The Final Post (aka When Things Don't Go As Planned...)

My sweet baby J; 7 lbs 3 oz and perfect in every way!

 
"If I have a fever, or my water breaks too early, I may have to transport to the hospital.  But we'll cross that bridge when we come to it."

That's what I wrote in my last post about being beta strep positive.  And my water broke (9 days before my due date!).  And labor didn't start.  Until I got to the hospital.  Then, it was 45 minutes and my sweet baby J was here!

My water broke about midnight, and I called my midwife right away, not knowing if labor was going to kick in NOW or what.  Her and her assistant headed right over.  When labor didn't start immediately, they settled in for a night on my couch.  11 hours later, with labor still no where in sight, we started talking transport to the hospital because of my GBS+ status.  I felt like crap at this point.  I was throwing up (something that I've never had in labor before, but is common apparently) and felt completely drained.  Then my hubby brought me a Sprite and the barfing stopped.  I was able to regain my energy at this point, made myself a chocolate-cashew-date-banana shake, and started walking and trying to get labor to start.  We decided to give it a few more hours.

Finally, 14 hours after my water broke, we decided it was time to transport.  Why was I transporting? To get Pitocin so my labor would start, and antibiotics in an IV because that's what they would do because of my GBS+ status.  Turns out I got neither.  I felt contractions starting (I had had a few already, but nothing consistent), and, as I stood at the top of the stairs, hospital bag in hand, thought for a brief moment that maybe we should wait 30 more minutes. 

Hindsight is 20/20.  
Oh well.  

(And here's a tip for ya home birthers: have a hospital bag ready, just in case.  This wasn't an emergency situation, and I had the luxury of taking a few minutes to pack a bag.  But if there was an emergency, you'd want something ready for your hubby to grab for you.  I had NO idea what to bring- it's been 8 1/2 years since I last went to the hospital to birth- and my midwife's assistant had to tell me.)

Instead we went to the hospital, where I felt contractions getting stronger and stronger.  By the time I was sitting on the delivery table, I told the nurse this is going to happen fast- I guessed in 45 minutes we'd have a baby.  Turns out is was 43 minutes, my midwife later told me. So they got an IV in me and gave me one dose of antibiotics literally while I was pushing baby J out- so the antibiotics were useless for the whole GBS thing.  

And now I was stuck in the hospital.  'Cause here's the thing I HATE about hospitals: once you're in, you're not coming out 'till they say so.  You are their prisoner.

Okay, maybe that's being dramatic.  But it is kinda true.  A few nice surprises about this hospital stay though, was that right after J was born, they put her on me for skin-to-skin contact, the hospital staff really seemed to believe in that, which is cool, because so do midwives and homebirthers. They also asked if I wanted the baby bathed (I said no, I wanted the vernix- the waxy coating babies have on their skin when they're born- to absorb in her skin, and she'd have her first bath at home), they asked if I was taking the placenta home ("yes"- and no one batted an eyelash), and the food was actually REALLY good. ('Cause really, it's all about the food.) 

After the birth, the nurse brought us up to postpartum and told me that that was a really cool delivery to  see.  My midwife commented to me later that the doctor who delivered me (that's a generous term- she showed up and caught a baby.  I did the work, mind you!), had a resident with her and that resident got a unique experience- catching a baby with the mother on hands and knees position, a natural, unmedicated birth.  Apparently that's something hospital personnel don't get to see a whole lot of (us natural minded folk seem to be heading home more and more for our births- home birth is up 20% from previous years, though it is still a very small percentage of overall births).  So, that was cool to be part of someone else's education I guess.

But still, I am a little sad I didn't just stay home.  But at the same time, it's not the most important thing.  I have an adorable, healthy new baby girl- straight from heaven!- and that's what really matters.

My sweet baby J~ what it's all about

So let's step back and gain some perspective, people. 

 If you were to go into, say, a kindergarten class, you wouldn't be able to tell which kids were born at home, which by C-section, which were organically fed wheat grass for their first year, which were raised on chocolate.  You wouldn't be able to tell which ones were nursed, which were formula-fed, which ones had organic, free-range, farm-raised crib sheets.   
 What you would see is which ones were loved at home, which ones received positive discipline, which ones were spoiled, which ones were rude, which ones were considerate of others. 

The birth experience is important- it's important to me how I bring my children into the world. And it is special, powerful, and spiritual. But sometimes things don't go as planned.  And that's a-okay.  'Cause raising these little monkeys and showing love to them and teaching them how to be good people is WAY more important and frankly, way harder, than the way they are brought into the world. 

And besides, I still got to eat my placenta.

  

P.S. FYI, I still continue my postpartum care with my awesome midwife, by the way.  Once we got to the hospital, she has to legally take the role of doula and can't actively participate in my care.  But once I was home, it's back to being my midwife. She has already been to my house for two visits to check me and baby, will come once more to my house this week, and then I'll have my last appointment with her somewhere between 4 and 6 weeks postpartum. 

And I want to point out that she and her assistant were with me a total of 16 hours- 14 at my house, starting at midnight, then 2 more during transport/delivery/afterwards. That's pretty amazing prenatal care, people.  Find me an OB/GYN that will do that!

My baby started seeing my pediatrician today, and that continues as normal as it would for any baby, regardless of where he or she is born. She got her first PKU testing in the hospital (which would have happened at home anyway), and my midwife does the second PKU screening later this week.  And I know it's called Newborn Metabolic Screening now and not PKU screening, but it's just easier to say.  It actually tests for something like 35 metabolic disorders. Don't skip that test, people. In the end, I decided to go with the Vitamin K shot and antibiotic cream in her eyes.  But the cream only has to be on the eyes for a minute, so I wiped it off just in time for her to start looking around at us.  And no one at the hospital seemed to care that I was passing on the Hep vaccine that they like to give babies at birth.  I just explained she'd get it later at my pediatrician's office (which she will...in a few months).

And in other randomness, the placenta lady told me that out of the 184 placentas she's processed, mine was the largest! A person usually gets 95 large-capsule pills, I got 156.  Whoa! I have no idea why this would be, since I'm not a large person, and my baby was 7 lbs 3 oz- nothing crazy.  But a fun fact, nonetheless. 

P.P.S. And Good-bye! Now this blog will sit in cyberspace, waiting to be read by anyone contemplating a home birth or by their family members who are freaked out by the idea and want a little more info on how a home birth or having a midwife works.  Ciao!

Are these girls excited to meet their new sister or what??

 

GBS+ and Homebirth: Compatible

Well, my beta strep test came back positive.  I've never been positive with any of my pregnancies before, but, considering that beta strep is a bacterium that 30% of the adult population has at one time or another, it's not hugely surprising.

Beta strep is a bacteria that is part of the natural bacterial flora of your body, it's usually harmless to you.  But it can be passed to your baby during birth.  This can cause complications, some very serious.  The good news is that even for GBS+ moms, the odds of passing it to your baby are extraordinarily low.  Like, crazy low (see the previous post).  So I'm not stressing about it.  Basically, I and my midwife will be monitoring the baby's temperature every 4 hours for the first week of life to make sure she's alright.  After that, we're in the clear.  There is late-onset GBS infection that can affect babies until 3 months old, but that seems to be unrelated to having GBS at birth. 

I scoured PubMed for loads of studies on this, and the scientific literature isn't clear on what's best to do to minimize transport of beta strep from a mom to her baby.  In the hospital, standard practice is to give GBS+ moms antibiotics through an IV for a minimum of 4 hours before the baby is born.  If I was delivering in a hospital, that wouldn't work- there's no way I'd be there 4 hours before my baby is born.  It'd be more like 40 minutes.  In that case, they'd take a blood sample of the baby after he or she is born and test it for C-reactive protein, an indication of an infection.  If the baby's levels of C-reactive protein indicate infection, he or she will then be treated with antibiotics.

Reading the studies made it clear that the medical community itself is not united on this. 
Many studies showed that IV antibiotics didn't do anything to prevent GBS in babies, and in fact, left the baby more vulnerable to other infections and to antibiotic-resistant superbugs (now that's scary!).  Some studies did show an effect.  And again, late-onset GBS is completely unrelated to whether or not a mom gets an IV of antibiotics.  The studies WERE clear on that. 

Also, beta strep (GBS) is something that a woman (or man) can have one day, and gone the next.  So testing at 36 weeks is not necessarily indicative of whether or not I'll have it during my actual delivery.  I read a few things saying that Europe doesn't even screen for GBS (but I have to research that a bit more, that may be heresay).  Several studies- in peer-reviewed scientific journals, people, not Self Magazine- questioned the veracity of screening and treating mothers for GBS the way we do.  The antiobiotic-resistant strains of bacterium developing in recent years is causing many in the medical community to question the practice of pumping every GBS+ mom with antibiotics.

There are a few important signs that I will have to pay attention too, however, that will put my baby more at risk for having a GBS related problem.  If my water breaks too early (like 16 hours or something before labor starts), if I have a fever during labor, or if my midwife performs lots of cervical exams during labor I will be putting my baby more at risk to contract the bacteria.  

My midwife already agreed she wouldn't check me (I haven't been checked before or during labor in either of my last two pregnancies and deliveries, so no biggie).  If I have a fever, or my water breaks too early, I may have to transport to the hospital.  But we'll cross that bridge when we come to it.

If the baby does develop a temperature in that first week of life, we'll take her into the hospital and she'll be treated with antibiotics.

I asked my midwife if she's ever had any other GBS+ moms, she said oh yes- lots.  Had any of them had GBS problems with their babies? No, she said.  In fact, she's only ever had one baby that had GBS, and that baby was a planned hospital birth to a mom who had tested negative.  See, it can be gone one day, and there the next.  My midwife's apprentice told me she had been GBS+.  So it's not unusual, and even though it CAN be serious, the likelihood of it being so are so slim, and the treatment options in the hospital not really being an option for a fast-birther like me, that I'm not stressing over it.  I also firmly believe that my baby is in God's hands, and faith plays a major role in my decision making process in all aspects of my life, including having my babies. 

p.s. Camping was awesome- I slept like a baby. Seriously, better than I have been at home! 
Also, I have almost 20 freezer meals prepped and in my freezer! AND I'm 38 weeks! SO CLOSE!!!!

36 Week Home Visit & Beta Strep Testing and.....Camping, anyone?

Well, I had my home visit yesterday!  My midwife and her apprentice came (and didn't have any problems finding my house- yeah!).  I gave them a tour of my house, told them where I was planning on birthing, got the info to order my birth kit, and did my beta-strep test.  So this is for real, folks.

Beta strep tests for the presence of a bacteria that, if present at birth, could not be so great for your baby.  It can cause sepsis, pneumonia or meningitis in your newborn. So if you're positive and delivering with a doctor, they will probably give you antibiotics every 4 hours or so during labor.  This isn't a sure-fire fix, either. A recent study said that antibiotics don't help protect the baby from beta strep, but other studies have said they do, and some antibiotics appear to be more effective than others. But some moms have had unpleasant reactions to these treatments.   So...do some research and definitely talk with your provider about your concerns and treatment options if you are positive.

If I am positive, then I will be treated with more natural options: oral garlic/Echinacea, and some others.  And, if transporting to the hospital becomes necessary, whether or not I am beta strep positive will be important for the hospital staff to know. I have never been positive before with any of my babies.  

Many women have beta strep present, some with symptoms themselves, some without, and the stats of it hurting your baby (even if you are positive) are mind-numbingly low, but because the effects on your newborn can be serious, it's important to be tested and develop a plan with your provider if that test is positive. Having a home birth does NOT mean that I (or my midwife) ignore all the amazing medical knowledge available today.  Beta-strep testing, PKU testing on baby, ultrasounds, thorough prenatal appointments....these things are important.  But they don't have to take place in a medical setting with the narrow medical viewpoint that many doctors have.  In other words, there's more than one way to skin a cat. (No, I would never skin a cat....I have one and I love him! It's just a saying, people!) 

Some Beta Strep Stats:

neonatal infection rate: 0.18% (that means 1.8 babies for every 1,000 live births)

neonatal infection rate of babies born to mothers who are asymptomatic, but are known to have beta strep: 0.68%

neonatal infection rate of babies born to mothers with beta strep and have symptoms:  4.68%

Even if you're negative, there's still a risk of you developing it between your test and delivery.  Newborn infection rate of mothers who tested negative is 0.05% (1 in 2,000)

So you can see that there's no magic bullet here for Beta Strep, not even for babies born in a hospital with an IV full of antibiotics being pumped into mom.  But the odds of your baby being harmed by it are very, very low, so don't let it keep you up at night. Your squished bladder and insomnia-causing hormones are doing that already.

Anyhoo, so I ordered my birth kit! The birth kit is a basically a box of supplies your midwife has put together that you order to have ready for the birth.  It includes things like disposable gloves, water tub liners for water births, peri bottles, etc.  It generally costs between $40 and $70.  Mine was $55.  Ordering the birth kit is super exciting for me-it's another reminder to how close I am!

So this weekend I am going camping. For 5 days.  I am not sure how this is going to go....sleeping is my main concern.  I figure that if I can't sleep, we'll just come home.  But I love camping, so I hope my cot, 5 pillows, and memory foam pad will get me through.  I've gone camping while pregnant before, but never this late in the game.....so I'll let you know how it goes!

Also, I've been freezing meals like crazy! This week I did 10!  I definitely feel the "nesting" instinct and feel like it's time to get ready for baby, and to prep my family to survive with a low-functioning mom for a few weeks (although, they would argue they are already doing that...).  Freezing meals will be a huge help in getting through what I call the "survival period"- those first 4-6 weeks.  My babies have all started sleeping through the night between 6 and 9 weeks, so I am excited to again have sweet slumber in my future!

See how my mind is just glazing over these last few weeks of pregnancy and the labor and delivery? I am just so ready to have my baby, hold her, and welcome her to our family!

I Can Do Hard Things....Right????

So, I'm not super great at this blogging stuff. Posting regularly is apparently too hard. But, you know, EVERYTHING at this stage of pregnancy is super hard.  Making meals for my kids, who are bottomless pits of hunger, trying to keep my home in some form of decency, and trying to keep up on a bit of exercise takes everything out of me.  Every day.  Good-bye, make-up.  See you later, hobbies.  Maybe one day we'll meet again.  Right now it's just down to the basics.  Like sleep. 

Sleeping at this stage is SO hard (I'm 34 weeks).  In previous pregnancies, I didn't reach this stage of sleeping awfulness until more like 36 or 37 weeks. So this stinks.  Not only is it hard to get comfortable, but let me paint you a picture of my sleeping challenge: 

1) varicose veins- I can't lay on one side very long before that leg starts to feel dead and aches. 
2) restless legs syndrome- when I'm not preggo and this happens (which is waaaayyy less often than when I am pregnant), sleeping on my tummy nixes it in the bud. You can see why that's not an option at this point.
3) sleeping on my back doesn't work because at this stage, you're not supposed to because of the pressure of the baby on your that one artery which name I can't remember.  And when I try, I get dizzy.
4) hormones & insomnia-  the hormones that are surging through my body cause insomnia for me.  So even when I do manage to get comfy, or find a position that works for my legs, some nights I'll just lie there- exhausted, but wide awake.  Plus, every morning I wake up at about 5:30 or 6. Not on purpose.  Not because of my other kids, who have (almost) all been blessed with my not-a-morning-person genes.  If you know me, you know that mornings aren't my strong point.  My kids' school starts at 9 am.  And they were late this past year. A lot. Because mom sleeps in.  (I know, I need to work on that). 
5) pee breaks- lots and lots of 'em
6)  aches-  in my lower right back I get this deep pain that hurts. It usually develops at night.  If I wake up in the night with it, I have to reach for my Miracle Ball and position it in a way that'll work out the knot that is there in my muscles.  Drives me crazy. 

So, you see that this gets complicated? Most nights I start out with about 7 pillows, and I prop myself up so I'm mostly sitting up (think hospital bed), then I prop up my legs to help my varicose veins. If I'm blessed to actually fall asleep, I will awake soon after to pee, or just because it's hard to stay asleep (again, thanks, hormones). Sometime during the night I'll usually reconfigure my entire pillow set up and do this weird belly-side position that works sometimes.  Needless to say, I am tired.  All the time. And I am tired of being tired.  

A friend, who was expecting her fourth, asked me if four kids were really hard.  I said, "Not as hard as having three and being pregnant is."  Yes, I am looking forward to the birth of this child not only because I can't wait to meet her, hold her, kiss her, put cute dresses on her, and love her, but because life will actually begin to get easier.  My energy will slowly be going up, not down, I will slowly be getting more fit, not less, and the hormones will begin to be flushed from my body (albeit, in a pool of sweat that I will wake up in every morning for the first few weeks, but I don't care. Bring it.)  At this point, all this sounds like paradise.

And when life gets easier for Mom, life gets better for everyone else, too.  I try to nap every afternoon so I can have some level of energy to make it through the dinner/bedtime routine.  I put my three year old down for her nap, then I go down. My older kids have strict instructions to NOT wake me unless someone is bleeding or there's a fire.  And that's not a joke, you can ask my kids. Hubby comes home from work and never really knows what to expect- if I got a nap, dinner is probably nearly on the table, and the house may have a chance at being semi-clean.  If I didn't, he has to morph into Superman and do dinner, be upbeat for the kids, and try to coordinate them to do some cleaning up.  So, needless to say, we're ALL excited for me not to be pregnant anymore!!!!

I realize this was kind of a whiny post.  Just trying to keep it real. On the up side, I had a midwife appointment yesterday and now my next appointment is my HOME VISIT!!! Whoo-oo!! That means I'm SO CLOSE! AT 36 weeks, your midwife will come do your appointment at your house.  This ensures she knows where you live. My midwife will also do the beta-strep test then. (I'll talk about that more after my next appointment.)   There's no point in a midwife doing a home visit before 36 weeks, because if you were to go into labor before then, you'd be having a hospital birth.  You must be a minimum of 36 weeks to have your baby at home, that's pretty standard among all the midwives I've known.  Before that time, your baby is very likely to need some TLC from sophisticated medical equipment, so off to the hospital you will go if your labor starts before then. 

Blessed sleep and energy, oh how I miss you. Can't wait until we meet again!

Glucose Tolerance Test & Iron levels

At my last appointment it was time to see if I'm at risk for gestational diabetes.  With my last two pregnancies, I've opted out of this awful-tasting, near torture test.  For those unfamiliar with it, it's a terrible tasting drink you drink then they measure your glucose levels in your blood a few hours later.  It doesn't sound that bad, but to me, it was.  

Anyhoo, it's not a terribly accurate test.  In fact, most pregnant women whose blood sugar levels measure high after this test do not, in fact, have gestational diabetes.  But gestational diabetes can be serious, and so it's good to get an idea of how your body is doing metabolizing sugar.

My midwife asked me if I wanted to take it two appointments ago, and I said NO!!! So instead, she does a finger prick test and measures my blood sugar with a glucometer (like a regular diabetic does many times a day).  She had asked me to eat 1.5 hours before I came, then not eat until after our appointment.  Easy peesy.  From the same finger prick, another drop of blood was squeezed out to measure my iron levels.  I was perfect on my glucose (meaning low- no high blood sugar here!) but my iron was low.  My midwife gave me some samples of Floradix, a liquid iron/herbal supplement that's easy on the tummy.  I really like it so far.

I wasn't terribly surprised about my low-ish iron levels.  It's something I've struggled with before, pregnant and not.  We don't eat a lot of meat in our house, and I take a prenatal without iron.  Iron supplements make me feel sick for an entire day after I take them.  Floradix hasn't, though.  I do eat many iron-rich foods, such as legumes, black beans, spinach, etc.  But since I'm in my third trimester, we will be eating more meat in our house.  Iron is just too important in the third trimester to my baby, and my iron levels will be crucial to me after delivery. (I talk about why in this post). So I want to do all I can to try to up my iron levels.  If that means changing my eating habits for a few months, so be it.  I also make this iron tonic syrup from a recipe in my favorite pregnancy book.  It's awesome and gentle on tummies! 

I don't mean we're going to be raving carnivores.  But we meat about once a week or less, and red meat hardly ever, so we'll probably be eating meat 3-4 times a week now, with red meat being one of those.  My hubby was pretty excited when I told him we'd be eating more meat for a few months, as were my steak-loving daughters.

But you don't have to eat meat to get enough iron.  Studies repeatedly show that vegetarians and non-vegetarians have similar iron levels.  But iron is also complicated.  Non-heme iron, from legumes and other non-animal sources is absorbed MUCH less efficiently than heme iron, which is found in animal flesh.  An interesting twist to this is that if your body's iron stores are low, your body will increase it's absorption of non-heme iron (or if your stores are high, it will absorb less non-heme iron), whereas for heme iron, the absorption rate stays the same independent of your body's iron stores. Pretty cool, huh?

There are also a few tricks you can use to increase your absorption of iron.  Vitamin C and carotenoids (think orange and red fruits and veggies and egg yolks) increase the absorption of iron.  In meat, there is an unidentified factor that increases absorption.  Conversely, calcium inhibits iron absorption.  So when I drink my Calcium/Magnesium drink (which I do for nighttime leg cramps and restless leg syndrome) I do it at night, whereas I take my Floradix in the morning.  If I took them at the same time, I'd be lessening the effectiveness of each.   

Iron stores take time to build up in ones' body, so that is another reason why I'm going to increase my consumption of meat.  It seems to be a bit more effective in a shorter time frame.  If I had been smarter, I would have been paying better attention to my iron levels throughout my pregnancy and then could've gotten away with sticking to primarily veggie and legume sources of iron.  My stores would still have built up, but it might have taken longer- which would have been fine if I had been on it. 

So if you're a strict vegetarian, don't despair and think you have to eat meat to up your iron.  You definitely don't.  But my iron has been low for awhile now, so I am willing to change my habits to see if I can change it for the better.  Don't be so stuck in a certain lifestyle that you're not willing to try something that will help you.  For example, if you're puking your guts out from morning sickness, try some chicken noodle soup and saltines.  You may be a strict vegan, but if that's what soothes your tummy, it's worth it.  Or maybe you don't eat anything that's not whole grain. Saltines are simple carbs with not much to offer nutritionally, but they just might get you through a few hours without throwing up.  So try them.  You can embrace your eating lifestyle again when you are feeling better. 

Do I vaccinate?

I'm not trying to start a fight here.  You may totally disagree with me, and that's okay.  I know many people (homebirthers and others) who do not vaccinate their children.  And they are my friends.  My children play with their children.  But I choose to vaccinate my children. I believe in it passionately.  I honestly think vaccines are one of the greatest modern blessing we have available to us, and I'd be remiss not to embrace it.  Imagine how many mothers in history would have scrambled at the chance to protect their children from the numerous diseases that are a distant memory to our modern world.  Diseases that snuffed out the lives of millions of children. For centuries.  And all we have to do is get our children a little shot. Presto, worries gone, child protected.  Seriously one of the greatest, most amazing wonderful things about living in these modern times. 

When my 5-year old stepped on an old, rusty nail last summer it was a huge relief to call my pediatrician and ask what should I do? She checked her shot record and told me not to worry, her tetanus was up to date.  Just clean it well and it should heal fine.  Instant stop to my freak-out, all because my child had her shots.  

But many people assume that, because I have my babies at home, I don't vaccinate them. True, they don't receive those first few shots at birth that a hospital-born baby would receive (which, by the way, you CAN opt out of, but nurses and doctors may treat you like scum for doing so).  But I'm nursing, so they have my antibodies available to them and are thus protected.  I nurse about 6 months before my supply runs out and I have to start formula. But my babies receive their first vaccine before that.  The first time I take them to the pediatrician is somewhere in the 3-5 month range, for a well-check and to get started on vaccines.  I only get them one shot at a time, which usually is more than one vaccine because so many of them are combined nowadays.  But just one poke in their fat little leg is good for me.

I've never had raised eyebrows or condescending tones from my pediatrician about having my babies at home or the fact that they are usually a bit behind the immunization schedule.  Or sometimes a lot behind. But hey, my kiddos are all up to date by the time they are kindergarteners and off to school, so who cares.  The only reason my kids ever go to the doctor is for shots- they just don't get sick very often.  And when they do, I turn to my herbs and oils and that works for everything from fevers to earaches for my kids.  So remembering to take my kids in for their vaccines is a major victory for me, since who thinks about the doctor when everyone is healthy? But somehow, despite how behind I may be in getting their well-checks, the schedule always seems to pan out and my pediatrician has never had a problem with it.

When I do take them in, I acknowledge to my doctor that my kids' shots are behind schedule, so, I ask, by looking at their immunization record, what shot should they get next?  And my pediatrician will say, "Oh, let's do such-and-such today, and such-and-such next time."  I don't march into their office armed with "knowledge" I read online about this or that vaccine.  Recognize that your pediatrician is a smart person and knows what they are doing (or change pediatricians!).  Showing them that respect will ensure that you don't receive those dreaded condescending tones or raised eyebrows.  

And autism is present in my family. My brother has it.  A nephew has it.  But the science just doesn't support activist's claims about vaccines and autism.  Many people have many different reasons for not vaccinating their kids, but the alleged link with autism should NOT be one of them- because study after study has said there is no link. 

Last Sunday I was listening to an elderly lady at my church giving a talk.  She spoke of having polio when she was 12. She talked about how their town lost many, many people to polio during that particular outbreak.  And I couldn't help thinking, Wow. All I have to do is get my kids a shot.  A simple, easy, fast, shot.  And I've never had to give polio or whooping cough or anything else a second thought.  What a blessing. How could I not embrace it?  

...and a few thoughts about other "pokes" your baby gets at birth: 

 {Vitamin K Tangent}  The Vitamin K shot (which is not a vaccine) is given to your baby in the case they will need surgery.  It enables their blood to clot, preventing them from bleeding to death on the operating table.  On the 8th day of life, your baby begins to make their own Vitamin K, and no longer needs a shot after that day.  So for the vast majority of babies, it's an entirely unnecessary shot.  In the case that your baby does need a life-saving surgery in that first week and didn't get the shot, no problemo- they still have effective medicines they will give your baby to enable their blood to clot. So....really, I don't see the point of a Vitamin K shot as a standard procedure for every healthy baby.  So, even though my midwife can give this shot to my baby at home, I opt out of it. I simply don't see the need for it.

{PKU Tangent} Also not a vaccine, but is one of the things your baby will get directly after being born. It's a quick prick-of-the-heel for your baby, and absolutely CRUCIAL. My babies get it.  Every baby NEEDS it.  If your baby has this rare metabolic disorder, you need to know ASAP! Just want to make sure people know we homebirthers aren't THAT crazy- the PKU test is an essential, folks. Wherever you choose to have your baby. 

A quick note on birth certificates & SS cards

A few days ago a friend sent me a link from California Families for Access to Midwives, asking if I've ever had trouble getting my baby's social security card or birth certificate after a homebirth.  I scrolled through other readers' responses, and it seems as though many people have.  I never have.  I also don't live in California, and the state you live in will dictate much of the experience you will have in obtaining these crucial documents for your baby.

Getting my babies' birth certificates was super easy- my midwife submitted the paperwork and later I requested a copy of the certificate from the county recorder's office.  In fact, I thought it was better than the hospital way of doing it, where you *HAVE* to have your baby's name written in stone before you leave the hospital so they can process the birth certificate paperwork.  It's nice to have a few days to get to know your new baby, straight from Heaven, and play with the names that have been your favorites and see which one is hers or his.  My baby's social security cards came in the mail- so problemo.  Easy peasy, didn't have to do a thing.  But I live in Nevada, a pretty awesome state when it comes to things like taxes and red tape. (And not so awesome when it comes to things like education and health care- hence, homebirthing here is pretty common in some parts of the state.)

Do some research, talk to your midwife.  She will be intimately acquainted with the paperwork process after you birth your baby and be able to tell you what to expect.  Each state has different laws governing midwives who deliver at home, and you should know what your state requires.  California, for example, prohibits midwives from delivering breech babies.  (Super lame, right?) But that's the law.  Other states require midwives to operate under an OB/GYN.  If, for whatever reason, they don't have a doctor undersigning their practice, they are technically practicing illegally.  (California recently did away with this law for MOST midwives, but not all.)  Regardless of my (or yours, or the midwives') opinions about these laws, you should know them and find a midwife who abides by them.  Afterall, having a baby shouldn't be a legal issue!

Even if you live in a state where it will be more difficult than my experience, don't get too hung up on it.  Your baby WILL get a birth certificate and social security card.  I promise. They are a living, breathing person, and whether you have to wait longer, get paperwork from your pediatrician rather than your midwife, or make a few extra phone calls, they absolutely will get these essential documents.  Your baby is not the first, nor the last, baby in your state to be born at home.  So keep it in perspective and don't stress! Save your stress for parenting, not pregnancy!

Here's a great link to get you started researching midwifery in your state: 

 http://cfmidwifery.org/states/

Friends...with Placenta Benefits

After my first home birth, I bought a DIY kit from Placenta Benefits to process my placenta into capsules to take postpartum.  Awhile after that, I "friended" the Placenta Benefits page on Facebook.  My sister sent me an inquisitive message, "Carrie is now Friends with Placenta Benefits." Yeah, that DOES sound strange.  But the best kind of friends are those with whom you have placenta benefits!  I didn't process my own placenta after that birth.  A good friend of mine- a friend with placenta benefits, if you will- offered to do it for me. "Buy the kit (which was like $60ish), and I'll do it for you," she said.  That way, I didn't have to  pay the $275 to have someone come and do it for me.  And I knew it was completely unrealistic to expect that in Day 1 postpartum I'd be up, in the kitchen, with a few hours on my hands to properly process my placenta. 

So she did it all- took my placenta home, steamed it, sliced it, dehydrated it, ground it, and encapsulated it for me.  I was super grateful, and I loved taking my placenta pills.  

You get A LOT of pills from one placenta.  So many that you'll have some left over well after the postpartum period when you take them.  When it came time to have my next baby at home, I had plenty of placenta pills leftover from my previous delivery.  So I had my midwife put the placenta in my freezer and figured I'd get to it in a few months.  

Why bother to process it at all if I had plenty of pills, you ask?  I have this thing with wasting.  I hate, hate, hate, to see something useful going to waste.  My food scraps go my chickens.  I sweep out the ashes in my fireplace and add them to my compost pile.  Useful food cartons go in our "junk" box to be used later in kid crafts.  And lots of recycling goes on.  So to just throw away something like my placenta- something that my body made and that provided life to my baby- is just unthinkable to me!  

Waste not, want not. We take it pretty seriously around here. 

Anyway, so my baby was about 6 months old or so and I thought, "I'm going to get to that placenta."  So I took it out of the freezer and let it thaw in a bowl in the fridge for a few days.  Then I went to get it out and process it.  I took it out the fridge and uncovered it.  It was a bowl full of blood with the placenta in the middle of it.  I couldn't believe how bright and red the blood was.  And I knew I couldn't do it.  I just couldn't.  I'm not a squeamish person, I'm not a wimp, and I always thought I could do absolutely anything.  But I could not do this.  And I knew it the second I looked at the bowl full of blood.  

But there was no way I was just going to bag it up and toss it in the trash, either.  So I took it out in my backyard and buried it next to a dwarf pomegranate tree.  My "waste not, want not" obsession was satisfied- that little tree would be nourished for years in a way no fertilizer ever could- and I still had plenty of pills, so I was good. 

How on earth did my friend do it, I wondered later? She not only processed a placenta, but it wasn't even her own! And she had told me afterwards how she had really enjoyed doing it.  Wow.  I'm still in awe of my placenta benefits-friend!

I'll refer you to Placenta Benefits' website to fish through their great info.  Frankly, there's NOT a lot of hard core, scientific research about the validity of this practice.  It just hasn't been studied in a comprehensive, scientific way yet.  Hopefully that will change in the future as this becomes more popular.  There are plenty of anecdotal experiences, however, and many, many women have reported fewer baby blues, less anxiety, increased lactation, and better moods while using the pills.  Honestly, it COULD be a placebo effect.  Or not.  I don't know.  Science doesn't know (yet).  But even if it was just a placebo effect, I think it's worth doing.  New moms need all the help we can get- and if that comes in the form of a placenta pill, so be it.  

At the VERY least, you'd be giving yourself a much-needed boost of an amazingly bioavailable form of iron.  And, after your last trimester and then the delivery, and postpartum bleeding, putting some iron back into your system would do any new mom a lot of good.  (Just FYI, iron is the only nutrient for which your baby truly acts as a 'parasite'- it takes what it needs and you get the leftovers.  This happens primarily in your final trimester. For all other nutrients, your body makes YOU the priority, and baby gets what's leftover.  Breastmilk has hardly any iron in it at all, so your baby's body stores the iron it took from you in your 3rd trimester, and it lasts about 4-6 months- at which time you'll start introducing other foods (that have iron in them) into her or his diet. Pretty amazing, isn't it? The beautiful orchestration of it all- it's perfect!)  So odds are pretty good that you'll be iron deficient in those first few postpartum weeks.  And eating an iron-rich organ that your body made would be a smart move for any new mom. 

So what am I doing this time around? My amazing friend...(with placenta benefits) and I live in different states now and I have NO pills.  So actually I will be forking out the $275 or whatever it is to have it done for me.  My midwife's assistant will take my placenta home and deliver it to the 'placenta lady'.  She'll process it and deliver it back to me encapsulated and ready to go.  

And just for another look at human maternal placentophagy (the technical term. Log that away in your brain for a future trivia game), read TIME's Joel Stein's humorous experience with it. 

And here's a few more interesting websites about it (but not as funny as Joel Stein's commentary):

LoveLiveGrow

MSN- lifestyle

a scientific look at cultural practices

Las Vegas Sun Article

Bon Appetit!!!!

BEST pregnancy book ever!

 Move over, What To Expect Books, my favorite book for us preggers is The Natural Pregnancy Book by Aviva Jill Romm.  It's awesome! And it's not just for homebirthers, either.  Any pregnant woman having ANY kind of birth will love this book.  

I am a library sort of person.  I rarely, rarely, RARELY, ever buy books.  I LOVE books, and if I bought them all, they'd be spilling out of my ears. So I just don't buy a book unless I feel I NEED it. I bought this one several years ago, and would buy it again. Nutrition, exercise, and herbs take center stage in this book as Ms. Romm details general recommendations, nutritional know-how, and helpful herbals for common & not-so-common pregnancy issues.  Everything from morning sickness to anxiety to edema and everything in between is covered.  Recipes for nourishing pregnancy teas, iron tonics, and other herbals are included as well.  Herbs that shouldn't be used in pregnancy, as well as the most helpful pregnancy ones, are also included.  In short, it's just what the sorta-a-hippy pregnant lady ordered.

Oh, and just what qualifications does Ms. Romm have to write this book? She's not just some crazy herb lady, people! She's went to Yale, became a doctor, is an herbalist (hello- she's a former president of the American Herbalists Guild), and a midwife.  You can check out more about her on her website. She knows her stuff, and that alone makes this a great book- the info you're getting is real and solid stuff. Which it needs to be, because you can't just go trusting any old anything when it comes to your body and your baby!

And on an unrelated note, my next post will be about the placenta....and what you can do with it!

Varicose Veins STINK

 Yesterday I had appointment #3 (which was super fun- it's like "girl time" with some cool ladies who also happen to be providing me awesome prenatal care).  I'm happy my uterus measured exactly where it's supposed to be- in past pregnancies I've been a week or week and half behind, and that's always depressing to find out your due date is off.  But my due date is right on, and that made me happy!

Anyway, here is the promised post about my varicose veins.  I'm genetically doomed from the start to have varicose veins, but that doesn't mean they can't be managed.  When I'm not pregnant, they are still there, but they don't hurt.  (Varicose veins don't go away- although you can get them surgically "stripped". I have no idea what that means but I may look into it after I'm done with childbearing.)  The hormones that help make your whole body loosy-goosy and more elastic as you prepare to deliver a baby also affect your veins, causing them to bulge more.  And that can make them HURT.  But I have found ways to manage them to where the pain only happens on few and far between days, or even not at all.

Go to any doctor with your varicose veins, pleading for help, and they will hand you a prescription for compression hose.  I'm going to be hugely pregnant in this summer. Who wants to wear compression hose on 100 degree days? Not me.  There ARE effective ways to manage this common problem.

 So what I do is pretty basic.  But it basically consists of four parts: 

physical exercise, nutrition, herbal, and rest.

1) Exercise

 This is the MOST important for keeping my veins from hurting day to day.  I take a 20-60 minute walk or just put on music and dance for 20-40 minutes. If you're laid over by morning sickness or on bed rest, flex your ankles in bed for 20ish minutes. I do have a treadmill, but only use it as a last resort if I really want to walk but can't get out that day.  This gets my blood moving and less likely to pool in my bulging veins, preventing pain.  I exercise at least every other day, but I try to do it every day to really be a step ahead of my veins. If I let three days pass without exercising, my veins will hurt.

2) Nutrition

“Let food be thy medicine and medicine be thy food”- Hippocrates

This is the most important for preventing new varicose veins from developing and current ones from getting worse. I majored in Nutritional Science at college, so this was the natural place for me to start when I was looking for ways to manage my veins. The secret is a compound called rutin. Rutin + vitaminc C = strong vein walls, making the veins less likely to bulge, and become varicose.  I don't take a supplement; rutin and vitamin C are both readily available in regular foods.  They are power partners in fighting varicose veins! 

You can do research to find all the sources of rutin there are, but I eat about a tablespoon of cracked buckwheat 3 or 4 mornings a week, along with a vitamin C-rich fruit.  Buckwheat is a great source of rutin, as are the whitish piths of oranges (which I also eat when I eat my orange; it's an easy way to get rutin and vitamin C at once).  

A great example of a good rutin/vitamin C rich breakfast would be hot buckwheat cereal (which I think is really gross, so I just add about about a tablespoon of buckwheat to my oatmeal or cream or wheat), with some strawberries on top.  Some mornings I'm rushed, so I'll just eat a tablespoon of raw buckwheat along with a kiwi, strawberry, or orange.  I buy Bob's Red Mill Buckwheat Cereal- it's already cracked, not whole like buckwheat groats, so it's easier to incorporate in my diet.  You can also get buckwheat seeds and sprout them and eat the sprouts.  

You can get way more creative than that, though- have a sandwich with buckwheat sprouts and red pepper slices (peppers are an amazing vitamin C source). Or use buckwheat flour to make pizza crust and load your pizza with fresh veggies (fyi- vitamin C is destroyed by cooking though, so be sure to eat some fresh veggies or fruits along with your pizza).  Do some research and find out what sources of rutin and vitamin C are out there that YOU like and incorporate them into your daily diet.

There's a lot of ways to get rutin, and that's the key to strengthening the vein walls to keep varicosities from developing: rutin + vitamin C. And you don't have to eat them at the same time to be effective.  

(By the way, buckwheat is a fruit, not a grain- isn't that interesting? It is completely wheat free, and is fine for those with celiac disease, wheat allergies, or gluten intolerance.)

3) Herbal

  I only drink herbal tea once in awhile, but when I do I make sure it has nettles, red raspberry leaves, and oatstraw in it (I get my herbs in bulk and make my own teas), which are all supposed to be good for veins.  Rose Hips are good to add, too. This is the "cherry on top" of my regimen- it's frankly the least important, and it won't save my veins if I'm not doing the first two things, but it's a good way to ensure I'm doing all I can to fight my veins!

4) Prop those feet up and REST

Each day try to find time to prop your feet up with pillows and just rest for about 20 minutes.  Sometimes all the stars will align for me and I'll be able to take a good hour long nap like this.  But even propping your feet up and chilln' for 20 minutes is great for your veins. 

And when all else fails, I put on a compression stocking.

  

During pregnancy #4 (during which I did this little regimen of mine) I only had to resort to compression hose about 4 different days, which was amazing, considering that during pregnancy #3 I wore them every day from 6 months on until I delivered (I didn't do anything to manage my veins during that pregnancy, which was the first pregnancy where my veins became a painful problem that needed attention).  So I consider my regimen working (at least for me!).  If you try any of these suggestions, I'd love to hear how they helped you!

Also, just as a side note, be aware that if you live in a hot climate, your veins will be worse- they come to the surface of your skin to help cool your body (this happens to everyone, but to those of us that have varicose veins it can make it harder for us to manage them).  But considering that I was living in Vegas, with 115 to 120 degree summers during both pregnancies #3 and #4, this regimen can still be VERY effective, even if you are living somewhere super hot or humid.  

A Book You Should Definitely Read!

This book is really, really awesome. True, I am a total history nerd.  Once, for my birthday, all I wanted was to go to the museum by myself. It was this really cool Titanic exhibit. I wanted to read every single plaque and soak in every bit of fascinating history without being rushed along or worrying about my children. And I did. And it was one of my favorite birthdays ever. But you don't have to be history nerd to love this book. Really, I promise.

 One of the reasons why I really liked this book is that it's NOT written by some crazy homebirth fanatic. In fact, it doesn't even promote home birth. Tina Cassidy is a journalist who had a baby, and she ended up unexpectedly having a C-section.  After the dust had settled, she was a bit peeved at her doctor and wondered if the C-section had been really necessary. Well, she asked her doctor, what would have happened if this had been 100 years ago? The doctor gave her a horrific answer of the baby being taken out piece by piece. She was shocked. Was that true? 

Well, being a journalist, she decided to find out.  

This is an amazingly well researched book. She has truly left no stone unturned. I was fascinated as I read about the history of midwives, the coming of age of the medical community, C-sections, and the like.

This book helped push me in the homebirthing direction.  But that was my own conclusion.  At the end of her book, while acknowledging that stats play into homebirth and midwives' favor, Ms. Cassidy confesses that she still couldn't see herself having a homebirth. And that's what is so great about this book.  It simply presents the facts, and every person who reads it walks away with their own conclusions. Herself not converted to homebirth, she is not trying to sway anyone in any direction.  The fascinating history that she has unearthed is in itself wonderful, made more authentic by the absence of a hidden agenda on the part of the author. 

So what are you waiting for? Get reading!

It's a GIRL!!!

Holy cow, we're going to be the parents of 5 GIRLS!!!  

My four girls were ECSTATIC, to say the least. Boys are apparently not welcome here. My hubby was, honestly, a little shocked! He's not sad that he's having a daughter, but kind of bummed that he'll never have a son. ('Cause this is it, folks.  The baby factory will be closing!)  Today at church, a teenage boy gave a short talk on his weekend campout with his dad. Rod told me later he was thinking, I'll never get to do that. And he was a little bummed. There are no father/son campouts in his future. 

So I found this consoling article for my hubby called 7 Scientific Reasons To Have Daughters. Check it out! Among the list is the fact that for each daughter a man has, he lives a little over a year longer.  So my hubby just added about 6 years to his life! Not bad, eh?

Exercise during and after Pregnancy

Part of the midwifery model of care is that you have an obligation to do all you can to prepare yourself for delivering your baby.  Keeping your body fit is a big part of that. 

I try to exercise almost every single day (except Sundays), but when I'm pregnant I'm especially diligent about it. I have to be.  I have varicose veins BAD on both legs and when I don't exercise, those veins hurt and throb.  Doing some sort of cardio workout is essential every day to get my blood moving. And it makes a WORLD of a difference in managing my veins. (I'll do a whole post on my lovely veins later- I know, you can't wait!)

Now, when I say "workout" you may be envisioning me running, going to the gym, or pumping iron in my garage for an hour.  Umm...no. I don't do any of that.  I refer you to the picture at the top of this post.  That's a little more my speed, especially when I'm pregnant.

And that's fine. As long as I'm doing something, I feel great and my body feels great.  I don't have to kill myself to get that great feeling or to get results. I know a lot of people of all ages who run- they run for fun, they run marathons, they just love it.  I am not one of those people. I hate running. With a passion. I used to like going to the gym, but with so much going on in my life (read: 4 kids), it's a headache to try to figure out how to get myself there. Plus it can be expensive.  And I'm cheap. And lazy.  When my hubby gets home from work, the last thing I want to do is run out to the gym.  I want to be home, I want to to chat, I want to curl up with him and read a book or watch some Jimmy Fallon. We have a bowflex in our garage and try as I might, I can never consistently stick with it.  It's just too boring. And in the winter it's cold out there, and in the summer it's hot.  You get the point- I need to be doing something I like or it doesn't happen at all.  

So what works for me? A few things, actually:

Dance workout. For years I've had a playlist (that I change or update periodically) of music that I dance to. To add a little more intensity, I'll use a step-stool and some light hand weights for some of the songs, but mostly it's just me getting my groove on.  And I work up a sweat. And I love it! The great thing about this workout is that the intensity is flexible- I can really work hard and dance for awhile, or I can keep it shorter and do less intense songs.  But I always have fun, and that's why this workout has stuck  for years and years, pregnant or not. There's actually a few websites out there that list songs according to beats (of your heart) per minute. Just google "running songs".  But make sure you put on songs you like, or you won't be motivated to move!

Walking.  I love to walk around my neighborhood. We have lots of hills, and that makes it even better. A good, fast-paced, hour walk is one of my favorite workouts ever.  It clears my mind and rejuvenates me. Once, I passed two teenage girls that totally started snickering at me and my power-walking. And I just thought, oh, just wait, ladies.  Give yourself 15 years and you'll be right here with me!

Swimming. I'm not doing this right now, because it's still cold, but lap swimming is awesome, especially for us preggers. I swam competitively for years, and it's just a great whole-body workout that tones and gives you cardio at the same time.  Not to mention puts great all-over pressure on my varicose veins at the same time.

This next one is going to make me sound like an old lady.  But I love Walk Away the Pounds with Leslie Sansone.  There's a gazillion different ones, but the link shows you to the only one I have. I did it this morning. Sometime I'll try some of her other ones. This is one I only do  when I'm pregnant, or in those first few postpartum weeks.  It's a great workout to get you moving when, well, you can't seem to do a whole lot.  I grow out of this workout when I'm fully back in shape, but when I'm pregnant and/or postpartum, it's just what the doctor ordered.

Fit2B.us is a great online pilates/yoga studio. And it's super cheap (and modest!).  All their workouts are tummy-safe (plus there's lots of diastasis-awareness material on the website) and they have a whole section for new moms and pregnant ladies.  Eventually, I will grow out of this website too, but it's perfect for me right now.  Not just because I'm pregnant, but because I'm new to this whole pilates/yoga stuff. I actually started this a few months before I became pregnant.  Whenever I do a pilates workout on this site, I always follow up with a few back exercises.  Lower-back stuff is crucial, crucial, crucial.  Your tummy muscles need your lower back to be strong, and I've found that unless I'm taking care to do specific back exercises, my lower back can hurt after I have my baby.

For post-baby time, I like the book Baby to Bikini.  If you're one wanting a step-by-step, week-by-week program for getting back into shape after you have your baby, this one is a good place to start.  It gives you a plan for the first 6 months.  Simple but effective. I've never followed it for the whole 6 months, but it has given me a good understanding of what exercises are safe after baby, and what ones should wait.  Not to mention a whole slew of exercises to pick and choose from.

So that's it.  Nothing magical or too hard.  Even when I'm fully back in shape, I still don't run or go to the gym.  Because I hate those things.  Dancing & walking are my mainstays, then everything else changes according to what I feel like doing and what my goals are. Currently, I'm getting more interested in pursuing pilates and yoga and want to make that a bigger part of my overall workout plan, even more so after I have my baby.  I like hiking and biking, too, so sometimes those play into my schedule. Or I'll try out a workout video from the library or from youtube (youtube can be hard, though- I have 4 girls and do NOT allow skanky workout videos playing in my home.  So most youtube workout videos don't make the cut around here). Change it up and keep it fun and interesting. And don't be fooled into thinking you have be killing yourself or doing something you hate to benefit your body.  Nothing could be further from the truth.

A few postpartum words: find out what a diastasis is and how to check your tummy for it and heal it.  This is muy importante.  Do NOT do sit-ups, crunches or anything of the like until you get your tummy healed.  There's a lot out there now about diastasis, so go do some research.  Second, plan on splinting for at least a few weeks.  You can buy a splint (Fit2B.us has a few links to different ones) or just use a stretchy piece of long fabic (I've done this and it works great. I'm cheap, remember?).  When a woman has a baby, she should be handed a bunch of diastasis-awareness material along with all those free formula samples. Remember, there's  no reason why you can't look amazing after you have a baby! 

So go kill it, ladies!

Appointment #2

Yay! Heard my baby's heartbeat today! And just, for good measure, I recorded it. Excuse my belly.

That's a hand-held doppler she's using.  And it's my midwife's assistant, Tiffany, who is finding the heartbeat.  Baby was super cooperative- Tiffany found the heartbeat right away- so I rewarded him or her with a grilled Italian from Capriotti's. For the baby, of course.   Next up is my ultrasound in a few weeks! Whoo-oo! How does that work, you ask? My midwife, Sherry, refers me to an imaging center and the imaging center calls me and sets up an appointment.  My insurance will cover the cost of the ultrasound.  It was fun, too, to chat more with my midwife and get to know her better.  She's super cool, and we're definitely forming a friendship. 

I love getting my half-way-there ultrasound.  It's so exciting to see your baby and a) see that's it's growing alright and b) find out the gender.  We have four girls, so statistically, we're headed for another girl.  After you have three of one gender, it's not 50/50 anymore.  You're actually more likely to keep having the SAME gender. Wierd, huh?  So in about three weeks we'll find out if that's holding true for us or if we'll break the mold.  We're excited either way.  Although, if we end up with another girl I am SO calling my hubby Tevye (as in Fiddler on the Roof) or Mr. Bennet (as in Pride & Prejudice).  There are so many great Fiddler soundbites already rolling around my head....

A 31% C-section rate? What the heck, people?

So recently a friend shared this article about having a C-section on the source of all essential knowledge, Facebook. Never having had a C-section, I was fascinated and totally freaked out.  

Ok, so you just read it right? I realize this is just one lady's experience- definitely not the final word in how C-sections are.  As with any birth experience, it's a varied as we are as individuals.  

Before I go on, let's set the record straight:  C-sections save lives.  Of babies. Of moms.  There are so many birth scenarios that have turned out happy because of C-sections.  And I am grateful that should something go awry, this option if available to me to save my life or my baby's life. I know many women who had no other option; some knew they'd have to have a C-section from the get-go, while some had C-sections as a last-minute emergency.  And, thankfully, I get to have those wonderful people (and their cute kiddos) in my life.  C-sections are nothing short of a wonderful modern miracle! 

That said, a 31% C-section rate in this country is nothing short of embarrassing. (And to think it was less than 5% in the early 1970s!!)  Only 5.2% of planned homebirths end in a C-section at the hospital. Hate to say it OB/GYN's, but midwives are kicking your trash here. Really, we're supposed to believe that almost 1 in 3 births is an essential C-section? Let's take a look at a few facts:

• The WHO (World Health Organization) says that no country is justified in having a rate over 10-15%
   
• Rates above 15% have been shown to do more harm than good (Althabe and Belizan 2006)
•  
• Countries with the lowest rates, like Nigeria (1.8%) and Ethiopia (1.0%), are typically poorer third world countries without the facilities or medical sophistication to do C-sections for any other reason than a last ditch effort to save lives.  C-sections done in these countries also are much riskier to the mother and baby
•  
• Other industrialized nations have rates similar to the U.S's.  Almost all European nations have rates in the teens and twenties (Italy is the highest in Europe, at 38%, Finland near the lowest at 16%).  South America and several Asian nations have rates higher than the U.S. (Holy Cow, Brazil! You're at 45%!) This C-section epidemic isn't unique to our nation.

  (These figures are from a 2010 study by the WHO, see the whole thing here- scroll to the bottom to see the tables). 

So, what's going on?  This article outlines a few reasons for the crazy rates. (And this isn't some hippy article, by the way. It's intended to be read by health care professionals and patients alike. Check it out for yourself.) In summary, it says:

• Low priority of enhancing women's own abilities to give birth: "Care that supports physiologic labor, such as providing the midwifery model of care, doula care providing continuous support during labor, and using hands-to-belly movements to turn a breech baby reduces the likelihood of a cesarean section" Side note- I've heard a lot of wonderful things about CNM's (certified nurse midwives- they usually work under an OB/GYN) that deliver in hospitals that have embraced this midwifery model of care, to the benefit of their patients. Many are supportive of the presence of doula's, the desire for a natural birth- and even water births in some cases.
• Side effects of common labor interventions: "Current research suggests that some labor interventions make a c-section more likely" (i.e. labor induction for a first-time mom)
• Refusal to offer the informed choice of vaginal birth: "...many women with a previous cesarean would have liked the option of a VBAC, but did not have it because health professionals and/or hospitals were unwilling (Declercq et al. 2013)"  Side note- according to the Mayo Clinic, 75% of VBACs are successful. Them good odds, ladies.
• Casual attitudes about surgery and variation in professional practice style: "Our society is more tolerant than ever of surgical procedures, even when not medically needed."
• Limited awareness of harms that are more likely with cesarean section: "Cesarean section is a major surgical procedure that increases the likelihood of many types of harm for mothers and babies in comparison with vaginal birth."
• Incentives to practice in a manner that is efficient for providers: "Many health professionals are feeling squeezed by tightened payments for services and increasing practice expenses. The flat "global fee" method of paying for childbirth does not provide any extra pay for providers who patiently support a longer vaginal birth. Some payment schedules pay more for cesarean than vaginal birth. Even when payment is similar for both, a planned cesarean section is an especially efficient way for professionals to organize their hospital work, office work and personal life. Average hospital payments are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit."  

 So that last reason- for profit- really irks me. What the heck, medical professionals? That feels a little like a betrayal.  Whatever happened doing what's in the best interest of your patients, not your vacation schedule? You're going to subject a patient to a whole slew of new risks because you want to speed up their delivery and get a fatter paycheck? Not cool, people, not cool.

Again, I recognize that C-sections save lives.  Lots of lives. But only in about 5-10% of cases. Heck, for all I know this pregnancy might end in a C-section. And that's okay. If that happens, I will feel that I am in that 5-10%. And at least I won't be wondering if I was just taking 'too long', and my doctor had a hot date to get to.

Just for Fun

 We all think Hollywood is a little Hollywierd- who honestly thinks celebs are "normal?" But these ladies- who have every option available to them when it comes to birth and healthcare- chose to have their babies at home:

Famous People who have had babies at home:

Demi Moore 

Meryl Streep

Joely Fisher: 

"I had this miraculous birth...I decided to have her at home and had a lot of friends around, and of course, her father was there. And of course, the doctor, the doula, the midwife, the butcher, baker, and candlestick maker."

Julianne Moore

Pamela Anderson

Gisele Bundchen:

 "Giving birth was the most intense and life-changing experience of my life. I am blessed to have had the opportunity to deliver at home, surrounded by love and where I felt safe. It was a really great experience. I never felt so vulnerable but so strong at the same time."

 

Ricki Lake

Woody Harrelson's wife, Laura Louie

Jennifer Connelly

Maria Bello:

"I remember the night he was born.  It was 22 hours of labor and a thunderstorm with nothing more than an aspirin. I never felt so much love and fear at the same time... I had a midwife, and after 12 hours I said, 'We’re going to stay here and stick it out.' Believe me, there were times where I wanted to say, 'Get the ambulance — I’m done.' But then I thought, 'I can do anything for 24 hours' and it was almost exactly 24 hours."

Cindy Crawford

Jim Gaffigan's wife

Alyson Hannigan: 

"It wasn’t something I knew I was going to do before I got pregnant, but once I was pregnant, I did more research, and I watched The Business of Being Born, and that sealed the deal. It’s not the right choice for everyone, but it definitely was for me. I never wavered on it. I knew if I needed to go to the hospital I would, but thankfully everything went well, and it was a magnificent experience."

Alanis Morrisette

Evan Rachel Wood

Erykah Badu: 

"Maybe to some it's scary, but preparation is the whole key. I expected success and health, so I made sure I surrounded myself with it. By the time I had my third baby, childbirth seemed a very natural part of life to me."

Thandi Newton

Nelly Furtado

Evangeline Lilly: 

 "We decided to have the baby at home because we wanted it to be a natural birth, and it turns out that it was 30 hours of natural."