Monday, March 28, 2011

Look What TCBN is Doing NOW!


 NEXT TCBN MEETING:  
VACCINATIONS

Fear not!  You did not miss the vaccination meeting for the Tarrant County Birth Network!  It is this Thursday, March 31.  We moved our meeting place and day so there has been some confusion.  Please check the TCBN website for details.  Just a reminder though:  Meetings will be held on the last Thursday of the month, not the fourth Thursday.  There are a few more of those this year, too.

We are expecting a large turnout for this next meeting.  Drs. Jim Bob and Cindy Haggerton will be addressing us on vaccinations.   There is so much conflicting information out there and I think a lot of us are quite confused.  Our pediatricians, and family doctors, are telling us one thing, but we've all read enough resources to know that there are potential risks associated with vaccinations.  This is a great meeting to bring your husband, but again, as always, lap babies only.  Thanks so much for your cooperation.  No one has put up a fuss over this "rule" and we know it is an inconvenience for many of you.  We appreciate so many of our TCBN dads that stay home and put kids to bed so moms can attend our monthly meetings.


THE ART OF BIRTH:  
A BOLD FORT WORTH RED TENT EVENT




I put this up here on my blog a few weeks ago but didn't say much about it.  Have you studied our logo?  Have you figured out what it is?  Yes!  It's a placenta!  Our producer of BOLD Fort Worth and TCBN Chapter Leader, Shannon Blackwell, has a bit-of-an-odd obsession with placentas and she came up with this logo.  We all love it so much, we are printing the cutest black fitted tees!  Visit our website to buy one for yourself!

The Art of Birth is a mixed media art and performance show, in addition to spoken birth stories.  Come see birth photography, belly casts, sculpture, henna, live art, and dance -- all celebrating this life-changing event called birth.  

The t-shirts will be available for purchase the day of the event, as well as a book TCBN is printing consisting of birth  stories of women who have birth in and around Tarrant County.  Let us know if you'd like to make the book available to your friends or clients by emailing us at birth@boldfortworth.org.

The Art of Birth will take place on Saturday, April 30 from 11:00 a.m. - 4:00 p.m.  It is a free event being held at the Fort Worth Community Arts Center at 1300 Gendy Street, Fort Worth 76107. 

If you have birth-related artwork you would like to display, please contact BOLD Forth Worth at birth@boldfortworth.org.  Likewise, if you'd like to share your birth story, please contact us at the same email or call (682) 710-BOLD.

We are looking forward to sharing with the community how wonderful birth can be though The Art of Birth.  See you there!










Monday, March 21, 2011

Why the Closest Hospital May NOT be the Best Place to Have Your Baby

When I was pregnant with my first baby, I was asked a number of times during the pregnancy where I was planning to have my baby.  I thought this was about the dumbest question ever (next to "Are you having the drugs?").  Obviously, I was having my baby at the closest hospital.  I'd seen enough TV shows and movies to know that I would have to get there really fast, so it just made sense to pick the closest one.  It wasn't until I was pregnant with my second baby that I discovered the significance of choosing a hospital wisely -- that maybe distance was not the top priority after all.

When people email me or call me about classes, one of my first questions is "Where are you currently planning to having your baby?"  The word "currently" throws them off, but I want them to know upfront that it's not set in stone.  More than 50% of people that take my class do switch their care provider and/or birth place. 

It seems that most people choose their hospital because that is where their OB delivers.  They've been with him/her for years and just loves him!  They honestly believe that their OB will support their decision to have a natural birth.  This post is not about your OB however, but the hospital.


Fact:  You are more likely to have a c-section in a busy hospital than elsewhere.  Define busy?  Well, the hospital I had Daymon averages 30 babies a day.  I'd call that pretty darn busy.  There's a hospital in the Ft. Worth area that touted more than 5000 babies a year on a billboard.  It is normal to think, Oh good, they do this a lot, so they must be really good at it.  Practice make perfect, right?  If you do the math, that average is almost 14 babies a day.  Doesn't sound so bad after the average of 30 a day I just threw out!  This particular hospital's c-section rate is 35-40% -- straight from the horse's mouth.

But does practice make perfect?  Why would a busy hospital have a higher c-section rate?  Let's face it -- it's like the Olive Garden (I worked there for  4 years and love the OG, so this is not a slam on them!) and you cannot sit at a table all night.  We need your table.  The lobby is filling up and your server needs to make money.  We cannot allow you to take up this table any longer!

And so it is with labor.  They simply will not allow you to occupy a room longer than a day.  At 24 hours, or very close to it, your time is up.  The OB can make up a million reasons why you need a c-section (fetal distress, baby too big, water broken for 24 hours, failure to progress, maternal exhaustion, the list goes on and on), but ultimately, your time is up.  You failed to progress on our time frame.

If you've seen Born In The USA, a PBS documentary, you've witnessed the scene where the residents are sitting around a conference room discussing a particular labor where the woman had a c-section because her time limit was up on pushing (my words, not theirs).  Part of that dialogue includes an OB explaining that it goes against their very nature to not do anything in the hospitals.  She explained that in the hospital, nurses and doctors are constantly monitoring and assessing, monitoring and assessing. They will not just sit around and wait on your labor.  You expect a baby out of this, and darn it, we will be the ones to do that for you!

So, we have imposed time limits.  Next, we simply have hospital policies.  Things such as:  continuous electronic fetal monitoring (EFM), routine vaginal exams (usually every 2-4 hours), no walking after water breaks (which you're not doing anyway if you have EFM), and a routine IV.  I talk about all of these things at length in class, so I don't want to spoil all the fun here.  Suffice to say, none of these things are good for your labor.  You are more likely to have a c-section when these policies are in place.  These are red flags!  Run!  The local hospitals that have these policies have 60% c-section rates.  Ultimately, your baby is left to figure labor and birth out on his own.  You will not be moving around, changing positions, rotating hips, or using gravity to assist the baby on his way down and out.  Labor is harder for mom and baby under these conditions.

Another red flag along the lines of policies are no VBACs (Vaginal Birth After Cesarean).  Over 800 US hospitals banned VBACs in the last decade.  ACOGs recent statement said that women should be given a "trial of labor" -- don't get me started! -- but I haven't seen any change as of yet.  A hospital who does VBACs is hopefully following evidence-based maternity care in other areas as well (allowing women to eat and drink in labor, intermittent fetal monitoring, hep-lock instead of IV, and no routine vaginal exams).

Honestly, I believe you are more likely to find this type of care with a midwife than an OB.  The vast majority of OBs simply are not trained in normality.  They are trained in the management of labor and birth.  And make no mistake -- they will manage your birth.  If your hospital does not even have midwives, this is also another red flag.  Midwives bring a different attitude and philosophy of birth to a hospital.  As long as the staff is open and willing to listen to the evidence, midwives can make a huge impact.  If the doctors won't listen to the midwives and let them be midwives, again, run. 



Birth is very political.  I was speaking with a CNM the other day about this topic.  She's only been out of school for about a year.  She said they didn't talk about how political things are in birth while she was in school and she's been shocked by it since working in the field.  It's like I always say, as long as the baby is still inside, you have options. I've had a handful of women change their plans in the middle of labor!  Don't let your birth be a political battlefield.  Fighting with the staff is not an option.  This also is not good for mom or baby and is not how anyone should remember their labor.

No matter how scary you think it may be, changing care providers or hospitals (or even switching to a home birth!) can be the difference between a c-section and a vaginal birth.  If you have an outcome you are not happy with, you will always wonder what would have happened if you had switched to a better birth place.  Like Tim sings, "There's no such thing as what might have been, That's a waste of time, drive you outta' your mind."  (Had to sneak him in there!)

You might have to drive a titch further, but in the long run, you'll only give birth to this baby one time.  Regret is a yucky thing, especially when you had the red flags laid out before you and you chose to tie your blindfold on and hope for the best.  Don't be a victim of bad hospital policies!

Monday, March 14, 2011

"My" Epidural

Have you ever noticed that when a woman refers to getting an epidural, she uses the word "my" epidural, not "an" epidural?  It is the only time I can think of off the top of my head that someone refers to pain medication as "mine."  If I have a headache, I don't say, "I took 'my' ibuprofen."  I say, "I took 'some' ibuprofen." 

So why is there ownership of the epidural?  Even the L & D nurses refer to it as "your" epidural, or "her" epidural.  You own it -- you better claim it before someone else steals it!  It is the weirdest thing.



When doctors in Europe were using a combination of different drugs to "help" women through childbirth towards the end of the 19th century, American doctors didn't want to use them.  They didn't feel they were safe.  I know, hard to imagine now, isn't it?  It was the women who demanded to have the rights to these drugs.  Up to this point, the majority of American births were assisted by midwives, not doctors.  More than 95% of all American births took place at home.

Much like today, women were afraid of childbirth, just for different reasons.  When male doctors started assisting in childbirth, women were willing to put modesty aside (no small thing) at the promise of having "pain-relieving" drugs for childbirth.  The doctors found it easier for the women to come to them in the hospital rather than have to travel to their homes.

And so it began.  Hospital birth.  In the beginning, only the affluent could afford to birth in the hospital.  It was fashionable to be "delivered" by a male doctor with his drugs and forceps.  Eventually, if you had a midwife-attended homebirth, you were obviously too poor to afford a hospital birth.  By 1940,  two-thirds of American births took place in the hospital.  (Both my parents were born at home.  They lived in southern Illinois in the middle of nowhere and were poor!)  By the 1950's, only 1% of babies were born at home.  It has largely remained the same after 60 years.

Historically, women fought for the right to vote just a couple of decades after drugs in childbirth were introduced, and birth was migrating from their bedrooms to the hospitals.  Women entered the workplace in the late 1930's during WWII to support their families.  During the Women's Rights Movement of the 1960s, women wanted equal pay and treatment.  We deserved it!  We wanted rights!  In the same decade, midwives began to resurface and the natural birth movement began rising up.  Make no mistake, 99% of women were still giving birth in a hospital with the drugs.  Just like today.

For the last 110 years, women have demanded drugs in childbirth because we should not have to endure the pain of childbirth, no matter how dangerous it may be for the baby, right?  As a woman, I have rights to those drugs!  I owned an epidural from the minute that pee-stick told me I was pregnant!  The doctors warned the women early on that the drugs went straight to the baby and were not good for the baby.  The women didn't care.  Today, we have doctors telling women that epidurals are safe -- there are no risks.  Why would you not have one, they say?  "There is no medal at the end of this race."  Oh, I beg to differ --  a drug-free mama and baby is quite a reward to behold.

Yes, women's rights have done some very important things.  But at what point did we get so wrapped up in our own discomfort that we can't see beyond ourselves?  Is it just human nature?  That sense of entitlement?

Here's the real kicker -- if women only knew the absolute empowerment that comes with giving birth to your baby without intervention or medications, they would understand that that is real Women's Lib.  Don't own the epidural ladies, own your birth!

Monday, March 7, 2011

Dads Begging for More Babies

My husband came home from a church activity a few weeks ago where he had been talking to this woman who is pregnant.  He was getting ready for bed and just sort of rambling while putting clothes away and turning down the covers.  In the middle of it all, he expressed that he felt jealous of people in that stage of life.  He went on to talk about how exciting those times were, waiting for a baby.  Wondering what would our labor be like.  And then those early days and months of having a new baby in the house.  Sigh.



So often I hear women say that they'd love to have more children but their husband is DONE!  I rarely hear a woman say that her husband would love more but that she is the one who is done!  Why is that?

I must admit that my husband is a unique breed.  He's sensitive and compassionate.  Clever and funny.  Oh, and incredibly handsome!  He loves babies.  He never protested at having the baby in our bed like many men. In fact, the other night he was in and out of our last Bradley class and we were talking about co-sleeping.  He threw in his two cents -- yes, he slept great -- except an occasional "boot to the head" from a toddler.  (David wants you to know that this is him holding one of our babies in the above photo.  OK, we can't all be Joe Gumm.)

Is it just that our kids are bigger now and we don't have a baby anymore?  Are we just missing that time of our lives?  David hates feeling nostalgic and I think he's been hit with quite a bit of it lately.  Maybe it's that his wife just turned 40 (he's 37), maybe it's having a kid in high school that is driving us completely crazy and he's missing the "simpler" days.  Whatever it is, it's real. 

I, on the other hand, don't have that I-miss-not-having-a-baby-in-the-house feeling like he does.  I really do live vicariously through my Bradley students.   I'm still surrounded by pregnancy, labor, birth, and babies.  I am selfishly enjoying my quiet days when they are in school.  I am unbelievably busy with other things, just not breastfeeding and changing diapers!  For the record, I miss the hours of holding a nursing baby and co-sleeping with my babies, feeling their warm little body mold to mine.  It was a wonderful time that flew by much too quickly.  Everyone says that to you when they are little and you think "Yeah, right, lady!  You have no idea."  Now I'm that lady!

Back to the men.  David had a vasectomy when Darcy was about 18 or 19 months old, which in my opinion, is the absolute worse age ever, or at least I thought it was until we had a 14-year-old!  He was dead set that he didn't want more babies and I was right on board with him on that one -- again, Darcy was at my least favorite age.  I haven't changed my mind, but I think if I said I wanted another baby, he'd jump right on that.  Don't get excited, it's not going to happen. 

A lot of dads don't enjoy having a baby in the house.  Am I wrong here?  Baby wants mom and doesn't really care all that much about his/her dad until later.  I did have one baby that really did seem to prefer her dad over me -- still does.  But for the most part, I think that is a fair statement.  Sex often revolves around the baby's routine.  Breasts are often off-limits with breastfeeding sensitivity and leaking.  His wife is often so distracted with the baby, dad gets "stuck" with more chores around the house.  If baby is not co-sleeping, dad is probably involved in night feedings and not sleeping well.  Right or wrong, I'm just trying to think from his perspective for a minute, so don't hate me.  We can't ignore the financial responsibility in having kids, that ideally falls mostly upon the father.  (At least that's how I was raised and how it is in our family.)

Mom typically is the one who spends many more hours with the baby and gets to know the baby before dad.  She figures out the different cries the baby has, what they mean, and how to calm the baby.  When she has to tell him how to calm his baby, he might feel inadequate.  Dads often get to know their babies through play, once the baby is big enough. 

I can't explain why David didn't seem to feel these things.  I hear from so many couples that struggle within the first few months.  I wish all new dads enjoyed the new baby phase.  It is something that many women want to experience over and over. 

I am thinking out loud on this post.  It's just something that's been on my mind lately since David made that comment about missing the baby phase.  I'm so grateful for such a compassionate man to share my life with, one that loves babies and co-sleeping.