Thursday, November 27, 2008

The Supine Position for Birth

As I wrote about in "The History of Childbirth in America" post, birth, before it moved into the hospitals with doctors, usually took place in a vertical position. When doctors entered the picture, they presented a "quicker" way to have a baby -- something the midwives weren't offering -- the use of forceps. In order for a doctor to use the forceps, the woman had to lay flat on her back with her feet in stirrups. An episiotomy, a surgical cut to the vagina to make it larger, was performed in order to allow room for the forceps. If you have never seen forceps, they are giant "blades," inserted one at a time on each side of the baby's head. Babies often will have injuries or permanent scars from their use.

A woman needed forceps because she was drugged, often completely unconscious, and couldn't push her baby out. She was "delivered" by a doctor. This is where that term came from and still seems to be the word of choice today for giving birth to a baby. In every movie, sitcom, or TV drama, this is the position we see the mother laboring and giving birth.

When the uterus contracts, it tips forward. If a woman is laboring at home or has the freedom to move around, she will lean forward naturally during contractions, following what her body is telling her to do. She will move around, rocking her hips. She will squat. She'll spend time on her hands and knees. She will rest, laying on her side, not her back. She will have a natural desire to be in water, a warm tub or shower. All of these things are wonderful for her and for her baby.

If you choose to labor in a hospital, they will prefer you to stay in bed, on a monitor, not moving, so as to not make them have to readjust it every few minutes. This is painful for mom and does not help baby out. This is where most women request an epidural.

Stay out of that bed! Use gravity. It is good for your labor and you will dilate faster.

If a woman is listening to her body, not a doctor, the last thing she will hear is to lay flat on her back! This causes unnecessary pain! The supine position, or laying flat on your back, is a position that is convenient only for a doctor. This is where it is so interesting to know the history of childbirth and why we are affected by certain practices today. It reminds me of the story of the woman who always cut the ends off her ham before placing it in the roaster pan. She didn't know why she was doing it, but her mom always did it, so she thought that's just what you are supposed to do when cooking a ham. Later she found out that her mom did that because her pan was too small to fit the entire ham. We get so used to the way things are done, we forget to question why we started doing them in the first place, and certainly why we continue doing them.

You need to ask your doctor, or midwife, how they feel about you giving birth (not "delivering") in the position of your choice. Your answer should be along the lines, "This is your birth. Follow your body and do what you need to do." If the answer you get sounds more like, "Well, it's pretty hard for me to see what's going on down there if you are squatting on the floor!" you need to switch your birth attendant. Your birth is not about your doctor or midwife. It's about you, being in control, and giving birth in whatever position you need to. There are plenty of midwives who will support you and encourage you to follow your instincts.

I read an interesting fact recently about birth satisfaction. It said that women, whether they had pain medication or not, had a more satisfying birth experience if they were in control -- having choices and helping to make decisions about their birth. Taking a childbirth class played a huge role too, as then they were informed and felt capable in making decisions for themselves and their baby.

I also wanted to share another funny quote I recently read. It was in a book titled simply, "Childbirth Education," commenting on how an anthropologist from another country might view childbirth in the United States:

"During labor, the Vestal Virgins assume their positions around the woman, leading her in a variety of magical incantations with rhythmic breathing to blow off the magic spirits of pain. Finally when the time of delivery is near, the Vestal Virgins position the woman in one of the most torturous of the culture's institutions, a special apparatus used only at the time of birth. In it the woman is made to lie flat on her back with her legs and feet raised at a 90-degree angle and bent at the knee. It is thought that if a woman is able to deliver her baby in this almost impossible position, she will have passed the first initiation rites of motherhood."

A silly way of approaching a tradition of giving birth that really must be done away with, especially for women who have no drugs. The majority of my students do not have drugs, but are expected to give birth in this ridiculous position. If a woman is given a choice of birthing positions, she will most likely choose a position that allows her to use gravity.

Monday, November 24, 2008

Products I Love


I recently ordered a homebirth piece of jewelry -- a necklace. It has the birthstone for each of my homebirth babies dangling from it. I love it. The woman making the jewelry is a homebirth mom of 2. Check out her website: www.moonovermaize.com She has other jewelry too, including pregnancy, fertility, and nursing necklaces. She even makes a "Remembrance Necklace" to remember a little one you might have lost.

I got my necklace super fast and am enjoying wearing it, being part of the "1% Club" -- women who give birth at home.



Another product I think is great and all nursing mothers should have is a nursing bra/tank. It will give a breastfeeding mom confidence to breastfeed in public without that silly blanket. (I could never get used to that thing and my babies hated it.) Check out Glamourmom to see their selection of colors. It is an easy site to get around and lots of colors and prints to choose from. You can wear the tank under any of your shirts, or even alone. No skin will be exposed to those passing by. You and your baby will be super comfortable and confident, no matter where you are breastfeeding.

If you decide to purchase, I ask that you use my code, DORY47. For every 3 shirts purchased, I get a free tank/bra. My breastfeeding days, after more than 7 years, are over. I give the tanks to students as prizes for various games, eating great protein in a given week, etc. Thanks for your help in making the day of a pregnant mom!

And yes, this woman does look familiar, doesn't she? It's Myra from "The Business of Being Born" with her sweet little baby. Her birth was so inspiring and wonderful.

Friday, November 21, 2008

The History of Childbirth in America

I love history. Especially American history. It was the only textbook I read from cover to cover in college. The history of childbirth in America tells so much about why we are at the place we are at. It is so fascinating and infuriating. I hope you enjoy it as much as I enjoy telling it.

Before 1900, less than 5% of births took place in the hospital. Birth took place at home. Birth was a social event with other women present to help the laboring mother. Nearly all births were attended by midwives. They focused on the whole person, not just the birth canal. Birth usually took place in a vertical position. This always surprises people.

Birth was perceived, especially by men, as superstitious and magical. As more men began training to become doctors, their courses in childbirth were minimal. They were scared off by the rituals surrounding birth and many felt it was beneath them to attend births. Midwives only called in a doctor when a cesarean was needed to save the life of the baby after the mother had died, or was going to die.

As these doctors began looking for work, they found that they could play upon the fear that women had of childbirth by convincing them that they could improve upon the natural process. They convinced women that they could possibly prevent childbirth from going wrong, and shorten the birthing process. And they had a tool that the midwives didn't have: forceps. Forceps were originally used to remove stillborn babies from their mother's bodies, but it eventually became standard practice for nearly all doctors as a tool to shorten the birthing process. With a forceps delivery, a woman had to lay on her back with her legs in stirrups. An episiotomy, a surgical enlargement of the vagina, was necessary to make room for the forceps. The majority of American women still give birth in this position, even if there is no episiotomy performed or use of forceps for the delivery.

Midwifery became a lost art form. Doctors demanded the midwives be licensed, which became synonymous with competence. She had to prove her skills to a state licensing board, which was controlled by the medical profession. Midwives today, even thanks to the release of The Business of Being Born, are gaining popularity again. Even as this happens, the American College of Obstetricians and Gynecologists (ACOG) has gotten the American Medical Association (AMA) on their side in opposing homebirth. History repeating itself in the defamation of midwifery.

And so it became "fashionable" to be delivered by a doctor in a hospital. If a midwife attended your birth, it was only because you were too poor to afford to go to the hospital. (Both my parents were born at home -- 1940 & 1942 -- for this exact reason!) I read an excerpt from a 1926 magazine convincing women that the hospital is better:
"But is the hospital necessary at all?" demanded a young woman of her obstetrician friend. "Why not bring the baby at home?" "What would you do if your automobile broke down on a country road?" the doctor countered with another question. "Try and fix it," said the modern chauffeuse. "And if you couldn't?" "Have it hauled to the nearest garage." "Exactly. Where the trained mechanics and their necessary tools are," agreed the doctor. "It's the same with the hospital. I can do my best work -- and the best we must have in medicine all the time -- not in some cramped little apartment or private home, but where I have the proper facilities and trained helpers. If anything goes wrong I have all known aids to meet your emergency."
Who could argue with that? This was very much the thinking of the day.

By 1936, 75% of all American births took place in the hospital. By the 1950's, only 1% of babies were born at home. That is still the percentage of births that take place out of the hospital today, be it at a birthing center or at home.

We cannot forget the introduction of drugs in childbirth. In all fairness to the doctors, a lot of them tried explaining to the women that the drugs were too dangerous. The women didn't care. They didn't want to feel labor or birth. Sound familiar? So strong was this fear, women overcame their modesty in order to have a doctor "deliver" them and use the drugs he could offer her in childbirth.

In the 1920's, Twilight Sleep became popular. It was a combination of 3 different drugs -- morphine to dull the labor pain, amnesiac scopolamine which caused her to forget the experience, and a whiff of chloroform or ether to put her out as the baby came through the birth canal. Women behaved like "deranged animals" and were tied to their beds. They were flat on their back, in terrible pain, and could do nothing to help themselves. When they awoke, they didn't remember any of it.

By the 1950's, women had lost all confidence in their bodies to give birth without intervention and a doctor. They began to look for "expert" advice on how to parent their baby. Breastfeeding numbers plummeted.

In the 1960's, a handful of women started to question the process. Childbirth classes started popping up. It was an era of change. Midwives, like Ina Mae Gaskin, appeared on the scene again, after being pushed out by male doctors for so many years.

The 1970's, thanks to Dr. Robert Bradley, saw husbands "allowed" into the delivery room for the first time. They weren't sure what to do with them, so they gave them the job of cutting the cord. It was something to make him feel important and he couldn't screw it up!

In the late 1970's and early 1980's, we saw the introduction of the Electronic Fetal Monitor (EFM). Shortly afterwards, we saw the c-section rate jump from 6% to 23%.

Introduction of "legal birth" which is very much present today. Women would be shocked to know how many of their "medical" decisions made for them have nothing to do with good medicine, but have everything to do with the doctor's or hospital's fear of being sued.

"Birthing suites" became popular, trying to recreate home -- as they figured out, this is where moms labor best. The drugs changed. The method of giving the drugs changed. We can speed labor. Slow labor. And end labor. We can intervene a million different ways. A woman almost never dies in childbirth anymore. We feel like the drugs are safe. A hospital is safe. Right?

It's amazing to look at the last 100 years in childbirth and how in the world we got to where we are now. I said it earlier, and I'll say it again: I love this quote by Brigham Young: "Would you want doctors? Yes, to set bones. We should want a good surgeon for that, or to cut off a limb. (!!) But do you want doctors? For not much of anything else, let me tell you, only the traditions of the people lead them to think so; and here is a growing evil in our midst. It will be so in a little time that not a woman in all Israel will dare to have a baby unless she can have a doctor by her. I will tell you what to do, you ladies, when you find you are going to have an increase, go off into some country where you cannot call for a doctor, and see if you can keep it. I guess you will have it, and I guess it will be all right, too." I do not know what year he made that statement, but Brigham Young died in 1879 when no one would have had a baby in a hospital or with a doctor.

The last time I put my quote by Brigham Young on the blog, I didn't get a single comment. Doesn't anyone else find it so fascinating that he would make a statement like that nearly 150 years ago?!

Tuesday, November 18, 2008

Breastfeeding and Bonding Immediately After Birth

This was David's pick for the next topic.

He has a coworker whose wife had a baby recently. She had a vaginal birth followed by a six hour separation from her baby. David did not get the impression that anything was wrong with the baby -- it was just for routine testing. They told the parents that they needed to get the baby's body temperature up and the baby was in a warmer. By the time she actually got to hold her baby, the baby was very sleepy and breastfeeding was very difficult. This new mom breastfed her baby for a total of two weeks.

Anyone who has ever given birth and immediately held her baby to breastfeed will tell you that the first couple of hours are golden. The baby is alert and looking into mom's face. A new baby can see about 12 inches away, which is about the distance from the breast to his mother's face. Babies are typically quiet, awake, and incredible suckers! Most babies come out ready to suck. It's an amazing reflex. Most babies will even latch on and suck hard. All four of my babies did this.

After a couple of hours, the baby will fall into a deep sleep, usually for many hours. They are exhausted too! Mom usually gets cleaned up, eats, and especially if she's given birth without medication, wants to hold her prize again! Baby will remember breastfeeding for the first 2 hours of his life and will not struggle like a baby who did not have this opportunity right after birth. Mom's body quickly got the message that it was time to make colostrum for this new baby if she spent the first couple of hours after the birth breastfeeding. It is good for mom, physically, too, as it causes the uterus to contract to expel the placenta, helps shrink the placental site, and helps control bleeding.

As for the warmth of the baby... Baby has been very warm it's entire life -- 98.6 degrees to be exact! It enters a 70 degree room, and yes, it's important that the baby is kept warm. What is the first thing that anyone is told to do if they are worried about developing hypothermia? Get naked and have skin to skin contact with blankets covering you. So why do hospital nurseries like to take a baby, put her in a plastic box, and warm her up artificially? It is well researched, studied and documented -- place a baby skin to skin with her mother, cover them both with blankets (or at least the baby), and place a hat on the baby's head, as we know that most of our body heat escapes through our heads.

When a new mom is "allowed" this time -- she should demand it --does she feel this deep instant connection with her baby? Maybe, maybe not. She may not realize it for months how significant those first moments and hours were in her relationship with her child. The oxytocin (aka: love hormones) levels in the mom and baby are the highest they will ever be their lifetime right after birth. In the animal kingdom, many animals, including monkeys, will reject their baby if they are separated for hours after the birth. Babies must not be taken from their mothers after birth!

Mothers will often talk of being tired after the birth (duh), and besides, they will have the baby forever, so why not have one night of good sleep and let the nursery keep the baby? First of all, you will not have a good night's sleep, as nurses will come in very often to check all kinds of things on you! With my first baby, I remember waking to a nurse drawing blood out of my arm in the middle of the night. I have no idea why. Second, who is holding your baby when he's not sleeping? Sure, you might have requested them to bring him to you to feed, but if he's not sleeping or nursing, is he crying in his designated plastic box? This is a sad start to a new little life.

Think about your new baby for a moment. He has never felt hunger before birth, he has never been away from your heartbeat, your voice, your walk, your laugh. He has never had all this space around him. Why do you think so many babies like to be swaddled? He has never felt cold or hot. He has likely (88% chance) never had to push poop out. A sling is most helpful with a baby's new adjustment. I have never put a baby in a sling who didn't like it. The user must be confident in using it in order to have a comfortable baby. Again, happy and confident mom -- you'll have a happy and confident (in his caregivers) baby. (I am doing a sling order this Thursday if you would like to order one.)

No baby wants to be away from his mother. Nor should he be allowed to be apart from her. Hospitals should be encouraging mothers and educating them on the benefits to the entire family to keeping the baby with them at all times during their hospital stay. No testing, footprints, weighing or measuring, vaccination, eye drops or Vitamin K -- nothing should interrupt those first few hours of bonding. Your relationship with your baby depends on it. Your breastfeeding relationship depends on it.

I am fully aware that I did not address c-sections or babies with immediate problems and the affects those things have on the breastfeeding/bonding relationship. Another day...

Sunday, November 16, 2008

Vaccinations: A Tough Choice for Parents

I had a question on vaccines, which I knew would eventually come up. And yes, it is like opening a can of worms. In fact, I'm not even sure where to start or what to say. I have pondered this for days...

Here's my story of vaccinations:

First baby: Do whatever they say you should do.

2nd baby: Do whatever they say you should do.

3rd baby: Delayed all vaccinations for 6 months, but she is up to date and has been for a very long time.

4th baby: Read lot of articles, teaching Bradley, and really wanted to be anti-vaccination because I felt like I should because of how I do other things. I was pretty freaked out by what I read. The majority of my information was from Mothering articles. I felt overwhelmed by all the information, and to be honest, I didn't really enjoy reading it. Darcy will be 4 in the spring and has had a handful of immunizations. I do one or two every now and then. This is where my true honesty comes in. I may be condemned by my natural childbirth counterparts, but I believe in being honest.

I have done loads of genealogy work and have read about lots of my family members that died, not all that long ago, from diseases that are largely not even heard about today. I believe that some vaccinations have done some good things.

What I, personally, perceive as the problem now is how many vaccinations are given at once. Parents should be very concerned over this issue. My oldest child is 12 and since he was born, they are giving so many more vaccinations at once than ever before. If your child reacts to a vaccination, you won't know which one it is if he was given 5 or 6 at once.

I don't believe that any baby needs a vaccination at birth, no matter what it is. The Hep B is made out to be a vaccination that your baby must have before leaving the hospital, but it is NOT required. Speaking of that word: No immunization is required. You always have a choice. Your child can also attend public school without having been immunized. You will have to jump through some hoops and fill out paperwork, but no one can MAKE you immunize your child.

I have a friend whose 2nd child is autistic. They have 5 children in total. Because of their risk, they did lots of research on vaccinations and delayed many and skipped some. She educated herself and they made decisions based on what they believed to be best for their children.

I read an article (again, in Mothering!) written by Dr. Robert Sears about aluminum in vaccinations. The book he has written is The Vaccine Book. If you click on that, it will take you to his blog where he will answer specific questions about immunizations. Some good info there. The affects of so much aluminum, according to Dr. Sears, is something that is not clear. It is recommended that no one have more than 250 mg of aluminum a day, but in a given day at the pediatrician's office, your child could receive up to 1200 mg at once.

What is a parent to do? In The Vaccine Book, Dr. Sears outlines a different immunization schedule that he considers to be more safe for your child. A lot of pediatricians are not going to be happy with you bucking the system. If that's the case, it's time to get a new pediatrician! In fact, when you are shopping around, don't even worry about all the other questions, such as how they feel about breastfeeding (they are all going to say it is best, initially) or circumcision, etc. Just ask if Dr. So-and-So "will accept patients who choose not to immunize." It doesn't even matter if you plan to vaccinate or not. If they respect your decision to not vaccinate, they will respect you in other areas of parenting your child.

I would also be wary of all the new vaccines, such as the HPV for girls; and even the chicken pox vaccine. They don't really know how long it lasts and now kids are receiving boosters every few years. It's much worse to get chicken pox (shingles) as an adult than as a child. I think my sister would agree that we loved spending 2 weeks of our 1st and 3rd grade at home playing Monopoly every day! Funny that I don't really remember the chicken pox, but I do remember all the games we played during that time.

These are the choices we have made as the parents of our 4 children. Educate yourselves and make decisions that feel right to you and your family.

Saturday, November 8, 2008

"Orgasmic Birth" Screening

Here is the date and time to see "Orgasmic Birth." It will be held on Thursday, November 20 at 7:00 p.m. If you are interested in seeing the movie, please contact me (donnaryan@juno.com) for the location. There is no charge. The movie runs about 90 minutes and we will have discussion afterwards. There are limited spots left for this showing.

I had a great response, so I am having to do another screening on Thursday, December 4 at 7:00 p.m. Please let me know asap if you would like to come to this date.