Women in Control of Epidural During Labor Use 30% Less Anesthesia


Epidurals have become the “drug of choice” in maternity wards across the United States. As of 1997, “nearly two-thirds of all women who give birth in hospitals with high-volume obstetric units had an epidural during labor. In many hospitals, epidural analgesia is routine and is provided to more than 90 percent of all women who are in labor in that hospital.” Yet epidurals are not without potential risks for both mother and baby, which is part of the reason the findings from a new study on laboring women are so promising.

new study reports laboring women given control over their epidural anesthesia resulted in a 30 percent reduction of the amount of anesthesia used and were “basically as comfortable” as women on a continuous dose. Researchers also report a trend toward fewer deliveries that required instrument assistance, such as forceps, in the patient-controlled group.

Dr. Peter Benstein, a professor of clinical obstetrics and gynecology and women’s health at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, said:

“My personal belief is that epidurals tend to slow labor down. So, if you can get away with less medication with patient-controlled analgesia, I think it’s a wonderful thing.”

“And, it’s not a surprise to me that women used less anesthesia. If you can titrate your own medication, you’re probably not going to give yourself a lot. An anesthesiologist will tend to give you a little bit more because they want to make sure there’s no pain.”

The author of the study is Dr. Michael Haydon, a perinatologist at Long Beach Memorial Medical Center in California.

Generally, epidural anesthesia is given on a continuous basis, according to Haydon. But patient-controlled devices that can control delivery of the anesthesia are widely available, he added. Patients are given a button to push when they feel they need more medication. The devices are programmed to only provide a specific amount of medication for specific time periods to ensure that people don’t give themselves too much.

The study randomly selected first-time mothers for one of three groups: “the standard dose given as a continuous infusion; a continuous infusion with an additional patient-controlled option; and patient-controlled anesthesia only.” The first group used an average of 74.9 mg of anesthesia during labor. The second group used an average of 95.9 mg, while the patient-controlled group used the least anesthesia of all, an average of 52.8 mg, according to the study.

Women in the patient-controlled group did report slightly higher pain scores when they got to the pushing part of the delivery, but also reported being satisfied with their pain relief overall.

Women’s Views On News says:

This is good news because epidurals, despite having made labor more bearable for scores of women, have their pitfalls: they can lead to prolonged labor and an increase in vacuum and forceps deliveries. They can also result in more C-sections, which is far from ideal.

Rebecca on Babble writes:

Less meds with the same level of relief? What’s not to like here? A lower dose of medication with adequate pain management would benefit both moms and babies. I find this study so exciting because it opens up new possibilities for women as active participants, not just passive patients, in hospital births. It’s ideas like these that may help us progress toward a hospital birth model that takes into account the needs of both babies and the mothers who give birth to them.

Laura Nelson at Think Baby writes about the study’s findings and how they might impact maternity care in the United Kingdom.

Patient-controlled epidural analgesia is currently only available in one-fifth of hospitals in the UK due to the expensive costs of the equipment needed. Experts are now looking into whether the positive effects outweigh the costs.??“The technique reduces the need for anaesthetic which in turn reduces the need for forceps delivery – and it gives women a feeling of control. The question is whether the small clinical advantages are enough to justify the cost of new equipment and staff training,” Dr Elizabeth McGrady, a honorary clinical lecturer in anaesthetics at Glasgow University said to the BBC.

Personally I’m all for empowering women to be, as Rebecca said, “active participants” in hospital births. Although I did not have an epidural with either my daughter’s hospital birth or my son’s home birth, there was a point during my induced labor with my daughter that an option like this would have appealed to me (had I not had complications including low platelets that prevented me from getting an epidural anyway). I hope this study leads to hospitals adopting patient-controlled epidurals as standard practice for women who choose to have epidurals.

Related links:

  • Over at Women’s Health and Pregnancy, there’s an informative post with diagrams and pictures about how an epidural is given, as well as the pros and the cons.
  • At Anticipation and Beyond, there’s another informative post about the dangers of epidurals. The author writes, “This blog isn’t to insult those who have made this choice, but to increase your knowledge, so you can make informed choices for the future.”

Photo credit: Women Health and Pregnancy

Cross-posted at BlogHer

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Preparing for a Wedding vs. Preparing to Give Birth – How Much Time Do You Invest?

I read a Tweet this week by Kristen (@OmahaBabyLady) that made me take pause. She said, “Why will people plan for a year for their wedding but 12 weeks of childbirth classes is too long? WTF?” I’d never thought of it in that way before, but it resonated with me. Many people spend a year or longer planning and preparing for their wedding, but how much time do they spend preparing for the life-changing and life-giving event of giving birth to their child?

Kristen, who is a Bradley childbirth educator and doula, was prompted to Tweet and blog about this after a potential client reacted to the news that the birth classes Kristen offered would be 12 weeks long. “Twelve weeks!,” she exclaimed. “You expect me to spend 12 weeks on something so simple as giving birth?” Kristen was at a loss for words and reflected on this for a few days before she made the analogy between preparing for a wedding and preparing for a birth. She said on her blog Baby’s Best Beginning that she planned for her wedding for more than 15 months, including visiting wedding message boards, interviewing people and spending “countless hours agonizing” over all of the details and says most of the people she knows did/do the same. “Of course at the end of the day all that really matters is that they are able to marry their partner but very few people say ‘well, the minister/priest/rabbi etc. is the expert on marriage I will just do whatever they say in regards to my wedding,’ yet when it comes to birth so many couples simply defer to whatever their doctor tells them is best even when there is no medical evidence supporting those choices.”

So is 12 weeks too long to spend preparing to give birth? Kristen obviously doesn’t believe so. She feels, “When it comes to bringing your child into the world this is truly not a case of less is more.”

Not everyone agrees though. @SybilRyan argues that the two events (wedding and birth) are “not even remotely similar” and shouldn’t be compared. Genevieve is taking Bradley classes now and thinks 12 weeks is too long, but eight weeks would be perfect. “I love my teacher, the other parents, etc., but 12 weeks is a really long commitment when you have so much else to do to prepare for your baby.” @Reecemg who blogs at Metagestation said she took an eight-week class and it was the perfect length. Others, such as Heather who blogs at Christian Stay At Home Moms thinks an intensive four to six hour one-day class would be good, as “its difficult to find time to go to a class 1x per week for 12 weeks.”

Mary, who blogs at One Perfect Mess, said on Twitter, “The length [of the class] probably depends on the quality. For us four meetings was plenty.”

Merry With Children also commented on Twitter and said, “I know there are things to learn but so much of it [birth] is going to go how its going to go. Too much info is just scary.”

Rebecca thinks people put more time preparing for their wedding than childbirth for exactly that reason — fear. She commented on Twitter, a “wedding is fun, childbirth is scary. ‘Experts’ will take care of everything when you show up at hospital.”

Andi who blogs at Confessions of a Judgmental Hippy agrees with Kristen and thinks, “if a woman can commit to 12 prenatal appointments (average) then 12 weeks (sessions) of [childbirth education] should be easy.”

Whitney blogs at The (Un)balancing Act of Motherhood took Bradley classes and thinks the length of time was “perfect,” although admits she gave birth before attending the last two classes. She added, “I can’t imagine learning about what happens in birth, what to expect, what to do, etc. in one class or even four classes. But like I said, that’s just me. Others would be fine with one or four classes.”

What do you think? Can the two events – a wedding and a birth – be compared? What is the “right” amount of time to prepare for giving birth?

I planned for more than a year for my wedding, and although I didn’t attend a 12-week Bradley Method session, I feel like I put a good deal of preparation into childbirth. I took Hypnobirthing classes before my first child was born, which were six two-hour classes if I remember correctly. I also read a lot and practiced the Hypnobirthing techniques.

I agree to some degree with Merry With Children in that no matter how much one prepares, birth is “going to go how its going to go.” But I also think the more you know and understand about birth, the better informed you will be to make choices along the way. Knowledge is power.

Photo credits:
Bride – http://www.flickr.com/photos/diannadesign/486944603/
Maternity – http://www.flickr.com/photos/mcgraths/3656184801/in/photostream/

Cross-posted on BlogHer

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Kourtney Kardashian: Inspiring Women with her Zen-like Childbirth?

Two weeks ago I wrote about the way childbirth is generally portrayed, even mocked, in popular culture and how that often negatively colors women’s beliefs about birth. Sunday, however, on the season finale of the E! network reality show Keeping Up With The Kardashians, surprisingly, amazingly labor and birth were shown in a largely positive light. In the episode, which had a record 4.8 million viewers, Kourtney Kardashian, 30, calmly gave birth to her first child Mason Dash Disick (born on Dec. 14, 2009).

I have to admit I don’t actually watch the Kardashians, but thanks to Jezebel, I was able to watch some clips from the episode. (Go watch. I’ll wait.) My friend Denise, who blogs at Eat Play Love, told me that she saw the whole episode and said, “I have to admit for the K-women coming off as such primadonnas the episode/birth was shown in a great way. I was shocked.”

Instead of the typical Hollywood water-breaking all over the floor in one big “sploosh!” followed by the frantic Oh-my-God-I’m-freaking-out-and-have-to-get-to-the-hospital-RIGHT-NOW, after Kourtney’s water broke and was shown(!) slowly trickling out onto the floor, she was totally calm, did some laundry, said she needed to shave, took a shower and put on make-up all before going to the hospital. A reality TV show actually showing reality? Wow!

Then there was the birth scene at the hospital, which appeared very serene. Kourtney was surrounded by her family who all looked on in awe as baby Mason was born. She appeared very calm, even zen-like. Once the baby was half way out, the doctor asked Kourtney if she wanted to grab him and she did. She reached down between her legs and pulled her baby right out of her vagina and onto her chest. It was amazingly peaceful and really quite beautiful.

Of course that had to be followed by some commentary from her sister Khloe saying, “that’s not normal.” But uh, yeah, actually it is. That’s what normal birth can look like.

Photo credit: The Unnecesarean

I can’t find any information about whether Kourtney received an epidural or gave birth unmedicated, but she certainly looks very zen in the video. She said in this interview about labor, “It was surprisingly easy and just an incredible experience. I always thought your first is supposed to be really hard, but it was easy.”

Regardless of whether or not she had an epidural, the fact that E! showed (millions!) what a normal, peaceful birth can look like is seriously huge, especially when you consider the demographic watching this show. According to this LA Times article, “Kardashian viewers tend to be single, college-educated women with no children, white-collar jobs and annual salaries of more than $60,000.” Keeping Up With The Kardashians “is the highest-rated series on cable among women ages 18 to 34.”

The Unnecesarean had this to say:

Kourtney Kardashian and E! showing a generation of young women someone reaching down and pulling their baby out of their vagina was one of the coolest things I’ve seen in a long time. Cedars Sinai in Los Angeles has gained a reputation as the celebrity c-section center, but there’s some mother-friendly stuff going on in the clips on Jezebel.

I didn’t watch the whole episode, but I smiled at the clip of her water breaking. When do you ever see that televised beyond the ridiculous images of actors having a gallon of water dumped between their legs, then instantly doubling over with contractions and being rushed down the hall to L&D on a gurney?

Momotics said Kourtney Kardashian renewed her “faith in birth.”

I was SO impressed to see Kourtney so calm, and cool while giving birth to her son Mason who was born in December. It seems like Hollywood has had a huge rash of scheduled cesareans, inductions, and over all just horribly medicalized births and this was just a huge refresh to the Hollywood natural birth stigma.

Carla Fran from Millicent and Carla Fran calls Kourtney “awesome.”

I cannot believe, I repeat, I cannot believe that the Kardashians are paving the way for positive images of childbirth. Last night’s finale showed Kourtney Kardashian going into labor, and pretty much backing up what doulas, Rikki Lake, and your friendly neighborhood midwife have been saying all along.

This finale is tremendous because of the audience the show has. If young girls see pop icons like Kourtney Kardashian having this kind of birth experience, their expectation of the event in their own lives is changed. I hope an entire generation of people saw this and thought “I didn’t know it could be like that.”

It would seem that’s exactly what some women thought. Here are a few of the comments on the Jezebel blog:

  • Kali Mama: “While am all for freedom of choice and choosing your own birth plan, big props for girlfriend not being too posh to push. No elective c-sections or nothing.”
  • Doyouloveit: “For years I’ve been chanting that I will get a C-section if I ever procreate, ‘Knock me completely out! I want to wake up like it’s Christmas morning with a baby under the tree!’
    But wow! Kourtney was really inspiring! Why can’t it always be shown this beautifully? Great documentary film making, Keeping Up With The Kardashians!”
  • Lilspitfire: “I am not a big fan of reality TV but the way they showed childbirth in this episode was nothing but positive.”
  • La Madrugada: “Okay, as someone who’s going to give birth to her first kid in a month and a half, I have to say, this is AWESOME. I’m not a huge fan of this show, but seeing a woman laughing and relaxed while in labor is extremely cool.”
  • Gra: “I have never given birth and therefore had NO IDEA that this was even possible. Its weird to realize that everything I know about labor and birth is based on what I’ve seen in the movies.”
  • Hotpants McGee: “It’s so crazy to say this, but I think I learned something from a Kardashian! Kourt was AMAZING. I had no idea you could just pull it out! I still can’t believe it. She could have just stayed home and done it all by herself!”

Yep, the Kardashians are changing the way women view birth – for the better. Who woulda thunk it?

Cross-posed on BlogHer

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For Better or For Worse? Childbirth in Popular Culture

After watching the live cesarean birth on the TODAY show last week and then the commercial for Jennifer Lopez’s new movie The Back-Up Plan during the Superbowl*, I’ve been thinking a lot about the way childbirth is portrayed in popular culture – on TV and in the movies – and how that influences us. In a perfect world I’d like to believe that women (and men) would learn about childbirth from reading books and websites and talking to their care provider (doctor or midwife), to a doula, to their mother, aunts and friends, but the truth is that unless ya live under a rock, women (and men) also learn about childbirth every time they are bombarded with images on TV and in the movies that depict childbirth as something scary, painful and out of control. Whether we want to believe it or not, our perceptions of birth are bound to be influenced – for better or for worse – by what we view and hear in popular culture.


Movie: The Back-Up Plan, photo credit: Jezebel

On Rixa’s blog Stand and Deliver she lists 61 film clips she compiled for a conference presentation about depictions of childbirth in cinema. That’s just movie clips. Think about all of the episodes of A Baby Story, or ER and many other TV shows where women are giving birth. Each one further reinforces popular culture’s birthing stereotypes.

Birthing Beautiful Ideas believes:

it’s pretty foolish to dismiss the effects that popular culture has on a woman’s beliefs and decisions about pregnancy and childbirth. In fact, I would venture to say that these effects are pretty widespread. Of course, I’m not saying many of us literally turn to pop culture when we’re deciding whether or not to consent to an episiotomy or to request pain medication in labor or to choose one care provider over another. That would be stupid, right? But that doesn’t mean that what we see on television or read in a (non-birth-related) book or watch in a movie has no effect at all on our thoughts about pregnancy and childbirth. Quite the contrary, in fact.

Because every time a woman reads that she “won’t be able to make it without an epidural”…

…every time she sees natural childbirth portrayed as something only for hippies and freaks…

…every time she sees a movie in which birth is a crisis or a catastrophe or a comedy of errors in which the mom is a crazed, expletive-hurling woman who is seriously out of control…

…those images and words start to affect the way she thinks about birth in general, and they may even have an effect on her specific beliefs about birth.

She goes on to give a real-life example (a positive example) of how a TV show changed her beliefs about birth. She describes an episode of Sex and the City where Miranda gives birth. Miranda asks Carrie to be there for the birth and tells her that when it’s time to push, she doesn’t want everybody getting all “cheerleader-y” on her and shouting “PUSH! PUSH! and shit like that.” She said that when she saw that scene, “it signaled a major change in the way I thought about how I was going to give birth some day.” Her birth paradigm shifted and she believes she has the ladies of Sex and the City to thank for that. She’s currently a doula and future lactation educator who’s working on a PhD in philosophy.

Not all examples of how popular culture influences women are as positive though.

Heather from A Mama’s Blog told me that watching TLC’s A Baby Story – which she described as “high drama” and ending more often than not in a c-section – “seriously warped” her view of childbirth.

The Feminist Breeder said:

When I first found myself pregnant, I was just like the vast majority of pregnant American women who never get truly informed about the birth process, and instead spend their pregnancies watching “A Baby Story” and reading Jenny McCarthy books. I got my hands on “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine, which told me that Lamaze was useless, as were all other birthing classes, and what I really needed to focus on was how quickly I could get the epidural.

Yeah — I got the epidural. The epidural that only went down half my body, that caused me uncontrollable shaking, that shut down my labor, that necessitated more pitocin, which put my baby in distress, which then necessitated a nice, traumatic cesarean surgery. Yep. That epidural.

Honey B., in her post Childbirth: Hollywood’s Take, wrote that after year of watching A Baby Story, 18 Kids and Counting, Knocked Up, Four Christmases, etc., she realized how much of what she thought she knew about childbirth was based on TV. She then shares sarcastically all that Hollywood taught her about birth. (The descriptions are longer on her blog.)

Natural Birth: The choice of masochists, women who don’t shave their armpits and have children named Moon Flower, and optimistic first-time mothers who don’t know any better. (My note: Case in point, The Back-Up Plan‘s home birth scene)

Birth with Epidural: This is the smart woman’s choice. This is what she does for the second birth, after going through the above ‘Natural Birth’.

C-Section (Emergent): These are completely normal, and happen all. the. time. And the doctor always knows best.

C-Section (Planned): This is the choice of the truly enlightened woman, the Real Housewives of Orange County type who view pregnancy as an invasion of their body. (My note: Perhaps this is why, according to the most recent data available (from 2006), the United States’ c-section rate was 31.1%, ranging from 21.5% in Utah all the way up to 37.4% in New Jersey. The World Health Organization actually recommends that the cesarean section rate should not be higher than 10% to 15%. When the rate is higher than 15% there is some research which shows it results in more harm than good. But who wants to talk about that in movies?)

Mallory who blogs at Pop Culture believes, “Childbirth in Hollywood movies is from a male perspective; rarely does childbirth show angles from the female viewpoint during the actual birthing.

We show killings, bombings, shootings, rapes and torture in movies, so why not show a woman giving birth accurately? Is it really that obscene and disgusting?”

Naomi, a birth doula, wrote her top 10 suggestions for an easier birth. Number two is “Prepare for an easier birth, now!” She cautions:

Don’t watch A Baby Story! Instead (if you are interested in watching birth videos), watch movies like The Business of Being Born, Orgasmic Birth, Pregnant in America, Water Birth, Special Women, and normal birth videos on YouTube which represent birth as it usually is. TV specials on birth are designed and promoted to offer drama and attract viewers, not to support women preparing for birth.

I also want to add What Babies Want and Birth Into Being to that list.

Teba told me that her sister was there when she had a home birth two months ago. “She said after seeing birth in movies she never imagined it could be so peaceful.”

That’s just it. Birth can be peaceful. It doesn’t have to be a hysterical emergency, but as a result of popular culture, most women are never exposed to anything that suggests a peaceful birth is even a possibility.

How has popular culture affected your beliefs and decisions surrounding childbirth?
* I didn’t actually watch the Superbowl, but have Lynn to thank for telling me about The Back-Up Plan commercial.

Cross-posted on BlogHer

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Follow-up to TODAY show guest post: childbirth resources


If you are visiting from the TODAY show blog, welcome and thank you for visiting. 🙂 If you haven’t yet read my guest post on the TODAY show, you can read it here: Viewer: Learn more about cesarean births. I’d love it if you would like to contribute to the discussion and leave a comment over there.

Because there was only so much information I could include in my guest post, I’ve put together some additional resources here for those of you who are interested in learning more about c-sections, VBAC, giving birth vaginally to larger babies, and more. I believe in informed consent. Knowledge is power.

Information about Cesarean Sections and VBAC:

  • International Cesarean Awareness Network – “The International Cesarean Awareness Network is a non-profit advocacy and support group whose mission is to improve maternal and child health by preventing unnecessary cesareans through education, provide support for cesarean recovery, and promote vaginal birth after cesarean (VBAC).”
  • Childbirth Connection’s Cesarean Section Resources
  • The Reality of C-Sections by A Mama’s Blog – Heather writes about the many things about c-sections that she didn’t know and wished she had been told before she had her own c-section, as well as includes pictures of actual c-sections (something we didn’t get to see on the TODAY show).
  • VBAC Facts – Jennifer, teacher of The Truth about VBAC classes, deeply believes that women, after educating themselves on the risks and benefits, should be the ultimate decision makers on their medical care – not OBs or insurance companies.
  • Maternal Death Rates Rise, C-sections Now Considered a Factor – another post by Heather from A Mama’s Blog
  • The Unnecesarean – The Unnecesarean provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond.

Giving Birth Vaginally to Large (Macrosomic) Babies – Information & Birth Stories:
Although your doctor may suspect that you might have a larger baby, that does not mean you should automatically schedule an induction or a c-section. Ultrasound exams are notoriously inaccurate for predicting the weight of a baby and can be off by a pound or more in either direction. There’s no way to know how much a baby will actually weigh until it is born and weighed. If you are told you are going to have a large baby, weigh the risks and benefits of any intervention and make the choice that is right for you and your baby.

  • Big Baby Bull****
  • Baby Julian – My son (pictured above) was born at home and was a surprise footling breech. He weighed in at 9 lbs. 8 oz., and was 22 inches long.
  • Baby Lazlo – Justine gave birth to her 11 lb., 23-inch son at home
  • Baby “D-Man” – Kat’s son weighed in at 11 lbs., 3 oz.
  • Baby “Muski” – Kate’s son was a VBAC and weighed 10 lbs., 3 oz.
  • Baby Peggy – Annette‘s daughter was 9 lbs., 6 oz.
  • Baby Jaxon – Jaclyn’s son weighed 9 lbs., 4.4 oz.
  • Baby Iris – Sybil‘s daughter was 9 lbs., 14 oz.
  • Baby Mikko – Lauren’s son was 11 lbs., 13 oz.
  • Baby Emma – Jessica’s daughter was 9 lbs., 2 oz.
  • Baby “Boychick” – Arwyn‘s son was 10 lbs., 6 oz. and born at home
  • Baby Julian and Baby Emma – Annie‘s two kiddos (not twins) were 9 lbs. and 9 lbs. 8 oz.
  • Baby “Junior” – Candace’s son was 10 lbs., 4 oz. and sunny side up
  • Baby “M” – Jennifer’s son was 9 lbs., 10 oz. – a home birth after cesarean (HBAC)

Additional Childbirth Resources:

  • Business Of Being Born – A documentary that “interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system.”
  • Pushed Birth a book by Jennifer Block – “The painful truth about childbirth and modern maternity care”
  • Ina May Gaskin – Author of Ina May’s Guide to Childbirth. “Discover the proven wisdom that has guided thousands of women through childbirth with more confidence, less pain, and little or no medical intervention.”
  • Doulas of North America – A doula is “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.”
  • Considering an induction? Use the Bishop’s Score for Labor Success – “This tool measures certain components with regard to the mother’s cervix and baby’s position to evaluate her readiness for an induction and ultimately increase the chance of having a vaginal birth. This scoring system can also be used to determine the likelihood of spontaneous labor.”
  • Post-Partum Crotch Care 101 – A humorous, but very practical list. This is one of those things that nobody ever talks about, but is good information to have.

Are there any childbirth resources YOU think should be on this list? Leave a comment and let me know. Thank you. 🙂

Disclaimer: The information included on this blog is not medical advice and should be used for educational purposes only. It should not be used as a substitute for the advice of a medical professional (doctor or midwife).

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Is there more to the Christmas “miracle” mom & baby “mystery?”

In what’s being called a Christmas “miracle,” a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then “inexplicably, astonishingly” both suddenly came back to life. At least, that is the picture that was first painted by ABC News.


Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. “‘Half of my family was lying there right in front of me — there’s no other way to say it — dead,’ Mike Hermanstorfer told ABC News’ Colorado affiliate KRDO. ‘I lost all feeling. Once her heartbeat stopped, I felt like mine did too.'”

First I must say that I’m so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can’t imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one’s heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother’s cardiac arrest or the recovery. “We did a thorough evaluation and can’t find anything that explains why this happened,” she said. In the video linked above Diane Sawyer says, “To Tracy’s doctors, the events are still a complete mystery.” A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the “mystery” may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest – the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were “a lot harder” than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy’s hand was cold, her fingertips were blue and a nurse noticed the color in Tracy’s face was completely gone.

Henci Goer, “an acknowledged expert on evidence-based maternity care” and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping the heart. High blockade happens rarely… It does happen, though, and I am willing to bet that high blockade and its sequelae happened to Tracy.

The moral of the print version would be: have your baby in a hospital where you can be saved should this happen to you. The video interview, however, reveals a different picture. The real moral of the tale is that the safest and healthiest births will be achieved by avoiding medical intervention whenever possible.

Danielle from Momotics asks, “Why was there a need for pitocin? Because no one wants to be sitting around waiting to deliver a baby on Christmas eve?” She also wants to know why the possible correlation between the epidural and the cardiac arrest isn’t being talked about in the media. “Why is the mainstream media not reporting these things? Mass hysteria? Loss of money for the pharmaceutical companies that make pitocin and these anesthesia drugs?”

Jasmine who writes for The Examiner offered up her own take on the situation:

Knowing the side effects of both pitocin and the epidural, Hermanstorfer’s history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing “miracles” and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

Nicole from It’s Your Birth Right speculates a few possibilities of what may have gone wrong. She admits that there is no way for her to say for sure what happened in Tracy’s case, but she wants people to know that having an epidural does carry risks.:

I just want it to be clear that Epidurals can indeed cause cardiac problems and can also stop a woman’s breathing immediately after administration. Does it always happen? NO. Does it usually happen? NO. Can it happen? YES. And did the media completely ignore the possibility of the epidural having anything to do with the cardiac arrest? YES.

Nicole adds:

Often when I tell people I don’t want an epidural they don’t understand why. THIS is why. The risks in my humble opinion are high for a procedure that is considered elective.

Often when I tell people epidurals carry risks that are not discussed with women resulting in misinformed consent for a procedure they know little about, I am considered an extremist. PLEASE if you want an epidural, that’s your choice but get INFORMED!!!

Here are the reported side effects of epidurals on both mother and baby.

Conspiracy theories aside, I think one of the reasons the possible cause of Tracy’s cardiac arrest wasn’t reported by the media is because it diminishes the feel-good Christmas miracle aspect of it. I think the media sensationalized the story to draw as much attention to it as possible. They succeeded.

The truth is we may never know what caused Tracy Hermanstorfer’s heart to stop beating, but it seems likely that the sequence of events – pitocin, epidural, lying on her back (which can cause “problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava).”) may have had something to do with it. While this story had a very happy ending, most like it do not. What can we learn from this? Educate yourself, learn about the risks of common interventions, and hire a doula.

Once again, I wish Tracy and Mike Hermanstorfer and their family all the best. 🙂

Cross-posted on BlogHer

Birth plan? Doula? Natural birth? Not here you don’t.

A sign posted at the Aspen OB/GYN Women’s Center in Provo, Utah has many women up in arms. What’s so offensive? Read for yourself.

The sign reads as follows:

Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doulah Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.

I first learned of this sign from Naomi, the Denver Doula, who posted it on Facebook. Being a doula (which is misspelled on the sign) herself, she took a particular interest in it. When she called the Center and inquired with the receptionist as to why the sign was posted she was told, “in case there is an emergency we don’t want anyone to get in the way of the doctor doing what he has to do.”

Annie from PhD in Parenting was inspired by the sign to write How Not To Have a Natural Birth and believes the center might as well have said:

Because Physicians at Aspen Women’s Center care only about doing things their own way and making as much money as possible from unnecessary birth interventions, even if it poses greater risks to the welfare and health your baby, we will not participate in a “Birth Contract”, a doula-assisted, or a Bradley Method delivery. For all patients who have done any research into having the safest birth possible, please notify the nurse so that we can transfer you to a facility that cares less about control and money.

Annie added, “I guess we can at least credit them with warning women in advance. Many hospitals with the same attitude don’t have a sign hanging out front.”

Amber responded, “I always thought the big ‘trust birth’ poster in my midwives office was a little cheesy. Now that I’ve seen the alternative, I think it’s truly marvelous. Really.”

Miriam Zoila Pérez of Radical Doula wrote a post called Signs You Don’t Want to See at Your OB-GYN’s Office. She believes the sign could be translated to say:

We don’t care at all what you want as a parent, or a person in labor. We want a patient who will sit quiet and do what we say–no matter what. Oh and if you have a partner you want involved, tough. Your desires don’t matter.

Miriam adds, “They should change the name of the center to the ‘Unborn Children Center’ since they don’t seem to care too much about the women involved.”

A commenter named Janna responded saying, “That’s what bothered me most about this hateful little sign–not once is the “welfare and health” of the MOTHER mentioned, just the “welfare and health” of the “unborn child” and the “quality” of the “deliveries.” Who would want to give birth in a place where they’re the lowest priority on their caregiver’s list? I hope women in this area have other options and the opportunity to have safe, healthy, supportive births.”

Does no doula, Bradley Method birth or birth “contract” equal no women’s rights?

Summer who writes at Wired for Noise says signs like this one and stories like the lack of choice with regard to our reproductive health and doctors’ personal “birth plans” make her sometimes think Doctors Hate Women.

What does it say when women have to escape, have to run away in order to do something as normal as give birth? What does it say when women are treated like children, talked down to, insulted, lied to, and handed letters telling them what the god-head doctor will allow or not allow. When all you want to do is give birth and you’re doctor is more concerned with telling you to sit down and shut up, what is that if not hatred?

I have to agree with Annie that at least some doctors are upfront with what they will and won’t “allow” as part of their practice. Kudos to them for being honest. Hopefully that will allow women to look for another care provider while she’s still early in her pregnancy.

Rest assured if the OB/GYN I had at my daughter’s birth would have given me a piece of paper with her “rules” or had a sign posted like that at the Aspen Women’s Clinic, I would have found another care provider pronto. Instead, however, she paid me lip service and acted like she cared about my birth plan (though she didn’t act very well and that should have been a big clue for me) and said we could “try” Hypnobirthing, etc. However, when push came to shove (no pun intended), it was her way or the highway. I had my healthy baby girl at the end of it and for that I am truly thankful, but I also got a lot more than I bargained for (and not in a good way). Then again it was that experience lead me to pursue a home birth for my second child and become a home birth advocate.

Although I admire the Aspen Women’s Center’s honesty, I find it truly offensive that they imply that if a woman wants a doula, natural birth, or has a birth plan, she is not concerned with the welfare and health of her baby (so much more personal than “unborn child” don’t you think?) or is even putting her baby’s life at risk. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. And how exactly is choosing a Bradley birth not good for the health or welfare of the baby? “Bradley® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient.” What about a birth plan or “contract?” Is that harmful to the “unborn child?” The American Pregnancy Association suggests, “Creating a birth plan can help you have a more positive birth experience.”

There are other things I find offensive as well, like Janna mentioned above, the mother does not seem to be included in the equation at all. Is there any concern for her “welfare and health?”

Who’s time money welfare are they really concerned with? I’ll let you draw your own conclusions. I’ve obviously already drawn mine.

Cross-posted on BlogHer.

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Babies come out of where?! Explaining childbirth to kids

I was due to give birth to my son when my daughter Ava was 2 1/2 years old. Since my husband and I were planning a home birth, we felt it was important to discuss with Ava how the baby would be born. Because she would be within earshot if not in the room when Julian was born, I wanted her to know what she may see as well as hear.

One of the ways I prepared Ava for what would happen was by reading “Welcome With Love,” a beautiful children’s book about natural childbirth. We also watched some childbirth videos (natural and water births) together, including “Giving Birth: Challenges and Choices” by Suzanne Arms. I made sure to explain what was going on and reassure her that although the mommy might make some loud or funny noises, even yell, she was OK. In “Welcome With Love,” the older brother speaks of his mother’s noises during labor but he’s not afraid because she had told him beforehand that although she “might make a lot of noise,” he mustn’t worry because “that’s what it’s like when babies are being born” and that she’ll feel better if she yells and screams.

I kept things fairly simple, but because she was likely going to be present, told her what I felt she needed to know to feel safe and secure during Julian’s birth. It worked well for us. Ava was never scared even though mommy made some very loud noises while giving birth to her brother.

I realized the other day that Julian is now older than Ava was at the time he was born, but because I am not pregnant (and have no plans to become so) and the subject hasn’t come up, he has no idea how babies are born. I will probably remedy that soon by reading Welcome With Love to him and another book I recently received to review called We’re Having a Homebirth!

A friend (who is expecting) recently pondered on Facebook how she will explain childbirth to her 5- and 3-year-old daughters, and I began to wonder how others handle the subject.

I came across a discussion on a BabyCenter message board where the original poster posed the question How do you explain childbirth to a child? Here are some of the responses:

  • One person admitted that she has been “skirting around this issue” even with her 9-year-old. She said she has told her most of the details, but doesn’t “want to freak her out too much or gross her out for that matter.”
  • Another said, “I tried to skirt the question by answering…that the doctor takes the baby out.”
  • Another said, “I have a child psychology book called The Magic Years. They say to be truthful, but give as few details as necessary.”
  • Yet another said, “I found it was quite easy to explain things using the correct words at a young age. And I’d rather explain it while my kids aren’t embarrassed by it and will ask questions instead of having a 10-year-old blush or roll her eyes and not wanting to ask questions about things she doesn’t understand.”
  • From another, “better he hears it from me than his peers at school.”

After I browsed the ‘net, I asked my favorite audience (Twitter) and got some more answers.

Many feel that honesty is the best policy.

@OneFallDay said: If my 7-year-old asks, I answer. I’ve always felt if they are old enough to ask they deserve an honest answer.

Jackie from Belen Echandia said, “[I] don’t have personal experience. But would like to think I’d tell the truth in a beautiful, non-frightening way.”

Penny from Walking Upside Down said, “[I] told mine they came out of a hole between my legs. 🙂 Honesty is the best policy. Did not show them said hole tho’. ;)”

Jessica from Peek a blog said, “I spoke to the doctor about what to say. We told my 3-year-old that mommies have a special place where babies come out when ready. Just enough info with more details on an as-needed basis, but totally truth.”

Cate Nelson said, “I told my then-2.5-year-old that baby was going to come out of Mama’s yoni. (our term for it) I also told him his own birth story, bit of the pain, but how it helped Mama push him out. He loved his (natural) birth story!”

Others think along with being honest, it’s important to use proper terminology with children.

@ColletteAM said, “I always tell the truth about bodily functions and use proper terms. I don’t want my kids to feel ashamed of their bodies.”

Mandie from McMama’s Musings said, “My 4-year-old can tell you about ovaries, eggs, sperm, uteri, birth canals, and c-sections. He calls egg+sperm a ‘seed.’ LOL”

@JenniferCanada said, “I got great advice from @babyREADY to prepare son [for] our home birth. We watched a lot of birthing shows. We talked about what would happen. He can tell you babies come from vaginas and you push them out. He has actions. He is 3 years old.”

Others prefer a more vague approach:

Lee from CoupleDumb said her son was 3 and “I told him that his brother would come out of me when I went to the hospital. That’s it.”

Kristie from Tilvee said she was asked how babies come out last night by her 6- and 3.5-year-old daughters. She “didn’t lie, just told them we would talk about it in 5 yrs?!”

One person thinks explaining a c-section is easier than explaining vaginal birth:

Beth from I Should Be Folding Laundry said, “I’m up for a c-section, so that makes the explanation very easy.”

Another thinks a c-section makes it more complicated:

@Loudmouthedmom said, “I haven’t been pregnant again but have always been honest with son, either vaginally or c-section. He took c-section much harder. Learned the hard way not to tell a 4-year-old a c-section involves mom being ‘cut open.'”

The reactions kids have about childbirth are often amusing:

Kailani from An Island Life said, “My 3-year-old thinks the baby will come out of my mouth. :-)”

Krista from Typical Ramblings, Atypical Nonsense said, “When I was pregnant with E, my older kids were 11 and 8 when he was born. I told them how the baby came out. My daughter asked if it hurt, I said yes but once it’s over the pain is gone. She says she is adopting kids. ;)”

Ann-Marie from This Mama Cooks said, “[I] told Nathan how babies got out when he was 7. He told me he wasn’t having kids. Truth is good birth control.”

Childbirth education props: Dolls and Children’s Books


If you are looking for some props to help you explain childbirth, you might be interested in these dolls. Thanks to Kellie, I learned about this childbirth education doll that can be custom ordered or the experience crocheter can make it herself. There’s also a Waldorf doll that gives birth and nurses. According to Droolicious, instead of just sitting there looking pretty, this doll “gives birth complete with placenta, and she nurses too. This Waldorfian handmade plush doll comes from Brazil where it is used to teach girls about natural childbirth.”


There are also lots of books that tackle the topic of explaining childbirth to kids. From books about home birth like Welcome With Love and We’re Having a Homebirth! to more mainstream childbirth books like What to Expect When Mommy’s Having a Baby, How You Were Born, and How Was I Born?: A Child’s Journey Through the Miracle of Birth, there is likely a book out there for your family. And for parents who are looking for some age-appropriate information about “the birds and the bees” check out It’s Not the Stork: A Book About Girls, Boys, Babies, Bodies, Families and Friends and a review of it over on Punnybop.

There’s more information on how to prepare siblings for the birth of a new baby over on babyReady where they suggest: make a game out of the kinds of strange noises that you may make when you are in labour, try not to make too many changes to your child’s routine close to the delivery, let your older child open the baby’s gifts, and take your older child to your doctor (or midwife) visits, and more.

Ultimately your childbirth explanation to your child has to be one that you feel comfortable with. I think it is important to answer children’s questions – about childbirth, puberty, dating, sex, etc. – as honestly as possible while making sure it is age-appropriate. Mactavish said to me on Twitter, “I can’t imagine not being old enough to know how babies are born” and I have to agree. Candace concurs, “I generally assume that if she’s too young, she won’t ‘get it’ anyway and if she ‘gets it’ then she’s old enough for truth.” Sounds like a good philosophy to me.

Cross-posted on: BlogHer

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Home birth advocate’s baby dies during free birth, prompts questions

Janet Fraser, a home birth advocate and founder of the site Joyous Birth, recently experienced a personal tragedy when her baby died at her home in Australia on March 27 during her free birth or unassisted childbirth (where a woman gives birth at home without the aid of a midwife or doctor).

When a tragedy like this occurs, people are often left scratching their heads wondering how something like this could happen, what went wrong, and lastly, who’s to blame? I don’t know if we need to point a finger to make ourselves feel better, but it seems to be human nature to ask, “why did this happen?”

While I did not consider giving birth at home without a midwife in attendance for my home birth, I know a handful of women who chose an unassisted birth and I respect them for it. I believe these women did a great deal of research in advance, knew what they were doing, trusted their bodies and their babies and were prepared to go to the hospital if any issues arose. Although I don’t know her, I trust that Janet Fraser would fall into this category as well. Not everyone agrees with me though and some, like Amber Watson-Tardiff, are suggesting that what Fraser did by having her baby unassisted was “reckless, neglectful and borderline criminal.”

Jessica Gottlieb of Eco Child’s Play says, “I support women who chose a home birth. But a free birth? I cannot see the wisdom in it. Neither can Ms. Fraser’s baby.”

Watson-Tardiff goes on to say, “I hope she is at least subject to an investigation for child endangerment.”

Ronda Kaysen of MomLogic says she sees the value of home birth as a way of reducing medical intervention, but believes giving birth without medical assistance is “absurd.”

Fraser’s “free birth” argument, which on the surface appears feminist, is actually the opposite. It doesn’t empower women to take control of their own bodies. It sends them and their babies into the dark ages of medical care – where women give birth with no medical care at all and face the very real possibility of death as a consequence.

For the record the police are investigating the death and have said “it was not clear whether the baby was stillborn or died after delivery. If a baby is stillborn, there is no autopsy. If a baby is alive at birth and dies soon after, it is considered a matter for the coroner.”

I guess I give Fraser the benefit of the doubt and assume that like most mothers she was doing what she thought was in the best interest of her baby. Although she coined the term birth rape (birth interventions done against the woman’s wishes), I don’t believe she would put her child in harm’s way rather than accept a potentially life-saving intervention. Then again I don’t know Fraser and have not spoken to her, so I can only speculate just as others are doing, but I prefer to give her the benefit of the doubt. However, I do believe that whenever a child dies, there should be an investigation into the death.

While many are blaming Fraser for her baby’s death since she did not have a doctor or midwife in attendance, no one seems to mention the fact that babies die in the hospital, where doctors are present, all the time.

Laura Shanley, author of the book Unassisted Childbirth and owner of the Bornfree! website who blogs at Letters from Laura – Thoughts on Unassisted Childbirth, brought up that point and shared another perspective many of us may not have thought of when she shared the following statement with me:

I don’t know Janet, but of course my heart goes out to her. An Australian friend of mine has told me that despite what the media is saying, Janet’s baby was stillborn and the outcome wouldn’t have been different had the baby been born in the hospital. Regardless of whether or not this is true, I find it sad that so many people are blaming Janet for her baby’s death. A baby is stillborn in an American hospital every fifteen to twenty minutes. According to a story on my local newscast, this is double what it was ten years ago. Yet almost no one blames hospital birth mothers (nor should they) for these babies’ deaths. This is because it’s assumed that if a baby dies or is stillborn in the hospital, everything possible was done to save the baby’s life. The possibility that at least some of these deaths might have been caused by early inductions, c-sections and other interventions is rarely discussed.

I can tell you, however, that as a homebirth advocate I have received numerous letters over the years from grieving mothers who wonder if their hospital born baby might have survived (or avoided injury) had they been born at home. The fact is, in most cases we may never know. Sometimes medical intervention saves lives, and sometimes it takes them. This is why I encourage parents to do their own research and decide for themselves where and with whom they want to give birth. In my case, I chose to give birth at home unassisted because from the research I had done I felt that the majority of problems in birth – both now and in the past – could be traced to three main causes: poverty, unnecessary medical intervention, and fear which triggers the fight/flight response and shuts down labor. Despite what most people believe, the act of birth itself is not dangerous. But our cultural beliefs and practices can make it so. In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home. Regardless of the outcome of this case, I will continue to speak out about unassisted childbirth as I believe that in most cases it’s the safest and most satisfying way to give birth.

Genie, an Australian blogger who writes at Home Is Where the Heart Is, blogged extensively about her thoughts regarding Janet Fraser and defends her choice to have her baby unassisted at home. She feels the insinuation that women who birth at home do it to feed their own ego at the expense of their child is “a crock.”

Women choose to homebirth with their baby’s best interest at heart. They do it FOR the baby, not in spite of the baby. Yes they want to feel empowered and blissed out, but the lack of trauma and the satisfaction a mother gets after a natural birth all benefits the baby too. A mother’s health and well being has a HUGE impact on the baby. So why should we ignore the interest and well-being of the mother?

In the wake of this tragedy and surrounding media coverage, some feel the need to point out that there is a difference between home birth and free birth. Dr. Meredith Nash of The Baby Bump Project says homebirth and freebirth are not the same.

The media has failed to differentiate between freebirth or unassisted birth (no midwife or doctor) and homebirth (a birth at home, usually with a midwife or homebirth doctor). For the most part, for low-risk births that are attended properly, homebirth has been proven to be a safe alternative to hospital birth. Freebirthing is significantly more risky (sorry, I’m a supporter but also a realist). It is essential to make this differentiation. Now that homebirth is on the precipice of being banned given that independent midwives are likely going to be denied indemnity insurance from next year, the suggestion that all women who homebirth are crazy radicals or that homebirth represents the majority of birthing women in Australia (only about 2%) is ridiculous. If anything, midwives and their ability to attend homebirths will be the saving grace of the Australian maternity system. Rather than convincing the small proportion of women who avoid a medicalized birth, why not support these women in their choices by making homebirth safe and easy?

Summer Minor, who blogs at Wired for Noise and gave birth to her daughter at home a little over a week ago, references the recent Nederlands study that says home birth is as safe as hospital birth. “A new study is out from the Netherlands that gives us home birthing mothers a nice little pat on the back. Despite the labels of ‘dangerous’ and ‘unsafe’ by some, once again it’s been found to be just as safe as giving birth in a hospital.” From the BBC:

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

I think that Shanley said it best when she said, “In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home.” We all must do our research and make the choices that we feel are the best for ourselves and our babies and then, find peace with our decisions.

I offer Janet Fraser and her family my deepest sympathy. My thoughts are with them.

Cross-posted on BlogHer.

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Planning for a homebirth

By now you may have gathered that instead of choosing to have an OB-attended hospital birth this time around, we are planning to have a midwife-attended homebirth. There are a number of varied factors that have led me down such a different path with this baby and I’d like to share some of them here.

I have to first admit that I’ve been a little reticent to post about this, not because I’m not excited about it, but because homebirth in our culture is not seen as a safe or wise choice (though in reality it is as safe or safer than hospital births in most cases – there are a number of studies that indicate as such). I am open to questions about why I’ve made this decision or things specific to homebirths, but I don’t wish to be attacked for my choice. I have no desire to get into a debate over which is better – hospital or home. Rest assured I’ve done a lot of soul searching and research to come to the conclusion that planning a homebirth is right for me. In the event that a condition arises during my pregnancy or labor that indicates that a homebirth is no longer a safe, responsible choice, I have no qualms about going back to my OB (whom I like and respect) or being transferred to a hospital (which is literally less than five minutes from our house) if necessary.
OK, now that we’ve gotten that out of the way, let’s dive in, shall we? 🙂

First of all, I believe that – in the majority of cases – birth is a normal, natural and healthy process. I believe in a woman’s (and my own) ability to give birth naturally, normally, without intervention, as women have been doing for thousands of years.

I am drawn to the midwifery model of care because it feels normal and natural. I like that a typical midwife prenatal visit lasts 60 minutes (as opposed to the typical 6 minute OB prenatal visit) and does not feel rushed. I like that I am getting to know the woman who will be there for my labor and birth and that she will gain my trust so that I feel comfortable with her while laboring and birthing. I like that my midwife is interested in my nutrition and in suggesting preventative measures (such as acupuncture) to help ensure that I have a healthy birth.

My midwife in particular has a 15 year background as an EMT (emergency medical technician). I feel her experience in that capacity has helped her develop critical thinking skills and the ability to think quickly on her feet. After all, how can you be an EMT without that ability? So I feel very comfortable that if a situation should arise that is beyond her comfort level, she will know what steps to take (i.e. a hospital transfer). Because of my history of complications with Ava, this was very important for us. Both Jody and I feel very confident in her experience and abilities.

I love the idea of birthing at my own home, where I am comfortable and able to relax without worrying about who’s going to be walking in the door next (nurse shift changes, etc.), where Ava can play or sleep or do whatever she needs to (in a safe environment) and still be in close proximity to me and Jody. (My sister will be her primary caregiver while I am in labor.) And when the baby is born, Ava can chose whether or not she wants to be present. (Yes, we will be preparing her with regard to what to expect when mommy is in labor, etc. We actually watched a birth video – “Giving Birth: Challenges and Choices” by Suzanne Arms – this week.) I’d like her to be there, but I’m not going to force her. If she is meant to be there, she will be. After seeing her interest in watching the birth video though, I am pretty certain she’ll want to see baby brother join us.

I also love the idea of being able to sleep in my own bed after the birth. That was one of the hardest things for me in the hospital, not being able to sleep. I eventually had to ask for sleeping pills because it’d been something like three days since I’d slept for more than a few minutes at a time, and having hallucinations while trying to care for a newborn is no fun. Having my own bed will be heavenly. And I’m sure Jody would agree as well after sleeping on a flimsy mattress on the cold, hard hospital floor for 5 days after Ava’s birth.

Another compelling reason for me to have a homebirth is I’d like to labor and possibly birth in water and my midwife has a birthing pool that we can set up right in our house.

Because of all of this and more, I feel planning for a homebirth makes sense for us.
—————————–
The following information was taken from The Homebirth Choice by Jill Cohen and Marti Dorsey and further illustrates why I’ve decided a homebirth is the right choice for me and my family. I cut and pasted some things that I feel are particularly important to me.

A BRIEF HISTORY OF MIDWIFERY:
“Midwife means “with woman.” Traditionally, women have attended and assisted other women during labor and birth. As modern medicine emerged in the West, birth fell into the realm of the medical. Since women were barred from attending medical schools, men became the birth practitioners. Having never had a baby themselves, they were unable to approach women and childbirth with the inner knowledge and experience of a woman. Childbirth became viewed as pathological rather than natural; unnecessary, and often dangerous or unproven, medical techniques and interventions became commonplace.

During the 1960s and 1970s, along with the women’s movement and renewed interest in homebirth, the midwifery movement rekindled. It has been growing steadily ever since. Midwives are becoming more and more involved with birthing families and have been instrumental in redefining birth as a natural event in women’s lives.

Midwifery empowers women and their families with the experience of birth.”

PRENATAL CARE:

“Prenatal visits may take place at the midwife’s home or clinic or at the family’s home. Prenatal visits are a time for the midwife to get to know the family and friends, neighbors, or other children who plan to be present at the birth.

Prenatal care for the pregnant woman includes discussion of nutrition, exercise and overall physical and emotional well-being, as well as overseeing the healthy development of the fetus.

Midwives include the family during prenatal care, inviting them to ask questions and to listen to the baby’s heartbeat. Intimate involvement of the family throughout the pregnancy allows for early bonding of the newly emerging family unit.

The midwife and family will often discuss the mechanics of birth. The more people know what’s going to happen, the more comfortable they may be while awaiting the birth.”

LABOR:
“In the safety and security of her own home, the mom is likely to be less inhibited about trying different labor positions and locations. She can sit on the toilet or go for a walk outside. She can eat or drink whatever she wants. She writes her own script. When it’s time to deliver, she can often try whatever position she wants: on her side, squatting, sitting or kneeling.”

BIRTH:
“Homebirth allows for full participation of family members. Under the guidance and assistance of the midwife, the opportunity is available for husbands or partners to “catch” their child as it is born. These moments can be very powerful and transformational in the lives of the new parents.

At homebirths, babies are usually immediately placed on the mom’s stomach or breast, providing security, warmth and immediate bonding between mom and baby. This contact provides security for both mom and baby.

In the rare case when the baby has difficulty breathing on its own, midwives are fully trained in infant CPR. Usually, putting the baby right to the breast and having mom talk to her baby will encourage it to take those first breaths.

Putting the baby immediately to the breast helps reduce any bleeding the mom may have. The sucking action stimulates the uterus and causes it to contract. This closes off blood vessels and reduces bleeding.

Some members of the medical community have recently acknowledged that having a homebirth decreases the mother’s and baby’s chances of contracting an infection. The mother is used to the bacteria in her own environment and has built up immunities to it. This is passed on to the baby through the colostrum. Even when women are segregated in maternity wards, infections are much more commonplace after hospital births than homebirths.”

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