Monday, November 21, 2011

Natural Childbirth and Science-based Medicine

I've recently figured out that I have become a passionate natural childbirth advocate. How do I know this? Because I literally can not shut-up about it when people ask me! So, I think it's time for a blog post about this topic.

While I was pregnant I spent a lot of time reviewing literature concerning the merits of various childbirth practices. I wrote some posts about some more flashy topics that I thought other people might find interesting, such as alcohol and marijuana use during pregnancy, treatment for vaginal group B strep, and placentophagia (see old posts). But most of what I read is technical, detaily, and in general, very boring to most other humans. What struck me as I learned more and more was the effect of standard hospital practices on babies and mothers. There are many standard obstetrical interventions that are used commonly. These include artificial induction of labor, the use of pitocin to augment contractions, manually breaking a woman's water, epidural anesthesia, an IV drip of antibiotics, and most concerningly, a sky-rocketing cesarean section rate (upwards of 35% for many hospitals). I began to find that each of these interventions increases the chance of harm to the mother and baby. And not only that, but it robs women of the experience that they were hoping for. It doesn't have to be this way. In many other countries, such as Norway, Sweden, and Finland, many women give birth at home or at specialized birthing centers with very little medical intervention. Babies born at home with minimal intervention are just as healthy (if not even a little better) and mothers are much more satisfied with their experiences, while in the USA, we continue to have some of the highest rates of infant and maternal mortality for any industrialized country (Check here for current stats).

I believe that the birth process has become medicalized partly because of the cultural attitude surrounding birth. Most Americans believe that giving birth is terrifying, horribly painful, and extermely dangerous. Furthermore, if you only watch TLC birth shows or see pregnancy and childbirth depicted in movies, you would have no reason to believe anything to the contrary! It's this attitude that leads women to expect that there is little they can do while giving birth. They must depend on drugs to take away the pain while their obstetrician "gets the baby out". I am sincerely heartbroken that this is the experience that many women get.

To illustrate this situation, here is a common scenario depicted on TLC's show, A Baby Story: A very pregnant lady is sitting in front of the camera. She is saying that she'd like to give birth as naturally as possible, but she knows that you can never control what is going to happen during childbirth. She is in early labor and the nurses have her laying in bed with an IV drip in her arm and a fetal monitor wrapped around her stomach. She is trying to breath through the contractions, but is having trouble. She just knows that is going to get much, much worse and even though she's OK now, she knows she won't be able to handle the pain coming up! The nurses bring in the anesthesiologist and she agrees to get the epidural.

(Note: from experience, I know that labor is much more painful when you are lying down. If she was standing up and moving her hips she would have felt much better. The difference is night and day. But rather than suggesting that she get up and try moving her hips in a circle, the nurses suggest she numb the bottom half of her body with powerful narcotics... go figure. Additionally, labor doesn't neccesarily get steadily worse and worse. It changes as the baby moves down and your endorphins naturally regulate your pain. I felt a lot better as I got towards the end. OK, back to the story.)

So now she's numb and completely out of control of her birth. The pain is gone, except the catheter in in her urinary tract is bothering her and the medicine is making her shiver uncontrollably. The medicine also begins to slow down her labor, so the nurses give her some pitocin in her IV to increase the speed and intensity of her contractions. The contractions start coming more powerfully now, so the nurses increase her epidural to take the pain away. But the increased epidural slows down the contractions again, so they bump up the pitocin a bit too. Now the contractions are coming very strong, much stronger than her body would be producing naturally, but for some reason her cervix has stopped dilating and she is stuck at 5 cm. The obstetrician uses a hook to break her water in the hope that it will make her labor begin progressing again. Now the baby has no cushioning and is being subjected to very strong contractions, the baby's heartrate becomes a bit erratic, this is called fetal distress. The obstetrician tells the women that she is not progressing and now it seems like the baby is not tolerating labor well (as if it is her fault), the Ob recommends a C-section. The women tearfully asks why this is happening and the Ob explains that, "The baby's head may just be too big to fit out of your pelvis. Oh well,  you can't control childbirth!" (This statement is especially ironic, because given all the intereventions that were performed, it seems like "controlling childbirth" was exactly what they were trying to do.) At the end the woman is left holding a perfectly healthy, normal sized baby and everyone is nodding their heads saying, "all that matters is that the baby and mother are healthy." 

Someone watching this show might think, "That person needed to have an emergency C-section. If she hadn't been in the hospital the baby would have been in great danger!". The truth is that each intervention performed increases the chance that the baby will have to be removed from the mother's womb by C-section. Although many women think that a C-section seems "easier", it's not. It's major abdominal surgery with substantial risks and a much tougher recovery. And this happens all too often just because of a misconception that labor is dangerous and unbearably painful.

Of course there are risks involved with birth. C-sections can save lives in situations where the baby is mal-positioned and cannot be delivered easily. Pitocin can help when a women is exhausted and needs help pushing the baby out. Pain medications can help with very difficult labors. The problems begin when these interventions are used routinely, rather than sparingly and according to medical need.

Let's imagine a different story. One where the woman mentally prepared to give birth. Where she followed her body's cues during labor to make herself as comfortable as possible and help the baby move down. Where she was able to feel how to move and know when it was time to push. Avoiding interventions doesn't guarantee a problem-free birth, but it does make it much less likely.

I think the world would be a better place if people thought about childbirth like this, as an intensely amazing experience that usually will go very smoothly. And let's not focus on the pain so much. Anxiety and fear are a great way to take a manageable situation and turn it into something excruciating. Pain is involved with childbirth, but it's not the wall of insurmountable, unbearable pain that people assume. You probably won't get a lot of help with natural childbirth if you ask your Ob about it. So read as much as you can and get support in your community or from friends who have gone through it before. Here is a good blog that really helped me- Birth Sense. Good luck! 

Tuesday, November 8, 2011

Anti-vaccine craziness...

This story made me sick to my stomach.

We've all heard of "chicken-pox" parties. This was the practice where the parents of children who had chicken pox would host a party to get all the kids exposed together. In the days before the chicken pox vaccine, this made some sort of sense. It allowed everyone to get sick at the same, predictable time and prevent infection in adulthood, which can be more severe. Let me say that again, IN THE DAYS BEFORE THE VACCINE, this sort of made sense. The chicken pox vaccine (aka. the varicella voster vaccine) has been available in the US since 1995 and is extremely effective at eliminating the risk of infection or making the infection very mild, if it does occur at all. This really is a wonderful thing.

Unfortunately, some parents are so distrustful of vaccines, that they prefer to expose their children to chicken pox, rather than getting them the vaccine. And now, there is a facebook group dedicated the helping parents get together for chicken pox parties.This is fucking crazy. But even crazier, is the practice of mailing pox-infected bodily fluids to other parents who are interested in intentionally exposing their children to a dangerous disease. You can read about this practice here at "Respectful Insolence". Briefly, here is an excerpt from Orac's blog:


True, such complications are fairly uncommon but they can be quite serious, all in the name of being "natural" and avoiding those evil vaccines. It turns out that some parents, apparently having difficulty finding children with active chickenpox in their area (thanks to the aforementioned evil vaccine, no doubt), are mailing the virus to each other:
Here's the local Arizona news report:

Doctors and medical experts are concerned about a new trend taking place on Facebook. Parents are trading live viruses through the mail in order to infect their children.
The Facebook group is called "Find a Pox Party in Your Area." According to the group's page, it is geared toward "parents who want their children to obtain natural immunity for the chicken pox."
On the page, parents post where they live and ask if anyone with a child who has the chicken pox would be willing to send saliva, infected lollipops or clothing through the mail.
Parents also use the page to set up play dates with children who currently have chicken pox.
Medical experts say the most troubling part of this is parents are taking pathogens from complete strangers and deliberately infecting their children.
One concern is that they are sending the virus through the mail.
This is not only idiotic, reckless endangerment of children and postal workers. It's also a federal offense, tantamount to bioterrorism.

Why would people do this? Because they have been swindled by anti-vaccine propaganda that uses sciencey sounding words to convince people that there are significant dangers associated with vaccines (there are not). When not using fake science and made up statistics, they take advantage of popular mistrust of doctors and bizarre conspiracy theories ("You can't believe doctors and scientists, they are all under the control of big pharma" etc).

Although it's true that most children will recover from chicken pox with little to no side effects, the risks of getting the disease are dramatically higher than those associated with getting the vaccine. In addition to prevented a very nasty, uncomfortable illness, the vaccine has reduced deaths caused by chicken pox by more than 90%. Also, 1 in 10 adults who had chicken pox in childhood will develop a painful nerve condition called Shingles, when the virus is reactivated during a stressful time. The vaccine likely prevents against this condition as well. Let's not forget about the value of herd immunity to protect people who cannot get the vaccine or are immunocompromised, including very young infants, children with leukemia, and pregnant women.

Please stop sending infectious packages through the mail, it's very illegal and dangerous. And please stop infecting your children with chicken pox. Its not "natural", its not safer than the vaccine, and to do so is nothing less than child-abuse.

Monday, November 7, 2011

Priceless...

At the end of my last post, I mentioned the adorable face that little one makes when she *ahem* eliminates. And by "eliminates", I mean she makes a huge explosive poo into her diaper. I finally got this sequence on film and I plan on keeping it forever and showing it to her when she's 15. 


Unfortunately, You can't hear the actual "poop" sound, although it was quite loud if you were in the room. The microphone wasn't picking it up. I'll just have to tell her about that.

Wednesday, October 19, 2011

Breast-feeding and poopies

It has been almost a month now since the baby was born. I've been meaning to keep up with the blog. I have ideas for all sorts of posts about our early experiences with staying up all night, boob-feeding, diaper changing, and baths with our super-cute newborn daughter. However, these things that I'd like to write about are the exactly the things that have held me back from stringing together some even remotely lucid sentences. Frankly, I'm having trouble being creative. I have about 23 minutes each day of clear adult thought. These are the precious moments of clarity when the baby is changed, fed, happy, and asleep and AT THE SAME TIME I have just managed to drink some coffee and I have nothing pressing to attend to (e.g feeding and washing myself).

Thus, I have about 22 minutes left to complete this post before the baby awakens and demands that I put my boob in her mouth so that she can attack it with her little gummy mouth. I wasn't prepared for the fact that taking care of a baby means that your entire life becomes a strange, sleep-deprived math problem. My day is now broken into roughly 2-3 hour long segments, 24 hours a day. About 40 minutes of each segment is spent breast feeding, followed by about 30 minutes of diaper changing/ playing/ cuddling. After this, the baby usually will begin to get all adorably sleepy and I'll put her in her rocker or swing for a nap. Now this is where it gets complicated. The length of the nap is entirely unpredictable. It might be 15 minutes, it might be 2 and half hours. During this time I wander around the house attempting to complete normal life-tasks, like dishes, laundry, showering and going to the bathroom before Charlotte starts flailing her chubby limbs while yelling and grunting. This means that I  have to drop everything I'm doing and battle her little fists to get my boob in her mouth, then cuddling and singing and staring into her eyes, then explosive, projectile poop ... and the cycle repeats itself.

Basically life is breast-feeding and poopies and no more than 2 hours of consecutive sleep (for me, at least) at any given time.

So when I experience one of these magical periods of clarity, I suddenly remember that I'm a highly educated adult who has friends, enjoys literature, science and creative hobbies,and I'm actually overwhelmed by all the things that I could do. I panic! I could read the grants for my new job! I could work on a painting! I could call someone and arrange to go out for a single delicious beer! Or even better, I could NAP! Right now I've chosen to write a blog post.

The next post will be more organized, I promise. And it won't include complaining. I know it only lasts a few weeks before she starts consolidating her sleep/wake patterns. Please spare me the comments about how I will miss this time when its gone. I know, I get it. The next post will be about how much I love my little spawn. She's so cute. She has these beautiful, huge eyes and she spends her waking time staring at the world and trying out her new face muscles. She makes this little scrunchy, pouty face and a quizzical raised eye-brow face. Sometimes she makes this super-concerned, angry face with a few loud grunts (like "eerrrrrgggg.... errrgggggggGGG!!! EERRRRrrggggggAAAH!) while she pushes out this huge farty poop into her diaper. Then she looks surprised, smiles, and immediately falls asleep for 10 seconds. Like that was the most difficult thing she's ever done. It's so adorable, I melt with love.

Friday, September 30, 2011

Baby's Birthday

Thank you all for the notes and congratulations. Charlotte is 1 week old today and she is wrapped up in a baby sling on my chest. She is beautiful and we are so in love with her. I'm amazed that this all happened so fast and we actually have a real live baby in the world. I'm anxious to get the story down so that we can remember everything that happened, so here it goes.

This is the story of Charlotte's birth.

On Thursday evening, I went out with my friends for some Mediterranean food at Alladin's. It was a nice distraction from being enormously pregnant. We hung out until about 9pm chatting and I eventually waddled myself back to the car and drove home around 9pm. I remember saying that I was really hoping that labor would start that night (haha). I found Chris at home reading up on the new camera that we bought specifically for taking baby pictures. He insisted on teaching me the basics of how to use it, but I was sort of feeling strangely emotional and weird and crampy. In hindsight, I was definitely in early labor. We watched the daily show and went to bed at around 11:30pm.  

At about 1am I woke up to go to the bathroom and my water broke on the way down the hall. At first I was confused and upset about being all wet, but when I realized what was happening I was super excited. I cleaned up and put on new pajama pants (big mistake, by the way, because there were 3 more gushes that followed in the next few hours, and lots more amniotic-fluid-soaked pajama pants strewn throughout the house. I thought that the "water" only happened once!). I came back to the room and told Chris that my water broke. We were both very excited, but a little dismayed that we had only gotten an hour of sleep. I was worried I wouldn't make it the 24-36 hours that labor would take. Good thing for us, the whole event only lasted about 11 hours.

Our birth class teacher had told us that the most important thing to remember was that if you thought you were going into labor, you should go to sleep. So Chris dutifully told me that I should go to sleep so that I wouldn't be too tired when it got really intense. Good advice, but this was totally impossible for me, because I had already launched into active labor. Contractions were coming every 4-5 minutes and lasting for about 30 seconds. I wandered around the house moaning through contractions and rocking back and forth on my hands and knees. Chris kept telling me to try and sleep. As the contractions got longer and more intense I needed help to get through each one. Chris was really good at pushing down on my lower back to take the pressure off my hips. He was still telling me that I should try and sleep, but by this point, I was ready to murder him if he looked like he was trying to sleep and I insisted that I couldn't sleep and he had to stay awake with me.

I got Chris to call the Doula at about 7am. He told her something along the lines of, "Whenever you get a chance, you can make your way over." I was in the background saying, "No, tell her to get here NOW! We need to go the hospital SOON!!!". He was ignoring me... which I guess was the best thing to do with a crazy laboring person, but it annoyed me at the time. Jessica arrived about an hour later and seemed surprised that I was in such active labor. She checked me and I was already 6cm dilated! Our plan was to head to the hospital when I was at about 5-6 cm dilated so that was great news.

Chris started running around the house gathering our bags and just generally having a panic attack. I, on the other hand, had started to go into "labor land". I was rocking back and forth with my eyes closed and really focusing on my body. I was heavily under the influence of crazy endorphins and other hormones getting me ready for the main event. The contractions were feeling a lot stronger, but they weren't quite as raw as before. I felt like I was in a trance. It was almost impossible for me to communicate because all I could think about was working on my labor. Jessica helped me through contractions while Chris packed the car. When it was time to go, I wandered out of the house to the car moaning and, in general, looking like an escaped schizophrenic patient.

The car ride and our arrival at the hospital is all a blur in my mind. Chris probably remembers it better. He looked over at me and said, "Jessica could feel the baby's head! We're so close!". I managed to nod and smile. Next thing I remember we were in the elevator going up to the labor and delivery floor. They were going to get me a wheel chair, but they were taking too long and I just marched in the direction of the elevators. I was furious at everyone in the elevator for making it go slower. Totally irrational. Next thing, they had us in the triage room and it was a blur of random nurses. They hooked me up to a fetal monitor and they checked my cervix. I was at 8cm dilated and 100% effaced. At this point they asked me to rate my pain level on a scale of 1 to 10. This question makes absolutely no sense. They could have been asking me what the square root of 569 was. All I knew was that if I said anything higher than 4, the nurses would be obligated to offer me pain medication, and I didn't want anyone saying the word "epidural" to me.... so I said 4.... then another contraction hit and I said, "It's a ten! I want an epidural!". Chris and Jessica calmly reminded me that I didn't want an epidural and I was already at 8 cm and it would be time to push very soon. I probably had a bit of mental deliberation, but thinking was so difficult that I just went back to laboring.

Next we were in the labor and delivery room and I was leaning in the shower with my hands on the wall and Chris was pushing on my back. I was in transition and completely in the midst of labor land. Chris was with me the whole time and he kept telling me he was so proud of me. They made me get out of the shower and the nurses checked me again and it was time to start pushing. They called in my Obstetrician, who arrived with a table full of scary looking metal instruments and she was donning what appeared to be a hazmat suit, complete with a face shield. They set me up with a squatting bar and put the bed low to the ground and threw a huge plastic tarp under me. With each contraction my body was involuntarily pushing down hard. As soon as I started pushing I felt so much better. The pain was gone. The contractions slowed down so I had 5 minutes between each one, but they were super strong. When I felt a contraction coming Chris and Jessica helped me pull myself up into a deep squat and I pushed as hard as I could. Chris started counting to 10 with me and reminding me to breathe in. The Ob was stretching my vagina and putting some sort of lubricating stuff around it. The baby's head started crowning and I reached down and touched the top of her head. I was so excited she was so close and I started roaring with each push. Her head was out and then her shoulders and at 12:04 pm on September 23rd, the Ob put a tiny, lavender, slimy, squirming Charlotte on my chest! The room filled with butterflies and rainbows and unicorns and Charlotte took her first breath and let out a big wail. She was breathing really well and turning nice and pink and she was wide awake. I looked up at Chris and he had tears coming down his face. The nurses cleared out and left us alone with her for more than an hour. She was so perfect.

Looking back, there is not a single thing I would have changed. Jessica was amazing with helping Chris and I stay calm and with the plan. The nurses and the Ob respected my wishes and really paid attention to my birth plan. I'm so happy that everything was going so smoothly that I was able to birth my baby with no drugs and minimal interventions. I was able to get up and walk around just a few minutes after having the baby. Within a few hours I took a shower, had an enormous dinner, and Chris and I napped with our new baby in the hospital room.

The past week has been amazing and exhausting. Expect more posts and pictures. There's lots of pictures on Chris's facebook page if you'd like to check that out. Thanks for reading!

Monday, September 19, 2011

Any day now...

Here is a picture of what the baby should look like in there right now. I really liked this one, because Charlotte seems to be in this exact position. I can feel two little feet kicking around in the top right quadrant of my tummy and a mound that moves around occasionally that is most likely her butt.

Right now I'm 40 weeks pregnant according to the date of my last period, but 39 weeks according to the sonogram I had at ~20 weeks. Not sure which is correct, it's all a big guessing game anyway. Regardless, I'm going NUTS waiting. It doesn't seem like anything is happening, and I feel totally normal most of the time. I've been having period-like cramps every now and then during the day, but nothing that sounds like what I've heard about labor.

Anyway, that's the super boring update. Come on, Charlotte!

Friday, September 9, 2011

The 15 most awkward and creepy pregnancy portraits

Many couples choose to commemorate their pregnancy by having some artistic photos taken of this special time in their lives. Although a good idea in theory, sometimes this goes alllllllll wrong. Check out the top 15 here.
In case you don't feel like going to the link, this is my absolute favorite.

Funny Bunny

There are no words. 

My friend sent me this link at a really good time too, because Chris and I just did a little DIY pregnancy photo shoot. I was afraid our pictures were a little cheesy, but I have no fears now!  At least I opted to not wear sequined bunny ears while aiming my crotch at my husband's face.