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!
Monday, November 21, 2011
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:
This is not only idiotic, reckless endangerment of children and postal workers. It's also a federal offense, tantamount to bioterrorism.
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.
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.
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.
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.
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!
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.
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.
Thursday, September 8, 2011
Bacteria in the Vag! Oh my!
One of the standard tests during pregnancy is for colonization of Group B Streptococcus (GBS) in your vagina. This is a common bacteria that colonizes the colon and vagina in about 25% of all women (and men also, for that matter, minus the vagina part). GBS does not make adults sick, but can be harmful to a baby. A woman who is positive for GBS has about a 1/200 chance of passing the bacteria on to her baby. The risk is very, very low, that the bacteria will affect the baby. However, the risks of GBS infection in the infant are scary enough that it is something to be worried about. There is a good chance of sepsis, pneumonia or meningitis if the baby does become infected and GBS remains a leading cause of infant mortality. The baby is especially at risk if it is born premature. Thus, all pregnant women are tested for GBS colonization between 35 and 37 weeks of gestastion and if a woman turns out to be positive, it is recommended that she be treated with intravenous antibiotics (usually penicillin) at the very start of her labor and every 4 hours following, until the baby is delivered. (This basic info can be found at the American Pregnancy Association website and the American Congress of Obstetricians and Gynecologists (AGOG) website)
Here is where the problem is. The recommendation to flood a pregnant women with antibiotics during labor is controversial, even among ACOG members. The high doses of penicillin necessary to kill the GBS has the effect of killing off all of the gut flora in the mother and in the newborn infant. Much of the infant's immune system is mediated by the gut flora that he/she is inocculated with during the descent through the birth canal. If this immune system is destroyed by high doses of antibiotics, it leaves the infant susceptible to antibiotic resistant strains of E. Coli and other nasty things. A recent study in one hospital noted that between 2004 and 2008 the screening of GBS colonization increased from ~10% to 65% and the use of intravenous antibiotic treatment increased from 40% to 90%. Although the rates of early-onset sepsis because of GBS decreased from 45.4% to 20%, the rates of sepsis caused by antibiotic resistant E. Coli increased from 40.9% to 70% (Lin et al., Pediatrics and Neonatology, 2011). The incidence of infant mortality due to early onset infections remained the same, even though antibiotic prophylaxis increased dramatically.
There are also problems with the overuse of antibiotics not just with pregnant women, but with society in general. In a recent commentary in Nature (Antibiotic overuse: Stop the killing of beneficial bacteria. August 24, 2011), the author wrote that,
The blanket recommendation to treat 30% of all pregnant women with penicillin during labor could be causing permanent changes in gut flora, leading to problems we don't yet fully understand. Not to mention that if a baby is born by C-section, they are not exposed to the vaginal flora and miss out on this important step in the development of their immune systems. The author continues,
The average child in the United States and other developed countries has received 10–20 courses of antibiotics by the time he or she is 18 years old1. In many respects, this is a life-saving development. The average US citizen born in 1940 was expected to live to the age of 63; a baby born today should reach 78, in part because of antibiotics. But the assumption that antibiotics are generally safe has fostered overuse and led to an increase in bacterial resistance to treatments.Other, equally serious, long-term consequences of our love of antibiotics have received far less attention. Antibiotics kill the bacteria we do want, as well as those we don't. Early evidence from my lab and others hints that, sometimes, our friendly flora never fully recover. These long-term changes to the beneficial bacteria within people's bodies may even increase our susceptibility to infections and disease. Overuse of antibiotics could be fuelling the dramatic increase in conditions such as obesity, type 1 diabetes, inflammatory bowel disease, allergies and asthma, which have more than doubled in many populations
I just had the results of my GBS test come back and I am negative! This is good because it means that I don't need to fight with my Obstetrician about hospital policies, and because my baby is lower risk for a scary infection. I believe that if I had turned out to be positive, I would have declined to receive the IV antibiotics. The antibiotics may decrease the spread of GBS, but at what cost? These practices are currently being reviewed and researchers are working on developing a vaccine for GBS that would eliminate the need for mass antibiotic treatments. Until better treatments are found, I would encourage other pregnant ladies to read the literature and make their own informed decision on this issue.Consequently, we should reduce the use of antibiotics during pregnancy and childhood. Antibiotics — particularly penicillins — are now given routinely to between one-third and one-half of all women during pregnancy or nearing childbirth in the United States and other developed countries. Babies acquire their founding bacterial populations from their mothers while passing through the vagina at birth. So each generation — particularly the 30% or so of infants born via Caesarian9 — could be beginning life with a smaller endowment of ancient microbes than the last5.
Wednesday, September 7, 2011
I love Rachel Zoe
This post is dedicated to Rachel Zoe and how much I love her. The new season of the Rachel Zoe project just started last night and I LOVE that Rachel Zoe is pregnant. OK, she's not pregnant anymore, she had her baby boy, Skyler, on March 23rd of this year. But the show is obviously a few months delayed, and I'm happy to continue pretending that Rachel and I are pregnant together and are best friends.
Even though being a professional scientist is a very different compared to being a stylist/designer, I still feel like I have a lot to learn from her. I greatly admire RZ's dedication to her career and her workaholic tendencies. She also is really confidently irrational about half the time, but is always dead-on with her decisions and constantly hilarious. It also helps that she gets to wear amazing clothes all the time, and spent close to $100,000 on her baby's nursery.... I can dream.
Even though being a professional scientist is a very different compared to being a stylist/designer, I still feel like I have a lot to learn from her. I greatly admire RZ's dedication to her career and her workaholic tendencies. She also is really confidently irrational about half the time, but is always dead-on with her decisions and constantly hilarious. It also helps that she gets to wear amazing clothes all the time, and spent close to $100,000 on her baby's nursery.... I can dream.
Tuesday, August 23, 2011
Empathy pregancy suit
Japanese researchers have developed a new pregnancy suit that is designed to allow men to "viscerally empathize" with their pregant wives or girlfriends. haHA!
Of course this idea is nothing new, but this fancy model has a few extra bells and whistles. Most impressively, it has mechanical devices in it to mimic the kicks of the baby and the wearer can "soothe the baby" by rubbing their tummy.
I'd put this in the cool but useless category.
Of course this idea is nothing new, but this fancy model has a few extra bells and whistles. Most impressively, it has mechanical devices in it to mimic the kicks of the baby and the wearer can "soothe the baby" by rubbing their tummy.
I'd put this in the cool but useless category.
Monday, August 22, 2011
Unnatural Selection: Choosing boys over girls and the consequences of a world full of men
The first question that anyone asks you when they find out you are pregnant is, "Do you know what you are having?". A girl or a boy??? And each answer is met with excited discussions of pink and blue, cute dresses, soccer/ballet practices, circumcision debates, potty training, and advice to meet the unique challenges of raising a boy or girl.... Or at least that has been my experience.
After reading Mara Hvistendahl's book, "Unnatural Selection: Choosing boys over girls and the consequences of a world full of men," I have realized that my experience would not be typical in many places in the world. Indeed, if I was a Chinese woman, my sonogram results at 20 weeks showing a healthy female fetus might have resulted in hushed trepidation, quiet discussions with my husband and the painful decision to abort the fetus and try again for a boy. In China and India in particular, there is an overwhelming imbalance of boys being born over girls. In some parts of the world the sex ratio is more than 160 boys being born for every 100 girls. (This is far from the natural ratio of ~105:100 boys to girls. This small majority of boys to girls born neatly makes up for the evolutionary history of an increased risk of mortality in boys and young men). This imbalance is almost entirely due to sex-selective abortion of female fetuses. The result is 163 million "missing" girls, which Hvistendahl demonstrates, has already led to significant social upheaval, a denigration of the status of women, and may lead to even more unprecendented changes.
Where Hvistendahl triumphs is in her analysis of how this condition came to be. There is a tendency to blame this phenomenon on "deep-seated gender bias" and "traditional values" that only exists in "backwards, impoverished developing countries". The gender bias explanation is convenient because it hints at a very easy solution. All we need to do is educate poor women and men about the value of girls and the oppressive patriarchy will be overturned. The author admits that even she was not immune to this type of thinking; in her proposal for this book, she wrote, "The best way to convince couples to start having more girls is to improve the status of women by boosting opportunities for education and career advancement." The truth is, that education and career opportunities for women have been getting better throughout the world for decades! Even in the face of almost universal improvement in the status of women, the numbers of girls being born has steadily decreased. Gender bias is certainly part of the story, but the reality is much more complex.
Hvistendahl makes a convincing argument that the sex ratio imbalance has its roots in agressive population control measures largely initiated by elite western institutions. She tells the story of the hysteria initiated in the 1970's by Paul Elhrich's book, The Population Bomb. This book created a generation of popular anxiety over the imminent threat of overpopulation (especially in developing Asian and African countries) that would lead to starvation, war, and the ultimate end of the human race. Hvistendahl goes on to argue that these sensationalistic concerns were underlyed by more insidious political motivations, including fears about the link between poverty and the spread of communism. In response to such pressures, in the 1960's and 70's organizations like the United Nations Family Planning Association (UNFPA) and the International Planned Parenthood Foundation (IPPF) began pouring millions of dollars into campaigns encouraging families to have less children. To add to the pressure, the World Bank made humanitarian aid efforts dependent on the condition that the countries meet the new, strict population restrictions. Thus began a generation of forced sterilizations, forced abortions and infanticide. Although shocking now, the hysteria of the time made permissible, "any means necessary," to restrict the population explosion.
In Elhrich's book, he notes the desire for male babies and that much of the resistance to the population control measures stemmed from a tendency to continue reproducing until a male heir was produced. He even muses that if only there were a way to ensure that couples could produce a male baby, then couples would voluntarily cease reproducing. Elhrich got his wish with the advent of inexpensive sonogram machines in the 80's that allowed for easy identification of male or female fetuses. The population growth rates dropped at record speeds, abortion of late-term female fetuses grew in popularity, and the ratio of boys to girls skyrocketed. A condition that remains today.
Regardless of the causes, the sex ratio imbalance has led to an alarming paucity of females. Which, most obviously, leads to a surplus of men who cannot find wives. This has led to an increase in the incidence of "mail-order-brides", sex-trafficking, prostitution and a general decrease in the status of women. Not only this, but the increase of young, unmarried men is speculated to be a possible cause of increased terrorism and war. This is the most speculative section of the book. No one really knows what the outcome of a dramatic increase in young, testosterone filled men will be. It is an experiment that has never been performed before. Nevertheless, Hvistendahl goes into a fascinating account of the historical situations where there has been a lot less females than males. This includes the "wild wild west" in the 1800's in America, and the early historical myths of Rome. Did I mention that this book is fabulously written? She has illuminated an issue that I had never even heard of and offers an extremely well-researched and meticulous analysis of the problem. It reads like a mystery novel at times, a scientific research paper often, and a memoir and biography at other times.
It is also fascinating how this issue has escaped public notice for so long. In a way, the fact that sex-selective abortion increased with little resistance, is understandable given that at the time it origniated it must have seemed like the most ethical population control measure yet! When compared with goverment bands of doctors rounding up women and forcing abortions and sterilization, couples actively choosing to control their family as they wished and voluntarily adhere to the population growth restrictions must have seemed positively utopian.
In addition, the issue is so politically charged and complex that the response of feminists and reproductive rights advocates is to simply avoid the problem or fall back on simplified "gender bias" arguments that ignore the issue of the misuse of abortion. Hvistendahl writes,
This book is very much worth reading. It's fast moving and filled with illuninating anecdotes, eccentric political and historical characters, and meticulously researched facts. Please check it out so that I can have someone to talk to about this stuff!
After reading Mara Hvistendahl's book, "Unnatural Selection: Choosing boys over girls and the consequences of a world full of men," I have realized that my experience would not be typical in many places in the world. Indeed, if I was a Chinese woman, my sonogram results at 20 weeks showing a healthy female fetus might have resulted in hushed trepidation, quiet discussions with my husband and the painful decision to abort the fetus and try again for a boy. In China and India in particular, there is an overwhelming imbalance of boys being born over girls. In some parts of the world the sex ratio is more than 160 boys being born for every 100 girls. (This is far from the natural ratio of ~105:100 boys to girls. This small majority of boys to girls born neatly makes up for the evolutionary history of an increased risk of mortality in boys and young men). This imbalance is almost entirely due to sex-selective abortion of female fetuses. The result is 163 million "missing" girls, which Hvistendahl demonstrates, has already led to significant social upheaval, a denigration of the status of women, and may lead to even more unprecendented changes.
Where Hvistendahl triumphs is in her analysis of how this condition came to be. There is a tendency to blame this phenomenon on "deep-seated gender bias" and "traditional values" that only exists in "backwards, impoverished developing countries". The gender bias explanation is convenient because it hints at a very easy solution. All we need to do is educate poor women and men about the value of girls and the oppressive patriarchy will be overturned. The author admits that even she was not immune to this type of thinking; in her proposal for this book, she wrote, "The best way to convince couples to start having more girls is to improve the status of women by boosting opportunities for education and career advancement." The truth is, that education and career opportunities for women have been getting better throughout the world for decades! Even in the face of almost universal improvement in the status of women, the numbers of girls being born has steadily decreased. Gender bias is certainly part of the story, but the reality is much more complex.
Hvistendahl makes a convincing argument that the sex ratio imbalance has its roots in agressive population control measures largely initiated by elite western institutions. She tells the story of the hysteria initiated in the 1970's by Paul Elhrich's book, The Population Bomb. This book created a generation of popular anxiety over the imminent threat of overpopulation (especially in developing Asian and African countries) that would lead to starvation, war, and the ultimate end of the human race. Hvistendahl goes on to argue that these sensationalistic concerns were underlyed by more insidious political motivations, including fears about the link between poverty and the spread of communism. In response to such pressures, in the 1960's and 70's organizations like the United Nations Family Planning Association (UNFPA) and the International Planned Parenthood Foundation (IPPF) began pouring millions of dollars into campaigns encouraging families to have less children. To add to the pressure, the World Bank made humanitarian aid efforts dependent on the condition that the countries meet the new, strict population restrictions. Thus began a generation of forced sterilizations, forced abortions and infanticide. Although shocking now, the hysteria of the time made permissible, "any means necessary," to restrict the population explosion.
In Elhrich's book, he notes the desire for male babies and that much of the resistance to the population control measures stemmed from a tendency to continue reproducing until a male heir was produced. He even muses that if only there were a way to ensure that couples could produce a male baby, then couples would voluntarily cease reproducing. Elhrich got his wish with the advent of inexpensive sonogram machines in the 80's that allowed for easy identification of male or female fetuses. The population growth rates dropped at record speeds, abortion of late-term female fetuses grew in popularity, and the ratio of boys to girls skyrocketed. A condition that remains today.
Regardless of the causes, the sex ratio imbalance has led to an alarming paucity of females. Which, most obviously, leads to a surplus of men who cannot find wives. This has led to an increase in the incidence of "mail-order-brides", sex-trafficking, prostitution and a general decrease in the status of women. Not only this, but the increase of young, unmarried men is speculated to be a possible cause of increased terrorism and war. This is the most speculative section of the book. No one really knows what the outcome of a dramatic increase in young, testosterone filled men will be. It is an experiment that has never been performed before. Nevertheless, Hvistendahl goes into a fascinating account of the historical situations where there has been a lot less females than males. This includes the "wild wild west" in the 1800's in America, and the early historical myths of Rome. Did I mention that this book is fabulously written? She has illuminated an issue that I had never even heard of and offers an extremely well-researched and meticulous analysis of the problem. It reads like a mystery novel at times, a scientific research paper often, and a memoir and biography at other times.
It is also fascinating how this issue has escaped public notice for so long. In a way, the fact that sex-selective abortion increased with little resistance, is understandable given that at the time it origniated it must have seemed like the most ethical population control measure yet! When compared with goverment bands of doctors rounding up women and forcing abortions and sterilization, couples actively choosing to control their family as they wished and voluntarily adhere to the population growth restrictions must have seemed positively utopian.
Many theorists are continuing to insist that the laws of supply and demand will hold true for human populations. Economist Gary Becker, and theorist Richard Posner wrote in 2009 that as the number of girls in comparison with boys increases, the value of wives and girlfriends will increase. (Don't worry! the free market will solve this problem, too!). Hvistendahl points out that this is only true in the crudest sense, that as they become rarer, women simply cost more as a commodity. Men must amass quite a bit of wealth to afford a wife, but the woman herself has not become more valued and she certainly does not benefit personally from the transaction. Indeed the whole economic logic here is quite silly, as Hvistendahy points out that,
"no majority group has ever aspired to become a minority under the illusion that a decrease in numbers will somehow lead the group's members to be more valued by society."In the case of the scarcity of women, this imbalance is more likely to make life worse. In seems counterintuitive, but the more valuable a woman is, the higher the risk that they will be deprived of that value. Indeeed, as the sex ratio becomes more and more imbalanced, it sets back the status of women considerably. Parents are worried that their daughters will be abducted and sold into slavery, or on the other hand, poor parents will actively sell their daughters into marriage. Laws to 'protect' women, like outlawing western fashions on college campuses, have grown in popularity, and have the effect of restricting the hard-won freedom of women. Either way, given the problems with being female under these circumstances, I believe I would choose to try and have a boy instead of dealing with these problems.
In addition, the issue is so politically charged and complex that the response of feminists and reproductive rights advocates is to simply avoid the problem or fall back on simplified "gender bias" arguments that ignore the issue of the misuse of abortion. Hvistendahl writes,
"If feminists and reproductive rights advocates bring up abortion in the devoloping world today, it is ordinarily to point out how many women die of botched operations in countries where abortion is illiegal. They don't talk about abortion being used for dark purposes. They don't talk about how the culture surrounding abortion has changed in Asia...."Indeed the problem of abortion's misuse in countries where it is used for sex-selective abortion is very different from the situation in western countries. In western countries a woman who chooses to abort is very early in her first pregnancy, young, poor, and unmarried. Multiple abortions by one woman are relatively rare in western countries. On the other hand, the average woman choosing to abort for reasons of sex-selection is aborting after 20 weeks (the time when sex can be determined by sonogram). She is typically married with 1 or more children, educated, wealthy, and has already had 2 or more late-term abortions. It is clearly not the same problem, but activists have good reasons for avoiding criticizing abortion on any level. Criticism can easily be latched on by anti-abortion groups who are dedicated to eliminating abortion regardless of the circumstances and reasons.
"After decades of fighting for a woman's right to choose the outcome of her own pregnancy, it is difficult to turn around and point out that women are abusing that right- that in union with population pressures and technology, choice has been perverted"The entire concept of "choice" indeed has been perverted when you take into account the economic, political, and social reasons for choosing boys over girls. UNFPA officers are warned against identifying sex selective abortion itself as a human rights abuse, because it implicates the choice of the women who perform it. Indeed, officers are instructed to not even use the word, "abortion", instead they should call it "prenatal sex-selection", which obviously doesn't really describe what's going on. The A-word is simply too dangerous. But the damage that sex-selective abortion has done to the condition of women warrants some attention from feminists and women's groups, even if it means confronting the A-word. It's not enough to insist that the patriarchal suppression of society is causing this problem, we must look at the factors that influence women's choices.
This book is very much worth reading. It's fast moving and filled with illuninating anecdotes, eccentric political and historical characters, and meticulously researched facts. Please check it out so that I can have someone to talk to about this stuff!
Saturday, August 20, 2011
One month (or so) to go!
Wow, it's been a while since my last post. I'll try to give a thorough update of the things that have been going on. Expect regular posts in the upcoming weeks
Most importantly, we are coming up to the last few weeks! My tummy is absolutely enormous. It seems like the baby finally dropped down a little bit. She's not packed up under my ribs anymore and I can get a full breath in now. On the other hand, though, she's settled down in my pelvis which makes me waddle and causes this strange hip stretching feeling. I'm gaining weight much more rapidly now. I gained 8 pounds in 5 weeks! This is probably contributing to the waddling effect. I was happy to find out that she is upside-down and ready to go. In about a month (or so), that is. I'm hoping for early rather than late... not scary early... but 2 weeks would be just perfect for me. The nursery is ready, all her little outfits and blankets are washed and dryed and organized, we have the bassinet, the carseat and stroller, and the soon-to-be grandparents are on standby- we're ready for the baby to arrive!
There's obviously lots of anxious anticipation going on here, but there is also life outside of baby (OK, not much, but a little bit). Last week I completed my revisions on my dissertation and got the green light to submit it officially to the graduate school. I handed in the final forms, graduation fees, ordered 2 bound copies of my completed thesis, and ordered my regalia for the graduation ceremony. All of this is shockingly expensive, by the way. It costs about $500 to graduate if you want to do all the things that go along with graduation. I wouldn't want to skip the ceremony though... You only get one chance for that photo-op with the silly robes, the diploma and handshake, etc.
Despite being mostly graduated, I'm still bumming around the lab a bit. I have a review paper to revise and resubmit, and I need to get my final chapter of my thesis submitted to a journal. In a more high-energy time of my life, this would all be done by now. Right now it's taking me about 3 weeks. I'm simply not motivated to 'bang-things-out' lately. I'd rather take my time reading whatever happens to interest me, writing, and painting art for the baby room, which is exactly what I've been doing. One more official week of employment at the lab (technically) before graduation. After which, I will transition to my new short-term (and unpaid) job of completing gestation and mentally willing this baby to start making her way out.
Oh yes, and the long-term (and unpaid) job of becoming parents. I keep forgetting.
Most importantly, we are coming up to the last few weeks! My tummy is absolutely enormous. It seems like the baby finally dropped down a little bit. She's not packed up under my ribs anymore and I can get a full breath in now. On the other hand, though, she's settled down in my pelvis which makes me waddle and causes this strange hip stretching feeling. I'm gaining weight much more rapidly now. I gained 8 pounds in 5 weeks! This is probably contributing to the waddling effect. I was happy to find out that she is upside-down and ready to go. In about a month (or so), that is. I'm hoping for early rather than late... not scary early... but 2 weeks would be just perfect for me. The nursery is ready, all her little outfits and blankets are washed and dryed and organized, we have the bassinet, the carseat and stroller, and the soon-to-be grandparents are on standby- we're ready for the baby to arrive!
There's obviously lots of anxious anticipation going on here, but there is also life outside of baby (OK, not much, but a little bit). Last week I completed my revisions on my dissertation and got the green light to submit it officially to the graduate school. I handed in the final forms, graduation fees, ordered 2 bound copies of my completed thesis, and ordered my regalia for the graduation ceremony. All of this is shockingly expensive, by the way. It costs about $500 to graduate if you want to do all the things that go along with graduation. I wouldn't want to skip the ceremony though... You only get one chance for that photo-op with the silly robes, the diploma and handshake, etc.
Despite being mostly graduated, I'm still bumming around the lab a bit. I have a review paper to revise and resubmit, and I need to get my final chapter of my thesis submitted to a journal. In a more high-energy time of my life, this would all be done by now. Right now it's taking me about 3 weeks. I'm simply not motivated to 'bang-things-out' lately. I'd rather take my time reading whatever happens to interest me, writing, and painting art for the baby room, which is exactly what I've been doing. One more official week of employment at the lab (technically) before graduation. After which, I will transition to my new short-term (and unpaid) job of completing gestation and mentally willing this baby to start making her way out.
Oh yes, and the long-term (and unpaid) job of becoming parents. I keep forgetting.
Wednesday, August 3, 2011
Notes on my belly button
My belly button is flat! It has gradually gotten more and more shallow over the last few weeks and now all that's left is is a little gathered spot in the middle of my abdomen. What's interesting is all of what was formerly inner belly button skin has now stretched out to become part of my stomach. The only way that its identifiable as former belly button is by the fact that the ring of tummy surrounding the middle spot is noticeably softer and smoother than the rest of the tummy skin.
It's hard to believe that there is 2 more months left. There is no more stretch room left, but the baby has to get bigger! Every day I rub palmer's cocoa butter oil over my stretched tummy and stare at it in disbelief. I can't believe this is happening to me.
Really, I'm barely involved in the process at all, except to be a warm stretchy incubator, providing nutrients and oxygen through an umbilical cord attached to a tiny human. The whole thing is exactly like having an alien grow inside of you. Every few minutes I feel the little human stretch around and settle in a new position. There are two kinds of movements, sharp pointy elbows or feet or little fists that feels like a kick or a punch, and what I believe is either a head or a butt that pushes against the inside of my belly and creates a hard bump that deforms the usual roundness for a bit and feels like a long stretch.
I'm in awe of umbilical cords, and placentas, and amniotic sacks and the way it seems like the whole complicated system was just installed in my body. A self-assembling installation that repeats itself, millions of times over, creating an infinite supply of belly buttons.
It's hard to believe that there is 2 more months left. There is no more stretch room left, but the baby has to get bigger! Every day I rub palmer's cocoa butter oil over my stretched tummy and stare at it in disbelief. I can't believe this is happening to me.
Really, I'm barely involved in the process at all, except to be a warm stretchy incubator, providing nutrients and oxygen through an umbilical cord attached to a tiny human. The whole thing is exactly like having an alien grow inside of you. Every few minutes I feel the little human stretch around and settle in a new position. There are two kinds of movements, sharp pointy elbows or feet or little fists that feels like a kick or a punch, and what I believe is either a head or a butt that pushes against the inside of my belly and creates a hard bump that deforms the usual roundness for a bit and feels like a long stretch.
I'm in awe of umbilical cords, and placentas, and amniotic sacks and the way it seems like the whole complicated system was just installed in my body. A self-assembling installation that repeats itself, millions of times over, creating an infinite supply of belly buttons.
Thursday, July 21, 2011
I am PRO Bikinis-while-pregnant!
I have noticed that all of the maternity swimsuits have a few things in common. They are all big, ugly concoctions with way too much fabric and ruching. They often have strange, little skirt-like things around the bottom. And they are expensive and impossible to wear when you are not pregnant. I say, if you were the kind of girl who liked wearing bikinis on the beach to start with, keep it up while you are pregnant!
We were in Maine last weekend for Jo and Tyler's wedding. The whole weekend was amazingly beautiful and I couldn't pass up some morning beach time before the festivities. I had brought with me a (non-maternity) one-piece. But it looked ridiculous stretched over my tummy and made me look like a cow. Luckily, I had also brought a bright pink bikini, which was adorable. I was proud to show off the bump and I actually felt more confident and less self-concious than I ever have before. Because... If you are obviously pregnant, who really cares that your tummy is huge? (And the extra-big, pregnant boobs are kind of a fun accesory, as well.)
I have seen this practice discouraged because people think it's "gross" and/or a risk because you have more exposed skin availble to be sun-burned. I think it's a little old-fashioned to be offended by pregnant-ness... Enough said about that. And people need to get over this irrational fear of the sun. The sun is good for you. Just be diligent with the sunscreen and stay well-hydrated.
Here are some pics of famous people looking pregnant and fabulous in bikinis.
Bethany Frankel (my favoritie real housewife)
Carla Bruni and Nicolas Sarkozy. (Sarkozy looks a bit troll-like, but Carla looks amazing!!!)
Tori Spelling and her adorable (growing) family.
We were in Maine last weekend for Jo and Tyler's wedding. The whole weekend was amazingly beautiful and I couldn't pass up some morning beach time before the festivities. I had brought with me a (non-maternity) one-piece. But it looked ridiculous stretched over my tummy and made me look like a cow. Luckily, I had also brought a bright pink bikini, which was adorable. I was proud to show off the bump and I actually felt more confident and less self-concious than I ever have before. Because... If you are obviously pregnant, who really cares that your tummy is huge? (And the extra-big, pregnant boobs are kind of a fun accesory, as well.)
I have seen this practice discouraged because people think it's "gross" and/or a risk because you have more exposed skin availble to be sun-burned. I think it's a little old-fashioned to be offended by pregnant-ness... Enough said about that. And people need to get over this irrational fear of the sun. The sun is good for you. Just be diligent with the sunscreen and stay well-hydrated.
Here are some pics of famous people looking pregnant and fabulous in bikinis.
Bethany Frankel (my favoritie real housewife)
Carla Bruni and Nicolas Sarkozy. (Sarkozy looks a bit troll-like, but Carla looks amazing!!!)
Tori Spelling and her adorable (growing) family.
Tuesday, July 19, 2011
Dumping my OB/GYN
At this point it has become clear that I've made a mistake in how I handled choosing an OB. Although all the books recommend it, I didn't go through the whole process of interviewing OBs and finding one that was on the same page as me. I just took the first one that had an open spot. I figured they couldn't really be all that different, and my choices of OB clinics are limited by insurance stuff, anyway.
I've met this person about 6 times now. I thought she was kind of in a hurry and a little overly "clinical" with her manner, but nice enough. I also hadn't really tried to ask any questions or had any major concerns. My pregnancy has been text-book normal and uncomplicated so far, so I didn't think much of it. At my appointment last week, I brought up when she thought we should talk about my birth plan. Right away it seemed like she had no interest in talking about anything of the sort. She said that they didn't usually set aside a specific time to discuss such things and there was no formal way that it worked. I said that was OK, and I hadn't actually written one yet. I then mentioned that my major desires for my birth were that I'd like to try and avoid aggressive induction measures (like pitocin) and I'd like to also avoid epidural pain medication, although I was open to other things. I also added, that the main reason for wanting to avoid these things was to reduce my chances of needing a c-section. She looked bored and exasperated and kept repeating that I could write down what I wanted but there are certain things that they have to do and she wasn't going to sign any birth plan that I brought in. She then suggested, that if I didn't want a lot of unnecessary interventions, I should labor at home for as long as possible, Because - get this - "This isn't a hotel"
This whole conversation couldn't have lasted more than 3 minutes, and ended with me sitting there staring at her with my mouth open. NOT A HOTEL??? Are you kidding me??? At this point, I'm thinking that I don't want this woman anywhere near my laboring uterus.
I guess the implication is that if you aren't going to submit to being pumped full of drugs while you are in labor you might as well just be hanging out in your comfy hotel room. What is she talking about? Oh, she also graciously explained to me that at the hospital there was typically more interventions than most people want or need, but these things are done for medical liability reasons. It's just appalling. The primary incentives of an OB is to get people in and out as quickly as possible, while keeping lawsuits at a minimum. Only after those conditions are met does the concern switch to making sure the babies and moms are healthy. Or at least this seemed to be the attitude of this particular OB, whom I have the misfortune of having to deal with.
I understand that there are policies that need to be followed at a hospital, like fetal monitoring and an IV during delivery. I like the idea of monitoring the baby, and having drugs and modern medicine and surgery immediately available. That's why we're going to the hospital (OK. We're also going because this is the only option that is covered by insurance). But I thought that I would be treated like an educated adult and giving birth at the hospital would give me more options and make me feel safer. I feel like this OB not only does not care about what my desires are, she finds the fact that I have opinions about my childbirth.... annoying. I don't trust that she considers me an active participant in the birth of this baby. I definitely don't trust her to do the healthiest thing for me and my baby.
That's where it ended. I called the office and I'm trying to switch to someone else. Unfortunately, it's sort of difficult to switch OBs this late in a pregnancy and there aren't too many other ones available. I'm also assuming that her attitude is atypical. I could be wrong. Either way, I'm really hoping that it works out I can find someone else.
Interestingly, I found out from the office nurse that the OB I have now is leaving the field of obstetrics in October. I'd probably be her last birth. Maybe this explains her dismissive attitude?
I've met this person about 6 times now. I thought she was kind of in a hurry and a little overly "clinical" with her manner, but nice enough. I also hadn't really tried to ask any questions or had any major concerns. My pregnancy has been text-book normal and uncomplicated so far, so I didn't think much of it. At my appointment last week, I brought up when she thought we should talk about my birth plan. Right away it seemed like she had no interest in talking about anything of the sort. She said that they didn't usually set aside a specific time to discuss such things and there was no formal way that it worked. I said that was OK, and I hadn't actually written one yet. I then mentioned that my major desires for my birth were that I'd like to try and avoid aggressive induction measures (like pitocin) and I'd like to also avoid epidural pain medication, although I was open to other things. I also added, that the main reason for wanting to avoid these things was to reduce my chances of needing a c-section. She looked bored and exasperated and kept repeating that I could write down what I wanted but there are certain things that they have to do and she wasn't going to sign any birth plan that I brought in. She then suggested, that if I didn't want a lot of unnecessary interventions, I should labor at home for as long as possible, Because - get this - "This isn't a hotel"
This whole conversation couldn't have lasted more than 3 minutes, and ended with me sitting there staring at her with my mouth open. NOT A HOTEL??? Are you kidding me??? At this point, I'm thinking that I don't want this woman anywhere near my laboring uterus.
I guess the implication is that if you aren't going to submit to being pumped full of drugs while you are in labor you might as well just be hanging out in your comfy hotel room. What is she talking about? Oh, she also graciously explained to me that at the hospital there was typically more interventions than most people want or need, but these things are done for medical liability reasons. It's just appalling. The primary incentives of an OB is to get people in and out as quickly as possible, while keeping lawsuits at a minimum. Only after those conditions are met does the concern switch to making sure the babies and moms are healthy. Or at least this seemed to be the attitude of this particular OB, whom I have the misfortune of having to deal with.
I understand that there are policies that need to be followed at a hospital, like fetal monitoring and an IV during delivery. I like the idea of monitoring the baby, and having drugs and modern medicine and surgery immediately available. That's why we're going to the hospital (OK. We're also going because this is the only option that is covered by insurance). But I thought that I would be treated like an educated adult and giving birth at the hospital would give me more options and make me feel safer. I feel like this OB not only does not care about what my desires are, she finds the fact that I have opinions about my childbirth.... annoying. I don't trust that she considers me an active participant in the birth of this baby. I definitely don't trust her to do the healthiest thing for me and my baby.
That's where it ended. I called the office and I'm trying to switch to someone else. Unfortunately, it's sort of difficult to switch OBs this late in a pregnancy and there aren't too many other ones available. I'm also assuming that her attitude is atypical. I could be wrong. Either way, I'm really hoping that it works out I can find someone else.
Interestingly, I found out from the office nurse that the OB I have now is leaving the field of obstetrics in October. I'd probably be her last birth. Maybe this explains her dismissive attitude?
Tuesday, July 12, 2011
Baby Shower in Rochester!
We spent the weekend out in Rochester at Chris's parents' house. Sue and Lisa were lovely enough to throw a beautiful baby shower with an adorable "owl" theme. My Mom and sisters all made it up and it was awesome to see them. I was absolutely delighted and so so so greatful for all the gifts! This baby is going to be the best outfitted baby on earth. We now have some big essential things. The all important crib and infant car seat are ordered and on the way to our house. We also got a baby swing and a portable bassinet. We have a fancy little whirlpool baby tub with a detachable shower hose (I think I want one in my size!) with cute matching bath towels and baby shampoo. Diapers! with a special trash bin especially made to handle poopy stuff. And of course lots of teeny tiny socks, hats, dresses, and onesies.
I've already unpacked and assembled some of the stuff, so the nursery is well on its way to completion (well, as complete as it can get, minus the baby).
Tummy at 30 weeks :)
My Mom and I (for some reason, only half the picture would upload)
Sunday, July 3, 2011
Fun with home blood type tests
Blood type tests are fun and readily available on Amazon.com for less than $10 each! I suggest ordering one for an educational and interesting home experiment to determine your blood type and Rh factor. :)
Even though it was really fun, we ordered the test for an actual practical reason. We needed to check Chris's blood type. I'm Rh negative which occurs in about 15% of the population. This means that if Chris is positive, I have to get immunized against the Rh factor to prevent potential immunoincompatibility with the baby (who has a 50% chance of being positive). Rh incompatibility occurs if the baby is Rh positive and the mother is negative. Late in the pregancy or during delivery it is possible that some of the fetal blood cells can cross over into the mothers body, and sensitize her immune system to the Rh protein. This means that in subsequent pregnancies, if the baby is positive, the mothers immune system will attack the blood of the fetus and cause all sorts of problems. For example, miscarriages will be much more common, and if the fetus does manage to grow, there is a risk of anemia and neurological disorders/mental retardation (eek!). There are risks to having the immunization (inducing an immune response in the mother is generally something to be avoided), but the possible complications with subsequent pregnancies are so extreme that the benefits out weigh the minor disadvantages.
However, if Chris is negative, then I can avoid having the immunization because the baby will definetly be negative. So we ordered the Eldon blood typing kit from amazon. It consists of a blood type card, an alcohol swab for your finger, a lancet (i.e. finger poking device), 4 little spreaders for applying blood to the card and a chart to determine your type. The card has 4 circles on it. The first one has antibodies to blood antigen A, the next has anti- B, the next has Anti-D (or Rh), and the last is a control circle that has no specific antibodies on it. The first two circles tell you if you have A, B, AB, or O blood and the Anti-D circle tells you if you are Rh negative or positive. Basically, if you are positive for that antigen, your blood will react with the antibodies and get all clumpy, if you are negative, nothing will happen and the blood will just sit there.
This is what a test for A positive blood should look like. Note the clumpiness in the first Anti-A circle and clumpiness in the Anti-D circle. This is what Chris's blood type turned out to be.
This is what the actual test ended up looking like, much messier and grosser, but we could still figure out the blood type. Mine is on the left, I'm A postive and Rh negative. Chris's is on the right, he is indeed A positive and Rh positive (although this is quite hard to see in the picture). So, it turns out that I need to get the immunization. This wasn't too surprising since Chris had an 85% chance of being positive, but it was worth confirming it ourselves to be sure. And like I said above, very fun. Go science!
Friday, July 1, 2011
The Enigma of Placentophagia: To eat, or not to eat?
On monday, we had our second visit with the Doula, Jessica, to go over medical history, concerns, and things to think about over the next few months. Over the course of our talk, Chris revealed to Jessica that one of his biggest fears was that I would have terrible post-partum depression (PPD) after the baby was born (Except, he didn't say it like that, instead he said, "I'm afraid that she will go crazy". Isn't that adorable?). So, here's the crazy thing, Jessica asked if we had considered encapsulating the placenta after birth. To which we replied, "What the heck is that, and what does it have to do with PPD??". Very briefly, placental encapsulation in when the placenta is carefully dried out after the birth, pounded into a fine powder and then encapsulated into pill form. The idea is that your hormone levels go totally wacky aftery you give birth. So, you take these placenta pills in the few weeks after birth and the hormones and other substances even out your hormone levels and this is thought to reduce PPD, stimulate milk production, and generally just be good for you.
You probably have the same incredulous face that I had when I first heard of this idea. Needless to say, I COULDN'T WAIT to blog about this topic. Is this practice weird pseudoscientific crunchy granola hippy crap? Or is it an adaptive evolutionary behavior that has been lost in modern human society to the detriment of women and babies worldwide? The debate is fascinating, please read on.
The most striking piece of evidence in this debate is that almost all mammals immediately consume the placenta and amniotic fluid that is delivered during birth. This behavior is called placentophagy. This behavior is exhibited by rodents, cows, carnivores, horses, primates, apes, etc. etc. There are very few exceptions to this rule (e.g. aquatic mammals do not eat the placenta, and marsupials reabsorb the placenta rather than delivering it, and therefore cannot eat it). This behavior is remarkably evolutionarily conserved. Even our most closely related relatives, the higher non-human primates and apes, universally display placentophagy. In all of recorded anthropological studies, however, there is no mention of humans eating placentas. In modern cultures where what happens to the placenta is known, the placenta is usually burned ceremoniously (or unceremoniously, as the case may be). Or it may be buried to fertilize a tree, and the fruit produced by the tree is eaten. Or a piece may be dried and saved as a talisman. Other cultures, like in china, the placenta is dryed and used in traditional medicines. There is no recorded history of direct placentophagy in humans similar to what is displayed by animals (Ober 1979. Bull. N.Y. Acad. Med. 55;6, p591-599).
The lack of a mention of placentophagy in our most ancient writings isn't neccesarily proof that it did not happen. Birth practices have traditionally been shrouded in mystery. In fact, there is very little recorded history about birth, in general. Interestingly, the most direct references to the fate of the placenta is in strict taboos against eating the placenta. For example, in the bible, Deuteronomy (Chapter 28), there is detailed descriptions of the good things that will happen if the Israelites follow the laws and statutes of God, and the horrible punishments that will befall them if they choose not to do so. Verses 52 to 57 describe how if the people were to disobey God, the men will practice cannibalism and the, "tender and delicate women among you will consume the afterbirth for want of [more appropriate food]" (Ober 1979). The fact that this was considered taboo, indicates to me that there may have been tribes of early pagans that practiced placentophagy and early religions seized on the practice as a way of separating God-following humans from other animals (or to place other humans that did not follow that particular God on the same level as animals). This would not be the only example of a common practice being arbitrarily banned by "God". It seems that God bans things as a convenient way of separating in-groups from out-groups (eating pork, leaving your head uncovered, homosexuality, to name a few). If these speculations are true, it is possible that very early humans did practice placentophagy before the beginning of recorded history and have since lost the practice. I tend to think this is a likely scenario, given our common ancestory with primates, which would lend credence to the evolutionary argument for placentophagy, but this is very difficult to prove.
So regardless of the human question, to which we will return to later, we still have the enigma of almost universal consumption of the placenta by all other mammals. Why would any mammal eat the placenta? There are a few hypotheses to explain placentophagy. [I'm paraphrasing from a review written by Mark B. Kristal in Neuroscience and Behavioral Reviews (Vol. 4, p141- 150, February 1980).] The main explanations are that 1) mammals consume the placenta simply because they are hungry after the exertion of giving birth and need the extra nutrition, 2) the placenta is consumed to remove it from the nest where it might attract predators, and 3) the mother is responding to specific nutritional or hormonal needs that are satisfied by consuming the placenta. The hunger hypothesis is relatively easily disproved by the fact that given a choice between placenta and a variety of other foods shortly before birth and immediatly after, rhesus monkeys will exclusively eat the placenta. Similar behavior is found in rats. The prevention of predation hypothesis is attractive, but is also easily argued against. It still doesn't explain why the mother would eat the placenta. Why not bury it? or move away from the site of the birth? Or, in the case of tree-dwelling monkeys, why not drop the placenta out of the nest to the ground far below? Instead, tree-dwelling monkeys will keep the placenta around for a while and take an hour or two to finish eating it. In addition, mothers that have little risk of predation will also enthusiastically eat the placenta.
This leaves the third hypothesis, that for some reason, the placenta becomes extremely attractive and tasty to the mother immediately before or during birth, likely for evolutionary reasons, in which mothers that ate the placenta produced young that survived better than mothers that shunned the placenta, thus conserving the trait. The reasons that placenta-eating might be evolutionarily adaptive stem from the fact that the placenta contains a variety of hormones, including progesterone, estrogen, and prolactin that have positive effects on the mother and/or babies. Studies show that ingestion of the placenta has a profound effect on the production and presence of these hormones in the blood of the mother. In one study, pregnant rats were either allowed to consume the placenta or the placenta was removed before the mother could consume it. Mothers that were prevented from eating the placenta showed a dramatic increase of progesterone levels on days 6 and 8 following birth. On the other hand, mothers that were allowed to eat the placenta maintained relatively steady levels of progesterone, they also showed an early boost of prolactin production that was absent in the non-placenta eaters (Blank and Frieson 1980. J. Reprod. Fert. 60, p273-278). These results are relevant because the fluctuation of progesterone levels following birth is hypothesized to be a risk factor for the development of PPD in humans. Also, an early boost of prolactin, a lactation hormone, could stimulate more efficient milk production in the placenta-eaters. In another study, when foster rat pups were given to a lactating female they had a much better chance of surviving when the placenta was still attached, presumably due to the beneficial hormonal effects of consuming the placenta in the mother (Deneberg et al. 1963. J. Reprod. Fert. 5, p131-141). More recent work from Kristal's group at the University of Buffalo shows that placentophagy in rats enahnces opioid-mediated pain suppression (DiPirro et al., 2004. Brain Research) and opioid activity in a certain part of the brain, in addition to suppressing pain, also stimulates maternal behavior (Neumann et al. 2009, Brain Research). These data, although limited mostly to rats, indicate that placentophagy can alter hormone levels and prodcution, induce maternal behaviors, increase lactation, and suppress pain. Even with all these beneficial effects, there doesn't seem to be an enormous deficit in maternal behavior if the placenta is removed before eating, indicating that it is not an essential factor in proper rearing of pups. Nevertheless, there do not seem to be negative effects associated with placentophagy.
If you have read up to here, I applaud and thank you! Annnnd you are probably thinking, "OK, now what about all the human studies?" There are none. There are absolutely zero studies where placentophagy has been studied with any sort of rigor in humans. Ok, there is one study, but it's somewhat fluffy, according to Kristal:
"In 1954 a group of women that had recently given birth were fed disguised freeze dried placenta [the women did not know that they were ingesting placenta]. Apparently, 86% of the subjects showed improved milk production and flow, whereas among control subjects, fed beef treated identically to the placenta, only 33% showed improvement. Further more, the authors classified more than a third of the placenta-improved subjects, but none of the beef-improved subjects, as having an "extremely strong" positive reaction. (Soyková-Pachnerová et. al., 1954. Gyneacologia, 138: 617-627"
Even with this relative lack of human-based studies, there is an extremely vocal and adamant movement towards encouraging placentophagy in humans. This is not all fringe either, it has even been popping up in USA today articles! These people, like my Doula, believe that consuming placenta pills after their birth prevents depression, enhances milk production, and makes them feel better. The personal testimonials are very interesting. Momaroo talks about her first experience with Placenta pills. She says that after the birth of her first children, she had debilitating PPD, but with her most recent pregancy, she has had much better symptoms. She says that even with being sleep deprived she feels cheerful and maternal, which is a complete turn-around from how she felt in the weeks following her first births. Of course these testimonials don't prove much of anything, but I doubt these women are lying about their personal experiences. Perhaps there is some sort of placebo effect that reduces the PPD? There is no way to know without randomized, controlled studies. My question is that with PPD being such a prevalent and horrible condition (almost 25% of women will experience moderate to severe PPD), why isn't this easy and inexpensive solution being taken seriously?
I would love to see continued research done on this. The animal data is encouraging, but this topic is vastly under researched. I have trouble believing that mere yuckiness factors and general prejudice against natural birth practices would prevent science from moving forward on something so important!
You probably have the same incredulous face that I had when I first heard of this idea. Needless to say, I COULDN'T WAIT to blog about this topic. Is this practice weird pseudoscientific crunchy granola hippy crap? Or is it an adaptive evolutionary behavior that has been lost in modern human society to the detriment of women and babies worldwide? The debate is fascinating, please read on.
The most striking piece of evidence in this debate is that almost all mammals immediately consume the placenta and amniotic fluid that is delivered during birth. This behavior is called placentophagy. This behavior is exhibited by rodents, cows, carnivores, horses, primates, apes, etc. etc. There are very few exceptions to this rule (e.g. aquatic mammals do not eat the placenta, and marsupials reabsorb the placenta rather than delivering it, and therefore cannot eat it). This behavior is remarkably evolutionarily conserved. Even our most closely related relatives, the higher non-human primates and apes, universally display placentophagy. In all of recorded anthropological studies, however, there is no mention of humans eating placentas. In modern cultures where what happens to the placenta is known, the placenta is usually burned ceremoniously (or unceremoniously, as the case may be). Or it may be buried to fertilize a tree, and the fruit produced by the tree is eaten. Or a piece may be dried and saved as a talisman. Other cultures, like in china, the placenta is dryed and used in traditional medicines. There is no recorded history of direct placentophagy in humans similar to what is displayed by animals (Ober 1979. Bull. N.Y. Acad. Med. 55;6, p591-599).
The lack of a mention of placentophagy in our most ancient writings isn't neccesarily proof that it did not happen. Birth practices have traditionally been shrouded in mystery. In fact, there is very little recorded history about birth, in general. Interestingly, the most direct references to the fate of the placenta is in strict taboos against eating the placenta. For example, in the bible, Deuteronomy (Chapter 28), there is detailed descriptions of the good things that will happen if the Israelites follow the laws and statutes of God, and the horrible punishments that will befall them if they choose not to do so. Verses 52 to 57 describe how if the people were to disobey God, the men will practice cannibalism and the, "tender and delicate women among you will consume the afterbirth for want of [more appropriate food]" (Ober 1979). The fact that this was considered taboo, indicates to me that there may have been tribes of early pagans that practiced placentophagy and early religions seized on the practice as a way of separating God-following humans from other animals (or to place other humans that did not follow that particular God on the same level as animals). This would not be the only example of a common practice being arbitrarily banned by "God". It seems that God bans things as a convenient way of separating in-groups from out-groups (eating pork, leaving your head uncovered, homosexuality, to name a few). If these speculations are true, it is possible that very early humans did practice placentophagy before the beginning of recorded history and have since lost the practice. I tend to think this is a likely scenario, given our common ancestory with primates, which would lend credence to the evolutionary argument for placentophagy, but this is very difficult to prove.
So regardless of the human question, to which we will return to later, we still have the enigma of almost universal consumption of the placenta by all other mammals. Why would any mammal eat the placenta? There are a few hypotheses to explain placentophagy. [I'm paraphrasing from a review written by Mark B. Kristal in Neuroscience and Behavioral Reviews (Vol. 4, p141- 150, February 1980).] The main explanations are that 1) mammals consume the placenta simply because they are hungry after the exertion of giving birth and need the extra nutrition, 2) the placenta is consumed to remove it from the nest where it might attract predators, and 3) the mother is responding to specific nutritional or hormonal needs that are satisfied by consuming the placenta. The hunger hypothesis is relatively easily disproved by the fact that given a choice between placenta and a variety of other foods shortly before birth and immediatly after, rhesus monkeys will exclusively eat the placenta. Similar behavior is found in rats. The prevention of predation hypothesis is attractive, but is also easily argued against. It still doesn't explain why the mother would eat the placenta. Why not bury it? or move away from the site of the birth? Or, in the case of tree-dwelling monkeys, why not drop the placenta out of the nest to the ground far below? Instead, tree-dwelling monkeys will keep the placenta around for a while and take an hour or two to finish eating it. In addition, mothers that have little risk of predation will also enthusiastically eat the placenta.
This leaves the third hypothesis, that for some reason, the placenta becomes extremely attractive and tasty to the mother immediately before or during birth, likely for evolutionary reasons, in which mothers that ate the placenta produced young that survived better than mothers that shunned the placenta, thus conserving the trait. The reasons that placenta-eating might be evolutionarily adaptive stem from the fact that the placenta contains a variety of hormones, including progesterone, estrogen, and prolactin that have positive effects on the mother and/or babies. Studies show that ingestion of the placenta has a profound effect on the production and presence of these hormones in the blood of the mother. In one study, pregnant rats were either allowed to consume the placenta or the placenta was removed before the mother could consume it. Mothers that were prevented from eating the placenta showed a dramatic increase of progesterone levels on days 6 and 8 following birth. On the other hand, mothers that were allowed to eat the placenta maintained relatively steady levels of progesterone, they also showed an early boost of prolactin production that was absent in the non-placenta eaters (Blank and Frieson 1980. J. Reprod. Fert. 60, p273-278). These results are relevant because the fluctuation of progesterone levels following birth is hypothesized to be a risk factor for the development of PPD in humans. Also, an early boost of prolactin, a lactation hormone, could stimulate more efficient milk production in the placenta-eaters. In another study, when foster rat pups were given to a lactating female they had a much better chance of surviving when the placenta was still attached, presumably due to the beneficial hormonal effects of consuming the placenta in the mother (Deneberg et al. 1963. J. Reprod. Fert. 5, p131-141). More recent work from Kristal's group at the University of Buffalo shows that placentophagy in rats enahnces opioid-mediated pain suppression (DiPirro et al., 2004. Brain Research) and opioid activity in a certain part of the brain, in addition to suppressing pain, also stimulates maternal behavior (Neumann et al. 2009, Brain Research). These data, although limited mostly to rats, indicate that placentophagy can alter hormone levels and prodcution, induce maternal behaviors, increase lactation, and suppress pain. Even with all these beneficial effects, there doesn't seem to be an enormous deficit in maternal behavior if the placenta is removed before eating, indicating that it is not an essential factor in proper rearing of pups. Nevertheless, there do not seem to be negative effects associated with placentophagy.
If you have read up to here, I applaud and thank you! Annnnd you are probably thinking, "OK, now what about all the human studies?" There are none. There are absolutely zero studies where placentophagy has been studied with any sort of rigor in humans. Ok, there is one study, but it's somewhat fluffy, according to Kristal:
"In 1954 a group of women that had recently given birth were fed disguised freeze dried placenta [the women did not know that they were ingesting placenta]. Apparently, 86% of the subjects showed improved milk production and flow, whereas among control subjects, fed beef treated identically to the placenta, only 33% showed improvement. Further more, the authors classified more than a third of the placenta-improved subjects, but none of the beef-improved subjects, as having an "extremely strong" positive reaction. (Soyková-Pachnerová et. al., 1954. Gyneacologia, 138: 617-627"
Even with this relative lack of human-based studies, there is an extremely vocal and adamant movement towards encouraging placentophagy in humans. This is not all fringe either, it has even been popping up in USA today articles! These people, like my Doula, believe that consuming placenta pills after their birth prevents depression, enhances milk production, and makes them feel better. The personal testimonials are very interesting. Momaroo talks about her first experience with Placenta pills. She says that after the birth of her first children, she had debilitating PPD, but with her most recent pregancy, she has had much better symptoms. She says that even with being sleep deprived she feels cheerful and maternal, which is a complete turn-around from how she felt in the weeks following her first births. Of course these testimonials don't prove much of anything, but I doubt these women are lying about their personal experiences. Perhaps there is some sort of placebo effect that reduces the PPD? There is no way to know without randomized, controlled studies. My question is that with PPD being such a prevalent and horrible condition (almost 25% of women will experience moderate to severe PPD), why isn't this easy and inexpensive solution being taken seriously?
I would love to see continued research done on this. The animal data is encouraging, but this topic is vastly under researched. I have trouble believing that mere yuckiness factors and general prejudice against natural birth practices would prevent science from moving forward on something so important!
Sunday, June 19, 2011
Tummy at 3 days before defense date (27 weeks)
Definitely starting to show! I'm starting to get "when is the baby due?" questions from relative strangers. It's about time since it has been 27 weeks now, seems like forever. This marks the beginning of the third trimester and our 1st wedding anniversary :) In addition, and probably most importantly at this stage, I am just 3 days from my defense date (Weds at noon in room 109 of the IBMR, in case you would like to attend), after which I will hopefully become a Ph.D.
I've been enjoying looking a little more indubitably pregnant. I've actually been wearing more form fitting clothing now that I have a legitimate bump to show off. The baby is playing the part too! She is kicking around a lot more vigorously. I'm constantly grabbing Chris's hands to put them on my tummy so he can feel when she starts moving. According to Chris, the baby is pumping her legs to mimic walking. It feels like she's pumping her little arms too and rolling around. It's a very weird feeling, very alien, it's hard to imagine someone living in there. In my imagination, it seems like it must be uncomfortable being all squished and dark and loud and hot... but I'm sure she's quite cozy.
I, on the other hand, have been an emotional, anxious wreck. I've spent most of the last few weeks mostly studying and writing and worrying, having weird dreams about failing my defense/giving birth to squid-like creatures, yelling at Chris about the house being cluttered, and just generally weeping and laying around, when not doing one of the other above mentioned things. I was in CVS the other day picking out Father's day cards for my Dad and for Chris. And for some reason, I was incredibly touched by all of the cards. So there I was with a bunch of sappy hallmark cards in my hands just crying in the card aisle of CVS and trying to get a hold of myself so I could go buy the stupid cards. I must have looked insane, or maybe people understood, like, "how cute, she's pregnant and emotional"... but probably not.
I'm hoping some of this gets better after my defense on Wednesday so that I can finally relax and just work 9-5 and spend the rest of my time eating ice-cream and doing prenatal yoga. Which is really all I want to do at the moment. Just 3 more days of studying and preparing... I think that's about all I can take.
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