Monday, September 30, 2013

Birth Buffet

Recently, I heard someone talking about "methods" when it comes to childbirth education and they put Birth Boot Camp in that category.  It got me thinking...  Do we really teach our couples to do things a certain way at a certain time?  I thought about it for about 3 seconds before I answered NO!

I don't know about you, but when I think "method," you need to follow protocol.  What positions to be in at certain times, what to say and do during the pregnancy and labor, etc.  If you don't "succeed" is it because you didn't follow the "method" or because the "method" isn't what you needed or didn't work for you? I've heard many women say they "just didn't do it right".  Without getting into it, there are many methods out there.

I like to think of the Birth Boot Camp curriculum as a road map (with various roads leading to the same place) to help couples get an unmedicated birth. We do "train couples in natural birth" but it's not with a "method".  I have found over the years that there are some key aspects to getting a natural birth. You could be one of those women that are "lucky", but I don't recommend leaving it to chance.   I have a list of things that I think are important for couples to do. The order goes something like this:
1.  Education - Birth Boot Camp classes are amazing.  Just sayin. (Did you know we have a blog and online classes?!)
2.  Choosing - or sometimes changing to - a supportive care provider and/or birth place.  Learn the questions that really need to be asked, including the red flags not to be ignored.
3.  Communication between partners - on so many levels, this may be the most valuable thing you take away from classes.
4.  Practice and review the material - weekly assignments keep you on track and keep filing your tool box.
5.  Get your head in the game! OK, it's true, I LOVE High School Musical and I use that phrase as often as possible, but it's very applicable right here.

This looks different for each couple.  Everyone comes to class with their preconceived ideas of birth. Some have been educating themselves before they were pregnant and others have never given a thought to how the baby is going to get out, let alone birthing with a midwife or giving birth out-of-hospital.

So, call it whatever you want - a road map, a tool box.  We know that our couples are smart.  We will not tell you exactly what to do in labor.  There are just too many variations of labor to tell someone that they should do the same things as everyone else.  Work with your birth team.  You have so many tools to pull out because you have spent the last several weeks educating yourselves.

Yes, people talk about instinct when it comes to birth, but that can be overwhelming for some.  Some women find comfort in that belief and others do not feel in touch with their bodies to believe that they will really know what to do when it comes down to it.  This is one reason we feel so strongly that partners are educated too, really with the exact same 5 guidelines as mentioned above for moms.  Everyone is on the same page come birth-day.

The empowerment comes from making your own decisions, not when decisions are made for you!

Monday, September 16, 2013

Prenatal Testing & Informed Consent - Guest Post by Hannah Reasoner, BBCI, LMT, CD(DONA)

I asked Hannah Reasoner to write this post for Banned From Baby Showers readers for a couple of reasons.  I've known Hannah for a few years now.  We've worked together as in a number of capacities.  I respect her and love her.  Really, she's like a little sister. With her 2nd pregnancy, she developed gestational diabetes.  She's one of the healthiest people I know, so her diagnosis shook me up and all that I've taught about this topic over the years. She is a Birth Boot Camp Instructor and I asked her to write for us to talk about the testing and if her opinions have changed since her experience. 

Did the joy and excitement of expecting a baby become overwhelming when you began going to your prenatal visits, being inundated with an array of tests and procedures? Many women who are choosing to birth naturally often want a minimally invasive pregnancy as well. Did you know that you have the option of informed refusal and informed consent on all of these routine tests done during your pregnancy? So, what does that even mean?
Informed consent or denial means you are opting in or out of a certain procedure and that you have read and understand all of the risks involved. You will sign forms verifying your healthcare decision.

Understanding each and every test that will be administered during your pregnancy is very important.  This may involve asking your care provider to go over the consent forms for each test at an early stage in your pregnancy.  You should be allowed to take these forms home with you and review them with your partner, research the test and make a very informed decision. This will keep you from feeling rushed and surprised when the time comes for a particular test.

A few questions to ask your care provider about standard testing and procedures are:

Why is this test done?

What does the test involve?

How often do you see false negative or positive readings for that particular procedure?

Is this necessary for the health and well-being of mother and baby?

If I opt out now, can I choose to do the test at a later date?

Until I was pregnant with my second baby, I really didn’t thoroughly understand some of the routine testing, such as the Glucose Tolerance Test (GTT) for example. The GTT is typically administered between 24-28 weeks and does not give you a diagnosis of gestational diabetes. It is specifically designed to identify women who may have a problem and need more testing to find out. So, a positive result doesn't mean that you have gestational diabetes. In fact, only about a third of women who test positive on the glucose screen actually have the condition. With both of my pregnancies, I knew I wanted little to no testing unless absolutely necessary. As I was approaching the 24 weeks of pregnancy, my midwife became concerned with the amount of weight I had been gaining in a short, 4 week time frame. She was willing to work with me to opt out of the GTT test, and allowed me to monitor my blood sugars with a blood glucose monitor. Although this wasn’t considered their standard protocol of testing, I was able to get a more accurate account of what my fasting blood sugars were, as well as my one hour and two hours readings after each meal. And, while I had none of the other risk factors of a diabetic, including, sugar in my urine, a family history of diabetes, or being overweight, I was ultimately diagnosed with gestational diabetes at 32 weeks. I was thankful for the option to take a more accurate account of my blood sugar readings throughout my pregnancy with a blood glucose monitor. The licensed midwife and certified nurse midwife that I was working with were both very accommodating in that regard.

I believe it is very important to have a care provider that is willing to take the time to review the risks and benefits of all the testing involved during pregnancy and is agreeable to provide alternatives at his or her clients’ and patients’ request. It’s your pregnancy and your birth. Know your options!

Monday, September 9, 2013

Indiana Couple Gives Birth in Their Bathroom -- ON ACCIDENT! (It's a Better News Story When it's Not Planned)

My uncle sent me this video over the weekend of a couple that accidentally had their baby at home just around the corner from their house in an affluent neighborhood in Indianapolis.  My uncle was born at home and his attitude about homebirth is as positive as they come.  He grew up on a farm and saw many animals born and always takes the attitude that birth is a normal physiological event.  I think he secretly wanted to catch my cousin when he was born but went ahead and drove my aunt to the hospital anyway! (She did have him very soon after arriving at the hospital - without any drugs!)  He always sends me interesting articles about birth or breastfeeding. This time is was a YouTube video.  It was a Banned From Baby Showers moment for me -- I was not about to comment on the video, but I have just a few things to say about this broadcast.

1.  First of all, congratulations to the couple.  They obviously were pretty excited about their unexpected experience.  She was obviously embarrassed to have been to the hospital twice before, thinking she was in labor.  She said she wasn't going to go again until "water broke" or she "just couldn't stand the pain anymore".  I think she discovered that she was able to handle it afterall - it never reached that point like she expected.  It was tolerable. Lesson #1.

2.  The nurse gave her a tool to put in her bag - take a shower to relax.  If she had taken a Birth Boot Camp class (even the online class!) her and her husband would have had lots of tools to, not only figure out if labor was "real", but to relax.  

In addition to learning about labor and to relax, the couple would have also have learned about "emergency childbirth", which I actually like to call "unplanned unassisted birth".  Both partners, while not giving birth in their intended birth place, still would have been confident in knowing what to expect and what to do and not do. He would not have just "thrown her a towel" and called 911.  We have a saying that we worry more about babies that don't come than babies than do!  How awesome would it have been for this mom and dad if he had just stayed with her and caught his baby?  (I'm embarrassed to admit how many of my couples have been in this exact situation.  I can say for sure that all of the dads caught, while none were out of the room on the phone with 911!)

3.  She instinctually knew what noises to make.  She admitted that she wasn't screaming, just vocalizing to stay relaxed.  That was awesome!  But then dad, who didn't realize the benefits of the sounds she was making, told her to be quiet, to not wake the 2 1/2-year-old.  They didn't want him "coming into this", like it would have been traumatizing, gross, or disturbing.  Adults think kids will be scarred from witnessing a birth, so we shield them instead of letting them be a part of it.  It's our own hang-ups about birth that prevent some pretty cool things from happening within our own families.  (I've written several posts about siblings attending birth if you are interested in learning more.)

4.  Didn't you love the part where the EMTs said they put on their "cover ups"?  It reminded me of the Cone Heads video clip, "The Birth Spasm Has Begun".

My pool builder, Chris, is also a firefighter/EMT, and we've had many conversations about childbirth.  He said that is the one call they all dread the most.  We've talked about all the misinformation they are given, but yet, it's what they are told to do.  For example, they are taught to clamp the cord immediately with whatever is available, even a shoelace.  According to Chris, they really know very little and are pretty terrified of being called to a birth.  A couple of years ago, one of my moms from class was taken by ambulance to the hospital while pushing.  The EMTs were begging her to not push!

And so, I imagine that these fellows were quite relieved to show up and the baby was already born.  They skipped several details, like when she delivered the placenta, did they cut the cord, etc., but they got the "patients" out the door via an emergency chair (since the stretcher didn't fit!) and off to the hospital!

5.  And then there is my favorite part of the story -- the part where the OB told them that he'd never seen a baby born in "this good of shape born outside of the hospital".  He/she must have some magical powers to make babies be in "good shape" when they are born in the hospital!  My guess is that this OB never sees all the healthy babies that are born at home.  Why would he?  If he does see a baby that was born at home, it's because that baby needs medical attention. Being born in the hospital does not mean that a baby will be in "better shape" than a baby born outside of the hospital. It's not a magical place.

6.  While this couple seemed excited to share their experience, I can just about guarantee that their next baby will be a 37-week induction to prevent this from happening again.

Monday, September 2, 2013

The Post I Hope I Don't Regret Posting

This may be one of those posts that I write and never publish.  I feel compelled to write it though.  It's political in nature, but I don't really want to talk politics.  These are just my thoughts.  They are not meant to offend, but I don't think it's possible to have this conversation without offending someone.  But it's something I think about quite frequently and am baffled at the political divide I see within the birth community.

My freshman year of college, I saw a video of how a baby develops from conception and throughout pregnancy.  It was very detailed and apparently made a huge impact on me.

A few months after seeing that video, a girl in my dorm asked me to go with her to the health clinic to take a pregnancy test.  As it turns out, she was indeed pregnant.  As we walked out of the health clinic, I started talking about the video, telling her how her baby already had a heartbeat, etc.  She immediately shut me down, telling me she was going to drive to Lubbock and have an abortion.  I have thought about her many times over the years. She left school shortly after and I never saw her again.

Around the same time, I had a conversation with my dad about him wanting me to quit smoking. (I had been smoking since I was 12.)  I remember telling him that the only thing that would make me quit smoking was if I got pregnant. Knowing that all the organs form so early on -- knowing that is how we all started -- I knew I could not expose my baby to the effects of nicotine and all that comes from smoking.  I had also heard that babies born to moms who smoke have a lower birth weight and are often born early. Even at that young age and being a 2-pack-a-day smoker, I felt that it was because the baby wanted OUT OF THERE!  Fortunately, I never found myself pregnant, and ultimately, that is not why I quit smoking.

In fact, I didn't get pregnant till nearly my 1st anniversary, and I was 24 years old.  From the moment I found out I was pregnant each time, I thought of the baby growing inside my belly in nearly every decision I made. Granted, I was very happy to be pregnant each time.

What perplexes me the most with this topic is with birth workers and the natural birth community in general. You all know that I am an advocate for women to be able to choose their care provider, birth place, and how they give birth.  I've had people say to me, "What about cesarean?  What if the mom wants a cesarean and never experience a single contraction?" I admit that I don't like that.  I don't believe it's best for the baby, or the mom. Seems like talking through things is in order rather than having surgery. Maybe I am naive to think that it can be worked through.  But, yes, I realize I contradict myself on her right to choose here.  It's a conflict within my head and heart.

Typically, most birth workers/junkies seem to have an understanding of how a baby develops.  They usually like babies. Listening to them over the years, they usually refer to the "fetus" as a "baby".  We talk a lot about what is best for the baby during pregnancy, etc.

And yet, so many birth workers are rooting for women's right to choose to abort, even late in the pregnancy. Again, maybe I am naive, but it doesn't make sense to me to try to protect the baby, only to support or defend the right to abort.  It really does confuse me.  No matter what the mom's situation, there is a BABY in there.  Is abortion really a better option than helping her work through the situation or helping her place the baby for adoption?  It's only an immediate "fix" too.  There will be ramifications - physical, mental, and emotional.  Yes, they will affect her life, but her life will be affected either way.  Down the road, however, she will know that she gave life.  How can that be a worse choice?

I only know 3 women that have admitted to me that they've had an abortion.  In all of them, it has affected all of their lives for years, especially as they've started their families and have other children.  It's effected their relationships, 2 of which have ended in divorce.  The husbands said she could never get over the abortion.

If we really want to support women, why can't we support and help them -- and their babies -- in choices that allow all to live.  For me, I always go back to education.  I do believe that when people have information, they make different (and usually better) choices.  I simply wish we were fighting for the women AND the babies.