Giving birth can be good, ecstatic and even orgasmic

I know I just wrote about this topic last week, but I have more to share and wrote about it for BlogHer this week.

Last week, Lisa Belkin, parenting blogger at The NY Times, wrote about the upcoming 20/20 special on the film “Orgasmic Birth.” The topic apparently hit a nerve with many, many people as she quickly received more than 500 comments.

Many people, as to be expected, are skeptical.

Mir of Woulda Coulda Shoulda had the most humorous response I read to the idea.

As soon as I

1) Find a man with a 9-pound penis
and
2) Become drunk enough to let him put it inside me for thirty hours at a time

I’ll definitely see if those conditions can result in an orgasm.

But until then? Whatever, man.

Catherine, who blogs at Her Bad Mother, had similar feelings and said, “Me, personally …? I think that I’ll stick to getting my orgasms the old-fashioned way.”

The day after Lisa Belkin’s initial NY Times post she followed up with About that orgasmic birth… and went into a little more detail about the responses she received, the film and one of the women featured in the film.

I was not surprised at the number of comments that dismissed the possibility as a fairytale. I was very surprised at the number of women who wrote to say that they had experienced what the film explored. I was a little distressed at the hostility the first of these groups showed to the second. And I was somewhat surprised, and very pleased, to receive an e-mail from Tamra Larter, one of the subjects of the film, who had been following all the comments, and wanted to make a few of her own.

It’s really worth it to click over there to read what Ms. Larter had to say about the film and her birthing experience, but here’s a snippet.

“I hope people will see the film,” she wrote. “Then they will see that it is about much more than the title suggests. There are many choices and possibilities when it comes to birth.”

And she uses the word “orgasm” with conditions. “I never claimed to have a pain-free birth,” she wrote, “but laboring with my daughter was awesome and for the most part felt really good.” The actual “orgasmic experience” did not feel like the climax of sex, she says, but rather “sensations which were something different than sex, but similar enough I feel O.K. using the word orgasmic. It was a wonderful feeling.”

She also confessed that upon first hearing about the idea of orgasmic birth, she thought it was “gross,” “weird,” and “not possible,” but said it was before she had had any children and the only childbirth she had seen had been on TV.

After reading many comments and several blogs about this, I clicked over to the Orgasmic Birth web site, where I watched the trailer (again). The first time I watched it was many months ago and I felt a refresher was in order.

I admit that even with all of the birth videos I’ve watched in the past and my “crunchy” ways, it makes me shift uncomfortably in my seat to hear a woman making pleasurable sounds while in childbirth (or in any situation really). And yet, I see the whole “orgasmic birth” thing as being just a small piece of the film, and believe it is titled the way it is to grab our attention. (And it’s certainly worked, hasn’t it?) I still believe, as I wrote on my blog over a week ago, “that it does not appear they are not saying all women will have an orgasm or that an orgasm should even be the goal. I think the point is moreso that birth can be a good experience.”

Marsden Wagner, MD, who is interviewed in the film, makes an excellent point about childbirth saying, “It’s got to be like it is when you make love with someone. It’s got to be safe, secure and uninterrupted. And that is how you have an orgasmic birth.”

I do not want to turn this into a debate over home birth vs. hospital birth, but having had both types of births I will say I felt much more safe, secure and uninterrupted at home than I did in the hospital. Although I’m sure it’s possible, I think that for the most part, these “orgasmic births” are much more likely to occur in a birthing center or home environment than in the hospital.

I think the term “orgasmic birth” is subject to interpretation too and noticed that on the Orgasmic Birth site, in their call for birth stories they say, “Please share your ecstatic or orgasmic birth story with us.” I would never say that I had an orgasm while giving birth to my son, but the experience was amazingly intense and was one of the most empowering moments in my life. Does that mean it was an orgasmic birth? Maybe. Was it an ecstatic birth? I believe it was.

Ninotchka had an empowering birth experience as well and commented about it on my blog:

I can’t say that I had an orgasm while giving birth. But after birthing Elle right into my hand, I felt so triumphant and organically happy that I would certainly call that feeling “orgasmic.” It all happened so fast and we’d waited so long for that little sweetheart. It was a definite rush and I was absolutely elated.

I think giving birth will always conjure up different ideas and feelings for different people. No two births are exactly the same and I think that’s the way it should be. Innerbrat summed it all up nicely when she said, “The important thing here, as with everything regarding women’s health, is to give women the ownership of our own bodies, so we can make an informed, conscious decision about what’s best for us and our children; and the first and best way to be informed is to openly talk about the subject.”

ABC’s 20/20 special on Orgasmic Birth, which will also include segments on home birth (unassisted and midwife-attended) and long-term breastfeeding, is currently set to air Friday, Jan. 2, 2009.

Cross-posted on BlogHer.

Orgasmic birth on 20/20 this Friday

Update: The show has been pushed back. The new tentative air date is Jan. 2 now.

Just a quick note to let you all (but especially the birth junkies) know that ABC’s 20/20 is doing a segment on Orgasmic Birth this Friday, Dec. 12.

Have no idea what I’m talking about? OB-GYN Dr. Christiane Northrup, midwife Ina May Gaskin, and childbirth educator Debra Pascali-Bonaro all agree that under the right circumstances, i.e. when a woman is relaxed (and in my opinion very comfortable with her body), and due to the huge hormonal changes that occur in the body during labor, a kind of birth ecstasy is possible.

To learn more about the 20/20’s Orgasmic Birth, check out Labor Orgasms called ‘Best-Kept Secret’ – Moms, Experts Say Relaxation is Key to Pleasurable Childbirth. Then be sure to tune into 20/20 on Friday. I’ve already got my DVR set to record it.

What do you think? Is a segment on ecstatic birth “a bit too much information” as one woman on Twitter called it or, in a largely-medicalized, fear-based birthing society, just the kind of information women need?

Additional resources:
Orgasmic Birth, the film
Orgasmic Childbirth: The Fun Doesn’t End at Conception! by Laura Shanley
Pioneering midwife touts ‘orgasmic birth’ on MSNBC

Edited to add: I want to point out that it does not appear they are not saying all women will have an orgasm or that an orgasm should even be the goal. I think the point is moreso that birth can be a good experience.

For women who hope to create a similarly happy ending for their labor, Pascali-Bonaro hopes they realize that it’s possible, but the goal is not necessarily an actual orgasm.

“I hope women watching and men watching don’t feel that what we’re saying is, every woman should have an orgasmic birth,” she said. “Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience.”

Study: First-time moms want more information about life with new baby

A new study including 151 mothers in Brisbane, Australia has found that first-time moms want more information about what life with a newborn will be like and says they often don’t feel prepared for the recovery period after giving birth and emotional toll of caring for a new baby.

A new study published in The Journal of Perinatal Education finds first-time mothers want more information about how a newborn will impact their lives. Thirty-five percent did not feel prepared for the physical experience following birth and 20% did not feel prepared for the emotional experience.

“This study demonstrates that new mothers are eager for high-quality, accurate information of what to expect of life with a newborn,” says the study’s lead author, Margaret Barnes, RN, MA, PhD.

While I think there’s a definite benefit to educating expecting moms information on what life with a newborn may be like, (after all, knowledge is power), until every child comes with his/her own user’s manual, I think ultimately there’s only so much you can prepare for. Every woman’s birth experience is different, every child is different, and every new mother’s experience with her child is different. Each child has a unique temperament and will have different needs. Some will want to nurse every few hours, some will want to nurse much more frequently (or never let go of the boob). Every child’s sleep patterns will be different as well.

If you try to explain to a woman ahead of time how much a newborn will affect her life, is it realistic to think your words will have that much of an impact? Could it really help her prepare for what lies ahead? Is recovering from birth and caring for a newborn something anyone can really prepare for ahead of time (without having access to a full-time nanny, personal chef, housekeeper, etc.)? I feel like this is one of those things that a woman has to experience for herself to truly “get it.”

Before I had my first child I knew that once she entered the world nothing would be the same, that I would be sleep-deprived and have a baby nursing around the clock, but I couldn’t fully grasp the extent of how different my life would be, how beyond tired I would be, how sore I would be from an (unnecessary and unwanted) episiotomy, nor just how much love I could have for one tiny person until it actually happened to me.

However, I do think that it’s important to equip first-time moms especially with information and resources that will help and support them in their first few weeks and months of life with a new baby. Instead of sending moms home from the hospital with a diaper bags full of a few diapers and a can of formula, perhaps hospitals should instead give women lists of names, numbers, websites and email addresses of people, places and organizations they can turn to if they need help. Organizations like La Leche League International – with dates and times of local meetings, phone numbers to certified lactation consultants, warning signs of postpartum depression and who to call if you or someone close to you suspects you have PPD, links to groups such as Attachment Parenting International, house cleaning services, numbers of postpartum doulas, local moms support groups like MOMS Club, MOPS (Mothers of Preschoolers), etc. That is real information that new moms can use.

What do you think? Do you feel you were adequately prepared for life with a newborn? If not, do you think classes or a book could have helped? Do you have other suggestions?

Additional resources:


Cross-posted on BlogHer

Rate your doctor, midwife & hospital on The Birth Survey

If you’ve given birth in the United States in the past three years, you are eligible to participate in The Birth Survey. Thanks to The Birth Survey: Transparency in Maternity Care, “women can now give consumer reviews of doctors, midwives, hospitals, and birth centers, learn about the choices and birth experiences of others, and view data on hospital and birth center standard practices and intervention rates.” If enough women take this survey, it could have a serious impact on maternity care in the U.S.

The survey was developed by The Coalition for Improving Maternity Services or the CIMS. “Our goal is to give women a mechanism that can be used to share information about maternity care practices in their community while at the same time providing practitioners and institutions feedback for quality of care improvement efforts.”

tbs_button1_5×2.jpgFrom The Birth Survey:

We are dedicated to improving maternity care for all women. We will do this by 1) creating a higher level of transparency in maternity care so that women will be better able to make informed decisions about where and with whom to birth and 2) providing practitioners and hospitals with information that will aid in evaluating and improving quality of care.

Can I just say I really wish this type of resource had been available when I was pregnant with my daughter? If I had been able to read about my OB’s episiotomy rate for one, I think it may have helped me pass her by and find another doctor who’s intervention rates were more in line with the type of birth I was hoping to have. My doctor may be a great surgeon, but I felt that she was cut-happy and performed an unnecessary episiotomy that I still doesn’t feel right 4+ years later. Since my daughter was born more than 3 years ago I cannot complete the survey to rate this particular doctor, but boy, oh boy, do I wish I could to help other women with their choices.

However, on a positive note, I was able to rate the midwife that was in attendance for my son’s home birth 20 months ago. She received a glowing review from me and I am hopeful that the information I shared in the survey will influence women as well, just in the opposite direction.

The survey itself goes into quite a bit of detail about your prenatal care, labor, birth, and postpartum care with a doctor or midwife as well as asks you to rate the hospital or birthing center in which you gave birth (though you may complete it for home births as well – as I did – you just aren’t rating a facility in that case). I believe it took me about 30 minutes or so to complete. A very nice feature, especially for busy moms, is you have the option of saving your answers and returning to it later, something I definitely took advantage of.

I believe The Birth Survey has the potential to make a real impact on the maternity care in this country and I hope that many, many women will take advantage of it to share their experiences and their knowledge with other women. I really feel it is every woman’s duty to share her experience in an effort to educate others and, in turn, hopefully improve the quality of care. As Citizens for Midwifery points out, “For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care providers and birth settings was nearly unattainable–but no longer.” Doesn’t it just make sense that there should be some sort of resource to compare care providers so that we can all make educated choices for our health and the health of our babies?

Heather at Meet the Heathons shares my excitement and optimism about the survey:

I am SO excited that this is FINALLY getting done. It was my dream as a public health graduate to do something like this. I’ve heard rumors that there are efforts to do this sort of thing for ALL types of medicine. So that say you needed a knee replacement, you could look up the hospital/doctor and see their success rate, compare prices, methods, etc… How AWESOME would that be. It would be one step towards changing health care in America– but I won’t get started on that one!

Giving Birth With Confidence says, “Hats off to the Coalition for Improving Maternity Services, the incredible women working within community based birth networks throughout the US, and to all the women who are sharing their birth stories. Finally, there is hope that birth, and women’s decisions about care provider and place of birth, will no longer happen ‘in the dark.'”

Upon completion of the survey, I found it interesting and helpful that there were additional resources listed for women who may have experienced negative feelings about their birth while taking the survey. Had I been taking it for my daughter’s birth instead of my son’s, I am sure a lot of the anger and negative emotions I have had in the past about the care I received during that time may have been brought to the forefront. (Heck, I’m experiencing some of them just writing the little bit that I did about it.) While it sucks that women may experience these feelings, it’s good to know there are resources available to help them deal with them.

If this survey brought up traumatic feelings for you regarding your labor, birth, or postpartum experience we encourage you to seek help from a licensed mental health professional who specializes in birth trauma. The following resources may also be helpful to you www.postpartum.net, www.ican-online.org, and Solace for Mothers.

Now let’s spread the word. Activistas says, “Share your story, voice your opinion, mamas. It’s important, and it feels really good (kind of like having a baby!). If you don’t, how will your experience help others?”

If you’ve given birth in the past three years, will you take The Birth Survey? Will you forward it on to your friends? Will you add a button to your blog? Let your voice be heard!

Other bloggers who have written about The Birth Survey:

Think Mama Think
Faith Walker
Mama Knows Breast
Finally Living Deliberately
…And a doula, too

Cross-posted on BlogHer

Because no baby should have to grow up without knowing her mother

Cross-posted on BlogHer

While wondering today how I would segue into writing about model Christy Turlington and former Spice Girl Geri Halliwell’s recent campaign for maternal health, I unexpectedly came across a blog post about that very subject that stopped me in my tracks and left me in tears. The post was on Single Mom Seeking by guest blogger Matt Logelin who lost his wife and mother of their child just hours after she gave birth. It’s called Forevers.

Matt’s wife Liz died of a pulmonary embolism before she even had the chance to hold her daughter Madeline. She was on her way to see her baby girl after spending 24 hours in bed following her c-section when she said she felt “light-headed” and passed out. The doctors and nurses were unable to revive her.

Although I’d never met any of them, I started crying for Liz, her husband Matt and their now 4-month-old daughter, as memories of my own daughter’s birth came flooding back. I had lost a fair amount of blood after Ava was born, and after holding her for a minute or so, I too uttered those words, “I feel light-headed.” My husband Jody took Ava and the nurses immediately sprang into action and reclined my bed as far back as it would go, putting my feet in the air. I remember feeling very strange and scared as Jody and my sister coo’d over my new baby girl, and I didn’t know what was going on with me. But ultimately I was OK. I am OK. I am alive.

I was so moved by Liz’s story that I shared it with my husband this evening. We talked about how sad it is and upon overhearing that part, Ava (4 years old) asked what was so sad. I’m generally all in favor of honesty with my children and considered for a second telling her the truth, but quickly decided against it. She’s not old enough to bear that kind of weight – that sometimes (actually much more often than should be the case) babies lose their mommies.

No baby should have to grow up without having ever known her mother. No partner should have to bury their loved one during what should be one of the happiest times in their lives. Which is why the work of mothers Christy Turlington and Geri Halliwell is so important. When we hear a statistic like “a woman dies every minute of complications from childbirth,” it might sound shocking, but ultimately it is hard to wrap our heads around. Unless we personally know someone who has died from giving birth, we assume it’s happening to women elsewhere, in other countries, across the world. And while that is more often the case than not, stories like Liz’s show that it’s happening here in North America as well and help put a face and a name with a statistic, making it a little more real.

According to ParentDish and EcoRazzi, Christy Turlington and Geri Halliwell are campaigning for maternal health and attempting to get the U.S. government to provide more resources to women around the world during childbirth. Christy, who is the mother of two with actor Ed Burns, says “I’m really involved in maternal health. I’ve been working in Washington to help raise awareness. I’m a mum, so maternal health is very important to me.” She is also an ambassador for CARE – a humanitarian organization fighting global poverty – and adds, “I’ve had safe deliveries for both my children because I have had access to skilled medical care. Yet for too many women in the developing world, pregnancy and childbirth is a serious life-and-death issue.”

Both Christy and Geri also campaigned earlier this year for legislation to help fistula survivors. Obstetric fistula is a devastating injury of childbirth in which the baby usually dies and the mother is left with a hole either between the woman’s vagina and bladder or vagina and rectum (or both), resulting in the leaking of urine, feces or both.

You can read more about Christy, including her quest for maternal health and myriad other topics, in an interview with Betsy Rothstein on The Hill.

If you want to make a difference in the lives of women and children around the world, BlogHer’s partnership with Global Giving is still accepting donations.

Guest post: From my Belly to my Chest

While I’m on vacation until Aug. 9 (and quite possibly for the day or two after I get back), I’m featuring several guest bloggers. Today marks the beginning of World Breastfeeding Week and today’s post, about breastfeeding, is from Nell who blogs at Casual Friday Everyday. Please be sure to check out my earlier WBW post and giveaway (two breastfeeding books) and API Speaks is giving away a copy of The Womanly Art of Breastfeeding as well.

From My Belly To My Chest

My breasts are heavy and full. The bright blue veins running through my chest also remind me of the life growing inside my womb. My entire upper body reminds me that one day this baby will be on the outside and will need my breasts to feed her/him and will no longer rely on my womb to sustain its life.

Soon I’ll be exhausted from laboring and delivering this little life and as they place the wee little one on my chest she/he will latch on for the first of many times. The life giving liquid will pour from my body giving her/him life.

It’s a beautiful and natural thing our bodies do. A pure, sweet bond is instantly developed when our young infant is nursing at our breasts. It’s also a powerful feeling, much like when giving birth. Look at what our bodies can do. Look at what they were made for.

Even with it being such a beautiful, natural and bonding thing it doesn’t always come easily for everyone. I’m one of the “unlucky” ones who experienced many of the issues some of us face. From a baby who was tongue tied to a yeast overgrowth that made my breasts ache to sore nipples that cracked and bled (the first time) to nipples that were so irritated from the pads rubbing against them they’d actually begin to invert. I’ve experienced it all…well maybe not all.

Even through the pain and difficulty I knew I was doing the right thing. I knew I was doing what was best, what I wanted to do, what this baby needed. And I fought it tooth and nail. But all the fighting on my own never got me very far into the process. The bond was lost. The nourishment gone. The natural, beautiful experience forever buried in my memory as I let go of breastfeeding.

A lot has changed since my 18 month old was an infant. My parenting style has changed. What I’m willing to do for the betterment of my children has changed. What I understand about living a more natural lifestyle, laboring naturally, vaccines, taking care of our earth and yes, breastfeeding has changed.

Aside from my increasing knowledge on such topics, another large change that I know will help me along is my desire for help. I’ve sought out the help of a doula for this labor and delivery. Doing it alone is no longer an option if I wish to achieve the birth of my dreams. And neither is breastfeeding alone. I now realize if I wish to overcome many of the hurdles I’ve experienced in the past I must get hands on help from a professional.

I must seek out the knowledge of someone who is trained and has successfully breastfed their own children for long periods of time. I’ve read all the books and emailed really amazing women with my previous experiences…now it’s time to step out of my comfort zone and get one on one guidance for as long as it takes so that I’m still nursing this new little one well into her/his second year of life.

Breastfeeding is sweet — and when it doesn’t come easy, we need to seek out help. I know I will…this time around.

Nell is the mother of two young boys with another baby on the way later this year. She’s a blogger at Casual Friday Everyday, a home-based business owner and freelance writer.

Guest post: The Longest Birth Story Ever

While I’m on vacation until Aug. 9 (and quite possibly for the day or two after I get back), I’m featuring several guest bloggers. Today’s guest post comes from Sonja from Girl with Greencard. Sonja shares the birth story of her son Noah who was born just weeks ago.

The longest birth story ever

The plan:

Midwife-attended, natural home birth, potentially in the water.

The Husband and I made this choice for many reasons, but mainly because a normal pregnancy is not a disease and does not need to be medically managed. We wanted to have control over the parts of the birth process you can have control over, like avoiding routine interventions, knowing all the attendants, being comfortable in our surroundings, and making choices ourselves rather than having doctors or nurses make choices for us. On top of that, I was radically and irrationally afraid of being admitted to the hospital. I haven’t been to a hospital in the last 15 years or so without becoming lightheaded – and that was just when I visited others!

The preparations:

Find a midwife.

Take Bradley class.

Take many a supplement.

Buy lots of plastic sheeting and cheapo towels and set up birthing tub (sans water, of course).

Prenatal care and due dateapalooza:

After we had found a midwife and decided on the home birth, I saw both her and a midwife at Kaiser for prenatal appointments. Generally speaking, the appointments at Kaiser were awful (low iron! too much weight gain! scary big baby stories!) and the appointments with The Good Midwife (TGM) were great. I was low-risk, happy, healthy, and progressing normally. From the get-go, I had two different due dates: June 17th from Kaiser and June 19th from TGM. Then, Kaiser did the 2nd trimester ultrasound, and on the print-out it said that my due date was June 23rd.

Forward to week 35 of my pregnancy, when the baby dropped (I carried my belly between my knees all of a sudden), and TGM told me that first babies usually arrive four weeks after they drop. So now I considered my “due date” to be between June 12th and June 23rd.

Waiting…:

I didn’t have a baby on June 12th. Nor on the 13th, the 14th, or even on the 23rd. TGM went to a conference in Canada (leaving me in the capable hands of a very sweet stand-in). She was due back on July 1st, which was also my “due date + 8” (first time moms on average deliver 8 days past their due date) from June 23rd. I dealt with some crampiness and mucousiness while she was gone, but I had decided that I would have the baby on July 1st (because at that point I had STILL not gotten it into my blonde head that this was NOT UP TO ME). Starting on Thursday (June 26th), the crampiness progressed into nightly occurrences of pre-labor (or false labor), which was exciting, but robbed both me and The Husband of sleep. And… it didn’t progress into anything serious at all.

I didn’t have a baby on July 1st. Nor on July 2nd. I was getting a little desperate. Okay. A lot desperate.

Finally! Labor! Wooohooo!

Thursday night, July 3rd, I could tell my contractions were different. The Husband and I decided that FINALLY! I was in labor, and called TGM to giver her a heads-up. I took the birthday cake out of the freezer. In between my contractions we talked about how our baby had just waited so he could have parades and fireworks for his birthday every year. Needless to say, we were excited. Of course, being obedient Bradley students, we went to sleep. That is, The Husband went to sleep. I realized that real contractions are a heck of a lot more painful lying in bed that in pretty much any other position, so I walked around and dropped to my knees a lot.

Towards the morning, I felt increasingly annoyed with the contractions and got in the birth tub. This of course slowed the contractions waaaaay down, but I managed to wedge myself in so I could take a floating nap, which was great.

TGM arrived around daybreak. I was only 3 cm dilated and incredibly discouraged. She recommended resting and distracting ourselves during the day and felt sure that my contractions would pick up again at night.

The next night went much like the night before. When TGM arrived at the house early the next morning, I was 3 cm dilated and clearly not in labor. Also ready to jump off a cliff – angry, annoyed, and just way too pregnant to deal with still being pregnant.

Hospital:

That Saturday was a long day. Saturday night was the first night in over a week that went by without so much as a single little cramp from ye olde uterus. Sunday morning, I had a really hard time peeing. By 9am, I couldn’t really pee at all even though I had been drinking water and juice like crazy. I figured that this was just a new nuisance of being extremely pregnant – baby is putting pressure on my bladder (because BOY did I have to go!) and simultaneously sitting on the exit. It wasn’t until I dissolved into tears trying to pee at church around 11am that it dawned on me that something was not right (I’m real bright sometimes, what can I say!). We went home. I called TGM who phone diagnosed me with a UTI (a diagnosis that proved accurate though I shrugged it off as preposterous because it didn’t feel like a UTI) and sent me to urgent care.

Of course, when we got to the Kaiser hospital, we were re-routed from urgent care to labor and delivery.

I was asked to pee in a cup (HAHAHA!) and actually managed to squeeze out a few drops. I had to exchange my clothes for the breezy gown and was hooked up to a fetal monitor. A surly midwife scolded me for not having come in for a biophysical profile at 41 weeks. And this, my dears, is when I found out that Kaiser only adjusts the due date based on the 2nd trimester ultrasound if it is more than two weeks different from the due date based on LMP (which I think is sound medically – I just wish I had asked that question back in January!). In other words, June 23rd had never actually been my due date, which now put me at almost 43 weeks pregnant. I felt like a giant fool. But not for long, because of the commotion – baby’s heart rate dropped! Dramatically! To the 50s! Nurses rushed into the room, The Husband was pushed out of the way, and an oxygen mask was pressed on my face. As soon as the monitor had been adjusted, baby’s heart rate was fine again, but this “random decel” turned into another Big Deal, though I am convinced that it only happened because the monitor moved on my giant belly.

An ultrasound determined that I had next to no amniotic fluid left (not good) and an exam revealed that my bag of waters had ruptured – unbeknownst to me. It had quite possibly (and likely) been ruptured for three or four days (really not good).

So here I was – with premature rupture of membranes, too little amniotic fluid, a “random decel” of baby’s heart rate, a UTI, and 2 weeks 5 days past my due date. Oh, and without any contractions. We agreed to induction, happy that they were offering it rather than arguing for a c-section right away.

Intervention carnival:

Before I knew it, I had an IV with fluids and antibiotics. My bladder was catheterized (oh, sweet relief!), fetal monitoring was done internally (sorry baby!), and I got an infusion of amniotic fluid. Once everything was situated, they hooked me up to Pitocin.

Fast-forward about 12 hours. I was stalled at 7 cm but felt veeeery pushy with each contraction. Baby’s head was tilted (not good) and his heart rate continued to have “random decels” (Pitocin side effect). TGM had come to the hospital to support us, and at this point, she recommended I get an epidural to give me the chance to continue dilating without having to try not to push, to relax me so that perhaps baby’s head would move into a more favorable position, and to allow me to get some rest. I went for it, and it really helped. I dilated to 9 cm while I took a little nap. Baby’s head turned. I got a second wind. But… I had to keep the oxygen mask on at all times to prevent baby’s heart rate from dropping (and take slow, deep breaths). Baby had turned posterior (no wonder – I had to labor on my back!) and I stalled at 9 cm with my cervix stuck between baby’s head and my pubic bone.

We decided that at that point, a c-section would be the best option to get the baby out safely.

Noah was born at 10:15am on Monday, July 7th. He was covered in meconium, but had APGARs of 8 and 9. His daddy fought the nurses for skin to skin contact while they were cleaning and suctioning him and then stayed with Noah until they had sewn me back up. I was able to hold and even nurse Noah in recovery – before I could even wiggle my toes (or actually really feel my boobs).

The aftermath

Healing from a c-section is no picnic. Getting into and out of bed was nearly impossible for the first few days – even in the hospital. At 16 days post-surgery, I still cannot carry Noah and the diaper bag at the same time. I don’t stand a chance lifting the stroller into or out of the trunk of the car. Sneezing, coughing, and blowing my nose are extremely painful – I feel as though those things rip me apart at my incision.

Healing emotionally

I’m actually doing pretty well emotionally. I certainly have learned a lot.

One of the reasons why I chose a home birth was my fear of hospitals. I didn’t want to have to assert myself and to fight for the natural birth I wanted. In many ways, home birth was the path of least resistance for me. Not only did the hospital turn out to be very accommodating of all of my special little requests, but I never felt judged for my decisions (like refusing the eye treatment and Hep B vaccine for Noah). My wishes were actually respected (I told the first nurse I did not want pain medication offered to me and nobody ever mentioned it after that.)! I felt well taken care of the entire time I was in the hospital, and I realized how strong I was. I was able to get what I wanted without having to drop-kick anybody (or even arguing for it).

I know that I did everything I could to have a natural delivery. I feel that all interventions were medically necessary. Sure, the Pitocin led to the random decels in baby’s heart rate which ultimately led to the c-section, but I did need the Pit to get me to go into labor. The stalling at 9cm and baby’s poor position could have been avoided (or remedied) had I been able to move around while in labor, but again – with the issues I came in with, laboring on the bed was my only option.

And so I learned that the hospital is not an evil place (though choose your hospital wisely if you’re planning to birth there), that I am stronger than I thought (I sort of want to cross-stitch “12 hours on pit with not pain meds” into a pillow), and that even though it can sometimes appear as though they are, medical professionals are NOT the enemy (but… do your research! I’m always amazed at people making decisions based on little to no background info. One of the nurses actually asked me if I was a nurse because of how much I knew about labor and birth.).

And to end the longest birth story ever told (which is fitting since it felt like the longest pregnancy known to womankind), here are some photos:

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Girlwithgreencard is the pseudonym of Sonja. She is a retired elementary school teacher and new SAHM living the high life of smog, terrible traffic, and crazy hot summers in Southern California. She has a green card because she came to the States from Germany eight years ago to get married to this guy she fell madly in love with. Sonja likes the smell of rain and her baby’s blissed-out smile when he comes off her boob. She very much dislikes crumply sheets and people talking on cell phones in public restrooms.

Sonja chronicles her daily life at Girl with Greencard and shows off her crafting endeavors at Girl with Fabric.

Everyone’s eager to meet baby, but are elective inductions safe?

ivbag.jpgElective inductions are on the rise in the United States, and while this means many excited mothers get to meet their babies sooner than if they waited for labor to begin spontaneously, it also means they are much more likely to meet their babies as a result of a cesarean section, which of course comes with it’s own set of risks to both mother and child.

According to a study linked on Birthfriend’s Place to Ponder:

In 2004, the National Vital Statistics Report showed the total induction rate (in the United States) to be 21.2%. Of that number, 25% were reported to have no apparent medical indication and were done for the convenience of either the patient or the physician (Martin et al., 2006). This rate represents a 9.5% increase since 1990. An even higher induction rate of 41% was found by the Listening to Mothers II survey (Declercq, Sakala, Corry, Applebaum, & Risher, 2006).

The desire to bring about the onset of labor is nothing new. Throughout history, women have tried to induce labor naturally through “home remedies” such as nipple stimulation, Castor oil, herbal remedies, sexual intercourse and more. As I neared the 41 weeks marker with my son, even I tried to naturally jump start labor by way of acupuncture to increase my chances of having a home birth. I went into labor that night. Had I reached 42 weeks, my likelihood of being legally allowed to have a home birth would have decreased.

The way I see it though is the difference between using natural means of inducing labor and medical means is the end result. With either one labor will begin only if the woman’s body (cervix) is ready. However, with the natural methods, if labor doesn’t begin, the end result is the woman is still pregnant and has to wait until her body is ready. With the medical/pharmaceutical means of induction, if labor doesn’t begin or progress according to the care provider’s timetable, the end result will most often be a c-section.

It is important to note that a woman should consult with her care provider before trying any induction method, even natural ones.

If you are leaning towards a medical elective induction, in addition to discussing your options and risk factors with your care provider, it is also important to do your own research and be an informed customer so you can make the choice that’s best for the health of both you and your baby.

Although the American College of Obstetrics and Gynecologists recommends against elective inductions citing “Induction of labor is indicated when the benefits to either the mother or fetus outweigh those of continuing the pregnancy” (in other words, when medically necessary), many doctors are more than happy to accommodate a mom who is tired of being pregnant. Some doctors routinely do inductions at 40 weeks, even if “it’s perfectly normal for 80 percent of healthy babies to have anywhere from a 38- to 42-week gestation” and even if a woman is not asking for it.

NedaAnn (AKA Iluvmysweetpea) who blogs at The unstable mind of an unhealthy body told me on Twitter that when she was preparing for the birth of her daughter four and a half years ago, she and the rest of the women in her childbirth class were told that at 40 weeks they would be induced. “We were told that at 40 weeks our fluid started to diminish, so it was a danger to baby. That’s why we needed to be induced.” On top of that, she said, her doctor who practiced at Albert Lea Medical Center in Minnesota told the class they use Cytotec for inductions. Having had done her research about the safety of Cytotec, she asked him about it and was told it was “not that bad.” Her daughter Trinity came a month early, so she never had to deal with a possible induction, but NedaAnn believes, “Pregnancy used to be 42 weeks long, so why are we inducing at 40 weeks or before? I know there are legit reasons in a few cases, but overall it is a matter of convenience and I just don’t think the risks are worth the convenience. And Cytotec should be banned.”

The issue with Cytotec (misoprostol), if you are unfamiliar with this drug, is it has been FDA-approved only for treating ulcers, NOT for inducing labor. According to Marsden Wagner, MD, MS, “On the Cytotec label it is explicitly written that this drug is contraindicated for use on pregnant women.” Using Cytotec to induce labor has many “serious adverse effects … including maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock.” These risks are even greater if the woman is attempting a vaginal birth after cesarean (VBAC). According to an article on iVillage, “Cytotec’s sole appeal is price. Cytotec costs pennies per induction, whereas Prepidil and Cervidil cost close to $100 per dose, and more than one dose may be needed. Cytotec also reduces the need for intravenous oxytocin (Pitocin), the hormone that stimulates contractions, another savings.”

According to an article on CNN “Five Ways to Avoid a C-section,” the number one way to avoid having a c-section to to get induced only if it’s medically necessary and points out that first-time moms have a greatly increased risk of having a c-section after an induction.

One of the biggest risks of an elective induction is that it will, the majority of the time, end up in a c-section.

“If you decide to have an induction because your obstetrician is going out of town, or because your husband is going out of town, that may seem like a bona fide reason, but you’ll pay the price with an increased rate in C-sections,” said Dr. Michael Klein, emeritus professor of family practice and pediatrics at the University of British Columbia, who’s studied C-sections.

Klein says studies of first-time moms show that 44 percent of those who are induced end up with a C-section but that only 8 percent of those who go into labor spontaneously end up with a C-section. Doctors say many times, inducing women way before the cervix is ready can lead to unproductive labor, which then necessitates a C-section.”

A labor and delivery nurse who blogs at At Your Cervix says in her post Inductions Galore, “My last few shifts at work have been a wide variety of patients. Inductions that go no where, inductions that take off super fast and precipitously deliver, pretermers, preeclamptics, c-sections. I think I’ve done it all in the last few shifts. What bugs me are the inductions. These docs really dig for reasons to induce.” And then she details the list of reasons doctors will induce. Then she also adds, “Then again, we have some docs who refuse to induce for made up reasons.”

While many women may not have heard of this, there is a tool that helps care providers assess a woman’s likelihood of having a successful induction – it’s called the Bishop or Bishop’s score. According to Revolution Health: “For the purpose of inducing labor with medicine, the Bishop score helps a health professional assess a woman’s physical readiness to progress through vaginal delivery. The Bishop score is a rating of how soft, open, and thinned the cervix is (dilation and effacement), as well as how low in the pelvis the cervix and baby are positioned.

Bishop scores range from 0 to 10. The higher the number, the more likely a vaginal delivery will be successful. ”

Want to know if you are ready for induction? You can even take an interactive quiz online that will assess the readiness of your cervix.

Jennifer Block at Pushed Birth discusses Why Not Schedule It?

What will an induction mean for you? If you induce, you’ll be admitted to the hospital and will most likely spend the next 24 hours of labor confined to bed. Because staff will need to kickstart and maintain contractions and dilation with drugs like Pitocin, Cytotec, and Cervidil, they will require IV fluids and continuous fetal monitoring. At that point you’ll very likely want an epidural, because Pitocin contractions are more painful, especially when you can’t move around. A director of OB/GYN in New York City called Pitocin without an epidural “cruel and unusual punishment.”

Jennifer adds:

If you’re considering a medically unnecessary induction, think about whom it will really benefit. While it may seem more convenient to just book it, think of the inconvenience of recovering from major surgery, or waiting for your baby to be released from a NICU — two very real possibilities. And think also about the increased risk to your pelvic parts of a pushed birth. Again, the best, healthiest option for both you and your baby is labor that your body starts on its own, progresses on its own, and concludes on its own terms.

Although there is a lot of information out there against elective inductions, there are legitimate reasons why a woman would opt for one. Christine from Watch me! No, watch me! (a mama who graduated from medical school just a month before her son was due) decided on an elective induction at 41.5 weeks. She had contracted PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) at 38.5 weeks, which, in her own words, is “a HORRIBLY itchy rash that is covered in hard plaques. So, you’re itchy but can’t even get any temporary relief from scratching because of the hard top layer (gross, I know). Worse than that, the hard plaques themselves irritate the underlying rash. It was a nightmare. I couldn’t wear clothes and even sitting down was and excruciating mix of unbearable itchiness and pain.” By 41+ weeks, the rash had spread everywhere except her face and breasts and she was unable to sleep for more than two hours at a time.

The only thing that cures PUPPP is delivery, so at 41.5 weeks, Christine asked to be induced. After considering her condition and that she was getting weaker and weaker from lack of sleep, her doctors agreed to it. Due to her son being posterior, she was unable to progress past 6 cm, and decided along with her doctor that a c-section would be best, which Christine had a very positive experience with.

Christine notes that because of her medical background she was “a very well-informed patient.” She adds, “I knew what was going on from start to finish and this is the route I chose.”

Sheridan at Enjoy Birth Blog believes there are Five Good Reasons for an Induction, as well as Five Questionable Reasons for Induction, and Five NO Risk Alternatives to Inductions.

I’ve personally given birth to two children – one was medically induced with Pitocin due to my developing HELLP syndrome at 39 weeks and the other labor began on it’s own (well, after a round of acupuncture the night before). The difference in the two labors was very noteworthy. When I was induced with Pitocin, my contractions quickly became nearly unbearable and I felt I had no breaks in between them. They just kept hitting me over and over. With the induction I was also restricted to laboring in bed, which I feel inhibited my ability to effectively deal with the pain. Even though I had no intention of having an epidural when I went into it, I quickly changed my tune and asked for one but was denied it due to my falling platelet levels, so I had to cope with the pain in other ways. With my labor that began naturally I was able to move about freely and change positions. The pain never became unbearable. In fact, it only got really uncomfortable in the last hour or so, but was still manageable, as opposed to my medically-induced labor that was uncomfortable and borderline unbearable for hours. Both labors lasted around 12 hours, but the differences between the two were unforgettable. I’d never choose to be induced again unless (again) I had very good reason for it. I can’t imagine putting my body or my baby through that without good reason.

Additional resources:
– Mothering magazine: Let the Baby Decide: The Case against Inducing Labor
CYTOTEC petition: Cytotec (misoprostol) for Labor Induction Consumer Awareness
– From Henci Goer, author of The Thinking Woman’s Guide to a Better Birth: Elective induction of labor – “Is elective induction safe and effective?”, “Who makes a good candidate for elective induction?”, and “How can women considering elective induction minimize the risks?”
– From Descent to Truth. To Life. To Birth. To Motherhood.: Stop the Misuse of Cytotec to Induce Labor

Cross-posted on BlogHer

Loss of insurance – another price to pay after a c-section?

An article in the New York Times this weekend reported that some women are being forced to pay higher health insurance premiums or are being denied insurance coverage all together if they’ve had a Caesarean section in their past. Peggy Robertson of Centennial, Colo., was turned down for individual health coverage by Golden Rule Insurance Company because she had given birth by c-section. No matter that she was in perfect health. “Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it.”

Photo courtesy grendellion
Photo courtesy grendellion

This could be a serious problem and affect countless women given the c-section rate in this country. It is believed that the current c-section rate in the United States is at a record high of more than 30% (that is nearly 1 in 3 babies is born via cesarean section) despite the World Health Organization’s recommendation that says “the best outcomes for mothers and babies appear to occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good (Althabe and Belizan 2006).”

Tina Cassidy from The Birth Book Blog believes the situation with the insurance company all comes down to money.

As always, it is money dictating the rules of health care. Of course, money (malpractice fears) is one of the reasons why the c-section rate in the US at 1 out of every 3 births. Honestly, it is surprising that it took insurance companies this long to wake up to the fact that they are paying either way — for the c-sections that don’t get done when they should, those that get done poorly (regardless of whether they were necessary) or when a woman is denied access to a vaginal birth after cesarean, which is happening more and more…

Perhaps it does all come down to money, but if that really were the case, then why wouldn’t my insurance company reimburse me a measly $2000 (relatively speaking) to cover my prenatal care, home birth, and postnatal care that I had with a midwife for my son’s birth in 2006? They refused to pay me one single penny, yet had I given birth in a hospital, they would’ve covered the entire thing (tens of thousands of dollars since I would’ve had a c-section due to my son being a surprise breech) less my one-time $10 copay. Logically, I figured that they’d rather pay for the lesser of the two, but logic apparently has no place when dealing with insurance companies. Maybe Tina is right on with her assessment. After all, why would they want to reimburse me and pay $2000 when they can get away with paying nothing at all?

Sharon Holley at The Traveling Midwife feels this is a great example for why we need national health coverage and also pondered what this could mean for the future of midwives and had other questions as well.

If insurance companies are going to start denying coverage for previous cesarean sections then what is to stop them from denying coverage for any type of previous surgery? Will this help bring midwives more respect as we have better c-section rates and still maintain excellent outcomes nationwide? Currently midwives are always battling with insurance companies to reimburse for care. Even Medicare and Medicaid does not pay 100% for services when compared to same services that are provided by physicians. Will this push women to question the need for a cesarean at the time of delivery?

Heather at A Mama’s Blog who has had both a c-section and a VBAC (vaginal birth after cesarean) and has written about in the past about her c-section experience and what a c-section is really like believes the insurance situation should be alarming for all women in their child-bearing years.

Even if you have no intention what-so-ever of having a c-section, in the rare case that you did need a medically necessary one, you can be denied insurance coverage now, because the procedure has been over performed.

Doctors and hospitals must start allowing VBACs, and return to delivering breech babies, in order to lower the ever rising c-section rate. If nothing else, c-sections should be reserved for true emergency situations. Something has to change – now more than ever, our very health depends on it.

Louise at Colorado Health Insurance Insider writes about her experience in the insurance business and says:

I’ve written before about how caesareans should only be covered by health insurance if they are medically necessary – “elective” c-sections should always be patient-pay, regardless of what health insurance carrier the patient has. It mystifies me as to why someone would willingly choose a c-section instead of a vaginal birth, considering the increased risks, much longer recovery time, and permanent scar. But at the same time, a lot of doctors are also guilty of over-using medical intervention for convenience in obstetric care. Part of the problem is the ridiculous malpractice system we have in this country.

Louise goes on to add:

For women who are trying to secure individual health insurance policies, a prior c-section can be a headache. They should be able to find at least one company willing to offer coverage, but it may not be their first choice, and it may come with a higher price tag. Just one more reason why a c-section should be a last resort, and should never be performed without a medical reason.

Jennifer Block at Pushed Birth feels a policy like this is adding insult to injury.

The losers in all this, of course, are women and their families: going through unnecessary primary cesareans, then being discouraged or flat out denied normal, physiological birth for their next pregnancy, on top of that being denied health insurance because the repeat cesarean their providers are insisting upon would cost the insurer more money, and having babies at higher risk of being born too early, not to mention the risks of repeated major abdominal surgery for mom. And we call this maternity “care”?

Carolyn McConnell of Rock the Cradle – The Politics of Motherhood agrees and points out the results of a 2005 survey where one quarter of the women polled “reported feeling pressured by a medical professional to have a C-section.”

And then they pay for it, in a high rate of infection of the incision, extended recovery and pain in comparison to vaginal birth, risks of injury to the baby, greater difficulty initiating breastfeeding, and greater risks of breathing problems in the baby—and finally in a loss of insurance coverage.

So, what now? On one hand I think it’s good that insurance companies are finally realizing the cost they having to bear as a result of a c-section rate that is inexcusably high and perhaps this will encourage more women to become better informed about c-sections before they go to the hospital. Maybe this will also put some pressure on the OBs that are performing unnecessary c-sections. On the other hand, I don’t feel it’s fair to women to raise their premiums or deny them coverage based on something that many of them may have been pressured into in the first place. And in the case that it was a medically-necessary c-section, then what? Another thing that is disturbing to me in all of this is that many hospitals have banned VBACs, so even if a woman wants to have a vaginal birth after a c-section, her options are often very limited.

I don’t know what the answer is, but I do know something needs to change in this country and the c-section rate must be lowered. Women, and their babies, deserve better care than this.

What do you think?

Additional resources:

Cross-posted at BlogHer

Breastfeeding while pregnant: trying at times, but ultimately worthwhile

Welcome to the May Carnival of Breastfeeding, hosted by Motherwear Breastfeeding Blog. This month’s topic is pregnancy and breastfeeding.

When I became pregnant with my son, my daughter Ava was about 20 months old and still nursing regularly. While I had friends who’s children had self-weaned when they became pregnant, I had my doubts that my “na-na”-loving kid would consider weaning for a second, even if my milk dried up.

Photo courtesy seanmcgrath
Photo courtesy seanmcgrath

At that age, Ava was still a comfort nurser, and still woke at night to nurse. After finding out I was pregnant I worked towards gently night weaning her by letting her know she could nurse as much as she wanted during the day, but at night the na-na had to sleep and she had to wait until the sun woke up in the morning to have mama milk.

By 22 months, miraculously (or so it felt) she was sleeping through the night. (Can you hear the angels singing? I thought I could. 😉 It was wonderful. 🙂 She was still happily in our bed, but no longer waking for na-na, and I was able to get the sleep I needed while growing a baby.

Of course, night weaning her did nothing to reduce her desire to nurse during the day, even when my milk dried up (somewhere around 16 weeks I think). However, as my pregnancy progressed, I decided that I wanted/needed to cut down on the number of nursing sessions per day for a variety of reasons. 1) My nipples were becoming increasingly tender. 2) My hormones were all kinds of crazy and the feeling of her nursing when there was no milk to be had sometimes honestly made my skin crawl. 3) I had my qualms about tandem nursing a newborn and a toddler.

The negative and skin crawling feelings were very much a surprise to me and I admit I felt guilty about it. I felt fortunate that I had a group of friends to bounce these feelings off of and was happy to learn that while all pregnant women don’t feel this way, my feelings were certainly not out of the ordinary and others had experienced similar feelings as well.

I used distraction to help reduce the number of times Ava nursed and my husband Jody helped out a lot too. We would ask Ava, “What else could we do to make you feel better instead of having na-na?” and often sang silly or happy songs together rather than nursing. It wasn’t always easy and sometimes I let her nurse even though I didn’t want to, but eventually (about a month or two before Julian was born), she was down to nursing only 1 time per day – before bedtime.

Before Julian was born we talked a lot with Ava about how he would be a little baby and need a lot of mama milk to grow up big and strong like his big sister. We really wanted to get the point across that he would be nursing all the time. And we talked up how she was a big girl and got to do lots of things that Julian was too little to do. I was also sure to let her know that we’d still have our “special na-na time” every night before bed. It honestly worked pretty well.

There were a few weeks towards the end of my pregnancy that I seriously considered weaning her all together. Like I mentioned earlier, my hormones were wreaking havoc on me and nursing her, even only once per day was hard because I had some seriously strong negative feelings that were hard to control. There were a few times that I had to tell her that I was feeling frustrated and needed a break and I would have to take a minute to calm and center myself before letting her latch back on. I think keeping the lines of communication open like that and being honest with her was helpful.

Part of the reason I didn’t wean her completely then was because I felt like it’d be harder to try to do that, than it would be for me to just suck it up and muscle through the last few weeks. I know that sounds horrible, but I knew that when my milk came back in and my hormones weren’t so crazy, nursing her would not affect me so. And I was right. It got easier, much much easier once Julian was born and the milk started flowing freely again.

At the end of my pregnancy, I remember every night I would lay down for some quiet, cuddle time to nurse Ava before bed, she would hold onto baby (put her hand on my belly), and I would wonder if it would be our last night together just the two of us before her baby brother would join us.

In retrospect, I’m glad that I didn’t wean her, despite my strong feelings because I think tandem nursing has been a nice bonding experience for the two kids. On the somewhat rare occasion that Jody is traveling for work and I’ve had to get both kids to bed by myself, we’ve shared some pretty special (though definitely awkward) times together with both of them at the breast, holding hands or giggling at each other, and it’s moments like that that I wouldn’t trade for the world. 🙂

I want to add that this is my experience only. Just because it was trying at times for me, does not mean it will be for everyone. It’s impossible to know how pregnancy and breastfeeding will go for each woman until she experiences it for herself and then can decide what is best for her and her family.

To read more about others’ experiences and thoughts on pregnancy and breastfeeding, please visit the other carnival participants listed below: