Pregnancy

I’m currently reading (and having a bit of a love-hate relationship with) Reclaiming The Spirituality of Birth.

In the “love” category: There is some really interesting research quoted in this book. It has encouraged me to look up some new authors, like Allessandra Piontelli.

Here’s one example of information that I’ve never seen mentioned elsewhere. The author, Benig Mauger, is discussing how babies in the womb develop relationships and socialize.

One twin (a boy) was observed to be consistently more active in the uterine environment than his sister, who generally slept peacefully curled up in her corner of the womb. Every so often he would wake his sister, by stroking the membrane between them, encouraging her to play. She would wake up and the twins would play together in their mother’s womb, moving around behind their respective membranes. They would have gentle boxing matches and tickle one another….(pg. 53)

Isn’t that so cool? Each of my babies have enjoyed kicking and playing with those of us outside of the womb. I think it is really fascinating to consider the way that twins interact in the womb and how much of a baby’s personality is already in place before they are born.

But then, in the “hate” category (and perhaps “hate” is too strong of a word), there is some information in here that is flat-out WRONG. For example, the author says that “the umbilical cord connects the baby to the placenta and within it are two major blood vessels, one taking oxygen to the baby and the other removing all waste products.” (pg. 39) Actually, a typical umbilical cord has 3 vessels — two arteries and one vein. About 1% of babies will have a two vessel cord, but that is not typical. The fact that such a basic fact could be incorrect makes me really cautious about believing anything that the author writes.

I’m going to continue reading it, because the gems in it are really good, but I think that the typos and obvious errors make it especially important to fact-check anything you learn in here. I looked up the information about the twins in utero, and it seems to be accurate.

I’ve been reading like nobody’s business, but unfortunately I haven’t had much time to update my blog.

One book that I read this month is Misconceptions by Naomi Wolf.  It was the monthly selection for the Unassisted Childbirth Reading Room. The reading room is one of many sponsored by AAMI, and I really enjoy them.  I haven’t agreed with every word in every book that I’ve read, but that makes me appreciate the reading rooms even more  🙂

Naomi Wolf writes this book from a very particular viewpoint: a feminist who is experiencing the world of motherhood for the first time.  As someone who had my first baby pretty early in life, I really enjoyed reading her perspective.  I find that these kinds of books really help me to understand where women in different circumstances may be coming from, and I love that.  I’d much rather be initially exposed to these views in the “safety” of a book, where I’m not going to put my foot in my mouth, LOL.

So, although this book focuses on the things that our society tends to hide about motherhood, there is actually a really good amount of science in it as well. One section that I particularly enjoyed talked about some of the things that we don’t understand that babies in the womb feel.  Here’s one great quote.

Dr. Michael Lieberman’s research possibly showed that a fetus might react in an associative way to mothers who smoke: measured by accelerated heartbeats, the fetus grew agitated when its mother reported she had considered having a cigarette, before the mother had even lit a match.  The authors hypothesize that the fetus learns to react this way because maternal smoking is so unpleasant to it — causing a drop in the oxygen supply in the blood passing through the placenta — that the fetus learns to associate the mother’s smoking with heightened distress.  How it registers agitation when the mother merely anticipates lighting a cigarette, even before the inhaled smoke has affected her bloodstream, is anyone’s spooky guess.

Isn’t that crazy?  I remember reading years ago about a study where breastfed and formula-fed babies and their moms were put in separate buildings.  The moms were exposed to negative stimuli that would create stress.  The breastfed babies reacted and cried (from the other building) when the moms were under stress, but the formula-fed babies did not.  They couldn’t figure out why, but it is fascinating to think that there could be (or is?) a connection on a higher level that we just can’t explain.

A lot of my other reading has been on brain chemistry stuff, especially as it relates to medications in childbirth, but also just the normal brain chemistry changes that happen during pregnancy.  I was excited to see that this book touched on the same subject.  I especially liked her lengthy discussion on hormones during pregnancy that make us act decidedly more “feminine”.  Naomi Wolf talks about how much she took pride in being independent and strong, and how bizarre it was to suddenly feel so emotional, clingy, and even fearful of being unprotected. I can relate to that, because I think that my personality has really changed since having my kids.  In one section, she says.

At the end of my pregnancy, I was aware that I was nesting, cuddly, and more traditionally “feminine” in my responses.  I felt more maternal toward helpless dependent beings, but especially toward babies and children.  This could be seen as part of “women’s eternal nature,” the excuse given for various antiwoman decisions.  Or it could be the result of this temporary chemical brainbath.  From thirty-four weeks on, hormonal changes take place to prepare the uterus for labor.  Estrogen stimulates the rise of oxytocin, the “love hormone” that promotes labor contractions and stimulates the let-down reflex in breast-feeding mothers….

…”From rodents to primates,” writes anthropologist Sarah Hrdy, “oxytocin promotes affiliative feelings.  A monkey mother whose brain receptors to these natural opiates are blocked makes fewer overtures toward her infants, is less likely to put her face near the baby’s and reassuringly smack her lips.”  Hrdy calls oxytocin a “natural opiate” that guarantees mothers greet their new offspring in a “broody, mellow mood.”

I just love to think about how miraculous the whole thing is.  The fact that there are so many interconnected things going on in our body, and yet science thinks that we can just pump some artificial hormones into our bodies and make it all happen on our own time.  It is such a delicate dance, and each part is so important.  In another article I read this week (which I fully intend to make a separate blog entry on), Sarah Buckley discusses how

Second, oxytocin, synthetic or not, cannot cross from the body to the brain through the blood-brain barrier. This means that Pitocin, introduced into the body by injection or drip, does not act as the hormone of love.

These hormones are so amazing, and they change us in so many ways… But artificially pumping it into our blood does NOT do the same thing as when our body and our baby create these hormones.  We cannot alter one part of the system and think that we can make nature follow our command.  It is so humbling, and yet so scary to think of what is being done on a mass scale in our country, and around the world, to the delicate balance of new families.

OK, I’m going to stop here for now, because it is bedtime for my babies  ;)  Hopefully I’ll get to come back and write more about Sarah Buckley’s amazing article, because I could just gobble it up, LOL.

OK, I know its been too long since I last wrote.  I’m slacking.  I’m sorry!

I’m currently reading A Wise Birth as part of AAMI’s Childbirth Reading Room. I’m enjoying it.  Its definitely aimed at parents rather than professionals, but I like switching up and reading about birth politics  🙂

There is a bit of a recurring theme in the book that touches on the way that women view themselves and their care providers after a traumatic birth. I hadn’t thought too much about it before, but it really described my grieving process very well. I still feel a lot of shame and embarrassment when I think about my first birth. Intellectually, I know its so silly to feel that way, because what happened to me was a perfect example of the cascade of interventions. It is really hard for me to get past the feelings that I had during the birth. I felt like a trapped animal. There was so much fear and horror. The end result was obviously wonderful, because my beautiful son was born, but the process to get there was so traumatic.

In talking about this subject, Penny Armstrong and Sheryl Feldman say that “most women do not criticize their birthcare directly.” I find this to be incredibly true in my case. I always compliment my OB, and yet she made all sorts of poor decisions – the steroid shots, bedrest, and terbutaline when I wasn’t in preterm labor… the cervidil to induce when I was already 4cm… the forced-lying position… the 4th degree episiotomy… the forced pushing when I didn’t feel the urge… The list goes on. Still, I compliment her when I describe my birth. I blame myself. Interesting.

They speak of a woman with a birth experience very similar to mine. They say

[We] send women like Leslie home to work out how it came to be. What is wrong with her that her body had to be cut, she must wonder… Leslie stands alone over the baby’s crib and faults herself for her baby’s birth stress.

She does not accuse us – those of us who failed… her… She absorbs the neglect, the non-answers, the damage, and the responsibility. She criticizes herself. She suspects that her child has been hurt and she grieves. She lives with the memory of the experience and the judgment she makes of herself as a mother for the rest of her life.

This is really interesting to me, because I really do fear that my son was hurt during my labor. That Cervidil (that I never needed), that was put in to augment my “post-dates” that came after months of drugging and bedrest to stop my body’s way of preparing for labor, also caused me to go into one huge contraction. The nurses didn’t notice, so my husband had to run out screaming to tell them. When they came in, my son’s heartrate had plummeted to the 30s. His brain was oxygen-starved. He passed meconium from the stress. He aspirated that meconium, which caused more problems. I feel so guilty about it though. I’ve never thought about it, but why do I blame myself and judge myself so harshly?

There is a note going around right now on Facebook where you write about your first born. I thought about doing it, and then realized that I’d either have to write about my first birth experience (my hospital birth of my late miscarriage) or else my son’s birth (the one I’m talking about here.) When I considered it, I decided that I’d rather not do the note at all. That’s so sad. I just feel such shame.

The good news, though, is that my last two births have been so healing. My oldest daughter’s birth healed me enough to believe that my body could pretty much work. My youngest daughter’s birth taught me that my body does work! My old posts on My Body is Not a Lemon and Check with Your Doctor reflect that journey.

I’m off to read some more. Its been nice to realize that I’m not alone in blaming myself, and also nice to know that its OK to let go of that guilt. Who would’ve thought that this little book would be like free therapy for me? LOL.

–This may not be a post for pregnant mamas–

This issue is extra sensitive for me right now, because one of my very dear friends is dealing with it head-on. I was present at her HBAC, and she inspired me to have my own homebirth. She is being told that she won’t be able to have another homebirth because she is currently living in a country that doesn’t allow VBACs. I don’t normally make posts about political issues, but this is really frustrating me. Grrrr.

I just finished Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block. Its really well-written. I highly recommend it. She does the best job that I’ve seen in explaining the modern maternity system. I could write dozens of posts based on this book, but I want to focus on the last chapter because it relates directly to an issue that is on the ballot here in Colorado this November.

Amendment 48 is being billed as a pro-life initiative, although I don’t think that a lot of the members of the pro-life community understand the way that similar amendments have been used in other states. Case law is an important thing, and I fear that the Focus-on-the-Family-backed initiative may do way more harm than they intend.

Jennifer Block devotes her last chapter to the reproductive rights of women. She’s not talking about abortion, contraception, or any of the issues that are typically called “reproductive rights”. She’s talking about the right to decide what is best for your baby and your body when it comes to giving birth. The current system leaves many moms in a position where they are forced to make riskier choices because the hospitals and doctors don’t want to deal with liability issues. Women should have the right to birth as they want. Women don’t choose dangerous births just for the sake of it. Women will choose what is best for themselves and their babies if they aren’t forced between two options that they don’t like (such as a repeat c-section vs. an unassisted home birth after Cesarean). In those kinds of cases, many moms are left to choose between two options that are not statistically their safest. If hospitals don’t allow VBACs, then what shall they choose?

Well, for many moms, the choice isn’t really a choice at all. Many moms have made the choice to attempt a VBAC, based on the statistics and the worldwide recommendations, and yet the hospitals have forced them to make different choices by getting an emergency court order demanding they have a c-section.

Block opens the chapter with the stories of several women who have been through this experience. She starts out with the story of Laura Pemberton. (You can read more about her story, including the legal decision). Laura decided to attempt a VBAC, and initially found a doctor who was supportive. The doctor changed his mind when she was about halfway through her pregnancy. Her only option was a repeat c-section, or an unassisted HBAC. She decided to try it at home alone.

Laura labored for 2 days, and was starting to get dehydrated. She decided to go to the hospital for IV fluids and then to return home. The nurses reassured her that she was doing well. The baby’s heart tones were great, she was dilating, her blood pressure was great, and the baby was descending. The attending physician insisted that she have a c-section though. He refused to give her the IV fluids unless she agreed to a c-section.

The nurses helped her to get dressed and showed her a back door for her to escape. She drove home, feeling reassured from the nurses, and confident about having her baby vaginally. When they arrived home, the police were after her. The sheriff and state attorney were at her house, and they had a court order issued by a judge. They strapped her onto a stretched by her wrists and ankles, put her into the ambulance, and took her to the hospital.

At the hospital, a nurse led her to a room and gave her a hospital gown to put on. She and her husband went into the bathroom and locked the door. Pemberton remembers squatting there, bearing down as hard as she could, willing the baby to come. “I reached up and could feel the baby’s head in my hand,” she says. She pulled at the water bag, still intact. It slipped out of her grasp. They were knocking at the door, and finally she opened it.

Two doctors, the sheriff, two attorneys, and a judge crowded into the small exam room, with Pemberton in a hospital gown on the exam table, and conducted a hearing… At no time was Pemberton offered an attorney.

In between contractions, Pemberton argued in her own defense. She said this was an informed decision based on months of research and preparation… The judge said that my unborn baby was in the control of the state and that it was the state’s responsibility to bring that baby into this world safely,” says Pemberton.

…Pemberton’s obstetrician did one final exam before he began operating. She was 9 centimeters dilated, the baby was literally inches from being born, yet the surgeons went ahead with the surgery.

Laura Pemberton is not alone. Women are often forced to have a repeat c-section when they want to attempt a VBAC.

Some women will labor in the parking lot of a hospital known to be anti-VBAC, arriving on the L&D floor just in time to push the baby out. The “showing up pushing” strategy is discussed in full on the ICAN list. Fully aware that the hospital would have required them to plan a repeat cesarean, they try to time the birth so that when they get to L&D it’s too late. This doesn’t work for everyone, though. Susie Nalbach showed up at a Coral Springs, Florida, hospital ready to push in 2003. Instead, she was pushed into a wheel chair, separated from her husband, and taken into the operating room. Then she remembers two nurses arguing with each other. “The younger one was telling me to push, and the older one was telling me not to push. I kept pushing because I couldn’t help it,” she recalls. “I remember being told to breathe into an oxygen mask. But it wasn’t oxygen, it was general anesthesia. I did not consent to it. I never signed anything. I woke up later with a son.” She says on her medical chart, the indication for the cesarean was “failure to progress.”

Amber and John Marlowe were attempting a vaginal birth to their seventh child. All of their children had been delivered vaginally. A triage nurse did an ultrasound and decided that the child was too big, even though their previous kids had been large – one 12lb 4oz, and she had never had a problem. They tried a second hospital, and things became even worse.

Marlowe spent 14 hours at this hospital, refusing a cesarean section. Meanwhile, unbeknownst to the couple, hospital attorneys were petitioning a local judge for custody of Marlowe’s fetus so that the hospital could legally compel its surgical extraction–and they won.

Before anyone could execute the order, however, the Marlowes were in their car driving to yet another hospital, Moses Taylor Hospital in Scranton, where Amber swiftly pushed out a perfectly healthy 11lb, 9oz baby girl, with nary a tear.

Hospital attorneys are able to petition for custody of your fetus, and can legally compel you to have a c-section if they decide it is in the child’s best interest. A 2003 survey of directors of maternal-fetal medicine programs found that 14% of them had used the court system to compel women to have cesareans. That’s really disturbing. What’s more disturbing, is that many of these hospitals get their powers from amendments like #48, which give rights to the fetus.

The campaign for fetal rights, led by those intent on re-criminalizing and stigmatizing abortion, has been a detriment to women who decide to carry their pregnancies to term.

The states that have had these kinds of initiatives have also been the ones to decide that a woman is not acting in the best interest of her child when she decides to give birth at home (or even just a hospital vaginal birth, as in the case of the Marlowe’s). The statistics disagree with these judges and hospitals, and some courts have later gone back and said that the judges were wrong in most of these cases, but it keeps happening.

I want to be clear that I don’t think that these cases are the norm. I understand they are rare, and Jennifer Block is very clear in her book that these are not normal cases. The fact remains that hospitals and states are using poorly worded legislation and amendments to take away the rights of women to birth as they choose. For amendments like 48, I just don’t think there are enough benefits to be worth the risk.

Joe and I were talking last night, and I was telling him that its not like I think that amendment 48 will make abortion illegal in Colorado. Its a federal issue right now, and I don’t think amendment 48 is the right way to go about abortion reform. I plan on voting against amendment 48, even though I am pro-life. I encourage everyone to look at all of the possible ramifications of this amendment and to weigh it against the possible benefits.