Welcome, Elijah.

Saturday night, January 22, our house was full of people. Your uncle Tyler from Korea, Grandma and Grandad from Denver, and Gran-D was here from Dallas. So, it was a great weekend to be born.  (You would soon be greeted by many who love you!)

While everyone else slept soundly on Friday night, I was awake with contractions from about 12 AM to 4:30 AM. But it was not to be. (This really confused your uncle. Ha.) After a great Saturday of visiting with family, and a pep talk/belly pat from Gran-D, my Birthing-Autopilot turned on around 1 AM. We arranged to meet Judy (Again! She delivered Daisy, too.) at the Birth Center around 3:30. And much like your sister, you were born a few hours later at 7:12 AM. All 8 lbs of you. I’m in love!

State of the World’s Mothers Report 2010

Happy Mother’s Day! I love you, Mom.

According to the 11th Annual Mother’s Index you’re better off being a mother in the following countries: Norway, Australia, Iceland, Sweden, Denmark, New Zealand, Finland, the Netherlands, Belgium and Germany. Those are the top ten developed nations, listed in order, for best quality maternal and infant healthcare. Forty-three developed nations and 117 developing nations were included in the index (see Save the Children).

Where does our nation land in the index? Well, not only did we not medal, we’ve gone down from 27th place to 28th since last year’s analysis. The United States has one of the highest maternal mortality rates of the developed nations, 1 in 4,800.

Why aren’t we improving?

I found these numbers from The New England Journal of Medicine* very insightful (Ha! I first typed “the new england jourbal of medicine”) , “In most European countries where midwifery practice still dominates maternity care, the involvement of midwives is associated with good perinatal health outcomes. For example, midwives in Ireland, Scotland, and England deliver more than 65 percent of all babies, and the proportions in Denmark, Sweden, Norway, Finland, and Germany exceed 85 percent.” The most recent study I could find (2003) said that about 10-15 percent of births in the United States are attended by a certified nurse-midwife. I wonder if that’s something significant to consider. Or are over 1 in 3 births in our country really high risk emergencies, requiring cesarean deliveries? Or have many of these emergencies been caused by hospital interventions? Good questions for Mothers Day.

Now, off to the kiddy pool out back with my sweet family!

*M.T. Lydon-Rochelle, “Minimal Intervention – Nurse-Midwives in the United States,” NEJM 351:19 (November 2004).

Unnecesarean

31.8 percent of all U.S. birth are now surgical, says CDC.

Unnecesarean – clever blog name.

I’ve noticed this family making the news. I’m so sorry for their situation, but I am so glad the country is hearing about the problem. Considering the fact that the maternal mortality rate in the U.S. is the highest it’s been in decades, it’s about time the issue came up. Let’s at least listen to someone’s story. In countries where midwives attend the births outcomes are worlds better.

Poor thing!

Abortion in the “Year of the Family”

(from rachelsvineyard.org, Vine & Branches. January 2009)

The Key to Increasing the Russian Birth Rate?
Healing the Traumatic Aftershock of Abortion.

By Kevin & Theresa Burke

The Russian government declared 2008 to be the “Year of the Family” to fight the decline in population resulting from the highest abortion rate in the world with nearly 70 percent of pregnancies ending in an abortion. Authorities in the southern Russian City of Novorissiysk scheduled a “week without abortion” in an effort to combat the country’s high abortion rate.

Government policies to encourage child bearing have had little effect to reduce the high number of abortions. Despite all the pregnancy perks and childbearing incentives now being offered, women in Russia are not biting the bait to breed.

Dr Theresa Burke the founder of Rachel’s Vineyard Ministries explores the dynamics of “Traumatic Reenactment,” the repetition of traumatic themes, feelings and actions as a hallmark indicator of trauma in her book Forbidden Grief, the Unspoken Pain of Abortion.

Dr Burke explains:

In order to understand the Russian population problem, it is essential to understand the psychological dynamic of traumatic repetition. This is directly connected to the phenomenon of multiple abortions.

In the United States nearly half of all abortions are repeat procedures…in Russia the conservative estimate is that Russian women average between 3-8 abortions. While it is true that many Russians view abortion as a form of birth control, there is a deeper dynamic at work here.

During trauma the feelings and knowledge of what is happening are so unacceptable that the mind refuses to acknowledge them. The trauma becomes fixed at a certain moment in a person’s life – dissociated from consciousness – and provides the material for subsequent post-traumatic reenactment.

Without healing and grief work following the initial abortion loss and the degrading and painful procedure, women are susceptible to cope with their painful feelings through the use of drugs, eating disorders, alcohol, drug abuse and promiscuity. These behaviors frequently lead to another crisis pregnancy, and abortion is once again seen as the best solution. Repetition is the greatest indicator of trauma.

With each abortion the individual becomes increasingly numb, more detached from their hearts, more disconnected from hopes and dreams for the future and susceptible to patterns of relational abandonment, ambivalence over motherhood, depression and anxiety. With each abortion there can be a distorted sense of mastery over the traumatic feelings…they may not be aware of feelings of loss or grief and not even be aware of a deeply entrenched self-destructive pattern of aborting new opportunities for love and life.

In many ways, women really do experience their pregnancies and their unborn children as part of themselves. When the woman destroys her pregnancy and developing child, she is also destroying an extension of herself.

If those in power want to lower the abortion rate and allow Mother Russia to recover from the ravages of abortion’s toll, there is a need to drastically increase the number of healing programs like Rachel’s Vineyard so that women and men can begin to heal from this complicated grief caused by the loss of so many children. Incentives won’t make women want to reproduce. Only healing can do that – and bring resolution to the trauma.

The Medical and Legal Risks of Electronic Fetal Monitoring

Summary. Journal article by Margaret Lent; Stanford Law Review, Vol. 51, 1999

“Electronic fetal heart monitoring (EFM) is the most widely used method of monitoring the fetal heartbeat for possible signs of distress during delivery. Soon after its development in the 1960s, EFM replaced intermittent auscultation as the standard of care in the obstetrical community. However, Margaret Lent argues that the widespread use of EFM is both medically and legally unsound Lent points to a series of clinical trials that demonstrate that EFM does not reduce fetal mortality, morbidity, or cerebral palsy rates. These studies suggest that EFM has a very high false positive rate, and that EFM usage correlates strongly with a rise in cesarean section rates. Similarly, EFM provides no protection in the courtroom. Though obstetricians believe that they should use EFM because its status as the standard of care will protect them from liability, Lent argues that it may in fact expose them to liability given its failings. Instead, she argues that auscultation is equally, if not more, safe and effective, and is more likely to protect physicians from liability. Lent concludes that obstetricians have an obligation to their patients and to themselves to adopt auscultation as the new standard of care.

The medical profession depends on the latest medical technologies to provide top quality care and to extend that care to a greater pool of patients. This dependence is all well and good where the method, drag, or device is tested in clinical trials that establish its efficacy and safety. But what happens when new technology diffuses rapidly into mainstream medicine well before it has been adequately tested?”

Epidural

Can someone explain why, during pregnancy, I’m allowed to have epidural anesthesia but not – heaven forbid – Advil?

Recommended Reading

For expectant mothers and fathers. Take the time to read, and even re-read, The Thinking Woman’s Guide To a Better Birth. Also, Dr. Grantly Dick-Read’s Childbirth Without Fear is full of valuable information and insight.  I was especially helped seeing The Business of Being Born, a documentary highlighting evidenced based maternity care (and how hospitals are generally failing to practice it).  Also, a report (PDF), Evidence-Based Maternity Care: What it is and What It Can Achieve.

Becoming informed is a big task. But, then so is becoming a mom or a dad.

The Epidural Express

“The Epidural Express: Real Reasons Not to Jump On Board”
by Nancy Griffin
Excerps from Mothering, Spring 1997

The main cause of pain in a normal childbirth is . . . the ‘Fear-Tension-Pain Syndrome.’ . . . [O]ur biology provides us with powerful instincts during birth. The first is the need to feel safe and protected. All mammals will instinctively seek out a dark, secluded, quiet, and, most of all, safe place in which to give birth. While birthing, mammals give the appearance of sleep and closed eyes to fool would-be predators, and they breathe normally. Some (those who don’t perspire) will pant in order to cool down, but humans will most easily achieve a relaxed state through closed eyes and abdominal breathing. This relaxation slows down the birthing mother’s brain waves into what is called an alpha state, a state in which it is virtually impossible to release adrenaline, the “fight-flight” hormone. Physical comfort becomes critical, along with the need to have a “nest” ready for the baby. Hospital environments often unintentionally disrupt the birthing atmosphere by introducing bright lights, lots of people, noise, and fear-inducing exams and machines.

The uterine muscles are beautifully designed to deal quite effectively with danger, fear, and stress in labor. The uterus is the only muscle in the body that contains within itself two opposing muscle groups–one to induce and continue labor and another to stop labor if the birthing mother is in danger or afraid. Emotional or physical stress will automatically signal danger to a birthing mammal. Her labor will slow down or stop completely so that she can run to safety. In modern times, this goes haywire. We can’t run from our fears–which may include the “horror story” our best friend told us about her birth–or even from our hospital or physician. Instead, we may release adrenaline, which causes the short, circular muscle fibers in the lower third of the uterus to contract. These muscles are responsible for stopping labor by closing and tightening the cervix. The result is that we literally “stew” in our own adrenaline. At the same time that the long, straight muscle fibers of the uterus are contracting to efface and dilate the cervix, the short, circular muscle fibers of the lower uterus are also contracting to keep the cervix closed and “fight” the labor. The result? The very real pain of two powerful muscles pulling in opposite directions each time the birthing mother has a contraction.

By learning to deeply relax mentally, physically, and emotionally; actively dealing with fears about birth; and choosing a birthing environment that feels safe and protective, birthing women will not have to experience the traumatic pain caused by the ‘Fear-Tension-Pain Syndrome.’

William Hunter, Anatomia Uteri Humani Gravidi. 1774

There are common side effects of the epidural…but you are not likely to hear about them at the hospital.