Tuesday, September 27, 2011

Placenta Medicine - The Evidence

Anyone who reads this blog for more than five minutes will know that I am a HUGE fan of placenta medicine, that is, the maternal consumption of the placenta following childbirth. Sounds gross, but it works - really works - and I have experienced firsthand its amazing benefits (emotional stabilization, energy, afterpain relief). My one regret is that I threw out my placenta from my first birth (hadn't heard of placenta medicine then), and one of THE biggest parts of my hospital transport plans is "Don't let them take away my placenta!" (Hopefully a hospital transport will never be necessary.)

One common question about placenta medicine is - "Where's the evidence? Show me the facts!" For me, I don't need to be convinced because I have experienced how awesome placenta medicine is. But for those of you who want the evidence, here it is! A list thoughtfully put together by an amazing friend of mine, Nikki, and shared here with her permission. Enjoy! Share!


Biological Evidence Supporting Placentophagy

Placentophagia: A Biobehavioral Enigma

Postpartum Fatigue, Anemia and PPD

Fatigue as a Predictor of Postpartum Depression

Have We Forgotten the Significance of Postpartum Iron Deficiency?

The Impact of Fatigue on the Development of Postpartum Depression

Iron Content of Intact Placentas and Cords

Maternal Iron Deficiency Anemia Affects Postpartum Emotions and Cognition

Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial


Placenta as a Lactagagon

Hormonal Fluctuations

Baby blues - postpartum depression attributed to low levels of corticotropin-releasing hormone after placenta is gone

Hormonal Changes in the Postpartum and Implications for Postpartum Depression

Effects of placentophagy on serum prolactin and progesterone concentrations in rats after parturition or superovulation.

Pain Relief

Enhancement of Opioid-Mediated Analgesia: A Solution to the Enigma of Placentophagia

Placenta ingestion by rats enhances y- and n-opioid antinociception,
but suppresses A-opioid antinociception

Participation of Placental Opioid-Enhancing Factor in Opioid-Modulated Events at Parturition

And there you have it! Enjoy!

Saturday, September 24, 2011

More on the Pill

I came across this article today, and it sums up my stance on birth control pills very nicely (that is, the ethical problems with the pill, which also applies to the IUD):

What About the Use of Birth Control Pills?

Again, it's not really my intention to start up huge abortion wars in the comment section. I am very pro-life and I believe that every human being is unique, precious, and sacred from the moment of conception until natural death - and this blog reflects that belief. Please keep the comments thoughtful and non-combative.

One more fascinating note on the pill - an article this week from Birth Faith dealing with the issue of histocompatibility, and how use of the pill interferes with the process of MHG (major histocompatibility gene) mate selection:

Mate Selection

Never in a hundred years would I have thought of that one!

Good stuff, ladies! Thanks!

Friday, September 16, 2011

Is It Bravery?

Yesterday, a MOMS club friend asked me if I was planning to have another home waterbirth with our newest little one. When I said yes, she said:

"You are so incredibly brave."

I get that a lot. In fact, that's pretty much standard response when people hear that we're planning a homebirth. Would you other homebirth mamas concur?

But is it bravery?

Nope, it's not - in my case, at least. As a matter of fact, I am the worst kind of coward when it comes to childbirth. Just ask my midwives and doulas, who have had to put up with my squalling during labor. I can't even get though a healthy Braxton-Hicks contraction without wishing fervently for an epidural. I am the world's biggest wimp when it comes to pain.

(As a matter of fact, my own cowardice is one reason that I choose to birth at home. I know that I want unmedicated births, but there is no way that I could refuse the lure of easily-available drugs in a hospital. I just couldn't do it. Mothers of the world who have unmedicated hospital births, I take my hat off to you. I really don't know how you do it. You are made of stiffer stuff than I.)

But the real reason that I birth at home?

I birth at home because I don't want to have to fight - for my birth, for my body, for my baby. Going to the hospital seems (from the common experience, not personal experience) to be more like entering a battle zone and planning for a war than preparing for a gentle and sacred life-transition. I don't want to spend my birthing time fighting for what I want and what I need.

I don't want to have to fight to maintain mobility. Many hospitals still seem to want mothers confined to bed, tethered by monitors and an IV. I don't want to fight to remain untethered, IV-less, upright and mobile.

I don't want to have to fight for my space - for dimmed lights, for non-intrusion into the labor space, for having people be silent and gentle around me (rather than peppering me with questions) so that I can labor undisturbed. 

I don't want to have to fight against other hospital policies - against routine vaginal exams, against hospital protocol time limits on labor stages, against routine AROM. I don't want to have to fight for the right to eat and drink during labor. I don't want to have to fight to have my family near me (most hospitals have now banned children under 12), to have a doula, to have limits on who can be with us.

I don't want to have to fight to keep my baby with me, instead of being whisked away for tests, shots, and baths. I don't want to have to fight for delayed cord clamping, for delaying or avoiding newborn procedures, for avoiding formula. I don't want anyone telling me that I can't take my placenta home with me (this is so common in the hospital that it seems to be almost routine).

I don't want to have to fight a continual battle against hospital policies, against caregiver policies, against matters of routine hospital practice that have proven to be bad medicine but are still entrenched in the hospital culture.

I don't want my birth to be a battle.

When I am at home, I am surrounded by family and by a midwife and a doula whom I have come to know intimately. I am monitored constantly, with one-on-one care that is second-to-none in quality.

When I am at home, I won't be given an IV, confined to bed, or tethered to monitors (midwives use intermittent monitoring with a fetoscope or Doppler). I won't have any vaginal exams unless I request them or the midwife feels that they are truly necessary (and asks first). I will be automatically given everything that I need for an undisturbed labor (silence, darkness, constant support). I will be constantly offered drinks and snacks to keep my strength up. Unless there are signs that something is wrong (and midwives here transport when that happens), I can labor for as long as I need to. My body and my birth will be respected and kept sacred.

When I am at home, my baby will be handed to me immediately - even if there is resuscitation needed, it will be done while baby is on my tummy. There is total respect for my decisions regarding newborn procedures (vitamin K, eye antibiotics, newborn screen, etc.), and I don't have to worry about his cord being cut immediately (midwives here just don't do that), poked, jabbed, or taken away routinely.

Basically, I can relax and know that I don't have to guard myself. I can get down to the business of birthing without feeling that I need a birth plan, a doula-as-bodyguard, or any other sort of battle plan. My birth can be a birth, and not a series of boundary wars.

None of this is to say that every mother should birth at home or that every baby should be born at home. (And I know that there are many hospital providers who work at providing quality experiences like that described above for their mothers.) But this is why I birth at home. It's not because I am brave (I am not), but because I want my birth to be safe and sacred - not a battle.

Belated Activism

Remember how (back in May) I wrote a post urging readers to write to Mercy Gilbert hospital, thanking them for installing their new labor pool? Well, I myself am just getting around to doing that very thing! Here is my letter, and here is where you can send your own note. The best activism is positive activism!


Re: New Labor & Delivery Pool

Dear Mercy Gilbert,

I wanted to drop your staff a note to tell you how excited I am that Mercy Gilbert has recently installed a new labor pool for the use of laboring mothers in your maternity ward. That is simply a splendid development which will be such an incredible blessing to the mamas who choose to birth at your location. Water is such an incredible resource for pain relief and mobility during labor, and I am so excited to be able to enthusiastically recommend Mercy Gilbert as a birth place for local mothers. Congratulations, and great work!

I have spent two labors entirely in water (with one ending in a waterbirth), and I don't know how I could have done it without that water. It helped so much! I will forever be a big proponent of laboring in water as an enormous aid to pregnant mothers.

Great work! Thanks again!

Sincerely Yours,
Diana Johnston

Saturday, September 3, 2011

Facebook Nightmares, the Sequel - Following Up

At the beginning of July, I posted on my frustration at the ongoing pregnancy story of a high school acquaintance of mine (now a Facebook friend) who was being put through the worst of what our maternity care system has to offer.

You can read the story at the above link, but a quick recap: This mama was in her third trimester, first pregnancy, healthy mother, no complications, and had been told by her OB that her baby at term would be a huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally, and that she needed to schedule a cesarean at 38 weeks.

* Pause to let anger subside. Breathe. *

I thought you might like to know how this story ended up, so here is the final chapter.

The cesarean was scheduled, but due to delays with the doctor being away, the scheduled date was for 39+0 weeks. However, the mother went into labor naturally, three days before the scheduled cesarean, and the baby was born that day. I do not know if baby arrived via vaginal birth or via cesarean, as the mother did not post.

Oh, and that "huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally"? He was less than an ounce over seven pounds. Going by average weight gain, he would not have even broken eight pounds at forty weeks.

Yay for late-term ultrasound weight estimates.

So that was the end of the story.

And now, I'd like to follow a few rabbit trails, if my readers will kindly indulge me. Some of these will take the form of a frustration-rant, and I am also in a big hurry, so please forgive me if I am repetitive or even completely nonsensical and occasionally hysterical.

Rabbit trail #1:

I was fascinated by the wide variety of responses that I received to my original post concerning this situation. It was all over the board! Go back and read the comments to see what I mean. It ran up and down a spectrum, everything from "It is your duty to write to her and tell her the true facts of what is happening to her," to "This decision is between her and her doctor and it's none of your stinking business, so keep out of it." Quite a difference of opinion there!

Well, I'll tell you. As a personal thing, I have a strict policy of non-interference in other people's births. Even when they make me as upset as this one. Why? Here are the reasons:

(1) Advice can be really annoying. And it's a bad habit to get into (giving unsolicited advice).
(2) Usually, when people are ready to receive advice, they're already actively looking for the information themselves and don't need it.
(3) If a person is not ready to receive information, she will shut down anything that comes in the form of criticism of her beloved doctor. This is just something that women (myself included) do naturally.

So I really do my best to keep my mouth SHUT. (Unless specifically asked for information, and then I try to give gentle and encouraging information, to the best of my ability.)

On this one, I almost succeeded. Not quite, though. During this saga, I kept my mouth shut (besides notes of congratulations) - except for once, when I left one comment - something to the effect of "please be aware that late-term ultrasound is notoriously unreliable and is often inaccurate by up to several pounds." Then I left it alone, hard as it was.

What do you ladies consider your own personal policies in terms of giving advice when mothers are being taken to the cleaner's with bad maternity care?

Rabbit Trail #2:

This is something I haven't written about yet, but I found it vaguely disturbing - the fact that the mother was actually thrilled to be told that she needed a cesarean. During the decision-making process, she was actively enthusiastic about the idea and was very excited when it was finally decided that way.


Well, I'm guessing that it was for a number of reasons. First of all, cesareans really are more convenient. They're scheduled! Maternity leave, visiting relatives, vacation plans, holidays, whatever - it's all right according to plan with a scheduled cesarean. There's no doubt about that.

I discovered the lure of the scheduled cesarean last year, when a friend (having her third cesarean) asked me to encapsulate her placenta for her. It was around Thanksgiving time and we were planning to go out of town, which might have been hard - except that I knew exactly when this baby was arriving! So no muss, no fuss! It's no wonder that doctors and patients nowadays are falling into this pattern - there's no doubt that it's super-convenient. Admitted!

Secondly, and more elusively. Women today, especially first-time moms, are dead scared of labor, for a couple of reasons. First of all, we all know how much people love to tell pregnant women horror stories of labor/delivery that are filled to the brim with pain/gore/screaming/etc. etc. I think it must be instinctual, because I have to fight the natural instinct to tell horror stories too! But it sure doesn't help a young mother to prepare confidently for birth.

Secondly, most of the young women I know (real life and acquaintances on Facebook) are coming home from the hospital with experiences that would give Jack the Ripper goosebumps. I can only put it in the words of a blogger I read recently - "violent birth." Unnecessary induction, pitocin-induced labors-from-hell, epidurals, things go wrong, baby is crashing, emergency cesarean, side-effects, you name it. The cascade of interventions in all of its worst forms - over and over and over again, told until new moms believe that this is the norm. That this is just how birth IS.

Is it any wonder that a mother would welcome the thought of a neat and tidy scheduled cesarean? No contractions, no labor, no pitocin, no waiting, no fear, no nothing. Just an epidural and then "Here's your baby!" I don't blame them. Or the women who, having been through this nightmare with their first, welcome the thought of scheduled cesareans for the rest of their babes. I probably would too!

Because this is not something new. I have now seen several women told (usually for the most trivial of reasons) that they "need" to have a scheduled cesarean with their first child. And most of them go in with utmost cheerfulness. Some of that may be ignorance, but I think a lot of it is joy that they are going to escape the obstetric violence that now seems to be the norm in hospital births. (Not across-the-board - there are always good caregivers and great hospital births, but they just don't seem to be the norm right now.)

I must say, however, that it is saddening that most young mamas nowadays are not prepared for their hospital births with any sort of proper childbirth classes. I have read repeatedly about the decline of attendance in birth classes - that parents are taking more of a "show up at the hospital and let the doctor make the decisions" approach, and it is very regrettable because it leaves parents utterly vulnerable to bad medicine. Do these mamas know - are they told - that there are real risks associated with cesarean birth, for the mother, the baby, and for future babes? That there are lifelong potential health consequences for cesarean-born babies? That the risks of maternal death and stillbirth rise with each cesarean? Nope, most of them simply think of cesareans as "going out the sun-roof" with a whole lot of convenience and no negative consequences. Childbirth classes help so much with that - they allow mothers to at least make informed decisions knowing both sides to an issue and without being taken advantage of.

(And of course, none of this negates the fact that the cesarean is a wonderful life-saving procedure when used correctly - just not when it becomes a matter of regular and over-used practice.)

Why do you think that mothers welcome the thought of primary cesarean birth? Have you seem the same trend? (Personally, I know that I'd be freaking out and running screaming down the street at the thought of voluntary major abdominal surgery!)

Rabbit Trail #3:

And please forgive the vulgarity of the following discussion: 

One thing that I saw during this story that was extremely, extremely frustrating and disheartening - and that was the number of women who wrote lovely comments on the mama's wall such as, "Hurray that you're having a cesarean! Now your vagina will stay all pretty!"


I can't even begin to unpack how much is wrong with those comments (and they weren't few in number, either).

First of all, a practical note. I have had two unmedicated vaginal births, one with a slight tear. I will be quite honest - I don't notice any real difference in the before and after of my own lady parts. Seriously, things do go back to normal. They're meant to. Sure, there are slight differences between a nulliparous woman and one who has had babies, but our bodies were meant to do this. My own set of downstairs parts is just fine, thank you. It's not like one's genitals are hanging in shredded strips just because one has had a baby. Our bodies were made to open for a baby's passage and then return to normal state.

Note: I know that this is not the case for everyone, particularly for women whose births were horribly mismanaged (episiotomies, etc.) or operative (forceps, etc.). So please do not write telling me how much permanent damage birth can do - I know that it does happen. But normal birth that is managed well really has less effect (on a majority of women) than one would think. We were created to birth.

But more importantly - much more importantly - is that important? Does that give us a reason to say things like that? Let's say that what I said above is untrue - that a woman's genitalia forever look like they have been mauled by an automatic cheese grater after having a baby. (Or even that there are slight differences following normal births.)

Even in that case, why would women say that to each other? Why would we choose to hurt each other like that? How can women do that to each other?

"Well, you've had a baby. No matter that you've just been blessed to participate in the holy and eternal act of bringing a new and precious life into this world. What really matters is that your vagina is no longer pretty. Too bad for you."

Why? Because now her husband won't find her attractive any more and will leave? Because her self-worth is wrapped up in the appearance of her genitalia? Because all that matters in life is dying with a pretty body instead of one that was used for the glory of God to do great and amazing things?

And would people say that about other things in life?

"Thank goodness you didn't have children. Think of all the hours of television you would have had to miss while you took care of them! And think of the weight you might have gained! Now your tummy will stay all pretty."

"Thank goodness you didn't breastfeed and nourish a child at your breasts. Now your breasts will stay all pretty!" (Well, unfortunately, people do say this one.)

"Thank goodness you didn't take up mountain climbing! You might have gotten icky blisters! Now your toes will stay all pretty."

My point being, of course, that there is more to life than maintaining a picture-perfect body. How much more glorious to use one's body in the service of one's family and society (and in doing other great and amazing things!) than to come to the end of life and say, "I did nothing, but my body is pretty."

Most of all, it is the unkindness that strikes one, though I know it is unintentional. "You had a baby, and now your vagina will be ugly. Poor you."

We women can be kinder to ourselves.

Okay, that's all the rant for now! I'd love to have everyone chime in - kind and civil comments only, please! And again, please forgive me - I'm writing in a rush (time limits!), so this probably wasn't the most polished entry.

Friday, September 2, 2011

VBAC or Bust

A high school acquaintance of mine recently wrote to me for advice on achieving a VBAC birth after a primary cesarean (that's what happens when one posts a continuous stream of birth articles on Facebook!), so I thought I'd post what I wrote to her!

And.... it looks today is this mama's birthing day, so I'm praying for her and sending VBAC vibes her way!

Unfortunately, my friend hasn't taken any birth classes or hired a doula, so her chances aren't that high in today's hospital environment. But she does have at least a marginally supportive care provider, so we will hope for the best. Regardless of birth outcome, we are looking forward to meeting her new bub! From "Gone With the Wind" - "The happiest days are when the babies come!"

So here's what I wrote..... what would you have added?


Hi, M!!

Congrats on your VBAC plans! Have a wonderful time, and don't stress if it doesn't work out. You have done an awesome job in preparing and planning.

My universal recommendation for all mamas, especially hospital birthers, is to consider a doula. There are lots of things that a person can do during labor, but usually one isn't in the state of mind to think of them and husbands usually don't. A doula can think of those things and help your hubbie to support you as well. If you're interested, I know you could easily find one even at this point.

Other things that come to mind randomly:

- Stay home as long as possible. You will be more comfortable and less confined.

- Stay hydrated. Eat when you want to, and drink at least hourly. Since some hospitals (or nurses) are still stinkers about this, make sure to take your own food. Some friends of mine recommend those portable yogurt tubes and/or honey sticks. And whoever is taking care of you (hubbie or doula) needs to offer you a drink constantly - usually juice or Gatorade with a straw, just offered maybe every 20 minutes.

- Stay mobile and upright as long as possible.

- Laboring in water (shower or tub) is SO incredibly helpful, both for comfort and mobility. I have spent both of my active labors entirely in water.

- Birthing positions are optimally something that you could discuss with your doc pre-birth. Most docs automatically do lithotomy with the bed broken down, but there are lots of other positions (hands and knees, for example) - though that depends on whether or not you decide on an epidural. Oftentimes your body will tell you very clearly what position you need to be in. During my labors, my body made it EXTREMELY clear that I should kneel leaning forward with my head resting on my arms on the side of the tub. Whenever I moved away, I was unbelievably uncomfortable and returned immediately. So a lot of it isn't planning ahead, but just following your body's lead.

You are going to be awesome, regardless of if this birth is VBAC or CBAC!!! Congrats in advance, and we can't wait to see pictures!! :)