Vancouver Birth Lounge

on January 23, 2011 9 Comments

I have been talking about Crafting my Life pretty much non-stop around here. I’m working hard to set the example that self-promotion is OK, because it is. I’m borrowing inspiration from Danielle LaPorte’s fabulous “radiate and state the facts” philosophy. But, that’s not all I’m working on.

I still have a book dream! If you haven’t heard about this, or you’ve forgotten, my big book idea involves collecting stories from first-time parents who welcomed their baby while living in Canada. I’m looking for pregnancy stories, birth stories, adoption stories, breastfeeding (or not breastfeeding) stories and stories about adjusting to life with a newborn. I’m collecting these stories because I believe that stories are important, and because I believe that there are very few books or resources that speak to the Canadian experience.

Putting on my aspiring birthy-baby-author hat, I want to tell you about a local Vancouver event that’s sort of up my alley. It’s BirthFest 2011, presented by the fabulous Birth Lounge collective. The collective got together out of their desire to create a community of care for expectant and new families. There are midwives, childbirth educators, a mama-run cloth diaper shop, mom and baby fitness instructors and more. All the kinds of people who make my hippie mama soul sing.

Their website says:

We’ve all heard that “it takes a village to raise a child,” but how many of us know what our village really has to offer? Local families are invited to discover their village with the wonderful support offered by members of Vancouver’s Birth Lounge.

See? My people, creating a village.

I’ll be dropping by this free community festival, and if you’re local, you might want to check it out, too. Here are the details:

When: Saturday, February 26, 2011 from 11am – 4pm
Where: Britannia Community Centre, Gym D
What: Shopping and services from over 50 vendors and organizations

To community, and babies!

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Blue Fleece Blanket

on January 4, 2011 18 Comments

It’s cold out right now, especially by Vancouver standards. So tonight, I added a blue fleece blanket to Hannah’s bed. It’s dark blue – almost navy, but not quite. It was a wedding gift from Jon’s aunt, as I recall. Or maybe a bridal shower gift. It came in a hat box with purple flowers all over it. I still have the hat box – and the blanket. As I smoothed the blanket out on Hannah’s bed, I remembered a day very much like this, almost six years ago.

It was cold and clear. There was no snow on the ground, but it was icy and frosty and you had to walk carefully, especially if you were 7 1/2 months pregnant, which I was. On that day, which happened to be a Saturday, I woke up in the very early morning because my water broke. I thought I must be mistaken, though, because my due date was still six weeks away. It was too soon. But I couldn’t sleep, so I went downstairs to lie on the couch and watch TV. The furnace hadn’t turned on yet, because it was so early, so I wrapped the blue fleece blanket around myself.

I couldn’t rest, because I had to run upstairs every 20 minutes or so, as my amniotic fluid leaked out in gushes. Abandoned on the couch, the blanket waited, and I returned to it again and again, until I couldn’t ignore the signals anymore. I made the call, and then woke my husband and hastily packed a grocery bag with a few things. But not the things I actually needed, of course. I grabbed some towels, and wrapped myself (still wearing pajamas) in the blue fleece blanket for the ride to the hospital. I waddled into the emergency room with that blanket, as Jon parked the car.

The blanket was discarded someplace upon my arrival in the maternity ward. I don’t remember what happened to it next. I only remember, afterward, washing it. It looked clean, but I knew it had amniotic fluid on it, and it smelled of hospital. I hate that smell, and I had to get it out.

Later on, I discovered that an infection in that same amniotic fluid had triggered my early labour, and resulted in my daughter’s prematurity. The pathology report from my (or, I suppose, Hannah’s) placenta showed that. This blanket bore the signs of that. It probably harboured the very bacteria that my uterus had, at least for a time, splashed as it was with my uterine contents. But now, it is just another blanket.

I remember Hannah’s second year, when she would wake up at 6:00am and refuse to go back to sleep. I parked her on one end of the couch, with my feet on top of her so that she couldn’t wander off without my knowledge, and turned on Treehouse. Then I propped up my head on a cushion and wrapped the blue fleece blanket around myself and tried to sleep. I usually could, at least a little. Sleep deprivation does that, it lets you sleep in places and positions that you normally wouldn’t consider restful.

Today, the blanket is much more innocuous. It is not the spectator at a premature birth, or even a premature waking. It is just a way to keep warm. Really, I suppose that’s all it ever was. A way to keep warm, at a moment when I needed that. But now I will never be able to look at it that way. It is the Blue Fleece Blanket in my mind, and it always will be. Just as the lamp I made the night before Hannah was born is now Hannah’s lamp, and the bean salad that I ate and marveled at after Jacob’s birth will always be Jacob’s bean salad. Sometimes, life stamps an object, and changes it forever. Even if you’re the only one who can see it.

What objects are forever associated with momentous occasions in your mind? Can you ever use them without thinking of that occasion? I’d love to hear!

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Born Too Soon

on November 17, 2010 16 Comments

1 in 8 babies is born prematurely. That’s not a small number. And, what’s more, it’s on the rise. According to March of Dimes, preterm birth has risen 30% since 1981. We know some of the causes – like a greater number of multiple births as a result of fertility treatments. But in half the cases, we don’t know why a baby was born prematurely.

One of my babies was born too soon. My daughter Hannah arrived at 34 weeks exactly. I had a healthy pregnancy up until that point. There were no warning signs or indications. Looking back, I can see that I was in early labour the day before, but by that point it likely wouldn’t have made a difference if I’d recognized what was happening. As it was, it all became very clear when my water broke at 4:50am on the day that would be Hannah’s birthday, less than 24 hours after early labour started.

At first, I thought I must have lost bladder control. I wanted to believe I’d lost bladder control. I certainly didn’t want to be having a baby a full month and a half early. But a person can only run upstairs to ‘pee’ so many times in an hour before it becomes clear that it isn’t pee at all.

Hannah was born less than 12 hours later, in a largely uncomplicated birth. She was a healthy 5lbs, 4oz, and she was pink and crying as she came out. Her Apgar scores were 8 and 8. While she struggled with breastfeeding, she fed well from a bottle and breathed well and was very healthy, aside from a little bit of jaundice. She only spent 6 days in the NICU, which is really very short. She did remarkably well for a baby of her gestational age.

Day 3 in Nursary
Visiting 3-day-old Hannah in the NICU

And yet, Hannah’s early start scarred me. They whisked my baby away from me within minutes of her birth. Even during our short NICU stay, we dealt with many, many different doctors and nurses, all of whom seemed to have different opinions and approaches. I suffered my own post-birth complications, and so I wasn’t able to make the trip down to see Hannah more than once or twice a day, for 20 minutes or so at a time. That separation is not something I would have chosen, and it’s something that I still carry with me today. And when I compare Hannah’s beginning to Jacob’s, who was born a couple of days before his due date, I see how much the separation impacted my induction into motherhood.

While I would never wish a preterm birth on anyone, we were very fortunate. They discovered the cause of Hannah’s prematurity when they examined her placenta later – an amniotic fluid infection. The antibiotics they administered in labour protected her and preserved her health. And because it was a random occurrence, I am not likely to have another preterm birth. I certainly didn’t with Jacob. And Hannah was a big, healthy baby. She faced very few struggles, and her risk of future health problems related to prematurity is low.

Other people aren’t so fortunate. Many babies are born much, much sooner than Hannah. Many parents face months in the NICU, and many babies face long-term health difficulties related to their early arrival. And much of the time, no cause is found. But we can change that.

November is March of Dimes’ Prematurity Awareness Month. You can get involved, and help March of Dimes in their fight to find answers to the issue of premature birth. Because I can tell you that no one, no one, wants to see their baby in a NICU isolette, if it can be avoided. As happy I am with advancements in science that help premature infants to survive, the best solution is to address the factors leading to premature birth, and keep babies on the inside until they’re ready to be born.

Have you been touched by premature birth, or has someone you know? If so, please share your story, I’d love to hear it.

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I Love my Socialized Medicine

on November 9, 2010 29 Comments

I live in Canada. Canada has socialized medicine. This is something that I take for granted, because I have always lived here. I have never paid a dime to visit the doctor or the hospital. Which doesn’t mean the experience is always rosy, and that every medical professional I’ve ever encountered was made of sunshine and rainbows. But it does mean that when I make decisions about health care for myself or my children, cost is not a factor that enters into the discussion.

When I decided to have my kids, money was a factor. Babies are expensive, we all know that. They don’t have to be as expensive as some experts say, but you do need to feed them and clothe them. And you need to ensure that they are adequately cared for if you work, or take the financial hit if you decide to leave work. But I didn’t have to consider how I would pay for the birth that I wanted. Or any birth at all.

Recently, I read posts from two American friends that gave me pause. Lauren, who lives in Seattle, weighed her health insurance options as a self-employed person hoping to have a second child. And Gina, pregnant with her third child, discovered that in spite of her research up front, she is likely going to have to pay thousands of dollars to cover her midwife. Even though I love numbers, and love to make financial spreadsheets of my own, their stories left me reeling. I have no idea what I would do in their shoes.

I am not American, so I don’t get a vote on the US health care system. But of course, I have my opinions. I don’t think that anyone should have to choose the kind of care they receive based on finances. I realize that I am a bleeding-heart Canadian liberal, but I honestly believe that health care is a basic human right. I live in a very wealthy country. It would strike me as a great poverty if we did not offer the best start we could to babies, by ensuring their mothers had access to adequate care during pregnancy and birth.

I chose midwifery care for both of my pregnancies, and I chose to give birth in the hospital both times. This was completely covered by our health care system, in the same way it would have been if I’d opted to give birth at home with midwives, or in the hospital with a family doctor or an obstetrician. My choice of care provider was my own, because my finances did not dictate it. When I had to have surgery following my first birth, and I spent 4 days in the hospital recovering, there was no question that we would do it. I needed the care, and it was covered.

I realize that I pay for medical care, both through the tax system and through medical premiums (which are about $60 per month for our family). But I have never seen a bill. And no cost is ever attached to medical care. In the moment, I don’t think about money when I decide whether or not to seek medical care. I am paying for it only indirectly, and I am paying for it whether I take my injured child to the emergency room or not.

I don’t know what the answer is for my American friends. As I said earlier, I am not American, and I don’t get a vote. I realize that there may be significant upsides to the US system that I’m failing to recognize. But as it stands, I am extremely grateful that I live where I do, and have access to public health care. With all its flaws, I wouldn’t trade it.

Have finances ever played a role in your decision to seek health care? If so, do you think that’s reasonable or unreasonable? And if they haven’t, what do you think when you hear about people having to pay hundreds or thousands of dollars to have a baby? I’d like to hear your thoughts.

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Supporting Other People’s Choices

on September 21, 2010 37 Comments

I am a crunchy granola kind of mom. I’ve had two unmedicated childbirths. I breastfeed. I babywear. I co-sleep. I cloth diaper. I do lots of the things that crunchy granola moms do. I even make my own crunchy granola from scratch occasionally. Mmm, granola.

In the natural parenting community, we talk a lot about supporting women’s choices. We want to make sure that if women want to pursue home birth or VBAC, they have the option to do so. We want to make sure that when women are struggling to breastfeed, they are able to find the resources to help them through. We want to make sure that there are midwives and doulas and lactation consultants and great doctors and nurses on hand to lend their support as needed.

When we talk about supporting choices, I think there is often an underlying, unspoken assumption. The assumption is that, all things being equal, most people would make the same sort of choices that we would. That they would sign up for unmedicated birth, and exclusive breastfeeding, and midwifery care, and all that jazz.

Of course, we know that not everyone will be able to have a ‘natural’ birth or exclusively breastfeed. Sometimes, for safety’s sake, we need to use a lot of medical technology. Other times, physiological or other issues get in the way and make it impossible to meet our stated goals. In those cases, I think it’s clear that we need to offer our compassion and respond gently.

Other times, plans don’t work out because people interfere with nature. Hospitals refuse to allow VBACs, or people give incorrect breastfeeding information. These situations are very real. They are the reason that groups like the International Cesarean Awareness Network and La Leche League exist. Mothers who are struggling deserve to find the help they need.

But there is a whole other side to this story. There are fully-informed women who completely reject natural childbirth. Women like Canadian author Rebecca Eckler, who famously chose to have her daughter via scheduled C-section, even though there was no medical indication. And there are mothers who have no interest in breastfeeding. They are making their own choices, based on their own situations, and they are quite happy with them.

This isn’t only about birth and breastfeeding, either. You could easily substitute something that matters more to you – choosing to vaccinate or not, homeschooling or not, working or staying home, discipline methods, what you feed your children. Every little decision we make as parents has been scrutinized at some point, and lines have been drawn by someone. We just love to judge mothers, no matter what they’re doing.

What I’ve been thinking about lately is where we draw lines when it comes to supporting other people’s choices. For instance, I call myself a lactivist, because I strive to support women as best I can to have the breastfeeding experiences they desire. Sometimes, in spite of everything, they don’t. When that happens, I remember that we are all just doing our best as parents, and that is the most important thing. Many things matter more than what you feed your baby. And so I support mothers who struggled and didn’t have the outcome they wanted, just as I support mothers who are attacked for breastfeeding in public.

But can I support someone who discounts breastfeeding altogether? Or someone who says that I’m irresponsible for choosing midwifery care? Can I say that all choices are equivalent, and we should be entitled to make them?

In general, I believe that women’s choices should be honoured, and their preferences should be given weight, especially in the journey to parenthood. After all, we are the ones who carry the memories with us forever. We are the ones who are shaped and changed through our experiences of becoming mothers. And so our values and preferences should carry more weight than, say, the preferences of a doctor. Or the preferences of your sister-in-law the hippie.

Given that, I have to acknowledge that someone may make a totally different choice than I would, even with the same information. I do think that there are lines to be drawn – clearly, we shouldn’t act in ways that recklessly endanger people, or that contravene our personal or professional ethics. But when everybody is playing safe and behaving ethically, we have to say that they have the freedom to make their own choices. Although we don’t have to agree with those choices.

We don’t have to defend a choice that we disagree with. We can call the actions of corporations, governments, and public health organizations into question. We can question our own health care providers and their motivations. We can advocate for people whose choices are denied, share information with those who ask for it, and offer our experiences and opinions when they are solicited. But none of us has the right to cast stones at people who are doing the best they can. And none of us has the right to deny other people’s stories, or discount their experiences, just because they don’t align with our worldview.

It’s not always easy, but the truth is that judging other parents serves no one.

How do you respond when you encounter someone with a radically different parenting style? How do you share your views and experiences, while still valuing those of others? I’d love to hear your thoughts.

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Share Your Story, Feed My Dream

on August 11, 2010 27 Comments

I have been sharing my dream of writing a book with you all here. In case you haven’t been following along, here is a summary of my book idea:

  • Talk to parents with diverse backgrounds and experiences from all across Canada.
  • Collect their stories surrounding the time that they welcomed their first child.
  • Talk about things like pregnancy, childbirth, hospitals, doctors, midwives, doulas, baby care, living with a newborn, breastfeeding, crying, maternity leave, grandparents …
  • Compile the stories into some kind of order, and include some stories of my own, as well as some information about pregnancy, birth and babies in Canada.
  • Create a book that feels like sitting around a kitchen table and sharing stories.

I want the book to have a Canadian focus, because there are so few books that do. My vision is that it would let other parents hear first-hand accounts of what this time is really like, from people who have walked the path before. It would also let us know that we’re not alone, that so many of us have wrestled with the same issues. And it would provide some illumination into what we’re doing well and what we’re doing not so well as we try to support parents through a big life change.

I feel pretty passionate about this idea. But I can’t do it alone. That’s where you come in. Would you be willing to share your story with me? If you welcomed your first child while you were living in Canada, I’d love to hear from you. I’m looking for adoptive parents as well as birth parents, and parents of multiples as well as parents of singletons. And I hope to hear from people from all different backgrounds. It doesn’t matter how old that first baby is now, as long as you can share your story accurately.

If you want to take part, and you’re willing to let me publish your story, visit my ‘Share Your Story‘ page and fill out the form. It will magically populate my spreadsheet, and I will be in touch with you to talk about your story further. Don’t be discouraged if it takes me a while – I expect this to be a long process.

I have to admit – I’m feeling pretty nervous posting this. It feels like a big step down the path of I’m actually doing this. There’s a big possibility that this won’t work out at all. But here’s what I know for sure – it definitely won’t work out if I retreat to my bed and eat ice cream all day, which I kind of feel like doing right now. So I’m going to ignore the fears and take a leap of faith. I think it might just pay off.

Jump 3
Leaping! – credit to Stephanie Wallace Photography on Flickr

Edited: I understand there was a problem with the form earlier, but it should be working now, as of 8:45am Pacific / 11:45 Eastern.

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On Becoming an Aunt

on July 14, 2010 32 Comments

When I had my babies I felt that I had earned all the congratulations that came my way. Through the long slog of pregnancy, through the difficulty of labour and through the sleepless nights, I invested my sweat equity. I was overjoyed when my children arrived, of course, but I worked for that joy. And I continue working for that joy. That’s the bargain that we make when we become parents.

Three days ago I became an aunt for the very first time. My younger sister Gretchen and her husband Aidan welcomed their son Tyson. He is adorable, and like most new babies he looks just like his father. The labour was a little rough, but in the end Tyson is perfect and worth every bit of it. Gretchen is so happy, and she deserves all of the congratulations and good wishes coming her way.

My sister, the radiant new mama
My sister, the radiant new mama, and baby Tyson

What has surprised me, though, is how many congratulations I’m receiving as the new auntie. I have done nothing, and I mean nothing, to earn them. Jumping when the phone rings and stalking email is hardly a trial. I made a few baby things, yes, but I have done the same thing when friends had babies and no one congratulated me for that. I am excited and happy to share the joy, of course. And I’m soaking up the congratulations whether I’ve earned them or not.

Baby boy
Baby Tyson

This is what I imagine being a grandparent must feel like. You get all of the well wishes and none of the work. You can visit once in a while and then hand the kid off when you’re ready to go home. Sweet! If I’d known how great this aunt gig was, I would have done it first. Or at least I would have spent a bunch of time nagging our various siblings to procreate, because this gig is plush.

So, help a newbie aunt out. What are your tips for living up to my new role in young Tyson’s life? How far is too far in totally ignoring his parents’ wishes and buying him all manner of contraband? Where do you draw the line in teaching rude songs and jokes? Please pass along your aunt-ly or uncle-y wisdom!

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I Can’t Believe I’m Talking about Epidurals

on May 28, 2010 56 Comments

I am hesitant to write about epidurals. Because, honestly, I don’t want to armchair quarterback anyone’s birth, or leave anyone feeling like I am looking down on them. So I want to be clear that I am not here to judge you, or your birth, or your birth attendant, or your hospital. I am not the birth judge. I am the parenting judge.

(Just kidding! I’m not the parenting judge, either. Except for myself, and I often come up lacking.)

I didn’t use epidural anesthesia in either of my births. In fairness, my births were really short. With Hannah, I was in active labour for about 4 hours, and with Jacob it was more like 2.5 hours. I am defining ‘active labour’ as being unable to sit still or talk during contractions, and feeling the need to engage in measures like vocalizing, swaying and so on. My birth records state that Hannah’s labour was 1.5 hours and Jacob’s was 45 minutes, based on confirmed dilation. Either way you slice it, there may be people out there who spent days in labour who would kind of like to draw a mustache on my photo. Feel free, but keep in mind that I am not responsible for resulting damage to your monitor.

Given my own birth experiences, I was very interested to learn that here in British Columbia, we have one of the lowest epidural rates in Canada for vaginal births. Approximately 30% of BC women had epidurals in BC, compared to 69% in Quebec, 60% in Ontario, 50% in Alberta and 39% in Manitoba. I actually thought this might be a good thing – perhaps it indicates that we are doing a better job of supporting women through labour and honouring their wishes.

On Twitter, Chad Skelton linked to an article in the Vancouver Sun with the headline “Women who want epidurals not getting them in B.C.: report”. You can read some of Chad’s thoughts on his blog. My summary of the article is that the British Columbia Anesthesiologists’ Society believes the disparity in epidural use is related not to women’s choices, but to a shortage of anesthesiologists. While the article states that we don’t know why epidural rates are lower here in my home province, it conjectures that 11,000 women are being denied pain relief based on the difference between BC rates and the national average.

Let me be clear. If women are asking for epidurals and being denied them, or being made to wait 4 hours, that is a problem. I am not here to say that epidurals, or the mothers who use them, are bad. However, I took issue with this article on several fronts. The anesthesiologists may be somewhat biased in their call for more anesthesiologists, for one thing. For another, there are no actual, concrete examples of women being denied epidurals. And finally, I felt the article did a fair bit of fear-mongering. For example, here is a quote from Dr. Roland Orfaly, executive director of the Anesthesiologists’ Society:

If you have an anesthesiologist dealing with a life-and-death surgery and the women needs an emergency C-section to save the baby and just by chance the surgery finishes as the C-section is needed you have a near miss…An hour earlier and the baby could have died.

We need to do everything we can to protect the health of mothers and babies. But I would prefer to hear about actual birth outcomes, rather than stories of what could have happened. We hear a lot of scary stories about birth in our culture. It’s true that birth can be scary. But it can also be miraculous and empowering. Many women, like me, find labour manageable with good support. So I take issue with articles like this one that paint birth as horrible, and suggest that women are being left to suffer in agony, without unbiased information to support that claim.

I had a back and forth with Chad about this, and we both came to the conclusion that more information is needed. But I think we still stand in different positions on birth. Chad took the pro-pain relief stance, stating that “[he] had a front-row seat and [he's] pretty sure [labour] hurt — a lot”. And I took the stance that supporting women to have the birth they want is the most important thing, and that lower epidural rates are not necessarily a problem.

Some research bears me out. In a review of 137 factors that affect women’s satisfaction with childbirth, 4 stood out: personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship and involvement in decision making. These factors overrode age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions and continuity of care. This comes from women evaluating their own childbirth experiences. So, epidural use alone does not indicate how most women feel about birth.

We know that women who have midwifery care, and women who use doulas, have lower epidural rates, as well as fewer C-sections and shorter labours. In my own high-risk labour with Hannah, having a midwife made a huge difference for me. She was an amazing advocate with the doctors and nurses, she helped me get into positions that I found comfortable and she helped me to avoid being strapped down to the bed with monitors. If I hadn’t had her, I don’t believe that I would have coped as well as I did. We had a good relationship, she provided me with quality support, she kept me informed and she listened to me. Like the study suggested, these things made all the difference for me. I feel very satisfied with my experience, overall, and I would wish the same thing for other women.

My position is not that women should not use epidurals, or that women should avoid all interventions. Epidurals, C-sections and induction all have their place. My position, rather, is that women deserve support through their birth experience, from people that they trust, who honour their wishes. And so, instead of saying that we should increase epidural rates in BC, I think instead that we should talk to mothers and hear their experiences. We should track outcomes for mothers and babies. Then we should act on that information, to help make birth better, and safer, for everyone.

What do you think makes for a positive birth experience? How important is epidural availability to you in birth? And can you believe I’m talking about epidurals, either?

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Scare Tactics

on May 19, 2010 41 Comments

The other day I was talking with some folks on Twitter about childbirth and breastfeeding horror stories. If you’ve ever been pregnant, you know the ones I’m talking about. They lay the fear on thick, and use words like ‘agony’, ‘devastated’ and ‘nightmare’. And they are just as likely to come from a random stranger as your best friend.

In general, I don’t see much value in sharing horror stories. Once you’re 7 months along with your planned pregnancy, you’re not about to change your mind. One way or another, that baby is coming out. And then you are going to have to feed that child, whether at your breast or not. Living in fear of the outcome isn’t going to change it for the better.

Smiling between contractions
Me, about 30 minutes before Jacob was born, not experiencing significant horror

Some of the people on Twitter disagreed with me, though. They said that negative stories can prepare women. Forewarned is forearmed, after all. If you are prepared for pain in breastfeeding or complications in labour, perhaps you will handle them better. You will know that you are not alone, and that you are not somehow abnormal. I see value in this perspective. If I had a very negative experience with a health care provider, I might share that with someone who was considering seeing the provider. Or if I knew that my friend wanted a natural birth, I might share the tale of how my own wishes for a natural birth weren’t honoured at a particular hospital.

Thinking about sharing horror stories got me thinking about my own birth experiences. I was actually not all that afraid of labour when I was pregnant the first time around. And, in general, I think that helped me out. Granted, I had a pretty short and smooth labour at around 4 hours or so, but I also gave birth to a preterm infant, hemorrhaged severely and required surgery and a blood transfusion. I think that excessive fear would have only made it worse, and wouldn’t have made the severe anemia somehow better. Being armed with someone else’s story of severe blood loss wouldn’t have changed anything for me.

Day 1 - Mom is doing better
Me, less than 24 hours after Hannah’s ‘horror story’ birth, doing OK

Thinking about it, I believe there’s a difference between sharing a horror story that scares someone out of her pants, and useful information that you can use to avoid problems. First of all, it depends on whether the input is wanted. If someone asks for your story, or you ask permission to share it, then you know that the person is interested. Second, you have to ask whether knowing your story would actually be helpful. If you experienced a strange fluke that could never be foreseen, telling random pregnant ladies about it probably isn’t going to accomplish much. I would say that my amniotic fluid infection, for instance, falls under the heading of ‘scary but not helpful’. My negative experience with my family doctor, on the other hand, might be useful to a friend.

When bad things happen, it’s natural to want to share your story. I have found sharing my own stories immensely helpful to me. All the same, it’s a good idea to use our judgment about who we share with, and in what context. Telling pregnant ladies that their lives are about to end and they are in for the worst pain imaginable accomplishes nothing. And it might not even be true, for them. Commiserating with others is cool, but I say that needlessly scaring isn’t so cool.

So, what do you think? Do you believe that cautionary tales are useful, or do you think that it’s best to keep your mouth shut about your 36 hours of labour within earshot of someone who is 8 months along? Please share!

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Making Hospital Birth Better

on February 16, 2010 35 Comments

Last week I watched Pregnant in America. It was a good film, with a very similar message to The Business of Being Born. My brief summary would be that, often, decisions for labouring women are made because of expediency or the fear of litigation, without taking the mother’s desires into account. Statistics like the rising cesarean rate seem to indicate that birth is highly-medicalized in many cases, although I am in no position to speak authoritatively on this subject.

Watching movies like this, and reading natural birth articles and blogs, homebirth is often promoted as the remedy to problems that can occur in a hospital. Many of my friends have chosen homebirth, and were very happy with it. I think it can be a great option, and I believe that it is as safe as hospital birth when experienced help is on hand and medical care is nearby. I am glad to see homebirth advocates fighting for birthing women, and ensuring that they have a choice of care providers and birthing environment.

While I believe in natural* birth, I know that homebirth is not an option for everyone. My first child was born at 34 weeks, and so the only responsible choice was to head to the hospital. Approximately 1 in 8 babies are born prematurely in the US each year, which is not a small number. And while most health authorities agree that the cesarean rate is too high, even if we reduced it by half, more than 1 in 10 women would have a surgical delivery. Homebirth is not the first choice for most folks when things go well, either. It could just be personal comfort level, it could be that homebirth is illegal in their area, or it could be that medical insurance won’t cover it. Even finding a homebirth provider can be a challenge, as demand for midwives frequently exceeds their availability. One way or the other, people are going to end up giving birth in the hospital

Watching Pregnant in America I wondered, once birth becomes a medical event, is it possible to retain its humanity? No matter what the circumstances are, no matter how many machines are in the room or how many masked and gloved surgeons are on hand, this is still about a family welcoming a new member. You will remember the events that unfold and the things that people say for the rest of your life. When things don’t go well, when you’re vulnerable and scared, that is all the more true. I will never forget the nurse who chastised me for being in labour at 34 weeks. I’m sure that she didn’t mean harm, but her offhand remark stuck in my head, and the message that I was at fault is something I still carry with me.

As it turns out, I gave birth prematurely because I had an acute infection. Another consequence of that infection was that I hemorrhaged severely following my daughter’s birth. Had I given birth in 1805 instead of 2005, I would not have survived the experience. The combination of antibiotics, synthetic oxytocin administered after I gave birth to stop my bleeding, and a blood transfusion likely saved my life. Modern medical care certainly has its place in childbirth. But so do compassion and gentleness. A kind word, instead of an unkind one, will not compromise someone’s care, but it can make all the difference.

I fear that there is polarization in the way that we approach birth today. There are people who advocate for natural birth and reduced interventions, which are great things. But they are often at a loss in terms of how to address a situation once it has already been medicalized, particularly if that medicalization is necessary. Then there are people who want all the bells and whistles and pain medication and machines that go ping. Their message is about protecting the health of babies, which is also incredibly important, but it doesn’t always acknowledge the emotional and psychological dimension of birth. I wish that there were a larger middle ground between these polarities, because I suspect that’s where most mothers actually fall.

I don’t have good answers, and I wish I did. I do think that as progress is made and women make their desires known change can happen. I hope that it does, and that it happens in such a way that all birth options are protected, and all mothers are treated respectfully and thoughtfully in childbirth, no matter how or where they birth.

*I don’t particularly like the term ‘natural birth’ because it is ambiguous and somewhat loaded, but it was the best I could come up with, without heading off on a major tangent.

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