Tuesday, July 24, 2012

What to think about this.

I've been really busy lately as my older son has been really, really sick (yup might have to start a Lyme Disease blog too!)


I had a moment to stop by my blog here and I was surprised to see a jump in the number of visitors.


When I looked into the source I found that a certain somewhat infamous "Dr.A" added my blog to her blog list.  I imagine this is because of my last post, which did express some dissatisfaction with my midwifery care.    Still how could a attachment parenting, non-vacinating, ICAN leader, home birth believing person, such as myself, end up being linked to by a blogger who I feel no common ground? A blogger who has been discredited by people I respect, and has a real hate on for bloggers I love, such as The Feminist Breeder.


Yes,  I wished that the day of the midwife was not the day before my son's birthday but I guess I should have been more clear that the problem I had was not with midwifery in general, but with the fact that I felt uninformed that registered midwives here are required to "tow the party line" and are in fact much more involved in medical style birth then I had understood.


I didn't realize that the info I was given by one of my midwives: that being 42 weeks pregnant was dangerous for the baby, and that cervidil's prostaglandin was the same as my own hormones and the risks of it's use were that it wouldn't work, were very much hospital dogma and not evidence based.


I didn't understand that in order to keep their hospital privileges, and be allowed to catch babies they must fall in line with the head of obstetrics, and classic OB protocols.   


I also feel that the chance of me experiencing an intervention based birth was not clearly articulated to me.  While we spent at least 10-15 minutes discussing the triple screen test, a test that give indication of relatively rare disorders we spent NO TIME discussing the fact that the hospital I was going to give birth at has more then a 30% cesarean rate, and the fact that my attending midwifes cesarean rate was 17%.  


Since entering the birth advocacy world I have heard so many stories of these types of problems, people thinking that Registered Midwife, means something other then what it does.  I think that a term like Nurse Midwife would be much more forthcoming of the type of care they are able to provide.  


Now all this might seem like complaints against midwives but that 


IS NOT WHAT I'M SAYING!


I believe that many big hearted, women centred, truly caring women become registered midwives.  I think that they are forced in to a position that is difficult to navigate, keep their hospital privileges and help women make choices that will lead them to happy births. Some appear to have become hardened by years of trying to lead women to empowering births against a massive medical/pharmacutical system.   I think back to the little comments my midwives made suggesting home birth, doulas, avoiding induction and now I realize that these little comments were their attempt to give me good information, but when it came mixed with the standard hospital "you could harm your baby" info I missed the good stuff.


I totally support midwives, both registered and not, I just think we are still a ways off from finding truely informed 

Saturday, May 5, 2012

Three Years Later, Day of the Midwife.

The day before the anniversary of my cesarean section also happens to be "Day of the Midwife" in "Midwifery Month" -so much as I would like to just let my thoughts be with my little boy on his last day of being two, I am being bombarded with requests to attend birth workshops, picnics, and even flash mobs all celebrating the greatness of midwives.

And don't get me wrong I think that the rebirth of midwifery in Canada is in general a very positive thing.  Too bad my experience with midwifery care kind of sucked.

Sure I am all up for taking the blame for not having the birth I wanted, for not doing enough of my own research, for not being more demanding, for assuming that midwife meant what I had read about in all of my hippie birthing books.  The truth is that I feel that the care I got put me in a dangerous position of relying on people who were trained to do one thing, uncomplicated birth, when I was encouraged to leave that realm by way of induction.

I wish that the eve of little boy's birth was some other day and that I had not been asked to give three cheers for midwives 40 times this week.  It makes me a little pissed off actually.  Guess it's the universe's way of reminding me that, like it or not, birth culture has gotten up under my skin and I must keep using that fire for good.

So, happy Day of the Midwife, and a part of my heart really means it.

Friday, January 27, 2012

P.T.S.D. and Me, 2 and A Half Years Later.

Through exploring birth advocacy I have met women who are dealing with birth trauma. Most show signs of trauma induced anxiety, and some, like me, have p.t.s.d.

I was recently asked by a newly traumatized mother "Does it get better?"

Of course, my first instinct was to say "Yes, it does".

And it is true that the first wave of constant hyper alertness, nightmares, intense fear for yourself and the baby, grief and panic does pass. But does it get better, or just different, was the question I found myself pondering.

The nightmares are less. The obsession about the birth is less. I can get past more of the fear. But the bigger ripples are starting to show up in my life.

I find myself doing somewhat "crazy" things. In fact the last time I was alone with my toddle in the house overnight, we ended up barricaded in his bedroom. Three large switch blades, (I DO live on the side of a mountain so I own these as protection against cougars and bears), a big can of bear spray, and the phone were not enough to make me feel secure. I ended up having to slide the huge heavy dresser across the door in order to sleep at all. I spent much of the night imagining a crazed person breaking in to my house and trying to get in to our room. Should I stand my ground and try to stab him? Use the fire ladder to escape out the window? Spray his face with pepper spray? This was not a great way to spend any night. Never in my life before my little ones eventful birth have I had this type of overwhelming fear. Fear that prompts actions that I don't want to teach my child.

Also my anxiety has caused issues for the health of other members of my family, most notably, my older son. I ended up calling an ambulance for him thinking he was having an asthma attack, and he was, sort of. He had good oxygen levels, but was quite distressed and scared and breathing strangely. After being interviewed by the paramedics, nurses and then doctors it came together that I had freaked out so much over what was most likely a pre teen hormonal moment(acting funny, not responding to what I was saying) that he had been convinced that he was having a major attack and started to feel terrible. Basically I had caused the attack, -not so awesome.

I also have to really fight to stay positive, and not constantly think about the demise and my loved ones, or myself. A bout 10 years ago a good friend, who had had early childhood trauma, told me that when she says goodbye to anyone she cares about she always believes it will be the last time she will see them, Because of this she feels sorrow and fear at all partings. I was shocked, how could she be living with so much sadness? Now, I too have this burden.

So does it get better? Well for me it gets less acute. I have fun now, I enjoy my children, there are many moments when p.t.s.d. is not affecting me. But it has settled deep, and two and a half years later the journey to healing is certainly not over.

The upside of this: I am sure that this journey was one that was given to me with purpose. I am moving in circles with women who I know were meant to be a part of my life. We are working together to help prevent birth trauma and that is a powerful thing.

I am part of a new birth trauma peer support group. Which has a user friendly, yet highly informative website that I would whole heartedly recommend.


Here's to healing and helping. And really I think it's fair to say that Yes, It Does Get Better.

Monday, December 5, 2011

Guest Post at Mothers of Change

I'd like to thank the great team at Mothers of Change for hosting my guest post on updating cesarean protocols. Please have a read and feel free to comment here, or there, especially if you have any suggestions for bettering the cesarean experiences

http://www.mothersofchange.com/2011/12/changing-cesarean-births.html

This post was not only a great oportunity to share information, it got me writing again, something I have been wanting to do for a while now!

Sunday, May 22, 2011

"Natural Cesarean" Why the Controversy?

This tissue has been brewing for me for the last year.

The issue is this; in most hospitals cesarean protocol is antiquated in a number of ways. Routine separation of mother and baby is the norm. Often baby is sent to the nursery, or at best is sent with dad(or partner) to wait for the mama to come out of recovery.

Even at the hospital I birthed at that allowed skin to skin in the OR, and babies in recovery, my perfectly healthy newborn was not shown to me for around ten minutes while he was weighed and measured and tagged, and a medical student practiced a newborn exam on him.
The atmosphere in the OR was "business as usual", cold impersonal, lacking in any "warm fuzzy" feeling at all. I was told my son had been born by having one of the docs declare "1:25" loudly at my face. When I didn't respond he clarified "That's the time of birth". The doctors talked to each other as if I wasn't there, discussing my "bladder dissection" as a example of how to avoid nicking a bladder. The operating doctor didn't say anything to me in the OR at all, in fact I didn't even know who had operated on me until three weeks later.

This was on top of numerous experiences in the lead up to the surgery that led me to file a formal complaint. And to suffer p.t.s.d. I still struggle to deal with symptoms.

As part of my healing process I started researching better cesarean techniques. I was sure that there had to be a way cesareans could be done in a more holistic and psychologically sound manner. I was thrilled to find this article:

J Smith,a F Plaat,b and NM Fiskac
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/

It describes a more holistic cesarean experience, keeping the focus on the family, early contact with mother and baby, allowing the parents to watch the birth and more. The result is much happier mothers. Less trauma more satisfaction.

I was so happy. A team of wise care providers had pioneered the exact type of technique I was thinking about.

And then I started talking about it on the "natural birth" type forums I was frequenting. Instead of embracing this "woman centred" cesarean the idea was attacked. And I was attacked for championing the idea. I was accused of promoting elective cesareans, being complacent to the cesarean epidemic, and told I lacked integrity. Let me tell you it was a shock, especially as a new cesarean mother suffering greatly due to the non woman centred protocols I endured.

Two concepts seem to really offend. First, the term "natural cesarean" that just gets so many folks nickers in a twist. "Cesarean aren't natural" they proclaim. One blogger says

The other is that the article describes a technique for elective cesarean surgery. Apparently this is an evil that haunts many birth advocates. The fact that the article clearly states that these techniques can be modified for the emergency situation. Obviously a emergency section mother is not going to tour the OR before hand, but they could still have the screen lowered to view their babies birth. Makes sense to me.

When I saw this post at Lamaze's Science and Sensibility by Kimmelin Hull got me all bothered all over again. I would summarize the authors stance as this: Doing cesareans in a more woman centred way is too risky as it might further increase an all ready unhealthy cesarean rate. The author quotes a doctor as calling gentle cesarean techniques "window dressing".

Are you freaking kidding me!

These are harm reduction techniques not fluffy inconsequential stuff.

I wrote the following response:

I believe that ALL cesarean should be done in a better, more human way. To imply that making them more “natural” will result in more women picking them I think is not giving women enough credit. As you point out no matter how humanly a cesarean is done it is still major surgery with potentially life long implications.

I also believe that one of the reasons that woman choose repeat sections is that their first section was not the experience the wanted and they believe, and are often told, that a planned section is much better then a emergent one. Perhaps if the initial sections were not so trauma inducing women would be emotionally more ready to choose a vaginal birth next time.

It seems wrong to not do what ever we can to promote emotional health of the mothers and babies, and I firmly believe that every care provider should be striving for the most holistic birth possible, even if that ends up being a “natural cesarean”. Emotional health is a part of birth that is often an after thought,but it shouldn't be. I believe doing woman friendly cesarean can help avoid the increasing cases of p.t.s.d., a debilitation and potentially long term health issue.

One of the saving graces of my sons emergency c.s. is that he was placed skin to skin in the OR with me. It a moment that I use to help balance the rest of my experience which was very non “natural cesarean”.

Many other woman agreed with these sentiments and many adding their our outrage. Still the author didn't back down defending her position by referring to a fictitious woman who is exhausted and not progressing, who given more support and time could have had a vaginal delivery but is convinced by a doctor to let them do the c.s. by promising low lighting and music.
Sorry but I think this is total B.S. Woman are convinced by doctors to have cesareans because they are told their babies could be in danger. I haven't met one unplanned cesarean mother who wasn't told some version of "it's better for the baby" to have surgery.

I followed up with this post:

@Jane “Failing to fully get behind efforts to make c-sections less traumatizing and unpleasant for mothers and babies is just disappointing and wrong” I totally agree! Thank you for your post.

If this topic were a way to make cesareans physically safer there would be no debate.

A technique to prevent maternal deaths from cesareans would be embraced. I really can’t see how can any birth advocate justify denying “gentle” or “natural” cesarean techniques . I recently read that p.p.d. and p.s.t.d. can result in suicide. It is also reported that cesarean mothers are at greater risk for these disorders. I feel it’s not too far fetched to infer that:

protocols that lessen the trauma experienced during a cesarean is life or death matter.

I think it’s terribly harmful to try to prevent the dissemination of good information in suppressing “natural cesarean” techniques simply because of fear and a misguided attempt to influence the cesarean epidemic this way.

To me the natural, woman friendly, family centred, or gentle cesarean is a topic that should be addressed outside of the debate as to how to reverse the tide of the dramatic overuse of cesarean sections in the developed world.

Empowered women make good choices, not women living in fear of outdated protocols.

Think of how ridiculous it would seem if home birth advocates were calling for routine separation of mothers and babies in hospital to try to convince woman to home birth.

It is misguided to defend leaving cesarean protocols as they are as woman are being harmed.

I’m ashamed to hear otherwise wise birth advocates(both here and in other forums) bowing to fear and trying to prevent harm reduction techniques

I didn't get a direct response from the author to either of my posts, but feel so glad to see the number of women who also stood up for this very necessary dissemination of information.

Okay, I feel a little less bothered now. I guess that's what's really great about blogging is you get to say your piece.

Here's hoping that we can come together to better the treatment of families during cesareans.



Monday, May 2, 2011

One year later...

Cesarean awareness month has come to an end and I am curious to see that it has been a year since I posted about my skin to skin experience in the O.R. SEE HERE

This post by far gets the most hits of any post on my blog, with dozens of people from all over the globe viewing it daily.

Of all the hard things about my little son's birth, (which is in a couple of days!) I am grateful that there are good things too. It makes me feel a sense of purpose to have a way to positively influence births. I hope that by letting the world view us in our first meeting we will help other mothers and babies meet each other sooner.

I have hear that the first two years after a traumatic birth are the hardest. So I'm almost there. Please wish me luck.

Saturday, April 9, 2011

Total Support Pillows

I totally love this idea.

Cesarean Support Pillows

From the ICAN blog http://blog.ican-online.org/2011/04/09/new-ican-support-pillows/

"ICAN debuted our newest support offering at our 2011 Conference in St. Louis. Designed by talented ICANer Mallory Brock from a concept by Education Director Krista Cornish Scott, this fabric can be ordered by the yard directly from www.spoonflower.com with a portion of the sales going to ICAN. One yard of fabric makes three support pillows. A caring and thoughtful gift for a mom recovering from a cesarean, it has both practical advice and emotional support that is the hallmark of ICAN."

I'm ordering two yards right now to make up pillows for cesarean moms in my community.

The words of the back are particularly wonderful... the one that is sticking in my mind is something like: It's normal to have more then one emotion about a single event"

How true, my littlest son's birth was both a amazing magical moment and a source of deep trauma.

These pillows will support in many ways. I believe that physical and emotional recovery needs to be active and almost violent, the same way an aggressive surgery is.

A wise friend of mine reminded me that

Sometimes you ave to meet the fire with your own heat.