband could be with me during L&D, and for a good portion of that 48 afterward. However, with the birth of my 5th, after the L&D part, we had NO one to take care of the kids, so I was pretty much alone in the hospital whilst my hubby cared for our other four. That sucked, frankly. I was actually prepared to go home before the 48 hours were up, because I just wanted to be reunited with my family, but then my baby developed severe jaundice, and was in the Level II nursery (don’t know what they call it in the UK!) for an additional 30 hours, more than 3 days total, and I stayed in the hospital with her. (For the last 24 hrs or so, I was technically discharged from the hospital, but they let me stay in my room for free — really! — but no longer provided medical care, which was fine, because I didn’t need it.)

          • I was just on my way out of the door last night when I replied to you initally, and I had to cut myself short. What I meant to say (but ran out of time!) was that when I had my first child, I was so nervous as I had no experience of babies, no family living nearby and we’d literally moved house ten days earlier. But the hospital was amazing and let me stay in until my baby was four or five days old and I felt able to go home. There was really no need for me to stay, but (luckily for me) the wards were quiet and the nurses were enjoying playing with my son as he was much chunkier than the babies they were more used to having (9lbs1oz born, and all the other babies born at that time were apparently nearer the 6 or 7lbs mark!). So really, both sorts of new mothers are catered for (in my experience), both those who want to head home as soon as possible, and those who need more support with their newborns.

            I hope that the hoped for healthcare reforms are achieved over there for you. I can’t comprehend living somewhere where I would have to worry over the financial implications of getting myself and my children medical appointments. I quite genuinely have developed a much greater appreciation of the UK’s NHS over the last few months, as well as a sense of how lucky I am to have it all available to me and mine.

        • Hey, I was just wondering about the SPD thing. You said it placed you in a slightly higher risk category, but did the doctors/widwives DO anything about it other than acknowledge that you had it? Last time I don’t think I even told my midwives about it because I thought the excruciating pain I felt rolling over in bed was something every woman got. Then I learned what it was, and this time I told my doctor about it and he pretty much smiled sympathetically and that was about it. I looked it up online and apparently it can cause some complications.. like lack of progress during labour and the baby’s face facing to the right rather than the left. Last time my water broke spontaneously before my labour began, and 24 hours later I was still only at about 3cm. In my case oxytocin actually was a bit of a necessity. I’m hoping that things do go better this time and that the oxytocin (and epidural) won’t be necessary…

          I know a lot of Americans think that Canadians are raving socialists, but let me tell you, I am incredibly grateful that we all have equal access to medical services. 🙂 We may need to wait a little longer for procedures than Americans with good medical insurance, but in my opinion, Canada too, like the UK, has a good medical system.

          • Heidi, I (again) was lucky with regards to the SPD. I was diagnosed at about 24 weeks, and was referred to a physio who gave me crutches and a support for the bump (supposed to shift the centre of gravity slightly!) and issued strict orders not to give up walking without coming back to see her first! My midwives were lovely too, giving me home visits towards the end of my pregnancy when walking really did get very difficult, and then in labour I was monitored in case it caused a problem. I was told though that it would only be a problem if I didn’t have the mobility to open my legs without pain, as the loosening of the ligaments could actually help the birth be easier. My son was born in less than an hour, all in (8 minutes 2nd stage) so I think they may have been right! I was certainly glad I was already in hospital! So I didn’t suffer with lack of progress, and as far as I’m aware he was facing the right way.

            Heidi, I hope it all goes well for you, and Karen Joy, I’m sorry for hijacking your comments section!!!

  7. Hmm… Support for the bump sounds like it would have been a good thing to have, but I think the crutches would have been unnecessary. From what I have read about SPD, I don’t have it in the worst form, since it mostly only hurts when I roll over in bed or if my foot catches on something and causes my body to jar. But it’s a little late for even bump support, I think, since I am only about 2.5 weeks from my due date.

  8. Well, my first baby was a c section thanks to the cascade of intervention–I was induced a week after my due date, and the evil (yes, EVIL) nurse would come in and ask if I was in pain. Now, i have a high tolerance for pain, just ask my husband, and I was rather proud of the fact that I was handling the contractions. “No, no pain,” I chirped. She said, “Oh, we NEED YOU TO BE IN PAIN.” and she turned up the pitocin, without consulting the doctor.

    That led to an epidural, which neccessitated a catheter, which said EVIL nurse didn’t place properly, leading to a distended bladder (the pain of which will cancel out any and all pain meds, let me tell you). By the time I was “ready” to push, I was so drugged up that I couldn’t. The doctor said at one point, “I *could* use the vacuum extractor, but I’d rather not,” and called for a c section.

    The second time around I educated myself. I found a doctor who had a 97% success rate for VBAC patients. I told him the whole sorry tale of my first birth experience, and he agreed that I had a 70% chance of delivering naturally. He supported no pain meds, and even though my first baby was 10 pounds, when the birth got to the same point, he said, “I’m using the vacuum extractor,” and out popped our second son, also weighing in at 10 pounds.

    He also delivered our third, 12 pounds, even with shoulder dystocia.

    Now, I did have pitocin with the second and third babies, and here’s why. My labor tends to stall in the hospital. It just does. And my third baby…well, we induced because we knew he could be bigger than his brothers, and I’m glad we did induce around his due date. BUT…we told the doctor that we would be keeping an eye on the pitocin pump, and he agreed that there was no reason to up the dosage as long as labor was progressing. Some of those nurses get trigger happy and just want to speed things along. My husband, being an engineer, figured out that pump and the numbers and if any nurse touched it he’d bark, “Have you spoken to the doctor?!” Basically we found a doctor who was fine with us being advocates for our own health.

    So sometimes pitocin can help. Sometimes. Not the huge doses they’d like to give you, but in my particular case, with no other health issues, it helped.

  9. Keep standing on your soapbox Karen, your voice needs to be heard in your country where there is definitely way too much medical intervention for reasons that aren’t always the best ones.

  10. I did plan a home birth for my firstborn, but five days before his due date my midwives discovered that I had developed pre-eclampsia, so I had to deliver in the hospital. It was an induced labour, and it was progressing quite nicely until I suddenly stalled 8 hours in at 8 cm. After an hour of nothing, my midwife suggested I get an IV (not just for oxytocin, I couldn’t keep any fluids down and was so dehydrated I was blacking out between contractions). After the IV was put in, my labour started up again, and I was fully dilated in 1 1/2 hours, and after 20 minutes of pushing Deklan was out! The only “pain meds” I consented to was the laughing gas, but only after the baby was born because it was ridiculously painful getting stitched up. My body for some reason has never responded well to freezing, and I could feel EVERYTHING the OB was doing with that needle. UGH! I put pain meds in quotations because the gas didn’t help at all, all it did was make me more dizzy. 😛

    I think my labour stalled because I was tied to a machine (they had to constantly moniter my baby to make sure his heartbeat and movement were good) and where I really wanted to be was in the shower. With my next baby, I want a waterbirth. My midwife was wonderful, she let me off the machine far more than she was supposed to, and when I was in the water it felt amazing, it was so relaxing.

    Keep standing on your soapbox! Labour & birth is something that women need to be more assertive about, it’s THEIR BODIES and THEIR BABIES, after all. The amount of horror stories I’ve heard from friends and family, it made me want to get educated and prepared for my own birth, and I believe I was. I had minimal interventions and a very healthy baby at the end of it!

    • Sarah, something you mentioned reminded me of something I’ve thought of before: Maybe my own labor (with my 5th) would have progressed faster if I had drunk more water. I did drink a LOT of water through the day, but while I was in the hospital, I didn’t drink much at all. I *just* wanted it to be my hubby and me, but if I had had a doula, she probably would have reminded me to drink more water. (I was “stuck” at 7 for about six hours.)

      I would definitely NOT call staying at 8 cm for one hour to be “stuck.” However, being severely dehydrated is a concern, for certain! Did they only have fluids in your IV, or did you have pitocin? Even though the results were good, I think that it’s likely that the fluids were more helpful than the pitocin…

      One more thing to file away for the future: Studies differ in their conclusions about the connection between diet and pre-eclampsia. However, there are things that *may* ward off pre-eclampsia: supplementing calcium, C & E, a fresh, whole-foods diet with lots of fruits, veggies, and grains, and don’t gain excessive weight. With my 5th, when I entered my 3rd trimester, I went on the South Beach phase 2 diet, limited my carb intake to 150 grams per day, and gained *no* weight for a total weight gain of 17 lbs. My baby was 8 lbs 13 oz, so it’s not like she suffered. 🙂 I am a big proponent now of limiting carbs in the 3rd trimester. However, many South Beach diet recipes call for artificial sweeteners, which I think are a bad idea. Lots of veggies, nuts, healthy meat, and a reasonable amount of whole grains and fruits…

      I typically have very low bp, even during pregnancy, and did not have gestational diabetes, but I had to limit my weight gain because of SEVERE varicose vein problems, and to hopefully keep my baby from growing huge (my first four were 8-13, 9-11, 10-0, and 9-0)… Lower weight reduced the pressure on my veins, and a slightly smaller baby reduced my chances of hemorrhaging.

  1. Pingback: Awkward homeschoolers, pretzels, and natural induction « Only Sometimes Clever

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