Posted by: kimberlyloomis | August 23, 2012

Review: Beyond the Sling

In this day and age of detachment parenting Mayim Bialik, or Dr. Amy Farrah Fowler for you Big Bang Theory fans, attempts to address the myths, the trials and tribulations, and the benefits of attachment parenting.   As an advocate for birth empowerment as well as a prosthelitizing believer in natural childbirth the words of a woman with a PhD in neuroscience held allure.  To me it was about finding someone who had done a home birth, breastfed (even did extended breastfeeding), and unschooled her children who was so credentialed the world was sure to stand up and see the validity in what so many of us non doctorate holding moms already know: learning is innate, our bodies are designed to propagate our species as well as take care of our young, and submitting to your babe’s needs does not mean you are permissive.

Unfortunately, when I caught a few clips of her on television while promoting this book it seems as though the world does not want/need credentials to view these things with validity, and instead seems to hold fastidiously to the notion that kids should be separate and independent of the parent almost from birth – the sex life of the parents holding higher import than bonding of each parent with their children.

This book takes on the issue of a sex life and the family bed with anecdotes and personal examples, but the most important aspects -the biology, anthropology, and psychology of infants-  are dealt with in both a blend of science and personal outtakes from her life.   Take, for example, this bit from her chapter about gentle discipline and particularly about the notion of telling a child to stop crying/discouraging them from crying:

Tears have been found to contain small amounts of cortisol, the body’s stress hormone.  Crying may serve to release tension and stress from tiny bodies, and it is normal and healthy.  Seeing crying as a natural and reasonable form of communication removes the stigma our culture associates with it.  It may not be the most effective communication tool, but it is sometimes the only one small children have in their limited arsenal.

As was typical of her work this was followed up with a bit of psychology as well as an example from her own family:

Some family and friends found it funny (or perhaps uncomfortable or unsettling?) and mocked our boys’ crying, albeit playfully.  This is, frankly, not at all helpful, and it perpetuates the idea that children shouldn’t cry when we think they shouldn’t.

This next bit I’m sharing simply because I found it beautifully stated – from the same section, but in a subsection called “Violence”:

The distinction between hitting in anger (as in “the heat of the moment”) as opposed to hitting as part of a purportedly “calm,” regimented spanking is an academic one but not a practical one; both methods involve hitting a child, thereby causing a tiny brain to release neurotransmitters and hormones to cope with pain and fear while suppressing fight/flight pathways.  The simplest reason we don’t hit is this: hitting is hitting.  It’s not love.  It’s not teaching.  It’s hitting.  You can say you are hitting with love, or that you are using hitting to teach something, but it’s still hitting.

Her sections on breastfeeding and natural childbirth are equally important, although for more information on the benefits of these practices I can not recommend Pushed or Born in the USA (I will review Dr. Marsden Wagner’s book at a later date) enough.  It is my sincerest wish that more people would read this book with an open mind.  Kids have nothing to lose by a parent reading this and taking much of its wisdom to heart and everything to gain.

Have you read it?  Have a favorite or not so favorite section?

Posted by: kimberlyloomis | March 7, 2012

Long Overdue

I wish to apologize for my long absence from this blog.  It is not due to there being a lack of material that this has been so long without an update, but rather solely due to many complications in my personal life which has led me to feeling quite overwhelmed.  First, the new addition who is now six months old is regularly testing my ability to juggle as well as my low back strength (any questions of sanity pre-dated this more recent bout of poor sleep) and second, the intense interest I have in so many subjects and the issue of knowing what to do about all of them.  There was a brief thought about combining all my interests and then realized THAT wasn’t a good idea.  So, here I am.  Keeping this blog open and deciding what to keep my mouth shut about.

Now that the awkward transition is over I wanted to share with you an interview with someone who is sure to be my new hero, Mayim Bialik.  Before we get to that I was wondering:  How do you think celebrities advocating homeschooling/unschooling, homebirth, and attachment parenting affect public perception?  Does it depend upon the celebrity?  Perhaps whether or not they have a Phd?

Mayim on Good Morning America

 

Posted by: kimberlyloomis | September 29, 2011

Midwives: To Regulate or Not?

The very notion of regulation comes about in the form of a kind of guarantee of safety.  Midwives think the regulation will keep them safe from government persecution/prosecution, while the populace thinks that by having licensure for midwives would keep the riffraff out of the profession and therefor make the consumer safer when deciding upon a birth practitioner.

But can regulating this field really make all of us safer?  The agencies involved in regulation in the US are plentiful, but for the idea of safety there is no agency that can really compete with the FDA.  It’s entire existence is based upon the notion of approving (or not) medications, putting in place regulations on farms and food manufacturing/processing plants that are all meant to keep things better for all of us consumers.  The first thing that comes to mind on the pharmaceutical front regarding the FDA is cytotec.  It’s use in induction has been spoken against by the FDA due to how much risk it poses to laboring women and their as yet unborn children and despite this doctors have and still continue to use it (keep in mind it was NEVER approved for this use by the FDA).  This organization does not lack in power as is noted by its ability to seize private property like birthing tubs, conducting stings then raids upon Amish farmers who sell unpasteurized milk, or in issuing recalls when it comes to drugs (even if prior approval was granted) or food packaged in approved plants, heck they can even grandfather in substances that were in use prior to their existence giving a false sense of safety – so why do they not prosecute physicians?

The doctors who have used drugs against label use with dire and disastrous consequences are still practicing.  Suits brought against doctors are often pitched in favor of the physician in that the insurance companies and/or hospitals are all invested in protecting their practices and as such will protect those who work for them.  Unfortunately, this often means suits of this nature are dealt with quietly and through settlements and most frequently do not result in anything more than a review of the doctor through a medical panel that is comprised of other doctors.  Doctors are regulated through licensure and all the trappings that come with it: accredited (by government) institutions, study, practicum hours, board certification – and yet we still have the above problem.

By the same token, when midwives have been prosecuted its been at the behest of the state medical boards in which they work – those boards usually comprised of doctors – not by the families.  While some states are somewhat friendly to midwives in many (this includes my own- CT) the midwives walk a line whenever they decide to help with homebirth.  There currently is no regulation in my state, but when it is the state that is persecuting a group of practitioners for doing what is best for their client (these suits only come about when midwives have transferred their client to a hospital) then whom do we trust to set up parameters that are in our own best interest?  The same individuals who perpetuate policy that has resulted in a national 32% c-section rate and a potentially linked increasing maternal death rate? Those same individuals who, at the very least, are engaging in suits to either scare midwives away from taking on homebirth clients (and thus forcing healthy women to have their children in hospitals and be subject to hospital policies) OR to deter them from making sound ethical decisions like bringing a woman and child to the hospital when it is imperative it happens?

Individuals must understand that when considering regulation it is in the regulators’ hands (politicians, people appointed by politicians/in a politically favored group) we are placing our faith in; that what they decide will be in our best interest, that it will be best for our families, our children.  And that when an organization looks to regulate who assists births they are looking to regulate birth.  We can not seek to control those going into a field (in this case midwives), or simply control those who are practitioners, without de facto attempting to control what they do.  And what they do is aid women in having babies. There is no way to craft regulation of this kind without it affecting the choice of the pregnant woman.  None.

Birth belongs in the hands of the pregnant woman, the partner whom supports her/she trusts in – no one else’s.  It does not belong to any professional, midwives or doctors (most certainly not politicians), but to the individuals who will be laboring and those others they trust.  No one else.  Do we not think ourselves and others as completely capable of making sound decisions regarding our/their bodies?  Our children’s?  I am just arrogant enough to say that I think I know better for myself and my family than a person who I do not know, whose education I do not know, whose bias is in their own favor – not mine.   I think you do, too.

The only impediment I see to this is the unfortunate stranglehold on information in the US.  Information that seems strangely difficult to come by given how absolutely vital it is for each medical consumer to obtain in order to have true informed consent.

Posted by: kimberlyloomis | September 8, 2011

The Home Birth Experience

It has been a while since I posted and, while I do have that regulation piece almost ready, I really wanted to talk about the oh-so wonderful and new experience of having a little one at home.  First, let’s begin with one simple thought:  Birth is natural, women’s bodies are designed to do it.  Second, imagine only having those people you know, trust, and have specifically invited to the birth of your child.

While I acknowledge that there is pretty much no compunction to be modest when in active labor the truth is I get twitchy when there are people around me I don’t know when I’m my animal self.  Birthing is the most primal and natural act available to our rather overly sterile society and so I use the term “animal”, not as a means of expressing condescension, but as a means of ownership and empowerment of this basic truth.  At the hospital it was this level of discomfort, this intense self awareness and hyper sensitivity of those around me that drove me to wanting the sterile experience: No moaning or screaming in pain (epidural), wearing a gown down to my knees so some PA/doctor I didn’t know could look up it, lying on my back because that’s exactly how to be a “good patient”.

So, there I was at 11:30 at night sitting on a balance ball in the living room telling him about my contractions so I wouldn’t obsess over the time.  Several episodes of Glee were kind of watched until he finally insisted on calling the few people we wanted there.  Our midwife was first, of course, the second was a dear friend who agreed to come over at whatever unseemly hour to be with and support our three year old.  Those calls were made at one in the morning.  Everyone was there by 2:15 (I think- my memory of that is kind of hazy).  The “everyone” in our bedroom while I labored and delivered?  My two lovely midwives and my husband.

The balance ball had been foresaken sometime before everyone arrived and I had walked my laboring butt up the stairs into the bedroom to pace, lean on the bed or bureau, rock and moan while really hoping whatever hubby was doing somewhere else wouldn’t take him too long.  Now, while I would love to regale folks with tales of colorful verbiage and screaming – there wasn’t any.  Oh, sure, there’s no denying it was in my head when I looked around and for SOME REASON my hubby WASN’T THERE RUBBING MY BACK – but apparently I’m polite when I’m in pain.  Who knew?

Things went really fast.  And by fast I mean my daughter was born into her father’s arms at 3:11am.  One of the midwives managed to get gloves on, hubby didn’t (no time for that – and I do remember that part since it was the only time when I really wanted to yell “SHUT UP!”  Apparently the two or three pushes it took to fully deliver the little one had everyone rushing.  Loudly.), while the other grabbed for the camera to take birth photos and managed to not get a single one.  I would have loved photos, but I have to admit that I’m pretty content that things went so fast they didn’t happen.

This littlest member of our family came out pink and squalling (babies are typically born blue because they don’t breathe before being born), APGARs were tens.  My husband handed her to me as she had come out, attached, covered in the process of birth.  She was never taken from me.  I went from my knees at the end of my bed to lying down for the first time – but she was now in my arms.  Immediately her father snuggled in as I put her to my breast, the placenta being quietly delivered somewhere around that time.  My husband was not squeamish, he wasn’t pushed aside by an eager hospital staff, and so he was an integral part of the delivery of his own child this time.  He caught her, handed her to me, cut her cord, and weighed her.  This birth was a family experience in every possible way with each moment beautiful and full of the technicolor of unadulterated life.

It was two hours later that our son woke up and he was brought in to meet his sister for the first time.  That night he asked to sleep in the bed with me and “the nice baby” even after avoiding the room all day.

There was nothing I would change about the experience.  Nothing at all.  [I didn't hear anyone in my family complaining about the lack of having to pay for parking when they visited later, either.]

Posted by: kimberlyloomis | August 18, 2011

Cytotec/Misoprostol and Labor Induction

This very popular and unapproved medication for labor induction is still used by many physicians today.  In many instances patients are not informed of the risks of this particular drug nor made aware that the drug manufacturer has never pursued approval by the FDA for this particular use BECAUSE of the dangers it presents.  It is important that if you or someone you know is considering a non-medically indicated induction (or, heck, even a medically indicated one) that you be aware there is no approved protocol for the medication and that the FDA itself has come out in support of the manufacturer in asking doctors to not use the drug for induction.  Much of the article posted below contains data that might be considered dated, however there is still no approval, official guidelines, or clinical trials indicating the safety of this medication for a laboring woman and her unborn child.  Nor, on any thread I have come across do the medical professionals site such a study to support their claims.  I can not say this strenuously enough: This is your life and your child’s and the decisions you make about how they come into this world need to be based upon as much information as you can muster should the time be available to do so.  Now, on with the post.

In my previous post regarding labor induction I briefly mentioned cytotec/misoprostol, a drug used for cervical ripening, and given the prevalent use of it thought it warranted its own post.  Inserted vaginally, known as “the abortion drug”, its prostaglandin properties soften the cervix; orally it is used for ulcers although, according to some studies, the drug can be used orally for induction as well.

This particular drug has a lot of controversy attached to it as it has never been approved by the FDA for the use of labor induction and, in fact, the manufacturer of the drug even went so far as to issue a statement warning against it.  The label of the drug even demonstrates rather compellingly why it should not be used for this purpose (the full label can be found here):

Labor and delivery: Cytotec can induce or augment uterine contractions. Vaginal
administration of Cytotec, outside of its approved indication, has been used as a cervical
ripening agent, for the induction of labor and for treatment of serious postpartum
hemorrhage in the presence of uterine atony. A major adverse effect of the obstetrical use
of Cytotec is the hyperstimulation of the uterus which may progress to uterine tetany with
marked impairment of uteroplacental blood flow, uterine rupture (requiring surgical
repair, hysterectomy, and/or salpingo-oophorectomy), or amniotic fluid embolism. Pelvic
pain, retained placenta, severe genital bleeding, shock, fetal bradycardia, and fetal and
maternal death have been reported.

There may be an increased risk of uterine tachysystole, uterine rupture, meconium
passage, meconium staining of amniotic fluid, and Cesarean delivery due to uterine
hyperstimulation with the use of higher doses of Cytotec, including the manufactured 100
mcg tablet. The risk of uterine rupture increases with advancing gestational ages and with
prior uterine surgery, including Cesarean delivery. Grand multiparity also appears to be a
risk factor for uterine rupture.

The effect of Cytotec on later growth, development, and functional maturation of the
child when Cytotec is used for cervical ripening or induction of labor has not been
established. Information on Cytotec’s effect on the need for forceps delivery or other
intervention is unknown.

According to the American Academy of Family Physicians (AAFP) “Misoprostol (Cytotec) is a synthetic PGE1 analog that has been found to be a safe and inexpensive agent for cervical ripening, although it is not labeled by the U.S. Food and Drug Administration for that purpose.”  There are no studies sited to support this claim and upon looking for them myself I found none that meets the threshold for a solid scientific study.  One paper I did find, however, worked as a meta-analysis.  As a consumer it is important to understand that this kind of study is not the same as bonafide clinical trials, but rather it is a way of lumping studies together that have different methodologies and potentially different results to come to a statistically significant one which can be marketed a certain way.  Basically, it’s a way of the authors of a paper to make a point without having to adhere to the rules of a true scientific study and the necessary approval for it.

In one such paper the authors found that the uterine rupture occurred in 5.6% of women who had a previous cesarean section and were induced with vaginal misoprostol.  Bear in mind that this is in comparison to a 0.2% rate amongst a group of women induced with a different prostaglandin called dinoprostone (a drug that is approved for the use of cervical ripening, however more costly than misoprostol and has to be kept at colder than room temperature).  All trial groups were incredibly small with one of the studies cited stating this:

BACKGROUND:

Although induction of labor in women with prior cesareans is controversial, we compared misoprostol to oxytocin in such women in a randomized trial. The investigation was terminated prematurely because of safety concerns.

CASES:

Disruption of the prior uterine incision was found in two of 17 misoprostol-treated women. The first woman underwent repeat cesarean delivery at 42 weeks because of fetal tachycardia and repetitive late decelerations. A 10-cm vertical rent in the anterior myometrium was discovered. The second woman underwent induction for fetal growth restriction. Loss of fetal heart tones and abnormal abdominal contour prompted emergent cesarean for suspected uterine rupture. An 8-cm longitudinal uterine defect was found.

Understand that some of these studies have been done as long ago as 1998 while the AAFP’s endorsement of it was in 2003.

I know this is already a long post, but the conversation about ob/gyns using this drug can not end without hearing from Dr. Marsden Wagner:

For more of his words I encourage you to check out his article on Midwifery Today.

Posted by: kimberlyloomis | August 9, 2011

Labor Induction

Taken on its own induction seems like a wonderful convenience and benefit of living in the late 20th Century/early 21st.  One can plan the date labor is to occur ensuring those we love will be around to support the laboring woman as well as to greet the new life making their entrance into the world as we know it (sometimes it is the estimated weight that is one reason people consider induction).  Every intervention contains a risk and so the first thing to consider must therefor be whether or not the mother or the child’s life is at risk if an induction is NOT performed.  In research there is also something known as the risk-benefits ratio which would take into consideration whether or not the risk of induction is greater or less than the benefits to the mother/child.

Obviously, when the risk of waiting for labor to occur naturally is greater than that of the issues of induction then nothing else needs to be considered, but in those instances when it is a matter of true choice I believe in being an informed consumer.

Labor induction can be done a few different ways:

Stripping the Membranes: Aside from how incredibly awkward that sounds this part is ultimately easy.  The physician uses a gloved finger that, once inserted into the woman’s cervix, will then move the amniotic sack away from the uterine wall.

Cervical Ripening:  Roughly speaking, this is the softening of the cervix that occurs naturally in labor.  When inducing this is often done pharmacologically with either a prostaglandin or a synthetic prostaglandin.  [There will be a follow up post on the particular agents used here, particularly cytotec/misoprostol as this particular drug has a disconcerting popularity amongst physicians in the realm of induction when a woman does not meet the requisite number on the Bishop Score.] Natural methods of cervical ripening are as follows: herbal supplements, intercourse, hot baths, castor oil, enemas, breast stimulation, transcutaneous nerve stimulation/acupuncture.  There are also mechanical methods such as balloon devices, etc.

Bringing on Contractions:  This involves the use of a drug, usually pitocin, administered through an IV.  The natural agent formed by the body in labor is called oxytocin.  The differences between the two are very important to note and so here is some information about those while below I’ve copy and pasted the two I think of as most important:

  • Pitocin prevents your body from offering endorphins. 
    When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.
  • Pitocin lacks a peak at birth. 
    In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.

Breaking the Laboring Woman’s Water: This is kind of self explanatory but basically this is when a doctor uses a special instrument to break the amniotic sac.

There’s an interesting article about reasons to avoid induction when not dictated by medical necessity, but here are a few of the more compelling reasons to consider an optional induction carefully:

The last few weeks of pregnancy are critical to both lung and brain development. Complications of elective deliveries between 37 and 39 weeks include:

  • Increased NICU admissions
  • Increased respiratory distress and TNN (transient tachypnea of the newborn)
  • Increased need for ventilator support
  • Increased rate of sepsis
  • Increased feeding problems

For the matter of a child being “too big” we know that ultrasound estimates in sizes are very often inaccurate (hence, they’re estimates not a precise recording) with even ACOG stating, “Weighing the newborn after delivery is the only way to accurately diagnose macrosomia, because the prenatal diagnostic methods (assessment of maternal risk factors, clinical examination and ultrasonographic measurement of the fetus) remain imprecise.”   Rarely do I have an occasion to quote ACOG on much of anything positive, but the research has to be irrefutable if even they made such a statement and recommended against induction for the reasons of “too big”.

Of course, this is still a matter of choice and so it is up to each mother to make the best one for herself and her baby.  It is merely my hope that I have provided some information that would allow for truly informed decisions to be made and to possibly give pause before agreeing to something that, in many instances in the US, is medically unnecessary. 

Posted by: kimberlyloomis | July 26, 2011

The Naturopath I Never Thought I Would See

I am going to have a home birth, I have two midwives I love and adore, my kid is vaccinated, the new little one WILL be vaccinated (against some things), and never did I think I’d see a naturopath.  Ever.  My mother was a nurse, I see a doctor when I’m sick (really sick, not like “have a cold” sick), and I was raised to trust in medicine.  I’m one of those people who really thinks some vaccines are prudent and know enough to understand that the tried and true ones are not to blame for many of the maladies today and yet – I brought my son to see a naturopath.  To say that I am grateful for this woman doesn’t even begin to do it justice.

Before the appointment my very opinionated three year old told me he didn’t want to go to the doctors’ because they were bad; he wanted to be mean to the doctors.  I’ve never said this to him despite those being my thoughts exactly about the last doctors he saw.  You see, I didn’t want to poison him against an entire profession when I know there are some good ones out there even if I hadn’t met them yet.  The blessing of technology allowed for me to pull up this doctor’s picture on my phone (via her website) and ask him what he thought.  His response?  “She looks nice.  I want to be nice to the doctor.”

Everything went without incident.  The office was to his approval as was the doctor who let him play while she spoke to Mama and Dada.  Then we had to do some examining.  He was okay until he had to lay down on the table and that’s when it struck me – he couldn’t bring himself to because he was scared.  The last time he did that we held him down to have an unnecessary blood drawn.  I can not explain to you the level of guilt I feel over this, to see how trauma has manifested in my son.  This is not something I would wish upon anyone.

There is no doubt in my mind that the other physicians would have forced the issue and had him lay on the table, to hold him down so they could do what they needed regardless of his fear.  Dr. Demanski asked if he would prefer to lay on the floor “near the whale” so she could feel his stomach instead of be on the table.  He readily agreed and a palpating she went.

There are many ways we can have our eyes opened to the beliefs we hold to be truisms in life, but for me the best and most terrifying ones I have confronted this year have been in the form of simply experiencing something else.  In the instance of this particular care provider I learned that I don’t have to live in fear for my child; with my midwives it was that birth and pregnancy are normal and to be cherished.  Both caregivers start off on the premise that the person(s) are okay, that we are whole and healthy – not that there was something wrong and in need of diagnosis.  Each individual before them are PEOPLE, we are not merely a sum of our medical histories, or waiting for the correct solution to the problem that is us.  To realize how infrequently those we go to for “health care” really involve care in their practice, the veritable inhuman way we’re processed and labeled, was something I had become somewhat desensitized too without ever having known it.

I almost wept when my son’s new doctor (how grand it feels to say that) spoke to him, used words he repeated to me later without fear but in fascination.  As I think about how my midwives asked me today if there were any special requests for the upcoming birth the reaction is the same.  When did life stop being cherished and start being factory made?

 

Posted by: kimberlyloomis | June 30, 2011

Informed Consent – Two Stories

My experience through obstetrics with my first child was pretty standard except for one thing: My doctors told me if I wanted to induce or schedule a c-section I would have to find another practice.  I trusted them immediately.  All diagnostic tests, the many pelvic exams were submitted to readily.  They were the experts, not I.  I was only the person who was going to carry a child to term (hopefully) and give birth.  There were no discussions about risks of tests, what their false positive results would be, or even if they actually helped anything beyond give them the ability to diagnose something early (or not).  Looking back on the experience it was a highly medical pregnancy and birth (although much less than many have) complete with my obedient consent.

The practice I saw at the beginning of this pregnancy, however, was a different matter simply because *I* was different in it.  Okay, this is not meant to give them a pass as the doctor I saw truly seemed high intervention and to want to encourage certain behaviors in her clients.  But I asked questions this time.  Talking about risks, asking why I needed certain tests were things I felt empowered to do this time around.  What it revealed to me was how happy she was to bill for all these things while she had no idea or no willingness to talk about risks.  There was no informed consent nor was there discussion of her credentials.

Upon first meeting the midwife I wound up choosing she gave me a booklet to read over that contained her views, her experiences, the worst case scenarios she’s dealt with, and all the equipment she would bring with her to the birth.  I knew I wanted her from the first.

Each visit we talk about what’s going on; blood pressure and pulse taken, belly measured, baby palpated and the heart is listened to.  Lately this means someone always gets kicked/punched by the baby, but anyone who knows me can pretty much vouch for the fact that this should probably be expected.  There are tests that are considered standard during pregnancy and for each I’ve gotten forms talking about the benefits of them and any risks (if applicable) there are.  Nothing is done without me knowing the pros/cons.  None.  And each one is something I have to opt in for or opt out of.

Most recently I got hand outs about Strep B, Vitamin K, eye drops, and the glucose test.  When I was reading about Vitamin K, the intramuscular shot delivered to newborns, I almost leaped out of my chair to do a happy dance.  This was informed consent.  The risk of my child having the clotting disorder Vitamin K is supposed to help (myths of this will be discussed in a later post) as well as what the shot can do and what it won’t do were addressed in clear/concise language.  I even got to take all the forms home before I had to sign.  Can you imagine- 32 years of doctors and this is the first time I’ve received true informed consent?  No smudging of statistics, all relevant ones disclosed openly and easily researched…

Why aren’t the MD’s doing this?  How is it that pediatricians aren’t required to do this prior to giving ANY shot to your child?  How can they justify any testing without talking to you about cost and the risks/benefits ratio?  Why don’t we as consumers demand it?

Each visit with the women I have selected to assist in this birth reaffirms to me that this is what care should always be like.  Information freely, openly given without prompting.  Fear mongering- non existent; trust springs from all of the above.

Posted by: kimberlyloomis | June 22, 2011

A New Awareness

As I wrote in the first part of my Journey to Home birth there was, what I felt, a suspicious requirement of no videotaping the birth of my child at what would have been the hospital of the event.  Now that I am reading a wonderful book called Born in the U.S.A. by Marsden Wagner, M.D., M.S. I thought I would share with you this tidbit of information he offers on page 24:

…ACOG’s Committee Opinion number 207, “Liability Implications of Recording Procedures or Treatments,” published in September 1998.  The opinion addresses the issue of hospital births videotaped by the family.  It includes the statement, “Recording solely for the purpose of patient memorabilia or marketing is not without liability-the Committee stonrgly discourages any recording of medical and surgical procedures for patient memorabilia.”  In essence, ACOG is recommending that doctors and hospitals refuse to allow women and families to videotape their babies’ birth for fear of litigation.  In ACOG’s world, protecting its members is a higher priority than women’s rights or family values.  Its fear is so strong, it cannot accommodate the need of families to record one of the most important events in their lives.  For this reason, recommendations from this organization cannot be considered the gospel.  We must always consider them carefully in the light of their primary purpose-protecting the welfare of the tribe.

I have a feeling this book will espouse even more valuable information than Pushed.  Please stay tuned for a review in the next couple weeks as well as more about the home birth journey.

Posted by: kimberlyloomis | June 16, 2011

An Update about the FDA Birthing Tub Situation

The FDA has released the birth tubs that had been held for two months AND are not classifying them as medical devices.  Yahoo!  Little had I known that ACOG, while only quietly in the background on this as any good lobby would be, had apparently made statements regarding water birth.  Their stance on home birth is pretty obvious, but in case you didn’t know I would like to share with you their views.

What is the ACOG’s position on home births?

The ACOG acknowledges that both labor and delivery, “while a physiologic process, clearly presents potential hazards to both mother and fetus before and after birth.” The ACOG’s statement continues to specifically state that “these hazards require standards of safety that are provided in the hospital setting and cannot be matched in the home situation.” The ACOG supports those actions that improve the experience of the family while continuing to provide the mother and her infant with accepted standards of safety available only in hospitals. These safety standards are outlined by the American Academy of Pediatrics and ACOG. Women considering home births should investigate the standards of the midwifery or birthing organization to which the birth attendant belongs.

The American College of Nurse Midwifery is more flexible, supporting home births within certain defined parameters. They refer to this as a “planned home birth.” They support the provision of protocols by hospitals, physicians, and insurers which define strict parameters for the care of patients at home.

What are the benefits of water birth?

ACOG’s Committee on Obstetric Practice addressed the issue of warm-water immersion for laboring women and for delivery of infants. The Committee felt that there are “insufficient data, especially concerning rates of infection, to render an opinion on whether warm-water immersion is a safe and appropriate birthing alternative.” The Committee also felt that “this procedure should be performed only if the facility can be compliant with OSHA [Occupational Safety and Health Act] standards regarding infection.” This would include the specific tub and water recirculation systems used. Also, warm water exposure over time can cause hypotension, and careful attendance by an assistant is necessary to prevent drowning. The American College of Nurse-Midwives has no current position on either hydrotherapy or water births.

One has to find that just a tad laughable when one looks over other organizations’ stances on the matter.  Here’s a few from the American Pregnancy Association:

What are the risks (of water birth) to the mother and baby?

Over the last 30 years as water birth has grown in popularity, there has been very little research done to determine the risks of water birth. Some studies have been done in Europe demonstrating similar perinatal mortality rates between water births and conventional births.1 According to an article written by the Royal College of Obstetrician and Gynecologists, there may be a theoretical risk of water embolism, which is when water enters the mother’s blood stream.2 Though the British Medical Journal is 95% confident in water births, they do see a possible risk for water aspiration. If the baby is experiencing stress in the birth canal or the umbilical cord becomes kinked or twisted, the baby may gasp for air, possibly inhaling water into the lungs.3 This would be rare because babies do not inhale air until they are exposed to air. They receive oxygen through the umbilical cord until they start to breathe on their own or until the cord is cut. The final potential risk to consider is that the umbilical cord could snap as the baby is brought to the surface of the water. This is preventable by using caution when lifting the baby up to the mother’s chest.

 

Coming next week:  More about the home birth journey (the prenatal care received) and hopefully a book review!

What are your thoughts on home birth?  Know anyone who had one?  What about water birth? 

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