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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Cesarean Awareness Month: Why is it so hard to get a vaginal birth?

April is Cesarean Awareness Month. You may wonder why an entire month needs to be devoted for raising awareness about c-sections. Here’s why. The c-section rate in the United States is on the rise at an alarming rate. It’s estimated that in 2008 over 1.3 million babies in the US were born by c-section, accounting for 32.3% of all births. It also marks the 12th consecutive year the Cesarean birth rate has risen, despite a number of medical organizations — including The World Health Organization (WHO) and American Congress of Obstetricians and Gynecologists (ACOG) — urging medical care providers to work on lowering the Cesarean birth rates and increase access to Vaginal Birth after Cesarean (VBAC).

Cesarean Awareness Month - April

My Gentle Birthing Blog discusses that while VBAC is often suggested as an option to a woman who has had a c-section, in reality, VBACs are hard to come by due to the fact that many hospitals no longer allow them.

According to the National Center for Health Statistics, the C-section rate in the United States has risen 53% since 1996. Cesarean birth is being overused, and VBAC (Vaginal Birth After Cesarean) is being grossly underused, at about 8%, because many hospitals are outlawing VBACs. Because of bans on VBACs, women have been denied access in over 40% of hospitals in the United States. The National Institutes of Health has found that VBACs are reasonably safe for women who had a previous cesarean birth and are low risk for uterine rupture.

Andrea Owen says, “Fighting for my own VBAC has changed my life. I don’t use that term very often, only when I truly mean it. It opened my eyes up to the world of American obstetrics, and how far we’ve come away from birth as a natural process. In my opinion, we’ve shoved a big, fat middle finger in Mother Nature’s face.”

And in the sometimes the truth is stranger than fiction category, the Keyboard Revolutionary wants to know how it is that “a woman can waltz in off the street, say she’s pregnant and wants a Cesarean, and everyone leaps to her command….yet a woman who IS pregnant has to jump through hoops and fight tooth and nail just to give birth vaginally?” Yep, in 2008 in Fayetteville, NC, a woman who was NOT even pregnant was given a c-section.

So how can a woman avoid a c-section in the first place? Knowledge is power. Here is a list of Five Essential Questions to ask your care provider. My Gentle Birthing Blog also has a list of the risks with cesarean birth as well as a list that might help you avoid having your first c-section.

On Live Your Ideal Life guest blogger Pamela Candelaria who writes over at Natural Birth for Normal Women discusses the risks of a c-section as described on a typical consent form and says, “what isn’t on the form may be surprising.”

Heather of A Mama’s Blog provides a lot of information about The Reality of C-sections.

And Breastfeeding Moms Unite posted What to Expect of Your Body after a C-section.

Bellies and Babies has a great round up of posts in honor of Cesarean Awareness Month.

There is one victory worth celebrating regarding Cesarean birth and women’s health in general. Thanks to the Health Care Reform, c-sections, giving birth and domestic violence can no longer be considered pre-existing conditions and used to deny insurance coverage. It’s a step in the right direction, but so much more needs to be done to lower the c-section rates and allow women access to VBACs, so that they don’t have to travel 350 miles just to have a vaginal birth. And that’s why an entire month is needed to raise awareness about cesarean sections.

Additional resources:

Photo credit: Flickr – Grendellion

Cross-posted 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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How will I know?

This past month I went digging around underneath my bathroom sink searching for something I haven’t needed in a long time. A pregnancy test. Although it was not something I was planning, I had this feeling deep down that I could be pregnant and knew that technically it was a possibility. Was I hopeful that I was pregnant? Was I worried? Was I scared? Definitely a little bit of all three.

As I waited for the line(s) on the test* to appear and my future to be revealed, my mind raced with possibilities. I imagined another home birth. I imagined Ava as a proud big sister again and Julian as a big brother for the first time and my heart swelled. I imagined another baby to love and nurture. I wondered how the baby would change the dynamics of our family. I pictured many sleepless nights and years more of cloth diapers. I thought about my health – both physical and mental – and wondered how I would do with another pregnancy. I thought about what my new psychiatrist recently said to me about the importance of finding time for myself and not taking on anything new right now. I wondered if my anxiety would get worse if I was pregnant and if I would need to go off my medication or increase my dose. I thought about how we plan to put our house on the market in the spring and all that we need to do in preparation. And I thought about how my life seems pretty darn great (and full) right now with just my two amazing kiddos.

The pregnancy tests (yes, I found more than one under my bathroom sink) were all negative and, low and behold, my cycle started. The future, for now, has been revealed. I am not pregnant. I will repeat, I am NOT pregnant. See?

I’m a little bit disappointed, but I also feel peaceful about it.

All of this got me wondering, how do you know when your family is complete? I don’t really know. I have thought about the “v” word – vasectomy – and have mixed feelings about it. I know it is technically reversible, but it seems so final and we’d likely only go that route when we are totally sure we’re done. Am I ready to close that door just yet? I don’t think so. I could still see us with one more, just not right now.

For now I think we’ll be a little more careful. At this point in time I don’t think a pregnancy would be the best thing for me, for us. That’s not to say I’m ruling out having another baby in the future, but for right now, as I continue to focus on my mental health and on my marriage, I think we’ll stick with these two wonderful kiddos we already have. And we’ll cross that bridge if and when we come to it.

* I think it’s kind of funny that all of the pregnancy tests under my sink were actually expired, so who knows how accurate they were. But I got my period so there’s no question anymore anyway. 😛

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Nursing a toddler (a 2-year-old) while pregnant

I said a long time ago that I wanted to write about my experiences nursing a toddler – not only for my own record, but in hopes that it might provide some insight to someone else out there. I figure I need to tackle this topic soon (and actually started this entry a couple weeks ago), while I still have time to reflect on it and blog about it before baby boy gets here, so here goes…

I always knew that I would nurse my children, but I never thought about the length of time I would do it. The American Academy of Pediatrics has their recommendations, as does the World Health Organization. Both seem to agree that breastfeeding should continue “as long as mutually desired by mother and child.” I figured I would play it by ear with Ava, allowing her to self-wean if possible, but not commit to anything one way or the other.


She celebrated her second birthday in June 2006 and nursing continued. By this time, Ava was only nursing a few times a day and had night-weaned as of 22 months. I’m not sure if the drop in nursing came as a result of her age or as a result of my milk drying up with my pregnancy. I had become pregnant with our second child in February 2006, and my milk dried up somewhere around 15 weeks pregnant.

While nursing a toddler was not something that bothered me, nursing a toddler while pregnant (with all the lovely pregnancy hormones coursing through my system) and without any milk coming out was less than appealing to me. I kept at it despite the fact that it wasn’t always easy, partially because I felt like it was easier to grin and bear it rather than wean. I know that may not have been the best way to respond and others chose different paths (which I can totally understand), but that’s how I handled it.

There was a time, several weeks ago, when I was seriously contemplating weaning Ava before baby boy is born. I was having such a hard time and feeling very overwhelmed with nursing (even though it wasn’t that often) and life in general. But after talking with several other moms who are either nursing now while pregnant or have nursed while pregnant, and reading the chapter about nursing while pregnant and tandem nursing in “Mothering Your Nursing Toddler,” I was reassured that all of the feelings I was having were completely normal. Such a relief! That didn’t make nursing any easier, but it did reassure me that there was nothing wrong with me for feeling the way I did.

Here we are now – me at 37+ weeks pregnant and Ava at 28 months old. She is still nursing 1 to 2 times per day – which consists of always before bedtime (though she doesn’t nurse to sleep) and sometimes once in the middle of the day. I managed to cut out the morning nursing session fairly easily by way of distraction. When she does nurse now, I place restrictions on it and it’s only for 2 to 3 minutes at most, which is really all I can handle. There have been times when nursing is just too much for me at the time and I tell her that mommy is feeling frustrated, etc. She understands and has been fine with me placing restrictions, so it works for us.

I’m hoping that by continuing to nurse her, it will make her transition from being an only child to an older sister a bit easier, since we will still have that special connecting time together each day. I know that moms who wean are still able to connect with their older child, but maybe by sharing something as sacred to her as mommy’s milk with baby brother, it will help calm her uneasiness with the changes of having to share mommy with someone else. Time will tell.

I never expected nursing while pregnant to be as difficult as it has been. Hormones can do crazy things to a person. I can totally understand why women wean while they are pregnant and I wouldn’t have been too upset if Ava had decided to wean on her own. Of course, that didn’t happen. 😉

I’m still not making any promises as to how long nursing will continue. We will take it day by day, even after baby boy comes. No matter what happens, I feel good about the nursing relationship Ava and I have had and know that we both have shared some precious memories together over the years.

I welcome any tales from mamas who have nursed while pregnant or tandem nursed. It’s always nice to know I’m not alone. Thank you. 🙂

By the way, I did some searches for nursing a toddler and found this info on LLL’s site with “Toddler Tips”, as well as info about nursing while pregnant. Also found this with “Toddler Nursing Testimonials.”

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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.
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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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