Friday, August 28, 2009
Our three year old has been learning a lot about birth in preparation for our birth, and some of his renditions of the process are similarly amusing. Right now his version of the whole thing is, "Miss Wendi comes over, and then you get in the bath, and then the baby comes out of your rump, and then we have cake." (I made a birthday cake for the baby and froze it for birth-day. The cake, by the way, is obviously the most impressive part of the story.) I can't wait to hear him telling people about the experience! That may definitely raise a few eyebrows.
Anyhow, Enjoy Birth has posted a "Response to ACOG Homebirth Survey" that is hilarious! Check it out and enjoy the brilliant writing.
Recommendations Relax on Liquid Intake During Labor
The long and short of it - ACOG (The American College of Obstetricians & Gynecologists) has reversed its previous policy and now conceeds that laboring women may be "allowed" to drink during labor. No solid foods, because, after all,
"As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common."
However, liquids by mouth are now no-longer forbidden.
So.... Good or bad?
Both, I suppose. It is progress in the right direction, at least, which is more than one can say for a lot of ACOG's decisions.
However, the following come to mind:
(1) Ummm..... Sorry to inform you guys of this, but midwives have known this for years. Decades. Centuries. Millenia. In fact, I don't think midwives (on the whole) have ever been foolish enough to restrict liquids from laboring women. Not to mention the fact that many sensible doctors and nurses have also promoted liquids by mouth for years. You're sadly behind the times, my friends.
(2) Similarly, midwives (on the whole) are way ahead of you on solid foods... Midwives do (and always have) encouraged eating during labor when the mother wants to eat. (Same goes for forward-thinking docs and nurses.) No athletic feat (especially one that can span hours or days) should be attempted on a fast, least of all labor.
(3) To tell a laboring woman what she is "allowed" and "not allowed" to do is absolutely demeaning, degrading and despicable. I personally would not be abiding by these rules just because "doctor said" any more than other unreasonable rules.
(4) Most women, being sensible beings, are already ahead of you on this one - they simply bring their own food and drink to the hospital and eat when caregivers are out of the room, or they eat before going to the hospital.
Of course, laboring women don't always want to eat during labor. I didn't. But some do, and they shouldn't be restricted from doing so.
So... This is a call both for a pat on the back and a slap upside the head. Thanks for your efforts, ACOG - but I know you can do better!
Wednesday, August 26, 2009
This week I find myself in an odd circumstance - that of (mentally, at least) sitting around and waiting for labor to start. Weird! Last time I didn't really even think about it - labor took me by surprise. But this time, I find myself doing a bit of clock-watching. Not that I'm anxious for this pregnancy to end, but I am curious about labor and excited to meet baby - and it will be nice to be able to walk comfortably again!
A week ago this past Sunday, three separate people told me, "Oh, you've dropped!" I hadn't noticed anything (didn't notice last time either), but the fact that non-first-time moms aren't supposed to drop until labor has already started put me into a frenzy of baby preparation - a frenzy which, though unfounded, proved extremely useful in that it helped me to finally pound through the last main items on my pre-baby to-do list. Hurray!
So as of this past weekend, our birth supplies are finally ready, our baby things are cleaned and set up, and I'm pretty much ready to go. The house isn't completely unpacked, cleaned, or organized, but it's not bad - and I've given up on any idea of EVER having the house cleaned to my level of perfect satisfaction - at least until all the kids are out of the house, LOL! For me, at least, "perfect" baby preparation was possible only for baby #1 (when there wasn't another ex-baby running about making messes as I cleaned!). But considering that all of my baby preparation from last time went down the tubes as soon as baby was born (i.e. the perfectly clean house, etc.), I don't mind too much!
I have been having minor pre-labor symptoms for the past 5 days or so (upset tummy, mild menstrual-type cramps), and that again convinced me that labor was imminent - but upon research, I discovered that these types of things can mean that labor is either hours away - or weeks away! So we may have a post-due-date baby after all.
Anyhow, having everything at least semi-ready has meant that I can relax a bit and get some much needed sleep - what a relief! So I've been indulging in super-long naps and trying to get some extra rest - anything to build up a buffer for when little one arrives and destroys any semblance of long sleep-stretches!
A quick note - Upon randomly surfing one of my blogs a while ago, I discovered that I have been receiving email notification of only some blog comments. Some are emailed to me, and some are not! I have no idea why - but I just wanted to let everyone know that I'm not receiving all blog comments, though I do my best to review entries manually to find the lost comments.
And to close (as starving hubbie is home and wanting dinner), I wanted to share this fun video! (Facebook friends have already seen this... sorry for the repetition.) This is purely personal - nothing to do with HG, pregnancy, birth, etc. - this is my sister-in-law (she's the dark-haired one) doing a commercial with Fred Willard, and it's fun! My SIL has been working with Mr. Willard for several years now, but being that we haven't been able to make it out to California for their shows, this is the first time we've gotten to see them act together. So fun!!
Love to all!
Sunday, August 23, 2009
Saturday, August 22, 2009
Anyhow, part of her birth preparation is having mothers write out their fears about birth... and so I did! I thought I might as well share them, and I've added my "birth hopes" as well (though these are really birth fears re-written).
My Fears About Birth
- Pain (I don't subscribe to the 'birth is really painless' model.... been there, done that, and it is NOT)
- Not being able to handle the pain
- Doing something that disgusts people (I won't give details... there are a lot of possibilities)
- Something happening to the baby (not that this would be minor, but I have complete trust in the competence of our midwives)
My Hopes For This Birth
- Having an easier time, pain-wise
- Being able to handle the pain better than I did last time
- Experiencing birth ecstasy/high - last time I totally missed out on this, bummer!!!
- Better bonding with baby - last time I was just in too much pain to care
- Easier start to breastfeeding
- Better connection to DH during the birth - last time I just wanted to strangle him, i.e. "You got me into this!"
- Better connection to doulas
- Easier postpartum period - I think that this will definitely happen, barring complications - last time I was so exhausted from the hyperemesis that I started out utterly exhausted pre-birth, and it just got worse from there
Friday, August 21, 2009
Anyhow, there are three main methods of notation for gravidity/parity (at least, that I know of!), which are as follows. I will use myself as an example: I have had three pregnancies, resulting in one miscarriage, one term birth and one not-yet-finished:
(1) G(x)P(y) - Number of pregnancies followed by number of births.
I am a G3P1 (three pregnancies, one birth)
(2) G(x)P(y)A(z) - Number of pregnancies, number of births, number of abortions (either spontaneous, i.e. miscarriages, or induced)
I am a G3P1A1 (three pregnancies, one birth, one spontaneous abortion)
(3) G(x)P(TPAL) - Number of pregnancies, and then "term births," "preterm births," "abortions" and "living children"
I am a G3P1011 (three pregnancies, one term birth, zero preterm births, one spontaneous abortion, one living child (counting only born children))
Anyhow, I am reading one of Anne Frye's midwifery texts, and she lists two further steps for individualizing this notation, both of which I find very helpful. Here is the method she lists:
That may look confusing, but it's not! It's just the TPAL method with two additions -
(1) After the aborta notation, she adds an "s" or an "i" to indicate whether an abortion was spontaneous (miscarriage) or induced (elective). This seems eminently sensible to me, as the mental and physical history and risk factors of a woman who has had five miscarriages are completely different than one who has had five elective abortions.
(If a woman has had both types of abortions, then they would be listed separately. For example, a woman who has had one term birth, one miscarriage, and one induced abortion would be a G3P101s1i1)
(2) At the end, she adds the number of multiple births in parentheses if there have been multiple births (each set of multiples counts as one, i.e. twins count as one birth, not two)
Thus, I would be a G3P101s1 - three pregnancies, one term birth, zero preterm births, one spontaneous abortion, one living child, no multiple births
The only thing that the notation is still missing, in my humble opinion, is a notation for cesarean vs. vaginal births - a very important distinction, as a lot of risk factors and labor patterns will depend upon this! For example, a friend of mine recently had her fourth baby, a VBA3C. Thus, although she was a G4P3 (or a G4P3003) and would thus be expected to have a fast and easy labor, she in fact had a labor like a primip (first-time mom) because it was her first time through labor and birth.
Thursday, August 20, 2009
I find that writing a transport birth plan for a hospital birth was much easier than writing a planned-hospital-birth birth plan, simply because I know that if we end up in-hospital, I will most likely need any suggested interventions. Much simpler!
So here goes (with names/numbers obscured for privacy purposes) ......
Homebirth Birth Plan:
- All coaching is welcome. I could really use it!
- I’m really interested in the red line phenomenon, so if anyone has time, see if it occurs or snap a picture
- I’m really interested in the physiology of birth, so whenever I’m lucid I’d love to know what’s going on.
- BUT please do NOT tell me my dilation unless (1) I really need to know (i.e. it’s an emergency situation), or (2) It’s super encouraging, i.e. “complete.”
- If and when anyone has free time, I would LOVE all of the pictures/video footage that can be taken (of anything and everything).
- I would love a waterbirth, if at all possible.
- Hubby would love to catch, if possible (that is, if I let him!).
- We’d love to have our son around for as much of the birth as he’s capable of handling.
- Delayed cord clamping, please!
- Please, no cord traction unless really necessary!
- Last time I had horrible afterpains, so I would like to take some Advil/Ibuprofen as soon as the cord is cut to try to get a jump-start on preventing them. (If I forget to put Advil in the birth kit, it is in the master-bath over-sink cupboard.)
- The current plan is for placentophagy, both immediate and delayed (encapsulated). Remind me if I forget.
In Case of Transport: Hospital Birth Plan
- Parents: -------- & ---------
- To our hospital caregivers: Thank you for taking care of us!
- Our midwives are ----------- and ------------ of [Midwifery Business X] (000-000-0000). We ask that at least one of them be able to stay with us at all times.
- Depending on the reason for transport, we know that medical intervention to some degree will be necessary; however, we’d love to keep our birth as natural as possible (based on the circumstances)
- Please, no Cytotec for any reason
- If I need a non-emergency cesarean, remind me that I should consider a tubal ligation at that time
- For Baby: Please, no Hep B shot, eye ointment, formula or vitamin K (except in case of a physically traumatic birth). Please make sure in case of mother-baby separation that [hubby] stays with the baby.
- In a life-and-death emergency, please always prioritize the baby’s life over D’s
- If at all possible, we would like to take our placenta home with us.
- Thank you for your kindness, support, and care!
Tuesday, August 18, 2009
Saturday, August 15, 2009
Don't push your already well-aged maternity pants too far.
Just don't. Really. I mean it.
Unless, for some reason, you relish that moment of exquisite humiliation when you realize that you have been walking around.... for at least 30 minutes.... in front of an entire battalion of firemen (albeit very well-mannered, gentlemanly firemen).... with all the bending, squatting and reaching that accompanies the care of an excited preschooler.... with a very revealing rip across the entire rear-end of said maternity pants! (Only finding out about said rip when DH sidles up to me and says, "Um, honey, let me get you a sweatshirt to tie around your waist... right now.")
Though I have no doubt that our local firemen are currently laughing themselves sick (who wouldn't?)... And the maternity pants are on their way to the trash - pronto.
But at least our car seats are installed properly! Yet another item to check off the to-do list.
We are moving ever closer and closer to D-day! Things are getting done, baby things are getting washed - I can't believe it's so close!
This is SUCH a different experience from last time! As I've mentioned before, last time I was just so sick that the thought of having a baby was a bit of an afterthought. I didn't think about the baby, the baby's gender, anything - I was too tired and sick to care! This time I'm curious about the gender and anxious to meet him or her! So fun!!
I must admit that this has been quite a stressful summer. Trying to move in and get unpacked and baby-ready, dealing with the stress of losing my paycheck as of next week (we've decided that it's time for me to be a full-time SAHM), dealing with the sticker shock of home-ownership and trying to set up a budget on a very small salary. Additionally, I am dealing with a family decision that DH is in the process of making, the initial conclusion of which has proven extremely unpopular with his constituency (i.e. me), and which decision has provoked full-out rebellion amongst said constituency, which has a tendency to be too pig-headed to submit to family leadership with any type of grace. *Sigh.* Anyhow, I'll be glad when things settle down (like when all kids leave home and we're retired).
Sometime when I have extra time, I plan to write "The Art & Science of the Vomiting of Pregnancy, A Complete Guide in Three Volumes." Honestly, I now know so much about throwing up! But seriously, I need to take my own knowledge seriously first... This morning I was so busy when I got up that I forgot to eat and then had to interrupt DH mid-sentence in order to run to the bathroom for a rather lengthy seance with the porcelain fixture installed therein - you'd think I'd learn, wouldn't you?
Well, I have tons more to write - but housework and family call! Have a lovely weekend, everyone - and don't forget my hard-earned wisdom on the fallacy of aged maternity clothing! :)
Love to all,
Tuesday, August 11, 2009
If you've been around the hyperemesis world for more than 30 seconds, you will hear thousands of women bemoaning the fact that their condition is belittled and ridiculed as being "all in your head." Such as...
"You need to just get out and get some fresh air. Stop thinking about yourself."
"Stop being selfish and think about the baby's needs instead of yourself. Just make yourself eat."
"So... Why don't you want this baby? Why are you subconsciously rejecting it?"
"Are you having problems at home? Why are you making yourself so sick?"
"Get some therapy."
All of this is, of course, beyond absurd. When was the last time you heard any of the following?
"So you've got gestational diabetes, huh? Why are you being so selfish and only thinking about yourself? It would go away if you'd just focus on the baby."
"Preterm labor? You must need counseling, or else you wouldn't be making yourself sick."
"Pre-eclampsia? Why don't you just go get some fresh air? That's all that's wrong with you - you need to get out more."
Yup, that's right... you don't hear those. So why is hyperemesis constantly (and I do mean constantly... look online for the stories) classified as an "it's all in her head" condition?
Ashli McCall has a great chapter on this subject in her book "Beyond Morning Sickness," so check it out if you haven't read it before. In that chapter she writes,
"Kaltenbach seems to have started this whole "HG as a neurosis" mess in 1891. In 1968 a frustrated Fairweather concurred and published a study that was shamefully uncontrolled and obviously biased. He hypothesized that women with HG had mental issues that basically caused psychosomatic illness."
Additionally, in my own experience I have noticed that any physical experience that is exclusively female (i.e. never experienced by men) has been in the past, or is currently, attributed to "female hysteria," "nerves," etc. - i.e. it's all in her head. Examples of this would include:
- Morning sickness of any kind
- Menstrual cramps
- Labor pain
- Emotional nature of pregnancy
- Postpartum depression
(And by "it's all in her head," people don't generally mean that a disorder is caused neurologically by hormone imbalances, etc. - they mean that the woman willfully brings it on herself by her own selfishness or weakness.)
Unfortunately, a lie is a hard thing to kill, simply because the fallacy of hyperemesis-as-imaginary has been repeated ad infinitum in medical textbooks and references. It is present equally in mainstream medicine and naturopathic medicine - perhaps even more so in the naturopathic world, as naturopaths are more likely to recognize the mind-body connection (which can be important but is usually irrelevant with hyperemesis).
For example, see the following excerp (which I am not going to cite, as I love both the author and the book and don't want anyone reading this to write her or it off!):
In reference to a hyperemetic woman, she writes:
"Loving help should be given the mother with any aspect of her life which makes her unhappy, whether it be her reluctance to have a child, her sex life, her fear of labor, or whatever. Encourage her to increase her activity, rather than laying around, and to do things that will get her attention outside of herself. If you can counsel a woman and give her real help, you can stop a condition which, left to itself, could require hospitalization."
That paragraph alone is enough to make your average hyperemetic woman fully suicidal, if not to send her on an enraged killing spree.
I found a similar passage in another book (which shall also remain uncited!) written by one of my most beloved birth authors:
"It bears mentioning that hyperemesis gravidarum is one of the only conditions for which conventional medicine acknowledges emotional underpinnings, and some midwives do note a correlation between hyperemesis and psychological conflicts or difficulties regarding the pregnancy..... With emotional factors outstanding, suggest counseling. Otherwise, have the mother immediately take ginger root three times daily..... If vomiting persists beyond the first trimester, consult with a colleague...."
Point #1 - See above comment about enraged killing sprees.
Point #2 - Ginger doesn't do squat for hyperemesis! Give it a rest with the ginger!!
Point #3 - If you wait to treat HG till after the first trimester, you (a) are incompetent as a caregiver, and (2) will have an extremely ill mother on your hands whose baby and whose life have been endangered by lack of needed treatment.
So, in conclusion, I will note the following:
(1) It is NOT in her head (or in your head).
(2) Unfortunately, the medical literature is often outdated and will point toward psychological causes.
(3) Ditch any caregiver who goes along with #2.
(4) And rest assured that you are not crazy!
Did I miss anything?
Love to all!
Monday, August 10, 2009
First of all, what is placentophagy? Quite simply, it is the consuming of the placenta after birth. (Pause for mass gagging.) Moving on...
How did I get to this dark, dark place? Good question! Immersion in the natural birth community does many odd things to an ordinary woman. With our last birth, I didn't even think about it - I just told our midwife to take the placenta away and get rid of it. (If we'd had a yard I might have considered burying it, but it's kind of hard to bury a placenta in 15 square feet of apartment patio concrete.)
But by the time this pregnancy rolled around, I'd been immersed in the natural birth community for 2+ years, and I had learned considerably more about the placenta and about options for using it. And so the madness began...
First of all, I considered a lotus birth, in which the cord is never cut - the placenta is swaddled and kept with the baby until the cord falls off naturally (usually within the first week). I thought about it for a while, but eventually discarded the idea for two reasons: (1) The postpartum period is one of extreme exhaustion, and adding placenta-care into the mix didn't sound particularly appealing (the placenta requires basic care to keep it from rotting), and (2) I realized that lotus birth is not particularly "natural" in keeping with the ways of the animal kingdom - I mean, how many baby animals have you seen that are walking around with their placentas trailing behind them? It doesn't happen. The natural thing that many mammals do is simply to chew through the cord... and then to eat the placenta!
And so I reached the next natural phase of thought - okay, why not? I mean, it's not really that gross. It's not like you can catch a disease from it, or like it's unnatural - it is an extremely common occurrence in the wild. And, being in the birth community, I'd already heard of it. So off I went to consult with a midwife friend! She told me that at least 25% of her clients consume some portion of their placentas, either raw in a berry smoothie (to disguise the taste) or dried and encapsulated.
So, never being one to know moderation, I am planning to do both! I'll post about how it goes. Frankly, I think it'll be great. The placenta is full of both nutrients and beneficial hormones, and I think it'll be a big help, especially as I tend to struggle with fatigue.
DH required a few minutes of convincing, but thankfully he's the tractable type when it comes to my birthing ideas. Most likely he'll become just as much of a hard-core placentophagy-fan as he is now a homebirth-fan! (Often overheard from hubbie: "Well, she wouldn't have had the cesarean if she'd just had a homebirth!" Pretty cool, no?)
I have heard two arguments against placentophagy that I'd like to briefly answer:
(1) Placentophagy is done by animals only because the placenta is a good source of calories and shouldn't be wasted by animals when food is scarce - for a well-nourished animal or woman, it's not necessary.
Frankly.... No. Nature has better plans than that, and the fact that the placenta is pumped full of hormones seems like a part of God's plan to get said hormones into said animal - i.e. there is a purpose for everything. It's rather arrogant to assume that the consumption of a placenta has no purpose other than caloric intake without further research.
(2) Placentophagy is merely an animal's attempt to clear the evidence of birth away so that predators won't smell it and come looking for easy prey.
That makes even less sense. Regardless of whether the placenta is left behind, it is not possible for any animal to clear away all of the scent left by blood, amniotic fluid, and little wet animals rolling around on the forest floor following birth! Not possible.
Anyhow, I'll let you know how it goes! Has anyone else tried this? Did it help? Let me know!! :)
Last night, in honor of the break in the heat, I spent an enthusiastic hour attacking the weeds in our yard (our "lawn" is a conglomeration of tack stickers and a weird, fast-growing tree-like weed that can grow to a man's height in a matter of three weeks) - and paid for it! I spent the rest of the night crashed due to a nice combo of painful Braxton-Hicks and round ligament pain - not unusual, I just overdid it! So my body seems to be saying, "It's time to slow down. Now!" I think it's about time! I've been nesting maniacally for too long.
So now I'm just trying to focus on getting my birth supplies gathered and my main to-do items finished, but without the frantic haste that has accompanied the past few months. No matter how hard I try, my house is not going to be perfectly clean or organized pre-baby (and wouldn't stay that way even if it was!). I'm going to do my best to be satisfied with "good enough."
I forgot to tell an amusing story that happened a couple of months ago, and which illustrates why pregnant women shouldn't be trusted with anything riskier than cold oatmeal.....
I was working at church (where I do secretarial work) and decided to send a quick email to a good friend of mine... from the church account. (I used to do this all the time... no more.) The email was mostly information about our new Phoenix birth center, and I threw in a link to a now-famous Spanish mattress commercial which features a homebirth and is one of my very very favorite videos. And then, not thinking.... I sent it out to the entire church. That's right... the pastor, elder board, deacons, congregation - everyone. How mortifying was that???
In all honesty, I was really glad in the end that the email just didn't contain any gossip, criticism, personal information, etc. That would have been oodles worse. But people have been teasing me about mattress commercials ever since!
Two weeks ago I went and did it again (sent an email out to the whole church by accident), but thankfully it was only a rough draft of the bulletin. Phew. I'll be thankful when I hand the reigns over to my successor in two weeks and don't have to worry about such idiotic adventures!
This past Saturday was a very special high point in my summer - it was the second annual reunion-breakfast that I've had with two special hyperemesis friends of mine: Sarah, who is a fellow-client of my midwife and whom I met at our midwife's annual picnic, and Jenna, who met Sarah over the web (Jenna is also the author of "Body Mutiny," an internationally famous book on hyperemesis). I am the junior member of our trio, having had an experience which some would call hyperemesis and some would not (had to live on a liquid diet - yes; hospitalized - no, though this was more an insurance thing than anything). But whether or not I am a true member of the HG (hyperemesis gravidarum) club, I'm still only the junior member - my HG/morning sickness merely made my life a living hell - both Sarah and Jenna nearly died, besides spending a majority of their pregnancies in the hospital on just about every drug you can name. Yikes!!!
We had an absolutely lovely time getting caught up, chatting randomly, and having lots of good "HG talk," something that is always absolutely refreshing in a world that often thinks that all morning sickness can be resolved by ginger pills and brisk walks, LOL!! I really need to get more hyperemesis articles on this blog... this is a condition that is so drastically underestimated and misunderstood - I would love to get more public awareness out there in any way that I possibly can. Hopefully soon!
Well, I have tons more to write, but life calls. Thus, I'll try to catch up more later! We are well, are having a very busy week, and are looking forward with our next appointment with our midwife, which is tomorrow. I'll be doing the GBS test (something I don't really agree with, for many reasons, but which I have elected to do so that I don't have to fight any antibiotic-happy hospital staff in case of a transport), so I'm hoping for a nice fat negative on that one. Then a friend of mine is going to do some pregnancy photography for us this weekend, so I'll try to post that after we finish.
Have a wonderful week, everyone!
Wednesday, August 5, 2009
This is one of the best, as well as one of the MOST hilarious birth stories you will ever read. Aside from some profanity, it is one of the most brilliant pieces of birth literature I've had the pleasure to read. Check it out! Right now!!
The Labor Story, Part III