Birth at Home in Arizona: July 2008

Thursday, July 31, 2008

Book Review: "Beyond Morning Sickness: Battling Hyperemesis Gravidarum"

I posted this on my hyperemesis-awareness blog some months ago, and wanted to just repost it here, as it is definitely about pregnancy and birth! Here it is....

This is the review as I have posted it on Amazon.com. I really cannot say enough in praise of this book! Here goes:

"Hyperemesis Gravidarum (HG) is a severe form of “morning sickness” which is characterized by one or all of the following: unrelenting nausea and/or vomiting, dehydration and/or malnutrition, rapid weight loss, and the inability to keep food and/or liquids down (or even eat at all).

If you are reading this review, you are most likely suffering from HG, a past sufferer from HG, or the friend, relative or caregiver of someone suffering with HG.

If that is the case, here is my recommendation: Before you read any further, stop, go back to the top of the page (on Amazon), and order “Beyond Morning Sickness: Battling Hyperemesis Gravidarum.” You need this book.

As a matter of fact, order a couple. One for you, one for your doctor or caregiver, and one for family members. If you’re exorbitantly rich, buy a small stack and hand them out to every person who says, through word or deed, “Oh come on. We all dealt with morning sickness. Stop whining and get over it.”

After my own relatively-minor bout of HG, I started looking for answers. Where does it come from? What can we do about it? Well, no one knows the answer to the first question (theories abound), and there are multiple answers to the second (although each person requires specialized treatment – what works for one may not work for another). This book deals in depth with treatment options for HG, from the minor to the life-saving, giving details, risks, procedure descriptions, drug information, and oodles of personal testimonies.

I first found Ashli McCall through her excellent blog, which details her fourth trip through this fiendish disease:

http://www.hyperemesisgravidarum.blogspot.com/

There is literally no experience having to do with HG that this amazing woman has not dealt with, from the amusing to the tragic. She is truly the be-all-end-all in terms of knowledge about this disease, because she has dealt with almost every drug, treatment and procedure for HG that currently exists. One of the best parts about this book is the realization that “Oh my gosh, someone understands!!” HG sufferers know firsthand the infuriating comments that we get by the handful:

“Oh yeah, I had bad morning sickness too. Couldn’t eat bacon for weeks.”
“Go outside and get some fresh air. You’ll be fine.”
“Stop thinking about yourself so much. You’re making yourself sick. Just snap out of it.”
“Eat crackers and drink ginger ale.”

Due to the rarity of this condition, most people have not heard of it. When you combine that with the fact that most women have dealt with some sort of morning sickness at one point or another, that adds up to a bad combination – and the result is that HG sufferers almost never get taken seriously, by friends/family/coworkers/general acquaintances or by doctors and caregivers. By outsiders, HG is seen as the subject of an amusing joke. “She’s really making a fuss over such a common thing. She needs to get over it.” etc. etc. etc. This book is incredibly validating in that it gives me something to give to people and say, “Here. Read this!” For myself as well, it was a very healing process to learn that there are other people out there who have been through this nightmare (and, let me say, with versions of HG that made mine look like a bad sneeze).

I recommend that one have this book in hand whenever one is dealing with the medical community. My husband and I are thinking of trying to get through a second pregnancy, and I will be taking this book with me everywhere I go.

Especially helpful are some of the appendices – There is an appendix of antiemetic drugs, with all of their classifications, alternate names, and information. There are also lists of books and websites that are of invaluable assistance to address the needs of HG women. This is the best book that I have read on the subject, and I HIGHLY recommend it. You cannot afford to be without this book. Thank you, Ashli!!!

Tuesday, July 29, 2008

Book Review: "Monique and the Mango Rains: Two Years with a Midwife in Mali"

"Monique and the Mango Rains: Two Years with a Midwife in Mali"

Kris Holloway
2007, 208 pages

I loved this book. Despite time constraints, I finished it within 48 hours and was utterly fascinated throughout. Before going any further, I highly recommend this book!

This book was written by a Peace Corps volunteer who travelled to Mali and lived and worked with a young Malian midwife (Monique) for two years, beginning in 1989. She kept in touch with Monique after her trip until Monique's tragic death in childbirth eight years later.

This book is very similar to "Baby Catcher" by Peggy Vincent, except that it is set in the third world rather than in modern-day America. But it is the same mix of laughter and tears, celebration and tragedy - a great read for anyone, whether interested in midwifery or no.

I grew up in a fairly insulated American environment, and the church in which I was raised did not have missionaries to come back and tell tales of the third world, so it has only been in the last few years (having moved to a different and more missions-minded church!) that I have heard about the non-Western world first-hand from people who have been there. This book is another of those experiences.

This book followed some very interesting themes, ones that we don't think about too often in America any more. For example, extremely high infant mortality rates are extremely common in the third world, due to protein deficiency and malnutrition, microbial infections, etc. Whereas in America a woman can almost always expect to raise all of her children to adulthood, in Mali it is a rare woman who has not lost one or more children in infancy.

Also raised was the issue of female circumcision, also known as female genital mutilation (FGM). I had read about this issue in an edition of "Midwifery Today," and so didn't find it as shocking as I might have, but this was a good "up close and personal" view of the practice and its effects. In a word: yeeeooouuch!!!!! And that's putting it mildly. Holloway gives some brief descriptions of the different levels of FGM practiced in Africa (practices vary by region in terms of severity of procedure). The effects of FGM are far-reaching in a woman's life. Effects may include constant infection from blocked menstrual flow, sometimes leading to uterine infection and sterility, painful sexual intercourse (and subsequent infections as well), sexual dysfunction, and massive problems during childbirth including deep, unnatural tearing of the perineum and surrounding tissues (despite vertical birthing positions, which in uncircumcised women are almost guaranteed to reduce or prevent tearing).

It is interesting to compare male vs. female circumcision. Unlike most of my natural-childbirth counterparts, I am not opposed to male circumcision (pause while waiting for stones to fly). This is due to both my religious persuasions (after all, the God of the Bible invented circumcision!) and scientific observation - male circumcision has never been proven to cause any health problems, and it has (in a huge majority of studies) been shown to lessen the chance of STD transmission and penile cancer). On the other hand, I am definitely opposed to female circumcision, which has been undoubtedly proven to cause a myriad of life-long health problems.

One interesting thing about FGM is that it is generally done when a girl is a pre-teen, not in infancy as American boys are generally circumcised.

This book also highlighted the health problems due to poverty in Mali. What might in America be an inconvenience is, in Mali, a death sentence. And things like protein scarcity, unclean water, drug shortages and scarcity of medical facilities contribute to much higher rates of morbidity and mortality.

One very interesting note came when the author recorded her trip to Mali following Monique's death in childbirth. Holloway questioned the birth attendant who had been present, and found that Monique had been given a labor-enhancing drug and had died shortly thereafter. While not being able to make positive conclusions, Holloway noted that the drug might have been implicated in Monique's death. Her observations made me realize the harm that Western medicine can do when it teaches faulty birthing practices to third-world medical practitioners. For example, when Westerners impose bad birthing practices like lithotomy (birthing on one's back) and artificial labor-enhancing drugs, we get skyrocketing levels of fetal distress and subsequent caesareans to "save the baby." In the third world, when they implement such techniques, babies and mothers die. Labor-enhancing drugs are especially dangerous in Africa and other poverty-ridden areas, where a majority of women are anaemic and whose bodies cannot handle the drugs. Interesting thought.

One thing I loved, which Holloway pointed out, was the everyday-attitude toward death. Death took place at home and was celebrated and mourned at home. There wasn't any cloistering of death and the dead in hospitals and mortuaries - it was much more natural and "this-is-part-of-life." I think that we might be a healthier society if we could adapt such an attitude.

I highly recommend this book to anyone and everyone. It was a great glimpse into a different world and a different life, one from which we can learn much - both about things that we Americans could change for the better about our culture, and also about things for which we need to be grateful.

Rating: Excellent, excellent!!

Monday, July 28, 2008

Book Review: "Two at a Time: Having Twins"

Any reader will no doubt wonder why I am reviewing this book on this blog, being that it has absolutely nothing to do with midwifery, homebirth, or natural childbirth. Well, I have decided simply to post reviews on any book having to do with pregnancy, childbirth, postpartum or infant health, and this is one of those! Unfortunately I read something like 30+ books on childbirth and etc. before thinking of this blog, so I am going to have to read most of them all over again before being able to post reviews. However, I can use the review! And I'm in no hurry, so it'll give me something to do when I'm running short of ideas for articles.

So, without further ado.....

"Two at a Time: Having Twins: The Journey Through Pregnancy and Birth"
Jane Seymour and Pamela Patrick Novotny
Pocket Books, 2001, 205 pages

I picked this book up randomly at the library, needing something new to read and having read through most of the available natural childbirth literature. I realized that there were fields of childbirth out there that I hadn't yet explored (miscarriage, infertility, multiples, etc.), and so grabbed this one pretty much because it had an attractive cover.

Having never seen "Dr. Quinn, Medicine Woman," I didn't realize that this book was written by the star of the show, Jane Seymour, and that this book was in essence a celebrity memoir.

What I liked:

This book is essentially one woman's personal story of the conception, pregnancy, birth and postpartum period of her twin boys, Kris and Johnny. Personally, I think that every woman who has a child should write a book like this - an in-depth story of one's experiences. This book will be truly precious to her children as they grow older. It's got lots of details and personal experiences and is a fun and easy read. She did a good job with this book.

Jane had a lot of experiences with her pregnancy that mothers of multiples will probably be able to identify with, and which would probably be helpful to read about - things like pre-eclapsia, preterm labor, double morning sickness, baby apnea, babies in the NICU, etc. Those were illuminating to me, who, having never dealt with most of those issues, was a bit clueless.

What I didn't like:

I was disappointed that this book didn't hold more information useful to other twin parents or those, like me, wanting to learn more. This book is almost entirely experiential rather than informational. Little snippets of information are offered in occasional side-bars, but that's about it. Most of the information that one can glean from this book will be from reading about Jane's personal experiences. While it may be comforting, there's a lot lacking in terms of pure information.

When I read the reviews on Amazon for this book, a huge majority of the reviewers put Jane down as a "spoiled brat celebrity mom." And she can come across like that occasionally, but I think that it is mostly the effect of writing of a pregnancy occurring while she was the star of a major television show. Of course she was going to be showered with love!

Americans have a weird love-hate relationship with wealth. We all want to be rich, but as soon as anyone becomes rich, we turn on them like piranha and tear them apart as "spoiled snobs, etc." I don't blame Jane in the least for the privileged status she held as a celebrity mom. But at the same time, most of the advice and experiential information she gives is not useful for the average mom, just by virtue of her celebrity status and high level of affluence. 99% of moms are not going to be able to afford personal chefs to help them through morning sickness, personal wardrobe designers to sew individualized maternity clothes (Goodwill, anyone?), day and night baby nurses, a nanny, etc. etc. etc. It's just not going to happen. So most of that advice has to go out the window in terms of usefulness.

At the beginning of the book, Jane says, "I'm keenly interested in homeopathic care and other forms of alternative medicine," (p. 3), so I was very hopeful that this book would be full of naturopathic pregnancy care suggestions (homeopathy, herbs, childbirth prep, etc.). However, on this count I was keenly disappointed. Barring one sidebar on pages 200-201 which gives a short list of "natural paths to health," there is absolutely nothing naturopathic about the book or her pregnancy. She had an extremely medicalized pregnancy with nothing natural about it, and no mentions of any attempted natural remedies or management. Quite disappointing! Of course I know that multiples pregnancies tend to be more complicated and need more active management, but there is still a lot that can be done naturopathically for pregnancy management.

Also, as a fan of natural childbirth and its subculture, I prefer maternity books that encourage mothers to think for themselves, examine statistics and evidence-based literature, and make decisions about their healthcare for themselves. There is nothing more annoying to a natural-childbirth-fan than a maternity book which preaches "Do what the doctor says, dearie, and don't ask any questions" ad nauseum. This is one of those books. Jane never mentions weighing options, reading literature, taking serious childbirth classes, discussing pros and cons, etc. - it's just an endless repetition of "My doctor had me.... My doctor said.... My doctor decided.... My doctor told me to....." It got pretty annoying!

I am again afraid of coming across as anti-doctor here. Rest assured, I do have respect for doctors' opinions. On several occasions over the past years I have visited a doctor and had a question answered or a problem righted by their expertise quite simply and quickly, when my own research was leading me in the wrong direction. Expertise and training do matter. But I have also been on the receiving end of advice from doctors which was incomplete, biased, one-sided, unethical (to Christian standards) or, occasionally, dead wrong. Thus, I am a proponent of the "informed consumer" model of receiving medical care. In other words, I will visit a doctor and get his advice, but I do my own research as well - best of both worlds.

Overall, this book gets a "whatever" rating. I liked it and disliked it at the same time. If you want to read it, go ahead, but make sure you fill up on the real "meat" of good pregnancy books which give you actual information and also encourage informed decision-making. Mothers of multiples will want to check out subject-specific books which offer more concrete and thorough information. I can't really recommend this book, but I'm not going to go on a tirade against it either. But I'm definitely not going to purchase it, and it's going back to the library pronto!

Friday, July 25, 2008

An Explanatory Note

I felt that I should add a note (probably a long note!) to explain how this blog came to be, i.e. how my passion for homebirth midwifery was developed. Actually, I'm not quite sure myself. It truly was God-thing. But here are the basics.....

Up until about four years ago, my conception of childbirth was the stereotypical image from the 1950's that most women have in their minds and that is, unfortunately, still quite accurate in many places. Woman in a hospital gown, draped in green cloths, lying on her back with feet in stirrups, nurses yelling "push," heroic doctor poised to catch the baby, hold it up by its feet and spank it, then hustle it off to the newborn nursery. Childbirth very much as an emergency, a crisis, etc. etc. etc.

And then I got pregnant.

We didn't have maternity coverage at the time - insurance, yes; maternity, no. I had heard of homebirth somewhere (online?), and not having any objections to it, I investigated it a bit further, found some midwives, and off we went to see them!

That was the beginning of my foray into midwifery, homebirth, and eventually, naturopathic medicine and a more holistic, natural way of thinking and living. I didn't intend to go there, but after diving in unintentionally, I realized that I had come home. This is where I was meant to be, and I have never looked back.

Having a midwife was the most wonderful experience of my life. First of all, I loved having the boundaries of hierarchy erased. I had always enjoyed the formality of saying "Doctor So-and-So," but oh, how much more I enjoyed receiving care from caring, loving persons who were on the same level as I was. I call my midwives by their first names. While they were my superiors in terms of knowledge, in actuality we operated on the basis of friendship rather than doctor-to-patient.

Then there was the time. Midwives give one-hour visits, something that I just couldn't (and can't!) get enough of. When I visit any medical professional, I want to connect on a deeper level than time constraints allow with most doctors. I usually also have a laundry list of questions to be answered and discussed, and an hour is usually just enough time.

Then there was the holistic type of care. Pregnancy was not seen as an accident waiting to happen or a bomb waiting to go off. Pregnancy was a normal, natural, physiological process to be supported and monitored, but not something to be controlled and actively managed. I LOVED that. No fuss over due dates. No threats of induction. No pressure to have unnecessary tests. (And when things did happen, the first line of defense was often herbal or homeopathic! I loved that.)

Which brings me to another thing I loved - the respect for my decisions. My midwife paid me the compliment of giving me information and then respecting my decisions, rather than browbeating me into compliance with her wishes. With my pregnancy, I (after doing the research) decided to refuse the gestational diabetes test, the GBS test, ultrasound, amniocentesis and other genetic testing, vitamin K shot, antibiotic ointment, etc. - and she was fine with it all. No power struggles!!!

When combining that with a great birth experience (no vaginal exams, no continuous monitoring, no IV, no time limits, continuous emotional support and respect and hands-off management, with plenty of love), I fell in love. Head over heels in love.

This combined with my growing disillusionment with western medicine. Firstly, I found that whenever I visited a doctor, I came away disappointed. The doctor was too busy to answer my questions in depth (if at all), and visits consisted of five minutes with a rushed and distracted professional whose mind was already in the next room.

You can't blame them. Insurance costs have pushed doctors to the limit in terms of client loading. It is not their fault - but it does result in really bad service to clients.

I also found fault with the operating procedure of most Western medicine. The focus seemed to be on popping pills to fix problems which usually could have been avoided with lifestyle choices (diet, herbs, etc.). I much prefer preventative maintenance over pharmaceuticals which tend to come with a myriad of side-effects. (Not erasing, of course, the obvious need for drugs in some cases - just noting the overuse of drugs in Western medicine.)

Without any further ado, I headed down the road to natural living and haven't regretted it since. I love my midwives and use them for all well-woman care. I have started frequenting other types of medical professionals rather than doctors (such as naturopaths and chiropractors) and am much more satisfied. I have begun to rearrange my own life to follow natural pursuits (whole foods, homemade natural cleaners, etc.) and am excited about the new avenues which are constantly popping up before me.

With that in mind, I have created this blog to promote midwifery, especially homebirth midwifery, to provide information, and to dispel myths. Homebirth families are beset with unfortunate public beliefs which name homebirthing families as foolish, dangerous, irresponsible and even criminal, and I want to make as much information available as possible to dispel those myths.

I should add a disclaimer here that I am not anti-OB or anti-hospital birth. We need 'em both. There are great OB's out there and women who have had great hospital births. Agreed! So this blog is not so much anti-hospital as pro-homebirth. Without tearing down the one, I just want to praise the other!!

And that's the whole story! (Or most of it, that is.) And now, onto more mundane things such as washing dishes.....

Hello!

Well, I have finally succumbed to the temptation to start a second blog! Whether or not it will last, I don't know. But I am excited about it!

For the past six months or so I have worked on my first blog, http://www.whiningpuker.blogspot.com/, a blog about my past experience with hyperemesis gravidarum, a severe form of morning sickness. I have been collecting research, working through my experiences, etc. HOWEVER, my passion for homebirth midwifery keeps leaking through and eclipsing my work with HG. I have tried to merge the two lines, but have come to the conclusion that I'd better separate them - it was getting as confusing as writing a book with two separate plots (and probably just about as hard to read).

Starting a second blog is an absolute absurdity for me, as I (a SAHM with a very active toddler) do not even have time to properly keep up my first blog! But I am hoping at least to be able to keep my thought lines separate, be a little bit more organized and less confused, and be able to run each blog more easily than I was able to run one combined blog.

This blog is intended to share my deep and abiding passion for homebirth and homebirth midwifery, to provide resources (websites, articles) for parents and professionals, to provide news updates in the ever-changing world of birth, and to share my wonderful experiences with homebirth and midwives.

I am hoping to provide information that will be of use both to the experienced homebirther, and also to the mothers and families who are just starting to think of homebirth or using midwifery services. I am hoping to provide a lot of Q&A articles, quick articles on specific subjects relating to pregnancy, birth, homebirth, waterbirth and midwifery, and more in-depth information that will be useful to all levels of homebirth individuals and families.

With that in mind, let's get started!