Midwives Save Lives

May 22, 2013 at 10:50 pm

Midwives have been saving mothers and babies for thousands of years. Long before the words “hospital” and “obstetrician” even existed, midwives were passing down the skills and wisdom of their wise women, nurturing mothers and babies into life.

In one of humanity’s oldest and most well-read stories, midwives were saving lives. The first chapter of Exodus tells of two midwives (Puah and Shiphrah) who saved countless lives through their courage and compassion. When Pharaoh demanded that they kill all the male babies born to the Hebrew women in slavery, Puah and Shiphrah saved the boys instead. It is likely thanks to them that anyone knows and reveres the name of Moses. Midwives save lives.

My own faith’s history claims many brave midwives. In the late 1800’s, Emma Andersen Liljenquist attended a course in midwifery after Mormon church president Brigham Young had urged many women to receive medical training to meet the needs of the Utah’s growing families. (You can read more about Utah’s midwifery history here.) Emma recorded these experiences from her years as a midwife among Utah’s early settlers:

Film Review: Birth Story

April 24, 2013 at 4:52 am

“Some of the best birth footage out there–a must-see for anyone even remotely interested in the subject.” -Ceridwen Morris, CCE, childbirth educator, and co-author of From The Hips

When I received an email last week asking if I’d be interested in reviewing the film Birth Story on my blog, I immediately responded, “Yes!” I received my copy of the film over the weekend. My husband watched some of it with me, in between doing the dishes. I was impressed at how much it didn’t seem to freak him out. I guess I shouldn’t have been surprised. He’s been married to me for almost twelve years, after all.

Gift

October 22, 2012 at 3:11 pm

Saturday was my birthday, and I was given a wonderful gift at the end of the day. I received an email from one of my readers, sharing how my essay “Unity with Providers of Care” (in the Unity chapter of our book) had a positive impact on her. She also shared a beautiful spiritual experience she had after reading my essay. With her permission, I share it today. -Lani/Busca

I’ve been reading your blog for a while now, and have been making my way through The Gift of Giving Life, and I wanted to tell you how much your book has helped me.

Long story short, I was very unhappy with the hospital care I received with my 3rd child. While I like the Ob/Gyn I normally see, they have about twenty doctors that rotate at the hospital. With my 3rd child, I played Russian roulette with this system and ended up with two very horrid doctors who threatened and yelled at me for giving birth the way I wanted to. So I have been hoping to find—and not have to pay for—a better option for my 4th child.

Yesterday I had a very important meeting with the head OB for the insurance provider we have to discuss whether or not I could get a referral to a birthing center.  I’d been waiting for a month for this appointment and was very keyed up about the whole thing, so I went to bed the night before knowing that I probably wouldn’t be sleeping well…

Read the rest of the post HERE.

Doula ripples

February 1, 2012 at 7:33 pm

“Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth” -(Hodnett and colleagues 2011)

Jennifer just asked this question on my Birth Faith facebook page wall: “My friend’s OB told her that hiring a doula was ‘dangerous.’ What would you tell her?”

Good grief.

I’ve shared in a previous blogpost (Why hire a doula?) what a doula’s presence can do for a woman’s birth experience using my own experience and stats from scientific research. Let me reiterate that research quickly.

Gathering and analyzing the results of 15 studies, a team of researchers found that, compared to women laboring without a doula, women who labored with a doula were:

• 26% less likely to have a cesarean section
• 41% less likely to have a vacuum extractor or forceps delivery
• 28% less likely to use pain medication or epidurals
• 33% less likely to rate their birth experience negatively
(Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2003. Issue 3. See DONA).

But did you know that the benefits of having a doula’s assistance don’t end at birth? There are significant ripples that can impact a woman, her baby, and her relationship with her baby’s father. 

Dolphins and birth plans

January 20, 2012 at 4:39 pm

[Originally posted April 2010]

While I was in California a few weeks ago, we hit the beach. Almost as soon as we got there, we saw something swimming several yards out in the water. At first I didn’t know what it was and sort of screamed (thinking shark), “There’s an animal!” Once it became clear it was a pod of dolphins, I had to smile to myself, reminiscing.

I used to be mildly (or… very) obsessed with dolphins as an adolescent. I had dolphin figurines, dolphin stuffed animals, dolphin posters, dolphin videos, dolphin stationary, dolphin everything. I did book reports about them, dreamed of swimming with them, toyed with becoming a marine biologist because of them, etc.

I was reminded of that adolescent dolphin fascination again this morning. I’ve been skimming through Marsden Wagner’s Creating Your Birth Plan off and on over the past week or so, contemplating lending it to my newly-pregnant sister-in-law. This morning I lingered on p. 176 where Dr. Wagner shares some fascinating details about dolphin birthing. Here’s an excerpt:

At its physical and emotional best, support for women in labor has always reminded me of dolphin birth. When a dolphin gives birth to a calf, several female dolphins swim in a circle close to the laboring mother. Slightly farther away, another larger group of all the remaining females in the pod circle around the laboring dolphin. Then, even farther away, all the male dolphins in the pod circle around her. The entire collective comes together to protect the laboring dolphin and her emerging calf from intrusion and harm. A woman giving birth to a baby thrives when she’s at the center of a circle of love.

Improving fetal monitoring

October 27, 2011 at 7:04 pm

My sister emailed me a link to an article about electronic fetal monitoring this morning: “Unnecessary C-sections performed due to fetal heart rate system” from KSL.com. The article explains: “Maternal-fetal medicine specialists believe fetal heart rate patterns may not be a good indicator of a baby’s health, and may lead to . . . unnecessary interventions and higher health care costs.”

I’ve heard this many times before in my own research, so I was glad to see it getting more attention in the mainstream media. While it’s definitely important to ensure our babies are weathering labor well, the current system of monitoring and interpreting eletronic fetal monitor tracings has proven itself unreliable. I blogged about this issue in July of 2009 on my old blog.  Here’s a re-post:

Cervical scar tissue and cesareans

September 12, 2011 at 9:13 pm

One of my most popular blog posts is one I wrote just over a year ago called “Cervical scar tissue.”  In that post, I shared important information about how scar tissue from various procedures (LEEP, D & C, etc.) can potentially impact future birth experiences, causing labor to stall for hours or days if the scar tissue isn’t massaged by a caregiver to help it release and allow the cervix to dilate completely.  I also said:

I have a hunch that cervical scar tissue is likely contributing greatly to the rising cesarean rate. . . . Unfortunately, doctors aren’t usually around while their patients labor, so massaging the scar tissue rarely happens. Instead those women far too often get stamped with “failure to progress” after a long, exhausting labor, and sent to the operating room.  Many spend the rest of their lives believing they’re incapable of giving birth vaginally. (Cervical scar tissue)

And now I’m even more convinced than ever that a large percentage of today’s cesareans and “failed” VBACs are happening as a result of cervical scar tissue. A comment from Lauren on my post has alerted me to something alarming:

Emergency Preparedness

January 29, 2011 at 4:56 pm

Regardless of what type of disaster may strike or how severe it is, there will always be pregnant women in need of special assistance. Pregnant women are among those most at risk in disaster situations, in part because severe stress can trigger premature labor, but also because so many women are forced to give birth under precarious circumstances. When hospitals may be over-flowing with sick and injured survivors, roads or transportation inaccessible, and electricity likely unavailable, women who would otherwise have given birth at the hospital will have to seek alternatives.  It is also a possibility that hospitals will only have resources for the most high-risk pregnant women, leaving low-risk mothers to give birth with little or no assistance from staff.   Even in the absence of a large-scale disaster, on just an ordinary day-to-day basis, sometimes a birth happens too quickly to make it to the planned location or before a qualified birth attendant can be present.

Robbie Prepas, a certified nurse-midwife, saw many such births first-hand during the Hurricane Katrina disaster.  She delivered five babies in the New Orleans airport, twins in an ambulance, and provided impromptu care to hundreds of pregnant and postpartum women, checking fetal heart tones, etc.  She explains, “There were no policies or procedures in place to care for pregnant women or mothers and their babies after Katrina.  We even lacked such basics as diapers, formula, baby bottles and clean clothes” (“Disaster Preparedness for Mothers & Babies: Getting Prepared”).  Midwife Mary Callahan, CNM, MS, also assisted in the Hurricane Katrina relief effort, providing midwifery services to displaced women in a large shelter and assembling emergency birth and prenatal kits for use in other area shelters (“Chicago Midwives Travel to Baton Rouge”).   While we may be fortunate to cross paths with a doctor, midwife, or paramedic with birth supplies in an emergency childbirth situation, we can’t be certain of such luck. Given all of the possibilities, the best course is to have plans and supplies in place so that we can meet our specific needs in emergency situations.

Birth Junkies: the next generation

November 20, 2010 at 4:35 pm

Speaking of my daughter… we had another birthy conversation over lunch yesterday. We got talking about her dream again, and then, between bites of her lunch, she asked me, “Mom, do you think you should have this baby in the hospital or at home?” Before I even had a chance to respond, she said, “I like home better.” When I asked her why, she kind of giggled and said, “If you went to the hospital, your baby would be caught by a doctor!” Her facial expression made it clear that this was not the ideal scenario in her mind. Then she said, “It’s better if a midwife catches your baby. Or if YOU catch it.”

You might think I spend my time brainwashing my children with my particular birth philosophy, but I really don’t. And I know there are countless wonderful obstetricians who catch babies every day. We’ve never had a conversation about the pros and cons of different types of care providers with our kids before. I also find it so interesting that she never says anyone will “deliver” my baby… only that someone will “catch” it. I know I’ve talked about babies being “delivered” many times, so it’s not that she hasn’t been exposed to that terminology. So so interesting. She also happens to be obsessed with birth YouTube videos. I couldn’t even count the number she has watched with me, always saying, “Let’s watch more!” The sounds and bodily fluids don’t frighten her in the least. She loves all things birth-related. :-) That’s my girl.

The Bed Rest Myth

September 28, 2010 at 10:53 pm

“Bed rest does not appear to improve the rate of preterm birth and should not be routinely recommended.” -American College of Obstetricians and Gynecologists

“The majority of women who are on bed rest don’t need to be, and many experience physical, emotional, and financial complications that are completely unnecessary.” -Mark Taslimi, M.D., professor of maternal-fetal medicine at Stanford University

“Just because something is widely believed doesn’t make it true. Scientifically, bed rest is simply not a valid treatment.” -John Thorp, M.D., a maternal-fetal specialist at the University of North Carolina School of Medicine in Chapel Hill

Disclaimer: Nothing contained in this post should be considered medical advice. If you have concerns or questions, please consult with your healthcare provider.

Several weeks ago, someone I care about was put on bed rest (at seven months pregnant) for some worrisome cramping she had been and continues to be experiencing.  Her situation catapulted preterm labor and bed rest onto my radar screen with big flashing red lights.  I had never really given preterm labor or bed rest much thought because I had never experienced them nor had anyone close to me.  As I started digging into the scientific literature on these subjects, I was totally blown away by what I discovered.  I’ve been researching pregnancy and childbirth topics for over seven years, but, yet again, I’m asking myself, “How did I not know this before?”

Before I dive into those stunning facts, let me first set the scene with the not-so-pretty reality of the bed rest experience.

Bed Rest Challenges

“Rest cure” has been recommended to women as a means of treating a wide variety of physical and emotional ailments since the 1800’s.   Almost a million American women are prescribed bed rest during their pregnancies every year for all types of pregnancy complications. 

Suicide: the silent thief of mothers

September 13, 2010 at 11:23 pm

A story my sister-in-law told several years ago has been on my mind today. She had been living in Denmark as a missionary and had a strong feeling one day that they needed to stop and visit a particular friend who had recently given birth. Upon their arrival at her home, the woman (visibly distressed) started crying and explained that she had become overwhelmed with thoughts of harming herself or her new baby, so she had been calling out to God to please send help. My sister-in-law’s arrival likely prevented a horrible tragedy that day.

This story was on my mind because of an alarming fact I discovered for the first time today. For so long I have read and believed that hemorrhage was the leading cause of maternal death. And hemorrhage does, in fact, account for a large portion of maternal deaths–25% of them, according to the World Health Organization. What I didn’t know was that there is (more specifically in the developed world) a larger and more disturbing cause of maternal death.  According to the 1997 to 1999 Confidential Enquiry into Maternal Deaths conducted by British medical researchers, the leading cause of maternal death (within pregnancy and the year following childbirth) wasn’t hemorrhage.

Cervical scar tissue

September 8, 2010 at 11:53 pm

Last Friday I saw my midwives, Mary and Nedra. We finished the whole urine, weight, blood pressure, fundal height, heart tones routine in about fifteen minutes, and I asked a couple of questions about vitamin K and ultrasounds, and then we just got chatting. Quite a bit of time passed, and their next client didn’t show up, so we just kept on chatting. I could have stayed all day, I think. It was so great to have extra time with them.

I don’t remember how we got on the subject, but Mary started talking about the cervixes of women who have had a LEEP procedure. I didn’t know what LEEP was, so she explained that it’s when they go in and cut away abnormal cells from the cervix. Then bells and whistles started going off in my head because I remembered reading several months ago about how having procedures done on your cervix can create scar tissue that often proves troublesome during childbirth. My midwives said they’re seeing more and more women with cervical scar tissue.

When I first learned about cervical scar tissue’s impact on labor, I thought: women need to know this! I did share a link on facebook and in the sidebar of my blog, but then I let it slip to the back of my mind. After the chat with my midwives on Friday, I felt driven, again, to spread the word. With more and more women approaching childbirth with scarred cervixes, this information is more important than ever. In fact, I have a hunch that cervical scar tissue is likely contributing greatly to the rising cesarean rate.

Improving your epidural birth: Hire wisely

August 17, 2010 at 9:13 pm

A former college roommate and beloved friend came into town this past weekend and stayed with us Saturday night. As we chatted late into the night, she made a request. Could I created some more basic posts for women like her who don’t spend all their free time devouring birth-related media… women who aren’t sold on the “natural” bit (at least not yet)… women who plan to get epidurals but still want to improve their birth experiences? I thought that was a great idea. I think I’ll call this series: “Improving your epidural birth.” And here’s the first installment…

The first, and perhaps most important, tip I would offer to pregnant women (whether they want epidurals or not) is this:

Hire your care provider wisely.

Magnesium for pregnancy and beyond

July 20, 2010 at 6:54 pm

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Magnesium is incredibly important.  (Especially for pregnant women, but I’ll get to that later.) Magnesium is probably most well-known for its partnership with calcium in muscle function–calcium contracts muscles, magnesium relaxes them.  But magnesium is actually involved in far more than that.  From what I gather, every time a nerve cell fires, magnesium is required to control the entry of calcium into the body’s cells.

Avoiding tearing and episiotomies

July 19, 2010 at 3:39 pm

Giving birth for the first time was one of the most empowering experiences of my life. My water broke, my contractions started, everything progressed smoothly, and, less than six hours later, my baby girl was born. It was an ideal birth experience, except for one thing. That one thing made my next few weeks of recovery extremely painful. I tore. I really tore.

Despite the painful recovery, this was actually the lesser of two evils for me. Though some caregivers continue to cut episiotomies in as many as 80% of their patients, medical research does not support routine episiotomies. Studies from as far back as the 80s made it clear that routine episiotomies have no benefits and carry real risks. One of the most detrimental risks is that episiotomies can lead to further tearing, sometimes extending into the anus. These fourth degree anal tears almost never occur without an episiotomy. In addition, a spontaneous tear may only reach into the surface layers of skin, while an episiotomy cuts into far more layers. Episiotomies are rarely warranted and should be reserved for those unusual emergency cases. Ultimately, even without all the evidence, I just didn’t want someone cutting me. I knew, going into my first birth experience, that if I had to choose between them, I would choose to tear. And, tear I did.

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