There was a discussion today that led to the comment that I was “dangerous”…why?
Because even when faced with others who firmly believe that they are doing the best they can, I still choose to advocate for women.
ACOG’s ethics statement offers us the idea that obstetricians are supposed to give women informed decision making and not force them, not coerce them, but let them actively participate in their care.
And yet, when a mother wants support for her birth, a trial of labor, even, we are supposed to believe that fears of malpractice within those facilities, or biased policies are supposed to trump her right to at least try to have a healthy labor and birth. Ethically, we are supposed to be bound to do no harm and yet, that premise has died a swift death in the face of a pretense for evidence-based care. Evidence-based care doesn’t mean there has to be specific evidence that every case will be perfect or that every case will be without risk. It means that we also have an ethical liability to not do procedures on women without evidence that it’s the best practice. We keep missing this part of the puzzle because it doesn’t fit our protocols. It can’t be fit within the parameters of a malpractice insurance document. It requires NOT acting unless there is a NEED to act. It requires prevention pf risk through being patient and awaiting a reason to act. And ultimately, it requires asking for permission to act from the woman herself, not telling her what she HAS to do, how NO providers will do it, and telling her that she should simply lie down for another surgery because it’s too risky to her providers.
I look at some photos of births and pregnancy and I think “wow, that is beautiful art caught in motion” but I don’t look at it like it’s REAL. It’s a moment of art caught by a photographer who is specifically looking to catch a moment in time that will then be transcendent. Birth IS beautiful but the reality is…reality. There is body, there are fluids, there is a baby entering the world, a mom working hard, people supporting her if not physically, then emotionally, spiritually, completely involved in her journey and their own. A life is pouring through into the world via intense powerful effort. Birth isn’t about that perfect photo. It’s about all the moments, together, as one, in a working form in all it’s ugly beautiful working sweating glory victory defeat surrender submission conquering action.
Being a teen mom makes you realize that stays with you for life. There is not a single story that mentions Loretta Lynn without mentioning her having her children as a young teenager. The thing is…what if we become who we are not in spite of having children young, but because of it? She sang to her siblings, she sang to her children and that led to her becoming a star. If she had never married young and sang to her children, she might well have lived in KY her entire life, undiscovered.
My children made me who I am, not because I didn’t make mistakes, do things young or act stupid, but because every time I did, I had to look at them and LEARN to be someone different. They are still working on me, I’m not a finished product.
Death is the one thing we simply don’t want to face. We fear the quiet, long goodbye, the misery of a life that is stretched out without alleviation from pain. We fear. We fear. We fear.
And therefore, we don’t do it well.
Mourn. Reach out. Have faith. Trust. And treat those who have had losses well, listen to them, even if you feel that you know better than them. This also extends to not using them for your own agendas or purposes. They have a right to believe in humanity as something that just listens to their loss and accepts it and helps them to be in that space of loss.
And remember that everyone around them was also touched.
This graph shows what happens when a hospital is part of a pilot program to reduce non-medically indicated births. Notice, this isn’t a program that is designed to do anything other than stop NON MEDICALLY INDICATED births. The March of Dimes piloted this program due to the exponential rise in using non-medicine to control birth in order to fit it into nice, neat practice management patches with fewer lawsuits. This rise didn’t reflect safety for mothers or babies, in fact, it did the opposite, it endangered them.
So why isn’t it enough? Why is it a red herring?
Because ACOG has now renamed all of the “term” pregnancies that used to be 37-42 weeks in order to help “reduce” pre-39 week nonsensical obstetrical procedures but does NOTHING for all of the non-medically indicated procedures after 39 weeks, zero days. In effect, we are still forcing thousands, if not millions over time, of mothers and babies to undergo procedures they do not need and often do not want. And now, we’re forcing hospitals and doctors to not do it before 39 weeks so they are reloading their case load to meet moms and babies at 39.1 and 40 and still with no medical need. This may mean that babies come off better but we’re still increasing both morbidity and mortality well above normal.
There is another casualty in this ACOG redefinition as well. That of the Non-Bell Curve mother. If you go past 41.0, you are now in some imaginary place called “late term” and 42.0 is “post term”. These numbers and dates are going to move across obstetrical systems such as homebirth midwifery where they have no place being. Where now, midwifery laws have used “42” as if it’s some arbitrary cut-off wherein moms and babies become dangerous, who knows where ACOG and other hospital-based obstetrical groups or legislative groups will try to push those lines.
Box 1. Recommended Classification of Deliveries From 37 Weeks of Gestation
Early term: 37 0/7 weeks through 38 6/7 weeks
Full term: 39 0/7 weeks through 40 6/7 weeks
Late term: 41 0/7 weeks through 41 6/7 weeks
Postterm: 42 0/7 weeks and beyond
Ultimately, all of these concerns are played out on mothers but they are not considered when decisions are made. Safety of mothers and babies are not the overriding concerns of these kinds of recommendations that are given the force of law and regulations. Individual accountability, informed decision-making, none of these come up as the rights of mothers and babies are stripped away based on a professional organization’s opinion pieces.
I had a lot of things on my mind to talk about for today’s CAM.
Really, it all walked out the door when a friend lost her husband.
So today, I want you to realize that when you look back on your life, did you birth in love?
Did the moment of birth, that stunningly amazing MOMENT make you go “wow” and stare into the eyes of your beloved and know your strength, your amazingness, your joy.
THAT is the message of the day.
And for all the mothers who will never do that, I understand and feel for your loss.
For all the mothers who stand a chance at doing that, fight for it tooth and nail and know that it is the most powerful moment in creation, the division of a dyad into two separate and whole new beings.
That kind of love is agony and will sustain you through everything because in that moment, it IS everything.
Give birth in love. No matter how you do it. Let go and feel the miracle.
#cesareanawarenessmonth Day 10
I’m going to say what you shouldn’t.
Women in the US are failing at educating themselves about motherhood, parenting and birth. We are failing our daughters. We are failing each other. We pretend that induction is okay because our doctors said so, that cesareans are harmless or better choices, that our bodies are just toooooo small for our BIG HUGE BABIES to come out of, that OUR baby and OUR birth is “that one” even when we know better. We allow ourselves to become victims at the tune of 1/2 women. We aren’t strong enough to have normal births, we aren’t brave enough to say no, we aren’t, we can’t, we won’t and we don’t.
I don’t excuse doctors in their role in this. Nor do I excuse midwives. They both have much to learn that they didn’t learn in school about letting go of their fears and about acting appropriately and ethically rather than precipitously and defensively.
But ladies, let’s stop kidding ourselves. As long as we go on the way we are, not teaching our daughters their biology, being afraid to discuss the reality of pregnancy and bodily function, being ignorant ourselves of how our cycles work, being dependent on doctors to tell us when we are pregnant because that fifteenth stick didn’t convince us, as long as we don’t do our own research and then STAND BY IT rather than trying to convince them to behave as if you are an individual autonomous adult, then we are simply walking around blaming those who prey on the weak when we are being the weak. Your doctor can’t induce you without your permission. She can’t increase your risk by giving you drugs you don’t need if you don’t tell her to. They can’t section you if you refuse unless they go through hell and high water to do so.
Wake the hell up, a 33% cesarean rate isn’t being done to us as much as are complicit in doing it to ourselves and our babies. #cesareanawarenessmonth Day 9
My baby has blue eyes.
They told me so on an ultrasound.
A friend told me her baby had blue eyes, so they had to be born by cesarean in case there was an emergency
A study in 1992 said that babies with blue eyes had a higher likelihood of being born by cesarean.
The study in 1994 says that babies with blue eyes had a higher likelihood of dying, so my doctor said I had to schedule my cesarean before 40 weeks. He won’t let me go past.
My doctor said that I am already 1cm dilated and that I should have the cesarean at 38 weeks to keep from putting pressure on the baby if I go into labor.
I found out today that the other doctor in my practice wasn’t even taught how to deliver blue eyed babies. She said they don’t teach it in school any more.
As I sit here holding my perfect, brown-eyed baby, I wonder what went wrong, but I am so grateful it all went right.
My brown eyed baby is 6 mos old today and a study came out saying that all the research about blue-eyed babies was flawed and that blue-eyed babies are just a normal variation of babies.
And other words, from other women…and their stories….and their emotions…
And one last:
Because, after all, this is the takeaway from cesarean. “You Should Be Grateful.”
Across the country, millions of women are carrying the child of a man who trusts her enough to feed, to care for, to change the diapers of and to maintain the basic safety of the child they are having together. They will leave her alone daily with their child, they will do all of the things that say “I trust you” until a VBAC or homebirth come up. Then, suddenly, there is no longer the trust of the woman’s ability, the woman’s innate sense of protection for her newborn.
They can only see their own fear. Fear of responsibility, fear of loss, fear of something they cannot express. They will give you a thousand reasons but in the end, there is only one thing that any woman wants to hear when planning a VBAC:
“I trust your judgment”
If you can’t give her that, don’t put a baby in her body.
And women, if you know he won’t give you that, then you are on your own and should make the best decisions you can for the child you carry because ultimately, you are the one responsible for you and your baby. #cesareanawarenessmonth Day 7
VBAC mothers are like all other mothers, with one exception:
Every one from the pool boy to the grocery store cashier to her plumber all know her risks.
She doesn’t need you to tell her, too. She’s already aware.
How about being the one person in her life that talks about the possibilities of success, help and support along with trusting her judgment?
#cesareanawarenessmonth Day 6