The Trial of Labor

On Tuesday I found out for sure that I am pregnant.  I had been testing for a few days and had a very very super faint positive on Monday, but on Tuesday, there was no denying it.  This is welcome yet . . . I don’t really have a word for it - scary, tentative aren’t good words . . . news for me and my husband.  I myself am amazed that through a UTI and subsequent horrific yeast infection that I even became pregnant.  The rub for me is STAYING pregnant.  I miscarried our previous child on August 1.  Click here and here to read a couple of previous posts regarding my experience with birth loss.

I had a visit with a CNM already set up as a follow-up to irregular mid-cycle bleeding and the out of control yeast.  The bleeding turned out to be ovulation bleeding.  The yeast got smart and died.  We had a good visit.  I felt free to cry a bit.  She’s very *neutral* which I’m not entirely sure is a good thing.  There I am trying to decide whether I should have a hcg test or schedule an early ultrasound, and really she didn’t weigh in.  Not that I interpret that as ambivalent, I just wish she could counsel me on how much information really can be gained from these tests.  She called me a little while ago to tell me that my quantitative hcg number - 292 - was good.  Ok, so good.  So now I should repeat the test in two days, but oops, I’ll be out of town.  Dag!  What to do.

I went to Meadowsweet Herbs and threw down a few pretty pennies.  In addition to echinacea for a brewing head cold, I bought some aromatherapy items, and a tincture for pregnancy support, pregnancy tea (which doesn’t taste too bad, I must admit), and a neat-looking book entitled Natural Pregnancyby Janet Balaskas.  Time to update my reading list.

It’s a big step for me to announce this so loudly in the big world.  I AM PREGNANT!  I’m REALLY pregnant . . . again . . . so soon after tragedy.  Thank God!  May this baby gestate in peace knowing how much he or she is wanted and loved.

Current pregnancy symptoms - exhausted, emotional, lower-abdominal “twinges”
Other feelings - scared, hopeful, worried, out of breath, heart racing, vulnerable, joyful, excited

What a blessing.  That’s what I’ll call my growing baby - blessing.

What exactly is this nasty little problem . . .

If you answered:  the epidemic of cesarean birth in the United States, then you are the winner!  Congratulations!!  Tell her what she’s won!  “Well, labortrials, your winner has now an increased chance of death due to abdominal section and quartering as an elective procedure appropriate for childbirth.  She may suffer from post-partum depression or post traumatic stress disorder, but who’s really checking.  She and her child may miss out on an important bond that established during and immediately following birth.  Her child may have respiratory problems and nervous system dysfunction, but since cesarean ‘birth’ is manageable, she might as well climb up on the table and strap herself down.  She can claim her prize at any just about any ole hospital!”

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“American maternity wards are fast becoming surgical suites.”

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You must read Jennifer Block’s opinion article from the LA Times (9/24/07).  Here is the opening paragraph:

“Pre-term births are on the rise. Nearly one-third of women have major abdominal surgery to give birth. And compared with other industrialized countries, the United States ranks second-to-last in infant survival. For years, these numbers have suggested something is terribly amiss in delivery wards. Now there is even more compelling evidence that the U.S. maternity care system is failing: For the first time in decades, the number of women dying in childbirth has increased.”  Click HERE to read more.

For those of you who don’t know, Jennifer Block authored the book Pushed.  So certainly you are getting a more radical perspective on the medicalization of childbirth, but I’m okay with that since the dominant culture surrounding birth typically plunks it’s head in the sand when you start talking about certain topics.  Well, it’s kind of like that crazy radical idea of global warming . . . interesting how after years and years of clear evidence (and head plunking), the government is at least entertaining the idea that global warming is man-made, reversible, and a real threat to the globe’s future.  So, just because something seems radical doesn’t make it untrue, ya know?!

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Caesareans are inherently riskier than normal, vaginal birth. They also lead to repeat caesareans. And repeat caesareans carry even greater risks.

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The next time you hear a pregnant woman joke cavalierly about cesarean birth, smack her.  Well, no don’t do that, but do say something to her that will make her think twice about that potential (or elective or scheduled or repeat) cesarean.  It’s hard to put yourself out there, but think about the difference you may make for one woman and her child or children.  You are obligated to speak out against the injustice of medicalized birth!

I was looking at Davis-Floyd & Sargent’s Childbirth & Authoritative Knowledge: Cross-Cultural Perspectives at Amazon (through GoodSearch) and lookie what I saw in the excerpt:

“The devaluation of nonauthoritative knowledge systems is a general mechanism by which hierarchical knowledge structures are generated and displayed.  Regarding its role in education, the French anthropologist Pierre Bourdieu comments on the role that formal education may plan in the devaluation of folk knowledge in a class-structured society.  He says,

‘[Formal schooling] succeeds in obtaining from the dominated classes a recognition of legitimate knowledge and know-how (e.g. in law, medicine, technology, entertainment, or art), entailing the devaluation of the knowledge and know-how they effectively command (e.g. customary law, home medicine, craft techniques, folk art and language, and all the lore handed on in the hedge-school of the witch and shepherd . . . ) and so providing a market for material and especially symbolic products of which the means of production are virtually monopolized by the dominant classes (e.g. clinical diagnosis, legal advice, the culture industry, etc.).  (Bourdieu and Passeron, 1977:42)”[1]

So, let me see if I can - off the top of my head - make this selection relevant and interesting  . . .

We start with “equally legitimate parallel knowledge systems” [2] (like midwifery, family practice care, naturopathy, etc.) in health care, but then one type of knowledge becomes more politically powerful (medicalized health care for pregnant women).  Education tends to legitimize and put forth TECHNOLOGY which also, in my opinion, exacerbates the issue of power (both from gendered and Marxist perspectives) in pregnancy and childbirth.  Those who are highly educated (it seems from the above quote) are actually DOMINATED by this legitimized supreme knowledge and know-how.  Those who reject this domination are cast aside as witches, bitches, nags, etc.

Whoa!  Can’t wait to read this book - totally in the same sociological models I studied with regard to music and music education (another marginalized way of *knowing*).  I was just discussing this book with a fellow ICANer, and she says it goes hand in hand with “unschooling”.  I’m sure it does, L!  =)

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[1] & [2] Robbie E. Davis-Floyd & Carolyn F. Sargent, Childbirth and Authoritative Knowledge: Cross-Cultural Perspectives  (Berkeley and Los Angeles: UC Press, 1997), on-line excerpt. 

It’s been a few weeks since I’ve been involved in a good ole game of blog “tag”, and since I’m currently sorting out my thoughts on homebirth, here’s a question for all of you, and a “tag” for fellow bloggers Birth Matters, Birth Under Siege, Elemental Mom, Empowering Birth, The True Face of Birth, and VBAC Adventure.

Here are my questions:

1. Have you considered homebirth as an option for labor and delivery with a previous/upcoming birth?
2. Why did you (or did you not) consider homebirth?
3. What do you see as the major advantages for homebirth, and what are your justifications?
4. What do you see as the major obstacles for homebirth?
5. Is your (was your) partner “on board”?
6. If not, did discussions (and research on the part of your partner) help?

Here are my answers:

1.  I never expected to consider homebirth for childbirth.  Several of the women in my childbirth education classes were planning homebirths.  I thought that was “cool”, but I didn’t think that was for me.  Women are supposed to deliver at hospitals, right?!  @@  It wasn’t until I joined the ICAN list in late July that I began to learn about homebirth as a safe environment for labor and delivery.  By about mid-August I was intrigued.  Since I’ve started reading Wagner’s Born In the USA, I have at least one foot (and most of my body) in the homebirth trench.

2.  Homebirth was not really on my radar during my first pregnancy.  I didn’t have any friends or family members who had worked with homebirth midwives.  The concept of certified nurse midwives (CNM), midwives who are authorized to attend births in birthing centers and/or hospitals under the guidance of obstetricians was new to me.  I had never heard of a doula before my childbirth ed classes.  Now I am interviewing certified professional midwives and direct entry midwives (along with CNMs and OBs) for future pregnancies.  I am beginning to see that it is very likely more safe (yeah, I’m not talking nuts here, I promise) birthing a child at home than at the hospital.  (Have a look at some of my other recent posts for learn why my hospital is not a good location for VBAC.)

3.  Advantages of homebirth:
     >  You’re in a comfortable environment - your domain, if you will
     > You are in control of your environment (noise, people, lights, music, food, water)
     >  You are not being constantly monitored and checked
     >  You don’t wear machines and aren’t hooked up to IVs
     >  You’re not as “on the clock” as hospital-birthing moms are
     >  You’re not separated from your child or partner once the baby is delivered
     >  You control the timetable with regard to treatments and exams performed on your newborn
     >  You’re far away from the hospital and people who have been trained to intervene in the natural physiological process of childbirth

One study that always comes up in discussions of homebirth is “A Prospective Study of Planned Homebirths by Certified Professional Midwives in North America,” by K. Johnson and B. Daviss.  British Medical Journal 330, no. 7505 (2005).  Also see Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First, Chapter 6, by M. Wagner.  Berkeley; Los Angeles; London: University of California Press, 2006.

4.  Disadvantages of homebirth:
     >  Not everyone finds home a place of comfort and solace.
     >  In case of emergency or in the event that vaginal birth is not achieved, you will have to transfer to the hospital.
     >  If something goes wrong (keep in mind that the chances of a true emergency in childbirth are quite slim), it may be hard to stay calm while waiting for transport and hospital service.  I do recommend at least registering at the local hospital in case hospital transfer is necessary.
     >  Most people will treat you like you’re a nutcase (as if you care).  You will likely meet resistance from well-meaning family members and friends.

5. & 6.  My husband is not yet on board.  I’m hoping he’ll get there.  Last night I told him that I am interviewing CPMs and DEMs in addition to CNMs and OBs.  He told me that he’s fully supportive of me going for the VBAC, but he’s not comfortable with the idea of homebirth.  I told him that until he does his own research that the subject is closed for discussion.  And that was that.  Round 1 is over.

Today while I was out and about, I decided to stop by Barnes & Noble for a latte and some reading. I picked up The Thinking Woman’s Guide to a Better Birth and also browsed through Spiritual Midwifery. I will probably buy the first title when I get back from vacation.

I’ve thought about my first birth experience and “what iffed” myself to death over it. Amazing how pregnancy brings it all back. A couple of “what ifs” on the top of my mind are:
+ What if I hadn’t been sick; would I have had more energy to withstand natural labor?
+ What if my CNM hadn’t broken my water; would my daughter’s position have been better and would she have descended into the birth canal?
+ What if my CBE had discussed the risks of VBAC as viewed from the interventionist side of the aisle; would I have refused the c-section longer?
+ What if I had my daughter at home with a midwife? Would they have been able to manage my sickness, found ways to relieve my pain, helped me get into better birthing positions, encouraged me to move around, or would I still have ended up with a c-section?

I’m thinking that I have a problem with faith. Right now I have little faith in the medical facilities open to me for birthing Baby O2. I have little faith in my body since I failed to deliver naturally last time and have since been told by an OB here that my pelvis is narrow (anterior-posterior). I have little faith that someone from the non-medical perspective can help me with the birth. I am afraid of rupture and of neurological impairment or death of Baby O2. I am new in my community and really don’t know much about how to receive the support I need for my journey. And, unfortunately, the little information I’ve shared with my husband on the risk of VBAC has scared him. One of the first questions he asked was “Are you going to insist on a VBAC?”

Lord help me. Have mercy on me and my growing baby.