Obstetric Lie #96- You NEED Us!

"In my personal experience, doctors are very much needed by about 3% of our patients, to do necessary cesarean sections. They are also needed by another 3% who, for various reasons, require to be delivered or medicated in birth. Of the remaining 94%, after careful prenatal training, the role for the doctor at the moment of birth is so insignificant as to be almost belittling, most of the time we doctors should merely be lifeguards, and be there for support and medical backup."
Dr Robert Bradley
Husband Coached Childbirth

When Dr Bradley was practicing as an obstetrician his c-section rate was around 3%. What is often forgotten is that this was not unusual at the time. All obstetricians had very low c-section rates. What made Dr Bradley especially different was that the vast majority of his patients had their babies without any medication or forced delivery methods.

He goes on to say this:

"We take a lot of kidding from our patients regarding this. 'What am I paying you for? I did all the work!' ....They realize that the most important work of their doctor is to stand by in case of unforeseen complications."

Yes, there are times when medicine and medical personnel are needed, just not near as often as we or they would like to believe.

We are currently looking at c-section rates over 30%.
Induction rates are high- some reports as high as 40%.
Epidural rates appear to be at least 70%.

The perception today, as it was then, is that medical interference was needed often if not always when it came to birth. By default, the medical doctor was needed all the time because only he could dispense that expertise.

What doctor Bradley, and other midwives and doctors like him found, was that women are perfectly capable of "delivering" their own babies. They did not need to be delivered. In fact, they were able to even catch their own babies.

What birthing mothers needed in place of medical expertise and intervention and drugs was confidence, education, a healthy body well prepared with nutrition and exercise, and a loving partner who also believed in them.

Was he a fan of unassisted birth? No- he knew that sometimes things did go wrong. What made him special was that he realized how rare that was, and he had no problem standing in the corner the rest of the time.

Birthing women need peace, confidence, faith, knowledge, health, training and love. They do not need 30% c-section rates nor do they need convenience inductions. Is it wise to have a medically trained person present at birth in case of complications? Yes (though I would never take away a womans right to choose otherwise or know what was best for her, weather that be hospital birth or otherwise).

The tricky part in birth is finding a person to attend your birth who believes in your ability to birth and is happy to NOT be needed.

Birth in peace~

Admit It- The Child is Difficult, Not Vivacious

Have you ever thought that about your own flesh and blood? You know the thought. You think it but you don't dare speak it. The though is this, "MY GOSH, this child is difficult!!!! Would she just sleep for love of all that is holy!?"

There is a lot of talk about how we describe our children and their personalities. High need, sensitive, smart, even (my favorite) vivacious! It kind of makes me laugh that we have to use words that truthfully, kind of sugar coat things.

I have a hard time being dishonest. Actually, I can accidentally be so truthful that I am outright rude. The same is true when it comes to my own children.

(Disclaimer- I fully expect to be torn apart for this post. But at this point I have realized that people will tear me apart for pretty much anything no matter how I meant it or not so I am throwing caution to the wind.)

Yes- I have a vivacious, sensitive, intelligent and high need child. Around here though she is often just referred to as "stinker pot" or "stormy" for her frequent turns of mood.

Oh we love her. And I mean we LOVE her. We really love her. She is the third so she has a brother and sister who both dote on her and adore her. Sometimes I think that if I had a favorite it would be her. (Of course I don't have a favorite, that would be wrong.) But I tell her every day that she is my favorite baby -- EVER.

She makes me laugh more than any of the other children ever did. I enjoy her more than I can describe. I thought she might be my last so I just held her and loved her and soaked her in when she was born. She is incredibly smart and talks and sings and plays earlier than I remember the others ever doing that. She is a joy and the most entertaining, fun filled child I have ever seen.

And though I would love to describe her as vivacious when she screams "NO!!! MINE!!!!" and smacks somebody in the face, honestly, that is not the first word that comes to mind. And though I know that as a supposed attachment parenting mom I should embrace the sleepless nights with a 17 month old who still wakes every two hours, I actually just want to scream. I guess I could scream but she is already screaming so it would be REALLY loud in the house if I joined in, at three AM no less. I should enjoy the sheer amount of NOISE that one child can produce on a nearly constant basis expressing her every need or displeasure or ache or pain. But, sometimes I just want some peace and quiet.

(I am not looking for advice on sleep training, co-sleeping, getting adjustments, parenting tips or anything else.) At this point in life I sincerely believe that some kids are just not good sleepers and some are. That is just how the chips fall sometimes. Some kids like to please those around them and will adjust their behaviour to do so. And some kids realize that the squeaky wheel gets the grease, and so they squeak.

Language is powerful and I understand that. I see the point in using nicer words to describe a child than the ones that immediately come to mind. I understand how calling contractions "rushes" could prepare your mind for a more painless labor. I have heard of labeling theory and I get it.

I also realize though that sometimes the truth is just the truth. Sometimes a kid is harder than others. There a lot of factors: circumstance, birth order, personality, patience of parents, and so on.

The point is not that we dare not tell it like it is. The truth is that sometimes a child is harder than another. Sometimes a child refuses to cooperate in the ways we would like. But the bigger truth is that there is nothing wrong with that.

Will I sometimes say this sweet child is difficult? YES! I will. Because it is sometimes the truth. The other half of that truth is that I love her all the more for it. I enjoy her more because she is strong willed and amazingly intelligent. My love for her grows stronger BECAUSE she requires more patience and kindness and understanding, not in spite of it.

So here is to embracing that difficult, screaming, no sleeping, "oh my gosh I think I am getting a tooth, you know that means I will wake up screaming hourly for a week mom" child. There is nothing wrong with the truth, difficult or not.

Coco's Birth- Birth Story

Another beautiful birth story day. Enjoy this fantastic birth center birth. Fantastically written and you can check out the mamas blog too- here.

Enjoy!

SEE THE SLIDESHOW HERE

The short version – Corinne Jae was born 3/2/09 at 1:03 pm in Peaster, TX at Heart’s Desire Midwifery Birth Center. I wrote this account three days later.

WARNING – IF YOU ARE A GUY WHO ISN’T INTO THIS TYPE OF THING, OR OTHERWISE SQUEAMISH ABOUT THE STATUS OF MY CERVIX, SKIP THIS POST! Thanks!

I know the gory birth story is the thing of interest here (and I will be quite verbose, no fear!) but I feel like I should mention a couple of things in preface.

1) My husband is the hands-down the best husband on this planet, and the best partner I could ever want. I wouldn’t have even considered choosing a birth center or home birth if I didn’t have Jason there with me. He challenges me to think bigger, learn more, and experience everything, then holds my hand when I doubt myself.

Through a series of fortunate events (beginning with the fabulous Trisha Blizzard, and then through Angelica and Lynsey), we found the perfect midwife for our baby and our birth. Kelly Miller is a huge part of our miracle. She helped us embrace our philosophy for our daughter from the moment Coco entered the world. Thank you Kelly – we love you so much for that!

3) I am a huge drama queen and my only disappointments with the birth were a) I wish it had been videotaped because I am too quickly forgetting, and b) had I known it wouldn’t be very long – I would have been a bigger crybaby in the first 4 hours.

Now – on with the show:

Monday morning, March 2, 2009, I had been awake for just a few minutes, and at 6:31 (official clock radio time!) I heard two little pops. For some reason the night before I had thought maybe I should start sleeping with a pad on since my due date was about a week away. The pops are followed by a little gush, and I get up, go to the bathroom, and shift around to see if I continue to gush, and just to confirm I didn’t pee on myself. I am, in fact, still leaking clear fluid, so I send a text to my midwife, Kelly. I didn’t want to wake up her whole house, and really, my plan was to go back to sleep at this point and see if I can rest until contractions start. It’s still pretty incredible to me that I can send a text message to my care provider (although she is pretty incredible all the way around!)

Here is the abridged version of our text exchange:
6:34am 3/2/09
Me: Good morning, my water just broke, Guess I won’t come to the hand meeting (Homebirth Association of North Dallas)… it is clear and no ctx… I will keep u posted. Nice of baby to wait for Monday…
Kelly: OK. Let me know. How much fluid?
Me: Not a 2-liter but two little pops and a small gush. Maybe half a cup?
Kelly: Ok – and Coco is still moving fine?
Me: She was moving fine last night haven’t felt anything this morning but will have a little cup of juice and let you know asap. Having a ctx now, but not too bad… Going to try to hold off on waking Jason.
Kelly: Sounds good, let me know.

7:34am 3/2/09
I check in with Kelly that I have timed 5 contractions, 5 minutes apart and we discuss the type of contractions. They are different than what I have had the past three weeks, but I have broken my water so it makes sense they would be different now. I also tell her I want Jason to be able to get up and leisurely pack the car, so she advises I should probably wake him up now.

Me (via text): I think I want the company now anyway.

I call Kelly and we talk a little more about how the contractions feel. At this point, I am simultaneously sending Lynsey Stone (our birth photographer) a message on Facebook, and figure I will actually call her later on if I haven’t heard back from her. She immediately calls me back too, because she is awesome like that. I also see on Google, it’s Dr. Seuss’s birthday. Go figure.

I make coffee (not for me – I don’t drink coffee) and go wake Jason up. I’ll interject that he has been furiously cleaning all weekend and I knew he probably didn’t go to bed until 3 or 4 am the night before.

Our conversation goes like this:
Me (shaking him gently): Hey, wanna have a baby today?
Him (waking up): Sure, why?
Me: My water broke.
Him: Where?

Later on that night, on our way home from the birth, I asked him what the heck kind of response “Where” was…. he replied that he assumed that he needed to clean it up.

He is a really awesome husband!

So, I caught him up to speed with my conversation with Kelly, and let him know Lynsey was notified and I leave him to wake up so I can finish up a couple of emails. He calls his parents, and just as we are packing up to leave, Kelly sends a check-in text.

There is a bit of blood and mucus in the water now, and I let her know we will be out the door in 10 minutes.

I text Lynsey in the car. I try to call my mom too, but she is sick home from work, so I leave her an undoubtedly bizarre message.

Somehow we make it to the birthing center (usually 1 1/2 hours away) in about an hour. This is the only time I use my carefully prepared Itunes labor list that I have working on for 6 months. It absolutely helps in the car, and contractions are manageable at 5 minutes apart.

Once we get to the center, Kelly checks me. I am dilated to a 4. Molly (who is the midwife over the entire center) calls Lynsey at about 11 to let her know and she plans to head out soon.

This is about the end of my rational thought – SO I will make my best guess about times from here on out.

After the check, they tell me the contractions will probably be rough for the next two or three contractions.

I want to lay on the bed on my side during the contractions, and Kelly wants me to stand up or be otherwise vertical. I argue with her (I’m arguing, she is gently suggesting), and we compromise to do three contractions laying down and three standing up. I think I did more than three laying down though – as I remember Kelly stepping out for just a moment, and thinking “ha, ha – I am having more than three and still laying down!”

I change in to my cute labor sundress (I had packed several) and put on a fashionable Depends undergarment since I am leaking and getting pretty bloody. They are on me to keep going to the bathroom, because an empty bladder makes for more comfortable contractions.

Around this time, I understand Molly asked Jason if it seemed like I had a noticeable change in demeanor. She came and let us know (in her very calm, collected voice) a few minutes later between contractions (score! still on the bed) that it seemed like I was progressing quickly.

I was so nauseous in between contractions, and I remember having brief moments where I thought about that being a sign of transition, but it was too soon for that (right? I had only been there an hour!).

Finally – and in reality this was probably only 30 minutes later – Kelly busted me and made get vertical. Someone suggested sitting on the giant birth ball, so I got situated on the ball at the end of the bed, with Jason sitting on the bed with my head in his lap and Kim (another excellent midwife who had taken over for Kelly for a couple of minutes) massaging my back.

A couple of contractions went by during which I recall starting to wanting to push, and thinking about getting in the pool, and wondering where my birth photographer was (since I was wearing a REALLY cute sundress!).

I told Kim, “I’m feeling really pushy, and it is too soon.” She told me it might not be too soon, and whenever I wanted to move into the pool we could go. I think the next contraction I decided I didn’t care anymore about looking cute, and it was time to move. I was flexible prior to labor about whether I would birth in the pool or not, but in the moment – it was absolutely where I wanted to be. The pool is like a heated, jetted hot tub, with thick padding, not like your garden tub in your master bath.

Molly mentioned somewhere in this time that Lynsey was struck in traffic in Weatherford (who knew Weatherford has traffic?) but had been instructed to “come in shooting.”

Kim was stripping the top off the pool while I was having Jason strip me down. I was insistent it was time to get in the pool. It is about noon, maybe 12:15. It is a beautiful day outside, and I can actually see the horse pasture from the window right over the tub. Little thoughts like that are a calming moment in between the insanity of my body working to expel my little alien.

Kelly checked me in the pool after a couple of contractions. Kelly declared I was completely dilated with the exception of a cervical lip.

Now, I have NO idea what a cervical lip is in all practicality, and I can’t describe for you what that means. But I quickly learned that the options were to wait it out for the “cervical lip” to move on it’s own, or Kelly could manually hold it back, but that wouldn’t be very comfortable.

I spend a couple of contractions seeing if the lip moves, and while it does decrease, my patience is also decreasing! Time to get baby out, and they can do whatever they need to at that point. I think Kelly was holding the lip, which meant her hand was inside of me during some contractions, but I don’t recall feeling it, or thinking that I would rather wait. The jets get turned off in the whirlpool in expectation of pushing.

I think now I am floating face up in the pool and pushing. I am thrusting my feet against the side of the pool, and people are telling me to relax and I am thinking they are crazy if they think I can push while floating and “relaxing”. I am not at the beach checking out the ocean floor in scuba gear.

Someone has the brilliant idea to tell me to flip over, sort of on my hands and knees, but with a leg out, and some other complexities. I manage to flip over, hanging my arms over the edge of the pool, and tell them to move my legs around to where ever they see fit.

I think my expectation of pushing was more like having a large puppy, and less like birthing a baby giraffe. It felt much more like a baby giraffe or a baby calf, all legs and arms flopping out – although in the end – they handed me a baby human, not a baby horse.

I had moments of lucid thought where I found it absolutely fascinating that I could hear and feel the bones in my body shifting to allow the bones in her body to escape. Those moments were few and far between – but I did have them. I did not feel a “ring of fire” although I am not sure if that was a result of the water, or something Kelly was doing on her end.

Someone later asked if I screamed a lot. I don’t think I screamed, since that would have been unproductive, but I made a lot of noise. If you have seen “The Business of Being Born” – Ricki Lake’s midwife (Cara Muhlhahn) shows her birth on that documentary. She seemed to make the most obnoxious guttural cow noises while birthing her baby. Yeah – that is what I think I sounded like! And as I was doing it, I kept thinking that I sounded like “that annoying midwife on BOBB.”

I felt Coco shift down during one contraction, and I think Kelly could see the top of her head. She then went back up, and thankfully someone told me that was normal and she would come out more on the next contraction.

The next contraction came, and baby stayed lodged down in that odd place with her 13 3/4 inch head wedged at the bottom of my pelvis. In these progressively-getting-weirder moments of calm between contractions, I reflected on the positive feedback Kelly had given me weeks prior regarding the ischial spines in my pelvis. They are not sharp, particularly, and I wondered if I would be feeling a stabbing pain if they had been. Some people have sharp ischial spines. I have a good pelvis for birthing I think and that made me confident weeks in advance.

Logical thoughts in a totally illogical moment, but I survived without fixating on the fact that there was a baby lodged in me, and she was escaping at any cost.

Pretty quickly and after a few more pushes – she was out. Well, the tough part was. Her head and shoulders were free but I stopped short of pushing the rest of her out.

My overactive brain waited for that moment to recall that one of the best ways to prevent perineal tearing was to “breathe” the baby out, letting the body do the work, rather than forcing her out with pushing. So – with baby half out – I decided now was the time to breathe the baby out.

Fortunately – my ever-so-competant team told me to push her out, and Kelly’s urgent tone, coupled with Jason whispering in my ear “you have to finish the job!” persuaded me to get her out.

Baby has broken free, and I am alive after a few slightly surreal moments of thinking I might break in half. It is 1:03 p.m. – 6 and a half hours after the first indication a baby would be coming today.

If you are so inclined to envision it – I now have a baby out of the water, but I am on my hands and knees and she is behind me. I had seen videos of babies born this way, so when Kim told me I needed to lift a leg and spin around so Coco could lay on my chest, I knew what to do. The cord was a little short so she laid on my chest without nursing while we waited for the cord to stop pulsing. I realize Lynsey made it just in time about now, and am so excited. I am trying to get slightly covered up so we have some decent PG-13 birth pool pictures. She hasn’t screamed like most babies coming into the bright lights of a hospital room. In fact, it will be 2 days before we hear her really let loose a good scream, but in her first moments she is serene and alert, adjusting to life on the the outside world.

After the cord stopped pulsing, Jason cut it and he took Coco to a chair in the corner of the room and wrapped her up and talked to her.

I eventually delivered the placenta in the water about 30 minutes later. The placenta birthing was an annoyance. There is no way around saying that. I was anticipating it being something like birthing the baby, so I wasn’t mentally willing it free, though it wasn’t anything like that. No bones. The midwives reminded me there were no bones, and that I would feel a lot better without the placenta in there. Somehow they talked me in to it (although I am sure that placenta was coming out whether I accepted it or not!) and I pushed the placenta out too.

I will interject here that at no time did anyone tug on the cord or try to massage my uterus to hurry the placenta out, or anything of the sort. I knew they weren’t going to do that – but for some reason now that my slightly rational brain had reappeared, I was concerned about the uncomfortable details of giving birth again.

After that, I got out of the pool (which was NOT a gory mess, surprisingly) and wrapped up in a robe. I go back to the bedroom, where my body figures out that I have done something different today than I usually do on Mondays.

Right after was like having the flu for 30 minutes – I was hot, then cold, and I finally threw up. I held the baby for a few minutes and she nursed, then she went back to daddy so I could concentrate on recovering for a bit. Jason called our families and sent a first picture via text message. All they got on that first call was her name, which we hadn’t told to anyone, and time of birth. Weight and height would be a little later.

Quickly I felt stable, and a post birth herbal bath was drawn complete with candles and another great view (in a different room) of the beautiful day outside. After I was in there a few minutes, Coco came in too, and immediately looked completely at peace submerged back in the water. In theory, only her face was exposed, but every time we tried to submerge her feet, she would startle. Kooky Pisces water baby. So she floated on me mostly underwater with her face and toes exposed for a while.

After our bath, we did our newborn exam and determined she was 7 lbs 12 oz and 20 inches long. Jason held the scale while she was weighed, and she gripped our fingers while Kelly did all of the necessary examining.

My turn was next – nothing extraordinary to tell here, it was once again confirmed that I did NOT break in half during the whole event, and in fact suffered only a minor tear that optionally got one stitch. Most likely, had I not had an episiotomy with Todd’s birth, that tear could have been avoided too.

Molly distracted me with a story about surgical glue while Kelly put in my one stitch. And yes, even with a drug-free birth – you still get lidocaine for the stitch! They also sweet talked me through it by promising me a Tylenol afterwards. Nothing says good times to me like some old-fashion pharmaceuticals!

Lynsey’s baby Eden had arrived while all of this was going on, and we got Coco dressed and Lynsey snapped a couple of pictures of the two of them together before she left. We weren’t far behind, pulling out of the birth center about 8 pm, with our perfect 7 hour old baby. We stopped at Starbucks for an iced green tea (Coco and I stayed in the car), and headed home for some spaghetti and a lovely first night together in our own bed.

One might say were extremely lucky to have such a relatively easy birth, although there is another school of thought that most births would be relatively easy if treated in a way that respects the natural process that our bodies are designed for.

I don’t have an agenda one way or another. I have friends who have had wonderful planned c-sections and I respect their choices and decisions just like I want them to respect mine. My hope is that we have options to choose a path that will put us in the best position to have the birth we want. If labor and baby hadn’t cooperated, I truly believe I would have been okay with a transfer or even a c-section – healthy Coco was always my top priority. But, my implicit trust in Jason, Kelly, Kim and Molly gave me the freedom to focus on laboring in a completely safe environment where I could let my guard down and just be. It is an unusual way to spend a Monday, but something I would recommend to anyone who wants to live in the moment…

Hope

Hope- 1) to cherish a desire with anticipation; 2) trust

Isn't hope a beautiful thing? I love it. One of my children even has that as a middle name.

When I am saddest in life it is when I have lost hope. It is the knowledge that things will turn out well. The desire for something better and the faith that it will happen. It makes the sad times easier and the disappointments more manageable.

Hope is necessary for life to go on. It buoys us up when all evidence points to the contrary.

Hope is necessary for birthing mothers. All around us we hear negativity. We hear comments about our beautiful roundness that are not beautiful comments. We might be chastised for planning a natural birth, when so many think that is just not possible and we should settle for whatever we are given.

When we plan home birth we hear horror stories about mamas and babies who wouldn't have "made it" if they were at home. When we plan breastfeeding we hear stories of women with no milk and starving babies. We are told to lower our expectations.

Do these things happen? Of course they do. Does it mean we shouldn't even bother? Only if we would rather plan for misery. There is enough of misery in the world without us planning on it.

But being hopeful is not silly or childish or pointless. It helps us see the joy around the corner when we can't see it yet. When times are the worst we need it the most.

I have been feeling somewhat hopeless about some things in my life lately. All I was left with, when I lost hope, was crushing, debilitating, misery.

I am choosing hope. I will choose it despite my fears about all the things that can and may go wrong. I will chose hope despite the evidence to the contrary and despite a past that discourages it.

Hope is worth the effort. Though not a guarantee of perfect outcome, it is a guarantee that as we plan we will be happier. It does promise us that if things don't go as we had hoped, we will still have enough light left within us to see the end from the beginning.

Here's hoping....

36 Obvious Reasons You Are Capable of Natural Birth

We hear so much negativity about birth these days that it sometimes gets lost in the shuffle that women are divinely designed to birth babies. This is a miracle, but it is also so totally normal and a simple bodily function. Here are a few reminders (yes, many of them obvious) of the truth that we have forgotten about our bodies.

1. You are a woman
2. Your mother was a woman and she gave birth to you.
3. As was your grandmother and all of their mothers before them.
4. Women have literally for 1000's of years been doing this and surviving. The proof is that we are all HERE.
5. Medical doctors stepped into birth only about 100 years ago, and yet people were breeding successfully all that time before.
6. You have a vagina.
7. You got pregnant.
8. You are gestating beautifully.
9. All the discomforts and aches and pains, though possibly annoying, prove that your body is DOING its job.
10. You have breasts.
11. Those breasts exist in large part for one reason: to feed your offspring.
12. Your monthly cycle.
13. Many natural urges exist in part to bring about this child.
14. Your growing abdomen.
15. Your extra weight gain.
16. Your full breasts.
17. Your food cravings.
18. Your pre-labor or Braxton-Hicks contractions show that your body is preparing to birth.
19. Stretch marks indicate growth and fertility.
20. The epidural= new invention.
21. The episiotomy= also, new (and unnecessary).
22. The c-section= again new, and yet, women most often survived birth during all those years.
23. Your bones and ligaments are moving and softening to open for the baby.
24. You have hips.
25. You have a pelvis, and it is very different than that of a man.
26. Your pelvis, though bony is movable.
27. Have a big butt? Embrace it- it is a sign of your fertility.
28. Small butt? That's OK too- you will just fit in your skinny jeans faster. Your pelvis still moves.
29. Your ancestors for 1000's of years gave birth with no medical intervention, and they must have survived, because, here you are! (I know, a repeat- it is important!)
30. Birth is the natural end and climax of the act of making love.
31. Worried about birth pain? Don't be. Contractions are natures way of letting you know that your baby is coming. Without this warning system, we could drop our babies ANYWHERE, safe or not. The birth process is necessary preparation for a safe arrival.
32. Your baby moves- he or she is preparing you to love them.
33. Your babies movement also shows how good you are (without even trying I might add) at feeding and growing a baby.
34. All prenatal tests are new inventions. Your ancestors also gave birth without these.
35. Even 50 years ago the c-section rate was around 4%. This "need" for constant surgery is a new occurrence.
36. Worried about motherhood? The birth process and all its stages are also helping prepare you to mother with confidence. The lessons you learn in labor (faith, excitement, hard work, pain, joy, giving up, euphoria) will all be repeated over and over as you raise your children. It is natures preparation for mothering.

ACOG Strikes Again

Just when I think I have nothing else to write about, they go and issue an "opinion." They is ACOG (American Congress of Obstetricians and Gynecologists) and the opinion is on home birth no less. Here is a link to the "opinion" so you can read it in full. (As an aside, did you know that this group, that has paved the way for a 30%+ c-section rate actually,

"strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care."

Yes, it actually says that in their description of themselves. Deep breath. )

Lets begin at the beginning, shall we?

"although the absolute risk of planned home births is low, published medical evidence shows it does carry a two- to three-fold increase in the risk of newborn death compared with planned hospital births."

Well, I can get behind the whole absolute risk of planned home birth is low, but it carries a two to three- fold increase in the risk of newborn death? Is this true? Lets check the sources for these studies cited in the "opinion".....

Wait, they didn't cite their sources. Are we dealing with a physicians group or not? Maybe they got called away to an emergency birth and didn't have time to cite their sources. That's fine, I can go see if I can find some with the handy dandy Internet. I have no doctorate so we shall see how it goes.

Wait! Here is one, from Canada but a nice big study. And I quote:

"Results: The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician. "

That looks suspiciously like the rate of death in the physician attended hospital group was 0.64 but was 0.35 in the midwife attended home birth group, almost half! No, this can not be the study they were referring too, the data is switched, more people are dying WITH the doctors. I must keep searching.

Here is another study. They found that:

"CONCLUSIONS: The perinatal hazard associated with planned home birth in the few women who exercised this option was low and mostly unavoidable."

This must not be the study that ACOG was thinking of either, it seems to indicate that sometimes, things just go wrong.

Ahh, this just might be it. A study in Washington done by looking at birth records which found that home birth was less safe than hospital birth. Here is Henci Goer tearing it apart for bad research practices and including pre-term and unplanned or unattended home birth in their data. This might be the famous "home birth kills" study that appears to be deeply flawed.

Lets move on though.

"A review of the data also found that planned home births among low risk women are associated with fewer medical interventions than planned hospital births."

Ahh, interesting. This is on of the big reasons why women choose to birth outside of the hospital and far far away from anybody associated with ACOG. Yes, even they admit (because maybe they don't realize that interventions are a BAD thing?) that home birth tends to result in much lower intervention rates.

I am getting tired but I am going to keep trudging through this "opinion" paper. Lets just skip to the end.

"The recommendations state that a prior cesarean delivery is an absolute contraindication to planning a home birth due to the risks, including uterine rupture. Women who want to try for a vaginal birth after cesarean are advised to do so only in a hospital where emergency care is immediately available. Attempting a home birth also is not advised for women who are postterm (greater than 42 weeks gestation), carrying twins, or have a breech presentation because all carry a greater risk of perinatal death."

Oh yeah, I almost forgot about the dangers of birth for women who have already been literally cut by a prior hospital intervention, or were crazy enough to go post dates or have twins. They need to be in a hospital where interventions they are trying to avoid are readily available.

I am not even going to take the time to look up studies to contradict this. In fact, I have no doubt that there are higher risks with VBAC, twins or post date pregnancies. Instead of trying to prove ACOG wrong with studies, lets just look at something that they themselves stated just a few months ago when they came out with a new VBAC statement. (TOLAC refers to trial of labor after cesarean.)

"most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. In addition, "The College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC,"

Nowhere do they say that they endorse home birth, but they do admit that women should be "allowed" to labor even if they have had more than one c-section or if they are carrying twins AFTER a previous c-section.

They also go on to admit some of the problems that can be avoided if a woman is able to VBAC rather than have a repeat cesarean.

"A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection, and abnormal placenta conditions (placenta previa and placenta accreta)."

Lets end with a sentence from ACOG's new opinion.

"A review of the data also found that planned home births among low risk women are associated with fewer medical interventions than planned hospital births."

Boys, let me get this strait- you admit that home birth has fewer interventions than hospital birth. You also admit that attempting a VBAC is safe as is twin delivery. You admit to the high success rates of VBAC. You also claim to advocate for patient safety and education.

Ladies and gentlemen, the reason so many women birth at home, in PARTICULAR when they are attempting VBAC or are higher risk for some reason, is that they WANT to avoid those higher hospital intervention rates. They know that they will be fighting an uphill battle if they dare gestate for longer than 40 weeks. They know that they are simply less likely to be interfered with if they birth at home.

I am not saying that ACOG is totally off base. There is some truth in their statement. I wholeheartedly agree that you must choose your birth attendant carefully and have plans in place for transfer or possible emergencies. Planning a home birth is NOT fool proof. Things can go wrong. Educate yourself. Know what is safe and legal. Know what your attendant is capable of and how well trained he or she is. Do everything you can to prepare for good outcome.

But I do hope that women will continue choose birth that is safe, beautiful, and natural and not be scared off by this ridiculous statement unbacked by any research notes.

What speaks louder than anything to me is that ACOG takes the time to even comment on home birth. They must know that only about one percent of women in America choose to birth this way. And yet, they are worried about it.

I think the reason that the powers that be care at all about home birth is not that they are worried about yours or my safety, it is because they realize on some level, that birth can be much more than they will ever be able to offer in their hospitals. They don't want the word to get out. That, could hurt their bottom line.

Birth safe.

Birth Story- A Positive C-Section

I have been posting positive birth stories on this blog for months now and this birth story is different than an others I have ever posted. I think it is important to read and very telling about what does and does not make for a good birth experience. For one, a good birth is different to every woman. That being said, I have noticed that how happy people are with their birth experience has more to do with how kindly and respectfully they are treated than where or how they birth. Enjoy!

I moved across the globe at 32 weeks pg. I was single and didn't know anybody. I had worked labor and delivery years before but really didn't know anything that hadn't been fed to me by medical staff. I was 40 weeks along when I finally allowed the nurse practitioner to even check my cervix, as she was doing so I told her it was pointless as I hadn't even had any CTX yet, she laughed and told me I was having one right then, further more I was already 4 cm.

Then she sent me on my way. I spent the weekend preparing, and on Sunday went out sightseeing with some new found friends. We spent the entire day out and about. I got home just after dinner time and finally went to bed. I couldn't sleep. so I got up and took a hot bath, ran out of hot water ( stupid broken tank lol).

So finally around midnight-1 am I called my friend and asked her to come get me and take me in, all I wanted was some sleep aids as I still didn't feel CTX. When I got to the hospital I was checked and found to be 5 cm. I asked for sleep aids and was offered an epidural. Even though I wasn't feeling CTX I agreed if it would help me sleep. By the time the Anesthesiologist got there the CTX were hard. so I was thankful. I fell fast asleep. In the morning I awoke to the Midwife saying this is no way to have a baby (he wasn't the kind to mince words) I just lay there thinking it was the perfect way to have a baby. A few hours later I was uncomfortable and briefly regretted the epi since I couldn't get up.and we'd discovered that the baby was facing up so moving me into different positions trying to get him to turn was difficult.

After 2 hours the Midwife finally called the Doc. he got there and came to talk to me. I remember how sweet he was assuring me I was doing a great job and that if I wanted I could keep pushing. It had been more than 3 hours at this point so I point-blank asked if the baby was moving and he said in a very disappointed voice, no I don't think he is, and he's too high for forceps. So I agreed to a C/S. they dosed up my EPI becasue it was a holiday and the surgical staff was doing an emergency appendectomy (I wouldn't have let them call in the back-up team without an emergency)

An hour and a half after the decision was made we went in and I had a C/S. The first thing the midwife said was WOW that is a big baby. While they worked they both ( Dr and Midwife) commented on how I had plenty of room in my pelvis. that just a cm less angle to his head and he would have flown out, but as it was my 9 lb 15 oz baby was not only facing backwards, but had his head tilted at just an angle to be completely lodged. My midwife told me that no matter what they'd tried it would likely not have worked because he was seated in there very well. they also laughed and said that his giant cone head proved I was an awesome pusher.

In the days after my birth my Dr. the surgeon mind you made a point to tell me that I was totally capable of VBAC'ing a baby at least this size if not bigger. He was so supportive, The midwife supported me insisting I had done everything that could be. I honestly had no clue why they were doing this. I felt emotionally fine about it all sure I was sore, but my baby was healthy and to me that WAS the important thing.

I share this because my story has many of the "natural birth" horror elements yet for me it was a satisfying experience that I have no problems with to this day. I am the poster child for successful VBAC. and I would never chose an elective C/S. I'm now a doula and active VBAC supporter. But my most recent VBAC was far more traumatic than my C/S. I had everything lined up against me the first time, no family, no close friends, co-workers delivering my baby, single mom with no involvement from the baby-daddy. But because of the support and care of my medical providers I had a positive experience.

During my last (3rd) textbook perfect- VBAC wonder story ( 9 .6 lbs flew out in 3 pushes) I was left with a lot of emotional trauma because of a horses posterior Doc.

~

I would like to add a note not really as part of my birth story but feel free to post it too. I have spent many years working in the OB field, don't assume that your staff does these things because they don't care,. With my second birth I asked my Dr. ( different one) What he thought about VBAC vs C/S and he said " I'm a jaded OB, I will choose C/S every time because I can control that. that doesn't make it your best option". See he worried more during a VBAC because it's out of his control, but he stood by my decision. I've seen medical staff cry right alongside a patient with a bad outcome. I'd seen a Docs get angry with themselves even though there was nothing they could have done. And I've sat in staff meetings were we scoured every second of a birth for any minute thing we could have done differently. Most of us care. we're just uninformed.

Anyway I certainly hope this made sense. I am a genuine supporter of no-intervention and Birth centers. To be frank I have seen just enough genuine emergencies that HB would never be an option for me. I don't want to come across as Pro-C/S because I'm NOT I just don't want anyone to think they should feel less of a woman, of a mom, because they had a C/S.