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Posts from the ‘Hospital Birth’ Category

11
Jun

“At Risk” or “High Risk” – We Should Say What We Mean

Over the last few years, I keep using the term “normal, low-risk VBAC” and I’ve found others have begun to use it as well. After all, isn’t less than 1% of a risk really a LOW risk of it? Especially if the actual risk of death or severe complication is even lower?

Evidently, It’s all in the eye of the beholder.

When I did searches for ACOG and defining what “high risk” means, there really isn’t any true definition. It’s like there is an imaginary line wherein doctors get the heebie jeebies and they call any risk a “high” risk.  So where is this cut-off and why is this word so prevalent in our society when it comes to medical care?

One definition states “of, relating to or characterized by risk” and another states:

                             high-risk

                             adjective Referring to an ↑ risk of suffering from a particular condition Infectious disease Referring to an ↑ risk for exposure to blood-borne pathogens,                                     which occurs with blood bank technicians, dental professionals, dialysis unit staff, EMTs, ER staff, IV therapy teams, lab, and medical technologists,                                             morticians, OR staff, pathologists, phlebotomists, surgeons, etc
So, according to this definition, ANY risk above average risk is suddenly “high” risk and average or normal risk isn’t readily defined.
And this is how having twins comes to be called “high risk” when some might be absolutely normal risk for having twins and others might be of a slightly higher risk or a much higher risk for certain conditions.  So how do we know what is normal risk, what is average risk, what is high risk? I’ll be exploring this through the next few posts.
Right now, many women are at high risk for having a cesarean just by virtue of walking in their local hospital. Normal women having healthy pregnancies have a 1/5 chance of having a cesarean without any further rise in complications during birth. So, all women are now at high risk? Are their doctors telling them?
There will be more on this over this week because I really want to explore this topic but we need to start holding doctors and nurses accountable to their language.
There is no “high risk” there is only risk. And my risk is either a relative risk or an absolute risk and you really only have a guess as to what my risk might be.
If we spent more time explaining to women that really, we don’t know what their risk IS even though we have an idea of what it MIGHT be in pretty rigid circumstances, then perhaps women would start understanding their care better.
Unfortunately, we’ve created a society where once you’ve told a woman she is high risk, she immediately agrees to whatever the doctors/nurses/hospitals say because she’s convinced that she and her baby are in very real danger of something that is very large and immediate.
This chart of ACOG’s helps outline exactly why they use terms like “high risk” in order to get women to consent to care rather than giving them choices and explaining individual risk. Are any of these procedures advisable? Recommended? Safe? Most individuals won’t feel it matters because they are told they are at “high risk” and it needs to be done. It’s horribly sloppy critical thinking on the part of the public, even if they WOULD choose these particular procedures, etc. And it’s intellectual laziness on the part of medical care to not allow individuals actual informed decision-making.
17
Apr

Cesarean Awareness Month Day 17

“Once a Cesarean, Always a Cesarean” never rings more true than when referring to a child’s birth. Even though a mother may later go on to have a vaginal birth or future healthy pregnancies, there is no way to step back into our footsteps in the snow and change that day in surgery. Sometimes, coping lasts a lifetime but there are critical moments in recovery in the first year that moms have to weave through and often, they are alone and unsupported. Most of the time, those close to them don’t even realize the impact of their words or actions, thinking they are sharing the moments with the new mother. On baby’s first birthday, many well-intentioned friends and family fail to see what is in front of them: a mother in mourning being forced into celebration.

A mom may ask herself if she’s even normal, because she feels so despondent or unwilling to plan birthday parties. She may throw herself into planning the biggest celebration possible, hoping it will drown all the pain out. The reality is, she often sees this is as the first anniversary of trauma. While not all cesarean moms view it this way, it’s important to understand how a mom could wind up in this emotional dilemma of baby’s birth vs mother’s birth experience.

Research shows that women remember their birth experiences for the rest of their lives. These stories impact not just today but the rest of their lives. A mother goes into labor and gives birth, remembering much of it while wrapped in the heightened sensations of labor. She remembers specific smells, looks, people’s faces and attitudes and words. As she goes into labor or is induced, she is often afraid of the unknown or even the known if this is not her first labor. She walks into the hospital and deals with strangers she is forced to trust at the most vulnerable time of her life. In some cases, she doesn’t really like her care provider or her nurses. Then, as labor continues, something changes and she labors longer and harder and suddenly, a cesarean. This isn’t what she prepared for, this is surgery. She is drugged, she is strapped down, and she is often throwing up. Sometimes, she is not even conscious, depending on the circumstances. Unable to help herself, she watches the ceiling as her body is cut open and her baby is taken away. Often, the obstetricians and nurses discuss their day or other clients or even football games. This event that was hers and personal becomes distracted and impersonal. Her baby is born and she gets a glimpse before having the baby removed, wrapped, and only a face and then gone to the nursery. There is no physical contact to solidify this bond between mother and child. There is no orgasm of love and completion in each other’s arms that is so tactile and important for every being. She is left alone with the staff, cleaned up and moved to recovery.

At this point, her husband or partner goes with the baby. They share joy, “Look at his hair! His fingers, his toes!” They call family and tell of joy in the new little person. His size, his weight, his features. They take cell phone pictures and post on Facebook or blogs. They are building a vision of love.

A year later, they share this vision. They talk over and over about the day he was born or the first moments they saw her. They are overwhelmed by the joy of that moment and they relish in it. “I was the first person to hold her!” a grandmother remembers. As they share these moments, the mother remembers, “Everyone held her but me. And when I finally got to hold her, it hurt so badly, I could barely move. “ They pass around pictures of baby’s first few moments, none of which include the mom except one, with an upside down baby’s face, wrapped tightly in a blanket, next to her head while she feebly smiles. She thinks to herself that even in that moment, she didn’t get to hold her baby or touch, skin to skin and feel the baby newness.

This is the reality of the first birthday. These flashbacks and moments where only the mother , and she alone, remembers and recovers her own experience. So how can someone help a mother in this situation? How can you, help yourself? Here are some tips on recovering at that first birthday:

Listen.

The new mother needs you to hear her side of the story.

Talk.

If you are the new mom, talk about the birth. Find someone you can share this with and just talk. Many women turn to online support at this time just to be able to get it out and share with other moms who get it.

Accept.

It’s not only ok but normal to wonder things like, “Is this baby really mine?” or “I don’t feel like her mom, I didn’t give birth.” Many moms have asked themselves these questions. Accept for yourself that your child and you have moved past that day, even if you were not unaffected by it. The feelings surrounding the birth do not have to stop you from loving your child, bonding with them and helping you both to grow.

Feel.

You have every right to feel however you want to feel. You do NOT have to dwell on feeling grateful that your child is alive or that your birth occurred the way it did. You have the right to feel questioning of the outcome and ungrateful for the way things happened.

Express.

Talk, paint, feel, write letters to the providers about your care. Write out your birth story in the way you wanted it to occur. Cry if you need to. Have a day for yourself, treating yourself well and celebrating your motherhood while allowing yourself the freedom to see the day as a multitude of different occasions that happened to different people at the same time.

Ignore.

You can ignore a child’s first birthday. The subtle way to do this is simple: Move the date. Make the party on a day that has nothing to do with the actual birth. Celebrate a half-birthday instead. You can still use a 1 candle at 1.5! You can have a small thing at home with just a cake and you and baby, celebrating together and being special in a way you were denied the first time.

All in all, treat this as if it were YOUR day. This is not simply a birthday, deserving of a Blue’s Clues cake smooshed by a happy baby. It is also the anniversary of a transition in your life that you deserve to memorialize in whatever way best suits your personal needs.

Would you like to share your story or ideas for surviving the first birthday?
http://birthaftercesarean.com/surviving-the-first-birthday-after-a-cesarean/

#cesareanawarenessmonth Day 17

16
Apr

Cesarean Awareness Month Day 16

I wait every night for the inspiration to hit. Or I pick up conversations during the day to expound upon. Every one of these Cesarean Awareness Month posts so far has been based on a real woman’s story during the day or something I saw or read. Real.
Tonight, there is a mother out there, giving birth. I saw her picture, arms wrapped around her partner, in love, in trust, in support. Not in an operating room, not in surgery, not in recovery. In the arms of those who love her, pouring out that beautiful moment of eternity between one contraction and the next and staring into the eyes of her star-eyed newborn who blinks against the first dawn.
She is eternal in that moment, one with everything that Creates in this moment, the knowledge of coming back from the edge in her eyes.
That connection fires the one of motherhood, fires the one of protectiveness, of instinct, of bonding. Strength and overwhelming chemical cocktails run through your body and your brain.
She is amazing.
And even if it was hard-fought, long days into long nights. Against the grain. She is a warrior.
She is not “A VBAC”, she is being born into being a mother and what she is doing is normal. The goal is not the overcoming of risk but the righting of her universe on the keel of that journey.
No matter how your cesarean happened….you deserve the right to try.
You deserve the right to believe.
Your body. Your baby. Your birth.
#cesareanawarenessmonth Day 16

15
Apr

Cesarean Awareness Month Day 15

There is a difference.
A world of difference.
Between choosing a cesarean at need. In knowing that your baby needs to be born now, in this moment.
And being told you have no choice.
That it’s not your choice.
That it’s not your decision.
That you will give birth alone, give birth without the support and care you wanted,
The type of support and care you need, desperately, to bring a baby into this world.
There is a world of difference in the ice cold OR gripping you when the tears flowing down your face are ones of lack of options.
And the ones that say “thank god, they are here, and safe”.
There is a world of difference in a mother who wonders if she could have done something differently and a mother whose confidence is in that this baby needed this now.
There is a world of difference in being a strong, compassionate woman who looks down, daily, at her belly and thinks “I would do anything for you”
And that same woman being led down a hall, to a wheelchair, to be taken back, unwillingly and against every fiber of her being, knowing there is no reason, lying down on a cold table, looking up at the ceiling and thinking “I would do anything for you”.
#cesareanawarenessmonth Day 15

14
Apr

Cesarean Awareness Month Day 14

We all know that sex is an amazing thing.

It can be beautiful and powerful, exciting and enjoyable. We also know it can be something to do to make a partner feel satisfied or to fulfill a need even when we know that really isn’t where we are *at right at the moment.

We also know that sex can be a nightmare. An act of power and coercion. Used against us to further another person’s goals, whatever they may be. When a person we know and trust uses us in that way, we are left wondering how we wound up here. Date rape, coercion, force. How did we wind up here and why did it happen this way. We are left, not broken, but fractured and trying to put the pieces together.

Birth is an amazing thing. It uplifts. We give, we strive, we are overwhelmed in the moment, we feel powerful, excited, and finally, overjoyed. Sometimes, we know certain things have to happen in order to bring our babies here safely and we know that need and weigh it against our own and make the choices that we need to make, for the good of that one we love. We even know that respectful care can happen under these circumstances.
We also know that birth can be a nightmare, out of control, a trauma, with others forcing us to unneeded procedures, telling us we are killing our babies if we continue, or that we will harm them, that we are stupid for trying homebirth, that we are broken and unable to give birth, that our babies being born through our bodies will result in brain damage and death. When a person we trusted uses their power in that way, telling us an induction is our only choice, that we can’t VBA2C, selling us a cesarean that will be “gentle” rather than giving us relationship, trust and good care, when we are forced to accept a coerced cesarean, it twists us inside. We wonder how we wound up here when we were desiring of a normal birth, we are fractured into the mother who wants to celebrate her love and look into her little ones eyes and the mother in pain who only wonders why she wasn’t stronger, more capable, why her doctor or midwife were so incapable of giving good care without the unnecessary procedures.
We are not broken but fractured and trying to put the pieces together.
This isn’t all cesareans and not all providers but with a virtually 40% cesarean rate, we need to stop buying acceptance and giving in because our providers have the capability to use power over us. We would never tell our daughters to accept date rape, we should stop giving them the example of birth rape. No means no, not convince me by making it nicer.
‪#‎cesareanawarenessmonth‬ Day 14

5
Feb

Got Links?

I’m always on the lookout for relevant links to post for mothers and right now, I’m trying to heavily upgrade the site, so I’m looking for “best articles EVER” on specific topics. Do you have a “best article ever!” on your list that you think is totally relevant to pregnant or new mothers who need more information?

Here’s one from me:
http://www.sarahbuckley.com/epidurals-risks-and-concerns-for-mother-and-baby

28
Jan

“High” is not a Clinical Diagnosis.

For the record, neither is “normal” or “low” and what the heck does “low normal” mean anyway?

Test results should never be given to mothers as “high” or “you failed the test” or “your numbers are low”. If numbers like this are given to you, here are some questions to ask:

1. What were my actual numbers?
2. What do you consider the range of normal? **
3. Why do these numbers concern you?
4. What is the chance of a false positive/negative or false reading?
5. Is there somewhere I can go to learn more about this?
6. I’d like to do more research before treating this, can you tell me what my options are in the meantime?

**THIS can be very important. One doctor might have an utterly different range of normal from another or one lab might use a different range of normal from another. There is also a serious concern arising with many mothers that a mother may be experiencing symptoms or testing that is abnormal for her even though the tests results show normal. Or that an individual’s normal may be a testing abnormal.
Example: A 15 year old active athlete or dancer might have a pulse rate in the 40s and a bp of 102/49. A heart rate of 72 and a bp of 120/80 might be a sign of serious illness. Same for a marathon runner or an individual with naturally low blood pressure. You should always know YOUR normal numbers when you aren’t ill, if possible.

And in regards to urine tests or other tests where a comparison is done vs. a color on a stick, you can put the little stick in the box, go out of the bathroom and stick your head into the diagnostic room and say “I’d like to see the comparison, please” or tell the nurse “I’d like to see the comparison, please, the stick and the bottle you are comparing it to. Thank you.”

14
Jan

Florida Hospital Violates Women’s Rights

Petition to get North Florida Regional Medical Center to give women back their rights

I ask you to sign this petition if you want, but please, contact the hospital involved. Send letters, emails, phone calls. PLEASE. The women of Gainesville and the surrounding counties deserve the care they were getting without having to give up their rights to support. This is in violation of Federal law as well as Florida State Statute. There is no legitimate reason for this policy and frankly, NFRMC and HCA should be ashamed as it’s clearly a power grab over women and their support.

I think the people in this world that do the most harm are the ones who sign up for these kinds of  regulations or laws based on good intentions. Laws are not there to grant freedoms. Laws are there to set limits. Regulations in this instance are there to set limits based on what the hospital wants, not on anything else, JUST on who they can control and put that control in place. They don’t want doulas not hired by them, who are not on board with their policies. This is the entire reason that doulas exist. To support women to have the births that they want, sometimes while not agreeing with hospital policy. They are there to be the woman’s advocate FIRST. Allowing this policy to continue means that doulas have given up their basic freedoms and rights as well as the woman’s right to hire who she will or have who she will as support.

It’s important to remember that this past year, doulas were helping women and supporting them and now, only one doula is ‘registered’ and supporting women and therefore, the hospital is sending her referrals. Unless we change this NOW, more doulas will be inclined to agree to this registration process simply from a financial standpoint and keep in mind, these are not hospital employees, but visitors who are non-medical in nature. They are being asked for invasive medical information and being required to violate their own privacy, even if they do as little as ONE birth a year at this hospital. Even more importantly, women have power. They can refuse to give in to this. If doulas stood up for themselves and said, “No, we have rights, our mothers have rights” then the women know that they can get support, and that they will have to exercise their power. Signing up for registration to save women to keep from having to do that is just one more way we act as if women need saving from birth. They don’t.

Please help change this NOW.
http://www.change.org/petitions/north-florida-regional-medical-center-respect-the-right-of-mothers-to-choose-who-may-visit-them-during-childbirth