Showing posts with label history. Show all posts
Showing posts with label history. Show all posts

Thursday, August 11, 2011

a couple thoughts on vbacs

My opinion is that in nearly every case of a physically healthy and mentally prepared pregnant woman, a vaginal birth is completely achievable after a previous cesarean section.  If you don't believe that, then you probably shouldn't try it.  It might be too stressful to be a good experience for anyone.

The one thing I hear people are worried about when attempting a VBAC is that their incision will burst.  There was a time when this did happen to multiple women; and it can be deadly for both the baby and the mother.  But according to my doula instructor (who is also a nurse ... among countless other things), this happened because doctors began trying out cytotec.

Cytotec is a drug that was made for a completely different purpose, but someone noticed that it caused horrifically strong contractions in pregnant women.  Stronger contraction will get the baby out quicker, right?  Well, whether or not that is true, your body can only handle so much.  A weight lifter can only lift so much before they will tear something.  A runner can only run so hard before they will collapse.  And your uterus was built to handle a certain amount of stress.  Drugs can do all sorts of crazy things to make your body change and/or simply ignore the limits that exist to protect it.  While this can be quite useful, it can also be deadly ... as in this case.  This drug caused contractions so strong that the incision burst in laboring women, and also wreaked some serious havoc on those without an incision.

Cytotec now has "Not for Pregnant Women" all over it's labeling, as was shown to me by a midwife recently.  She told me she keeps it on hand in case a woman is bleeding uncontrollably after the birth ... the contractions will close up the uterus and hopefully help stop the bleeding.  "It's something we would do as we were calling 911 at the same time ... I never use it otherwise."

Another newer trend that is contributing to the VBAC fear is that some doctors are favoring a single row of stitches in the uterus, instead of the previously required a double row.  The reasoning is that it is much faster; less time bleeding and having your insides on the outside.  Is it really better?  I don't know, but from what I've been told it's not widely accepted.

Whatever method your doctor may have used in the past, you can't do much about it now.  But there is a lot you can do.  Stay healthy.  Walk, walk, walk.  And learn everything you can.  Read "Understanding the Dangers of Cesarean Birth: Making Informed Decisions".  Scour these websites:
www.dangersofcesareanbirth.com
www.vbac.com
www.childbirthconnection.com

Take control.  Nothing contributes to a successful VBAC more than a prepared, positive mother.

Sunday, November 21, 2010

eating and drinking

During labor, nearly all hospitals restrict eating and drinking.  It stems from a procedure that is rarely used today, and is quite unnecessary.  Eating and drinking (juice, particularly) will boost your energy and aid you physically, and oftentimes emotionally as well.  Talk to your doctor to see if this will be a possibility.

I just read a really great article about it, and here is the first paragraph to tantalize your tastebuds ...
"The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new review co-authored by a Queen's University Associate Professor."
Read the rest of the article here.

Monday, October 18, 2010

a historical look at birth

In my doula training, we watched a movie entitled "The Timeless Way".  It was amazing.  Very well done.  I wish I could post clips from the film on here, but I cannot.  For this post, I will be drawing from notes I took from that movie, as well as things we discussed as a class.

In nearly every ancient culture, there was a goddess of birth.  She was a goddess of intense passion, ferocity, and mystery.  Pregnant women were considered to become daughters of this mighty goddess.  In the woman herself lay the power to bring forth the child.  Midwives and birthing assistants did very little besides support the mother, unless difficulties arose.  Today we are lucky to have many interventions that save the lives of women and their babies, but sometimes they are used as a routine, disrupting a process that has worked for hundreds of thousands of years.

When looking at artwork from years passed, across all cultures there are an amazing amount of similarities.  Most notable is that the woman is completely upright.  Whether standing and holding onto the husband -- when he was culturally permitted to attend the birth -- or birthing partner and the midwife kneeling behind, or sitting on some sort of chair or stool with the birthing partner at the head and the midwife at the knee, every culture worked with the aid of gravity and movement.


 It is interesting to note the differences in the artwork as time moved on.  In the 1600's men began to replace midwives, but usually only for the difficult births.  Medical journals consisted of drawings of the woman, the midwife, the birthing companion, and the surrounding area.  A doctor named Witkowski studied birth among the native Americans, and drew many such pictures including postures and facial expressions.  They were wonderful sketches.

As time moved on and these doctors became increasingly skilled at fixing things, the artwork began to change.  Medical journals no longer showed pictures of the birth as a whole, but were extremely compartmentalized.  Typically the woman was completely covered -- even her face -- so that only the birthing canal could be seen.  In any picture where the woman's face was left uncovered, the women appear alone and fearful verses early pictures depicting a fierce, passionate woman. With the rest of the laboring woman ignored, the focus on one specific area allowed doctors to learn much about what happened during birth, which lead to many different interventions.  Here is where we also begin to see women laboring flat on their backs versus upright, now still and working against gravity.

Up through the 1930's midwives still came to the homes of low-income families, but those who could afford it went to the hospitals.  Most women had been told that the pain they suffered during childbirth was a curse stemming from Eve, as she was the first to partake of the forbidden fruit.  When the women's rights movement was well underway, feminist activists demanded the use of newly-developing pain killers.  Most notable was a drug-induced "twilight sleep".

Women did not remember anything about the births, and so thought it was a painless process.  The drug did not actually diminish pain, but it did diminish the mother's memory and ability to control herself. There were many instances where women seemed to go mad and attack doctors and nurses, and so they were blindfolded and tied to the beds.  Babies were kept in the nurseries for several days, until the drug wore off enough that the mother could care for her child.

By 1945 most women were convinced of the safety of hospitals.  The fear of infection drove many to these sterile buildings, and babies were delivered without ever touching another human being's skin for several hours.  They were delivered with rubber gloves, bathed with rubber gloves, and brought to their mother carefully wrapped.

At that point midwives were thoroughly discouraged, even for low-income families.  Many advances were made to save the lives of women and their babies, and birth became a medical instead of natural process.  Husbands were not allowed in rooms until the sixties, when the hippies demanded the right to have their loved ones experience the process with them.

Today midwives are still mostly looked down on in our country, and illegal in some states.  One third of all our births end in c-section.  Out of 224 countries, the US ranked in the 180th spot for infant mortality rate.  The three with the lowest infant mortality rate for the year 2010 were Singapore, Bermuda, and Sweden in that order.  Most American women fear birth, and look to avoid the experience in varying degrees.  That option is available in much safer measures today, and most hospitals allow at least one person in the room during labor.  With all we have learned in the medical field, there have been many advances and we understand the process fairly well. This new-found knowledge has taken the ability from the laboring woman and given it to the machine.  The doctor became trained in everything that could go wrong, and the body is often distrusted and dangerous, switching out the goddess of childbirth for the god of medicine.

However, this knowledge has also improved the ability of midwives and the trust in the body in many countries.  Around the world doctors attend high risk or difficult births, and are there for any woman who may be fearful.  The birth of the family is becoming an extremely controversial event with countless options for those who seek them out.  Whether selecting a midwife or a doctor, laboring alone or with family, make sure you feel confident in your choices so your family can be everything you want it to be.