Heads Up On Infant Mortality

August 15, 2009 at 1:49 pm (Montana, advocacy, awareness, childbirth, data)
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A Notice from the International Center for Traditional Childbearing (ICTC)

ICTC is observing September’s Infant Mortality Awareness Month; JOIN ICTC IN THE “HEADS UP” ON INFANT MORTALITY AWARENESS CAMPAIGN” AND KNIT AND CROCHET HATS TO REFLECT THE INFANT MORTALITY RATE FOR VA, OR, FL, PA, CA, NM AND D.C.

Healthy Babies Are Everyone’s Business and I know that you care.

In 2008, over 27, 600 infant died before age one, most of the deaths were preventable. Monroe, president and founder of ICTC said, “factors that contribute to the higher rates of infant deaths include: premature births, low-birth weight, poverty, mis-education about proper food choices, poor pre-conception health, late prenatal care (beginning prenatal care late in the 2nd trimester,) less than 5 prenatal visits, high blood pressure (causing restricted blood flow to the placenta) and hypertension formally referred to as pre-eclampsia, SIDS, failure to thrive syndrome and accidents”.

booker1[In Montana, 70 babies die before the age of one.]

ICTC is asking every able body to join us in knitting or crocheting at least ten infant hats and sending them to the ICTC State Representative in your state by September 15th. The ICTC State Representatives are listed on WWW.ICTCMIDWIVES.ORG, or you can send them to the national at ICTC PO Box 11923, Portland, OR 97211.

The hats will be displayed at an infant mortality awareness rally in the week of September 26th. At the end of the public awareness project the hats will be given to infants as “Going Home” gifts when they leave the local NICU units. What a comforting gift to an ill baby and support to worried parents. By participating in the “Heads Up” Campaign, we can increase awareness about the causes of infant mortality and then create the solutions to reduce infant deaths.

The International Center for Traditional Childbearing (ICTC) is an international organization established in 1991, and head quartered in Portland, Oregon. It is an infant mortality prevention, breastfeeding promotion and midwife training organization. The mission is to increase the number black midwives, doulas, and healers, to empower families, in order to reduce maternal and infant mortality. ICTC educates on the causes of infant mortality and provides solutions through education, direct services and training midwives and Full Circle Doula Birth Companion Training.

This campaign is being co-sponsored by Birthing Hands of DC and other supporters.

To learn more visit http://www.ICTCMIDWIVES.ORG or call 503.460.9324

I didn’t actually find more info about this via the ICTC website.  However, Birthing Hands of DC has info on their site as well as links to easier patterns that you can knit and crochet, even a 10-minute preemie hat.

And I know that you have 10 minutes to make a hat for this wonderful cause!!!

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Hospital VBAC: The Don’t Forget List

July 21, 2009 at 7:33 pm (VBAC, advocacy, awareness, cesarean, childbirth, empowerment)
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[NB: Most of what I've written below applies specifically to the hospital venue.]

We all know the books to read when preparing for a VBAC or the videos that will help us gain confidence in our ability to give birth vaginally.  We all know to pack our hospital bags, including our mental focus recordings, and bring a copy of our birth plans.  We all know that we need a doula with us, one who is experienced supporting VBACing women. 

Many of us even know that we need to talk powerfully about our upcoming VBACs.  “I’m trying for a VBAC” is not nearly strong enough.  Replace that with “I’m planning a VBAC.”  Did you birth the first time with “I’m gonna try to give birth vaginally” going through your brains?  Probably not.  I myself never doubted my ability to give birth naturally.

Anyway, I digress.  In addition to constructing a clear but concise birth plan, you need to also do the following:

  1. obtain a copy of the hospital’s VBAC consent form; review it and make changes as you see fit; give a copy to your care provider and bring a copy with you to the hospital
  2. obtain a copy of the hospital’s cesarean consent form; review it and make changes as you see fit; give a copy to your care provider and bring a copy with you to the hospital.  My hospital doesn’t have a cesarean consent form.  They have you sign their generic “invasive procedure” form which I find unacceptable.
  3. discuss the modifications you’ve made to the above forms with your care provider(s)
  4. especially if you’re NOT married, make sure your will is in order
  5. make sure you bring a medical power of attorney in case medical decisions need to be made and you are incapacitated

Bruce Flamm’s VBAC consent form appears everywhere on the internet.  I personally didn’t find it sufficient, but it is a place to start.  Here’s a great post - an actual cesarean consent form with some added commentary from the blogger.  I’ve taken this form and modified it so that (1) consent is not given for elective cesarean; (2) consent is withheld until the situation would arise for an emergent cesarean; (3) my husband is named as having power of attorney in the case of an emergency where I was unable to make my wishes known.  I also added some things that were missed on the form.

Please ask questions or offer your own suggestions!

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NJ Rules That Mothers Have No Rights in Childbirth

July 21, 2009 at 7:11 pm (awareness, cesarean, childbirth, legislation)
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This is too complicated and extensive to reproduce here, but essentially a NJ mother’s refusal of diagnostics and “treatments” in childbirth (practices that aren’t evidence based) as well as her refusal to allow a cesarean resulted in her newborn baby being taken from her.

Interestingly enough, the initial reason for her losing her baby (refusing an unnecessarian – the baby was born vaginally without incident) was thrown out of court.  However, this woman has a history of mental illness, and evidently the court found this history compelling enough to take her baby away for neglect and abuse.  However, she never had a chance to neglect or abuse her newborn since she was taken away immediately following birth.

From what I can tell, she ended up in this horrific situation because:

  1. history of mental illness (this is terrifying; I’m currently medicated for depression and was advised to stay on my meds during pregnancy – do I risk losing my babies at birth if I go AMA?)
  2. refusal of standard procedures in this hospital such as epidural and continuous electronic fetal monitoring
  3. squirming around as hospital personnel tried to MAKE her get an epidural
  4. refusing a cesarean
  5. kicking the OB out of her L&D room

To read more about this case as well as interesting comments from the peanut gallery, see Wise Law Blog’s post and the Volokh Conspiracy’s post.  (Unfortunately the commentary at VC’s site turned into a big abortion and feminism flame war between Dillan, Theo, and later John.)

I will say that this family took their chances going to a hospital (St. Barnabas was featured in Jennifer Block’s Pushed) with a 50% cesarean rate.  Additionally, I’m not sure if they had a clearly outlined birth plan (possible protection in court?) or cesarean “consent” form which would indicate under which, if any, circumstances she would agree to a cesarean.  She also should have had a doula.  This family really did go to McDonalds assuming they could get steak anyway.  Not good.

Tragic.  Terrifying.

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Whoa! This pelvic pain sucks!!

July 20, 2009 at 7:18 pm (pregnancy)
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I’m 34 weeks pregnant, so these girls need to stay put for at least another couple of weeks.  But I’m in so much pain.  My entire pelvis feels WRONG.  I know part of it is pubis symphysis pain, but then there’s this other pain that started about a week ago.

female_pelvis1Ok, what is this pain?!?!  Not only do I hurt in the front (pubis symphysis) but also in my groin on both sides.  The worst thing, besides moving in general, is to sit on something that’s hard.  It’s like I rode a century on my road bike in one day without training.

It it the psoas?  Is it the sacro-iliac joint?  Here’s a link to some possible conditions.  Ice… heat… ice… heat… can’t lie down… can’t sit up… can’t walk.  (Can’t is an over-statement.  I’m still mobile, but it hurts like hell.)

Here’s a great resource for women suffering from pubic pain:
http://www.plus-size-pregnancy.org/pubicpain.htm

10 Comments

Undue Burden and Access to Evidence-Based Maternity Care

July 18, 2009 at 4:13 pm (Missoula, Montana, VBAC, Western Montana, advocacy, awareness, cesarean, childbirth, empowerment, homebirth, legislation, midwifery)
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I’ve been reading Jennifer Block’s Pushed and really enjoying what a journalist can bring to childbirth advocacy.  I’ve learned many new things - what a nice surprise.  It’s not that I’ve learned everything there is to know about childbirth, but I think I got “stuck” in reading books that basically said the same thing but in different ways.

A new term for me is “undue burden.”  Wikipedia’s definition falls short, in my opinion, but between Block’s discussion of it and other internet sources, I’ve come to understand it better (at least from a layperson’s perspective) and how it might apply to a LOT of women in the childbearing years.

I’ve learned that undue burden has been applied to reproductive rights issues, specifically abortion.  However, I don’t think we advocates have worked this “angle” enough in terms of childbirth choices.  Abortion rights activists have advocated for “morally agnostic undue burden standard[s]” [1]  Likewise, I would call for an “agnostic” undue burden standard applied to childbirth.

The undue burden standard is utilized in American constitutional law and historically has been applied in such areas as abortion rights, affirmative action, tax laws, and more.  The Supreme Court applied this concept to abortion, ruling that a state can’t put up so many obstacles to abortion procedures that a woman’s individual rights are violated.  [2] An undue burden is created when obstacles are severe and/or not justified.

Do you see where I’m going with this?  I feel like I am a victim of undue burden.  I have no reason to believe that I can’t successfully birth my twins naturally.  But the state has deemed that my preference of birth venue is not valid – women with breech babies or multiples are not allowed to birth at home with a licensed midwife.  My choices are to (1) birth unassisted at home, (2) go to the hospital against my will, or (3) enlist the services of an illegal midwife.  Additionally, the only services that would be covered by my insurance are hospital services.

In most states women with breech babies have no choice but to go to the hospital for a cesarean section even though breech presentation has traditionally been referred to as a version of normal.  We’ve lost access to vaginal breech birth.

In most locations women with multiples are pressured to succumb to cesarean surgery.  A number of folks have voiced their concern for my choice to birth these babies vaginally.  They simply don’t know any better.  Luckily I have found an obstetrician who is not afraid of normal birth.  However, I realize now that he may not be there for me when it comes time to go to the hospital.  He takes a week of vacation each month of the summer and is out of town twice next month, my birth month.  I found this out accidentally from his reception staff.

It is possible that I will show up at the hospital and some OB whom I’ve never met will show up and start pressuring me into surgery or ignore (or at least be unaware) of my birth preferences.  So because the state has deemed that twins should not be birthed at home, and because my insurance company won’t cover home birth anyway, I can either “choose” to go to a hospital that doesn’t practice evidence-based obstetrics or go eff myself, I guess.

Isn’t this an example of undue burden?  Lack of access to the care of my choice?  Paying for health care that doesn’t support evidence-based maternity care and forces me to go to a specific hospital in my town with a high cesarean rate and low VBAC rate?  Unjustifiably restricting scope of practice for midwives?  Not offering alternatives/access to the type of care I require?

I don’t want to be a patient.  I don’t see any need to expose myself or my newborns to the hospital environment.  Even my 4 year old doesn’t understand why I would go to the hospital to have babies.  “Mommy, are you sick?”

Don’t get me wrong, if I or the twins needed emergency medical services, you bet we’d go to the hospital.  I’m thankful to have access to obstetrics when necessary, but I resent being forced to utilize services that go against common sense, research, and are expensive and wasteful as applied to the great majority of laboring women.

I hope natural birth advocates, women’s studies researchers and writers, and lawyers will work together to expand application of the undue burden standard to the women who don’t have access to ethical, evidence-based care in childbirth, and are forced instead to incur great expenses to access the care they desire, to hire “illegal” or “under the radar” practitioners, to utilize unwanted services and support the over-payment of those services, or to go at it alone.

Please, give me back my right to birth.  Give me back my body.

1 – “Destacking the cards…,” Gender & Sexuality Law Blog, accessed 7/18/09.
2 – Jennifer Block.  Pushed. p.262.

5 Comments

Things Do Change or Welcome to Waffling

June 23, 2009 at 12:08 pm (CNM, Missoula, Montana, VBAC, Western Montana, childbirth, empowerment, homebirth, midwifery)

I had my most recent ultrasound a couple of weeks ago.  I was pleased to find out that both babies are guestimated to be roughly the same gestational age and size.  In fact, at 28-29 weeks pregnant, they were measuring 2lbs15oz!  They’re keeping up and even slightly ahead of the average singleton of the same age!

The other piece of great news is that they are both head down . . . or at least they were during that ultrasound.  This means the likelihood of a natural birth in the hospital is more likely.  It means that hospital birth is back on the table.

A midwife told me that I’d have to pay for the birth experience that would be best for me and my family.  It’s true – if I want an optimal experience, it’ll be a huge out of pocket expense with the possibility of additional hospital expenses should 1-3 of us need additional care.  I wish I were made of money and could afford the birth experience of my dreams.  I’m not so fortunate.  This is not how healthcare or maternity care works in the US.  No, I can’t put a price on the health and well-being of our triad, but that doesn’t mean that I can afford alternative health care or maternity care at this time.  And I’m not going to feel guilty about that either, ya know?!

My personal out of pocket max from 7/1-6/30 is $2300.  My family out of pocket max is $4600.  An out of hospital birth will cost at least $3500 (if I travel) or closer to $7000 if I stay home.  I can’t ignore the math – not on my salary.

I am so glad that I have explored my options.  I am still considering these options but am back to planning my “best birth” at the local hospital with an OB and a fantastic doula (who just happens to be a wonderful homebirth midwife).

* Check back soon for my review of Your Best Birth and a book giveaway.

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MRI Techs Post Top 100 Natural Birth Blogs

June 19, 2009 at 8:56 am (Resources, awareness, birth stories, childbirth, midwifery)

The MRI Technical Schools site posted a list of the Top 100 Natural Birth Blogs.  The compiler, L. Fabry, did a wonderful job of categorizing and providing brief bios of each blog.  Categories include: natural birth info, natural birthing stories, midwife blogs, and more.  Please do check out this list!

I’d like to thank MRI Technical Schools and L. Fabry for including Trial of Labor on this list.

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I’m Thinking Not

June 5, 2009 at 8:52 pm (childbirth, risk)
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I wonder if Gloria Lemay came up with this list herself or if she found it somewhere, but it’s brilliant.

I’m thinking I’m not a good candidate . . . besides not being afraid of needles, nothing else seems to work for or apply to me.

Click here to see how you match up!

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Cesarean Injury: Another Harrowing Tale

June 2, 2009 at 6:56 pm (awareness, cesarean, childbirth, risk)

Just today I stumbled upon the blog, The Man-Nurse Diaries.  If the blog title wasn’t interesting enough to catch my attention, his most recent post certainly was:

Nearly Bleeding to Death from a Cesarean Section

You must read it.  MUST!

The timing is interesting and something for me to consider.  I’m not superstitious, per se, but sometimes I do wonder if I am supposed to discover things along my journey at specific times.  Not only am I planning my own twin VBAC and have a persistently breech Baby A, but also I am working on a little project – a VBAC WebQuest.  More on that later.

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Stressed: Woulda Shoulda Coulda

June 1, 2009 at 7:16 pm (CNM, VBAC, awareness, cesarean, childbirth, fear, healing, homebirth, pregnancy, risk)
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Shoulda:  One of my strongest feelings from DD’s birth in 2004 is that I shouldn’t have gone to the hospital.  When my husband started to nag me about getting to the hospital (I was severely dehydrated, and he wanted to take me in to get that treated), I thought, “I couldn’t possibly leave my house right now.”  Somehow I did get in the car and didn’t puke or poop myself on the way to the hospital.  The minute I got there, I *needed* a wheelchair.  I was sick. 

I wasn’t treated for illness.  I was treated for childbirth.

I should have hired a doula.  I thought I was “safe” because I was being attended by a CNM.  I should have reminded her that my birth plan stated no artificial rupture of membranes.  I should have insisted on changing positions even though I was peeing out my butt.  What shouldas are ahead?

Coulda:  I could have told my DH no, I suppose.  I certainly could have told my CNM to go jump when she suggested breaking my water.  What sorts of couldas are ahead?

Woulda:  Had I a “do over,” I’d have stayed put.  Or I would have refused AROM.  I would have changed positions while laboring and for pushing.  I would not have purple pushed.  Not gonna do that again.  Thinking too much about future wouldas is overwhelming.  Let’s not go there.

Woulda shoulda coulda is that much more stressful when you aren’t given options.  I’m not supposed to give birth to twins at home.  That’s risky.  I’m supposed to want to give birth at the hospital.  That’s safe.  Yeah, hospital birth is so safe for American women and their babies that our infant mortality rate ties Poland and Slovakia.

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