Update: 34 weeks

I can’t believe I’m 34 weeks(ish).  This pregnancy is moving sometimes at glacial pace or meteoric speed!  Since I haven’t done an update or a post lately, I thought I’d give an overview of where I’m at.

git out of me belleeee!

I posted this ‘self portrait’ yesterday on Facebook.  It doesn’t give the full effect, but hey, I think it’s cute!

What I’m doing

  • cleaning – yesterday, I lightly organized and fairly thoroughly swept out the nasty garage; it’s really that gross – my friends’ comments on FB kind of embarrassed me…
  • shopping – groceries, plants, flowers, wish lists, baptismal dresses, you name it, I want to shop for it (who am I?)
  • reading – ICAN & BAC lists, twitter, Facebook, blog posts, MDC, pregnancy books, etc.
  • belly dancing!
  • going to appointments – midwife, OB, chiro; I need to take the dog to the vet and I need a haircut too
  • hanging out – with my kids, with good friends!

How I’m feeling

  • tired (gone are the days of sleeping well; hello to daily naps – TG I’m done teaching for the year)
  • restless in an excited and nervous way
  • achy – when I do too much physical activity
  • big
  • sexy
  • energetic in spurts
  • cluttered – still so much to organize here at home before the baby comes; too many birth resources at my disposal
  • anxious
  • ready to get the show on the road!

On Becoming a Birth Activist

I’m surprised that more people don’t ask me how I became such a “questioner” of the maternal-fetal care system.  So I’ve had a couple of cesareans, but it’s not like I work in a health-related field.  What does opera singing and being a professor of music have to do with health?  More than you might imagine.

2004 – I was pregnant with my first child; I did all of the ‘right’ preparations – I chose a CNM over an OB based on the recommendation and experience of a good friend (such a RADICAL thing to do . . . choose a midwife over an OB!); I took childbirth education classes from an independent educator; I took prenatal yoga classes and stayed in pretty good shape for most of my pregnancy.  As far as I knew, the baby should have just ‘fallen out’ after all of that good preparation.  But it didn’t.

My hindsight quarterback post of this birth experience is posted here, but let me tell you how it made me feel.  Actually, after the stomach flu > labor and dilation from 0-9cm in mere hours > AROM to speed things up and end my misery > cesarean . . . I felt like a rock star.  It was the most intense experience of my life, and I ROCKED.  Just ask my hubby!  He still talks about how I went to some ‘place’ he never new existed.  I broke a ton of blood vessels in my eyes (yes, I was ‘purple pushing’ but no, I wasn’t only pushing ‘high’).  I was still violently ill after the cesarean.  I had to send the baby to the nursury some.  My hubby had to leave because he caught the GI ‘death and destruction’ bug too.  (So did MIL!)  A lot of things went wrong . . . others were just far from ideal, but whatever.  I survived and a lot of things went right too – I recovered quickly from the surgery; breastfeeding was easy for me and my DD.  I was performing by 8 weeks post partum and took a few on-campus final interviews for University jobs.

Feb 2005 – I had my post-partum appointment with the doctor who performed the surgery.  For the first time, and I don’t know why this was the case, I heard . . . really heard . . . things like “risk,” “uterine rupture,” “dead baby,” “brain-damaged baby,” “repeat cesarean,” “VBAC,” and the like.  How did this happen after all I did to ensure that I went against childbirth norms!  Why me?!!!

In the heat of the moment when you’re feeling distressed because pushing isn’t relieving the pain or bringing your baby closer to you, the cesarean can seem like an easy way out.  I pushed for several hours . . . I resisted pushing when waiting for the OB and then waiting for the surgery.  When the OB arrived, she was pretty sure she could help me get the baby out vaginally.  However, she quickly gave up and fairly nonchallantly suggested the cesarean.  I was READY!  Phew, being ‘stuck’ like that sucked, and no one was really helping me get ‘unstuck.’  I didn’t have a doula (because I didn’t think I needed once since I hired a CNM); DH didn’t know any more or less than I.  I was totally relying on the medical providers.

Why do OBs not feel the need when childbirth hits a major roadblock to really explain the consequences of the next step?  I wasn’t in distress.  My baby wasn’t in distress.  The OB could have said, “Now Kimberly, you’ve been such a strong mama through this, but I want to offer you a cesarean as an option.  Before you agree to it, let’s talk about what happens and what impact this decision may have immediately and for future births.”  There was time for this discussion, and it’s not like she was busy with other patients . . . this was 3 or 4 am!

Please care providers, you MUST let us participate in our health care decisions.  We need information before we can make life-altering decisions like these.  When there is time to inform us of the benefits and consequences of interventions, you are ethically obligated to do so.

July 2007 – I became pregnant again, and a couple of gals from my 2004 due date club reminded me about ICAN.  I joined their Yahoo group and dove in.  My eyes were opened and resentment poured into every corner of my existence.  I lost that baby.  I lost the next baby.  I stuck with ICAN, began a local chapter, and brought The Business of Being Born to an indy theatre in town.  I lost another baby.  I found a new doctor who found new things wrong with me.  I struggled for my life.

Summer 2008 – I was going to spend the summer in Denver doing research.  I began looking for a reproductive endocrinologist so that I could get some answers.  Why these chronic losses?  Why this misshapen uterus?  I continued to struggle for my life.  The RE diagnosed what I suspected – really crappy progesterone.  He also believed that the misshapen uterus was not a didelphic uterus but a fibroid.  He wanted to do a laproscopic procedure to remove the fibroid; I insisted on the less invasive hysteroscopy.

He didn’t find a regular fibroid . . . instead he did his best to remove adenomyosis without compromising the integrity of my uterus.  He believed the adenomyosis was caused by the cesarean surgery.

By this time I was pretty disenchanted with traditional obstetrics.  I had been misdiagnosed or refused diagnoses too many times.  I had lost three babies.  I became aware that the cesarean had a negative effect on my ability to have more children.

Current – I hope by now that readers understand that this isn’t about hating cesareans or hating interventions.  Not at all.  What I have ‘hated’ is:

  • Not being asked to participate in my health care decisions ~ How does NOT having women participate in their health care serve mothers and their babies?
  • Being made to feel like ‘one of those’ patients for conducting my own research and presenting contrasting information ~ How does being an oblivious patient help mothers and babies?  How does being an empowered patient hurt mothers and babies?
  • Being denied tests and appropriate treatments that may have helped prevent another heart-wrenching loss :(
  • Being made to feel like my body just doesn’t work; being taught to be afraid of my body; being taught to not trust my body’s wisdom ~ How does making a woman feel badly about her body and breaking down her trust in the physiologic process of birth help her and her baby?
  • OBs using scare tactics to win compliance ~ Moo??
  • OBs putting their own beliefs about risks (what’s worth it or not) over their patients’ prioritization and contextualization of risk ~ How does putting medico-legal risks above the health (mental, physical, emotion) of the mother-baby dyad help mothers and babies?
  • OBs turning a blind eye to the fact that women may suffer from birth immediately (in the 0-6 week post-partum range) and long term (I was still in acute pain after my last cesarean 1 year post partum); once the ‘healthy’ baby has been ‘managed’ out of the birth canal or uterine incision, it seems as though that’s where their responsibilities end, especially if he or she is not the patient’s regular doctor ~ How does making mothers in the post-partum period low priority patients help mothers and babies?
  • Exaggerating the benefits of intervention and minimizing the risks to the mother-baby dyad ~ How do increased interventions really help mothers and babies?  Are you sure about that??
  • Doctors who aggressively undermine the valid experiences of homebirth midwives and families who choose to birth their babies away from the ‘comfort and safety’ of the hospital campus ~ How ’bout cleaning up your own backyard before you start worrying about mowing someone else’s?  And again, I ask . . . how does tearing down a valid though very different care system serve babies and mothers? 

This.  This is how one very mainstream person becomes a birth activist.  It’s not about hating on specific people but exposing the inadequacies of operating solely in one mindset with regard to health.  The sooner the medical, public health, and alternative care perspectives can truly collaborate, the better health care in the US will be.  This will require a radical shift in thinking and practice, especially from those entrenched in the medical model.

Coda – why an opera singer and music educator should care about birth?  I am of the opinion that the entire body is the vocal instrument.  Impairment of any part of the body can negatively impact the singing voice.  Particularly the trauma done to the lower abdominal region during a cesarean section need to be avoided.  The abdominal complex is the primary source of support for the singing voice.  Interventions and distruptions to this part of the body can have long-lasting negative effects on the singing voice.

Additionally, music gives us the opportunity to engage seemingly unrelated fields.  My dissertation dealt with gender subversion in modern opera.  Really, how different is this than the institutional hegemony of maternal-fetal medicine.  The female body is still a battle ground.

What I Gained from My (Cesarean) Birth Experiences

Today’s CAM task: Number a sheet of paper from 1-10. Now write ten things you have gained from your cesarean (or birth experience). If you can’t get to ten, it’s ok. Start with one… via ICAN

I have learned so much . . . and so little from my birth experiences that I can hardly decide what to list.  Here’s what is coming to my prego brain at this moment!

  1. We can’t take our childbearing years for granted
  2. We must participate in our health care decisions – this is hard for a lot of women to do when we’re pregnant and/or laboring in a hospital with stringent guidelines!
  3. That first cesarean changed my childbearing years in a profound way . . . profound ain’t always good
  4. I gained knowledge about my body
  5. I gained knowledge about our health care system, particularly the inadequacies of maternal/fetal care (treatment)
  6. My pregnancy losses (partially due to adenomyosis which was caused by the 1st cesarean) taught me a lot about the brokenness, resentment, trauma, depression, and heartache women can experience when they have cesareans
  7. I’ve learned a different way of interacting with my health (not that I am particularly good about practicing what I preach)
  8. I’ve gained a whole international network of friends (ICAN & BAC) – I can call these women, text them, Facebook them (ah, FB as a verb), IM them, and sometimes even meet them face to face.  I’m sure one of them would travel to support me through this birth if I needed.  <sniff!>
  9. I’ve gained the knowledge and courage to help other women in labor, and I can’t wait to learn more about being a doula!
  10. That most babies should be born normally, and that homebirth can be a great choice for families!  When I was pregnant with DD1, I was vaguely familiar with homebirth, but that was way too “granola” for me.  My hope is that women (and their friends and families) will at least research this childbirth choice and decide (based on more than a preconceived notion) if it’s right for them. 

Pissed! but Accepting?

Wednesday was a banner shite day.  My midwife had been encouraging me to maintain a relationship with an OB, and I knew this necessitated a change.  Friends and L&D nurses urged me to try this one doc, Dr. A (we shall call him), stating that if anyone was going to give me a chance at VBA2C, it would be him.

So, I naively went to my 9:50am interview/appointment with Dr. A.  I was nervous – didn’t really sleep the night before – but hopeful.  The staff was very nice; the nurse was nice.  (I had previously talked with her.)  I had previously met this doc, so at least I wasn’t worried about that.

He was interested to know why I was there since obviously I had been seeing another OB for the 1st three-quarters of my pregnancy.  I told him I had 4 reasons:

  1. I am very motivated for a VBA2C

He interrupts . . . “Don’t do it.”  Shaking head.  Patronizing tone.

I cry.

The rest of the appointment was him trying to scare me out of it, and by the time I told him I’d been diagnosed with a thin lower uterine segment (LUS) during the RCS, he was certain that I am a nut.  Actually, he recognized that I had done a lot of thinking and researching, but he didn’t think I had given enough thought to permanent damage to the baby and permanent damage to me.  (Like, DUH!  What else have I been thinking about the past 7 months.  FFS!!!!!!!)

What was scary is that he’s familiar with the same research I’ve studied.  He mentioned the Cochrane library.  He refuted the opinion of the NIH VBAC Consensus Panel (because most of them don’t deliver babies).  The research doesn’t point to maternal death from uterine rupture but he’s seen it.  Fetal demise begins within 8 minutes of the onset of bradycardia associated with rupture which is too short a time to get a cesarean performed.  Yada yada.

Terrifying.  And I’ve done my research.  I’ve been researching this since 2007.  I have a PhD.  I have fantastic research and analytical skills.  And I was still terrified.  And I still doubted myself, my support system, everything.  And I resented my baby.

And I freaked the hell out.  Couldn’t go to work. 

So, you probably see the “pissed” part.

Here’s the “accepting” part.

Of course he’s going to do “his job” and dissuade me from VBA2C.  In his experience, it’s too  risky to justify.  He’s not going to understand why I disagree.  I’ll never be able to “educate” him here either.  When I don’t rupture and have this baby at home without incident, he’ll assume I got lucky.  I accept that he views birth with a completely different lense.

However, he’s agreed to take me and said he won’t drop me either even if I go forward with the VBAC.  He’d rather babysit me through this poor choice than turn me away.  I’ll have to sign an AMA (against medical advice) waiver just to cover his butt.  Fine; whatever.  So, for now . . . I’m planning to continue my concurrent care with him.  If it becomes a regular thing for him to try and terrorize me, then I’ll drop him.

Although he really shook me to the core on Wednesday, thanks to the amazing support of ICAN and Birth After Cesarean, I’m back on track and actually feeling more solid about my birth plans.  I just don’t “see” the hospital figuring into this experience.  Perhaps God or my baby or some 6th sense will change things, but for now, I’m back to planning a peaceful birth at home.

Day 2 Pt 1 Impactful ICAN Conference Tweets

The working subtitle of this post is . . . you can lead an OB to the table, but can you keep him/her from cutting??

some rights reserved - thetorpedodog @ Flickr

Here are some of my favorite tweets from the Saturday morning sessions.  (And as I look at the 300+ conference tweets paused in twitterfall this morning, the day after, I realize there may not be a part 2 . . . kind of like History of the World!)

Disclaimer: Since I collated these posts from a public feed reader, I have not asked permission to repost them.  OPs may request their tweets be removed and are welcomed to clarify their tweets in the comments section.)

Regarding breech:

BirthingKristen “Women should have the right, the support, and the resources to choose their own set of risks.” #vaginalbreech #ICAN2011
I do believe this, but gee, it’s hard to achieve especially when you involve birth attendants, regulations, insurance, hospitals, even birth centers, etc.  I’m afraid to say that the fact is that women will never fully have the right to choose their own set of risks unless they birth on their own.

DeepSouthDoula Vaginal breech birth is in our reach but it’s up to the parents to make it happen. Like the parents who walked out 1 hour prior. #ICAN2011
Again, somewhat idealistic.  In my case, I knew I’d be trying to fight my provider’s malpractice insurance . . . me . . . alone.  I’m not saying there aren’t things we can’t and shouldn’t do, but realistically many, if not most, families are not going to fight the system one hour before giving birth.  And they shouldn’t be made to feel like failures because they didn’t fight this overwhelming machine.

ShannonMitchell GT: breech birth is a part of the traditions midwifery #ican2011 #breech
Yes it is.  Isn’t it a shame that it’s often not in the current scope of practice for traditional midwifery?

DoulaMari: “Mama loves you enough to have you at home even though you were breech!” #ican2011
This just hurts my feelings.  I know the statement had nothing to do with me or my choice to consent to a CBAC for double footling breech twins and that it’s excerpted from an emotionally powerful experience, but it still cuts like a knife.  Actually, it feels like a repetitive cut to the same wound that refuses to heal.

drpoppyBHRT When docs tell midwives, “you can’t do that” is it really because THEY can’t do that? #vaginalbreech #normalbirthignorance #ICAN2011
Nice.  Yes, I think a lot of the time it does mean that.  They haven’t been trained to trust the body’s wisdom; they’ve been trained to search for pathology and treat that pathology.  Even the NIH VBAC consensus report indicates that younger doctors may be more resistant to VBACs because they were trained during a time when VBAC was (is) so highly contentious.

heathertom Tully: the question may be Is the attendant safe? #ICAN2011 #vaginalbreech
Absolutely.  I personally would be more afraid to show up at the hospital pushing out a breech baby if I didn’t know that the doctor on the receiving end was experienced with breech.  In fact, I’m of the opinion that in my community it may be irresponsible to show up at my hospital with a vaginal breech.  It hasn’t been part of the local practice – obstetrics or midwifery – for more than 10 years.

poderyparto Breech: 80% no intervention needed at all, 20% need maneuvering. #CAM2011 #ICAN2011
In other words . . . HANDS OFF THE BREECH!

drpoppyBHRT OBs in Germany and Israel are working to unite midwives and OBs to increase vaginal breech birth. I love that! #kneechest #ICAN2011
This is wonderful to know.  We should be pointing to these case studies every chance we get.  This will help us as we advocate for evidence-based care.

Other awesome tweets: (before I fell off the wagon)

drpoppyBHRT: Midwives told to stop doing #VBACs, they responded “when you stop doing cesareans.” Gail Tully #ICAN2011
AWE.SOME.

MamaBear1326 Why am I lucky enough to live where I achieved a vba2c and some people dont have that option #breaksmyheart #ican2011
Many women don’t feel they have the option to birth their babies.  This is so sad.  The fact is that women have fundamental rights.  No one can force you to consent to a surgery.  And even ACOG’s 2005 committee opinion supports protecting these rights:

Efforts to use the legal system to protect the fetus by constraining pregnant women’s decision making or punishing them erode a woman’s basic rights to privacy and bodily integrity and are not justified.”  (via birthaftercesarean)

Unnecesarean Dr. Poppy Daniels: “Women who really want a vaginal birth can go to extremes to get it.” (No kidding) #ICAN2011
And we will.

ICANofAtlanta How many ob-gyns have not read the latest ACOG practice bulletin on VBAC, not to mention the NIH consensus? #ican2011 #hcsm @drpoppybhrt
. . . and won’t acknowledge that local practice should change to reflect the bulletin and NIH findings.  This is why I’m sending letters to all local OBs.  I’m done with their fear mongering and lies.

RobinPregnancy T-shirt spotted: Keep your politics out of my vagina on @shannonmitchell #ican2011
Nearly snorted my coffee when I read this.  And I want one.

mollytoba I keep hearing about better integration of midwifery and OBGYN care. Who is actually doing this? Any successful models? #ICAN2011
Someone did respond to this, but I can’t find the tweet.  She mentioned some place in LA (which I can’t remember if refers to Louisiana or Los Angeles!).  But that was the only ‘successful model’ response I read.

DeepSouthDoula Exploring birth trauma in mamas AND with birth professionals. What we witness can be traumatic for us too. #ICAN2011
I may have to dedicate a post to this.  Birth professionals who experience trauma need to be treated!!!  Please refrain from bringing your trauma into future births.

babydickey “I’m not a uterus walking into an operating room.” I’m a pregnant woman with a family. #ICAN2011
<le sigh>

blairlovesjason Glad @drpoppybhrt discusses the harm in shows like Deliver Me, A Baby Story, etc. Means a lot coming from a professional. #ican2011
Totally!  I didn’t know any better and was watching these shows in 2004 when I was pregnant with DD1.  It made me afraid of the cesarean, but it didn’t do anything to help me (or encourage) me to prevent it.  It was like watching a car wreck in progress, over and over and over again.  Dammit, and then I wrecked my ‘car.’

ShannonMitchell Acnm says they are working on revised vbac statement addressing “immediately available” #birthaction #ican2011
Very good news.  The ACNM needs to step up and not hide behind ‘big brother.’

babydickey Midwives Alliance of North America (MANA) has a c-section rate of 5.03%. YEA! #ICAN2011
I trust this to be true, but it would be so helpful if MANA would release the data.  People want to see it.  I want to see it.  MANA hold plenty of statistics that to my knowledge are not publicly accessible.  It’s a shame.

mollytoba Ida Darreagh of NARM: the safest place for a woman to give birth is where she feels strong, supported and capable. #ICAN2011
Absolutely.  This is why I try to be super careful when talking with mamas who have different ideas about where to birth.  Everyone should feel safe giving birth.  It doesn’t ensure a perfect outcome, but it’s still important to respect one another’s decisions.

DeepSouthDoula Don’t feed the trolls! Seriously not worth it. As @unmarketing says – you are not the jackass whisperer. #ICAN2011 AND seeKJtweet Ok who said Beetlejuice? #ICAN2011
Oh my.  There is a persistent non-practicing OB with too much time on her hands who just hates natural birth advocacy.  She has quite a cult following.  I used to go to her blogs thinking there was something possibly to learn there . . . but it’s just so polemic that I realized I was wasting my time and scaring myself in the process.

RobinPregnancy Every state needs to look at the safe transport bill for home births. #ican2011
And where do I go to find that?  Over to Google.  Searched ["home birth" "safe transport" legislation] which didn’t come up with much.  But I did find that a bill is working its way through the Illinois General Assembly.  Have a look!  I found this as a result of reading this action alert from the Chicago-area homebirth meet-up group.

Impactful Tweets (pt 3) ICAN 2011 Conference

I tried to catch as much of the Henci Goer chatter on twitter as I could tonight.  We have a full house tonight (our 3 plus 2 neighbor kids spending the night, oy!) so I’m playing with less than a full deck.  Ha!

Disclaimer: Since I read these tweets on a public hashtag channel, I’m not asking permission to repost.  If anyone wants their tweet removed or wants to clarify a tweet, please let me know.

anderzoid #ICAN2011 henci goer: how much we have over medicalized birth? IV drip- not allowed to eat or drink – induction- cord clamping- etc
I assume this was a slide of the topics used to justify the point that birth is over medicalized.  My previous research leads me to concur that these are some of the ‘biggies.’

poderyparto Ineffective & harmful practices: sonograms to estimate fetal weight, planned cesarean for breech,not supported by research. #ICAN2011
Ultrasound is such a poor diagnostic tool for assessing fetal weight in the 3rd trimester.  I can’t recall exactly ‘when’ ultrasound is more accurate for predicting due ‘dates,’ but it’s very early on – I’m thinking 8-12 weeks gestation, but don’t quote me on that.  Only one mom out of the many I know personally that were told they were going to have a big baby actually did have a big baby.  Friends and family members who have had 3rd trimester estimates done with specialists have birthed babies 2 pounds lighter than predicted!!!!  Regarding the no-questions-asked cesarean for breech – a flawed Canadian study is what dictates current US practice.  Thank goodness Canada is taking the lead to restore breech as a version of normal.

bbybirthingmama Scheduling a section for breech, twins, “big baby” and slow labor are not supported by research! #ICAN2011
I was sad to discover that 75% of twins in Montana are born by cesarean.  I imagine all breeches are born by cesarean except for the rare surprise breech or unattended breech births.  Many docs aren’t ‘allowed’ by their insurance companies to deliver breeches naturally – how convenient for them.  Slow labor – yeah!  Most women just DON’T dilate 1cm/hr.  I REPEAT – MOST WOMEN AREN’T GONNA DILATE ACCORDING TO FRIEDMAN’S CURVE.

tconsciousdoula The way to get a VBAC? Tell the Dr you are planning on having 10 children! #ican2011
Now that’s a good one.  I’ll have to add that one to my list!

babydickey: Perinatal death from csec scar uterine rupture is 6 in 10,000. But did you know pregnancy loss from amniocentesis is 60 in 10,000? #ICAN2011 AND Unnecesarean 6% of scar ruptures—> perinatal death (3 per 10,000). Compare to excess risk of pregnancy loss from amniocentesis… 60 per 10,000. #ICAN2011
Here’s what was stated in the NIH VBAC Report: “Approximately 6 percent of uterine ruptures will result in perinatal death. This is an overall risk of intrapartum fetal death of 20 per 100,000 women undergoing trial of labor. For term pregnancies, the reported risk of fetal death with uterine rupture is less than 3 percent.”

tconsciousdoula planned VBAC should be the norm (87%) actual rate is 9% (2007) #ican2011
Add this information to your notebooks in case you need to make the case for VBAC to a doctor, a nurse, a hospital administrator, or a friend.

tiffrobyn A 41 week pregnancy is not only normal, it is AVERAGE! #ICAN2011
Like . . . duh.  Why have care providers forgotten that?  Well, statistically that may not be the exact average for all childbearing groups (i.e. primip vs. multip), but it’s absolutely ridiculous to pressure a woman into inducing at 41 weeks.  Some providers will start pressuring you at 39 weeks, especially if you let them anywhere near your cervix!

bbybirthingmama WHO Recommends no more than 10% induction rate. I didn’t know that. #ICAN2011 BUT poderyparto US induction rate 2005: 47% (babydickey tweeted 41%) of women planning vaginal birth! #ICAN2011 #CAM2011

shedenka So hospitals and docs tell ALL women “you can’t eat/drink” during labor. Total CYA: aspiration risk is 3.2 women out of 10 million #ICAN2011

nashvillebirth Henci Goer makes my head hurt in a good way. She always melts my face off. #ICAN2011
*Giggle*  This really made me smile.  I love having my brain hurt in a good way.  It’s invigorating!!

bbybirthingmama Early Cord Clamping can take up to 40% of newborns blood volume! #ICAN2011
I had no idea!  All of my babies have had their cords clamped immediately.  I will definitely add this to my notebook – I had decided a while back that I wanted delayed cord clamping.  I know it’s not really a strange thing to ask of a CPM but may be strange for an OB.

anderzoid Henci Goer still on ineffective & HARMFUL practices: Care by an OB for LOW-risk & MODERATE-risk women #ican2011
This point was made by a NYC OB in “The Business of Being Born.”  It’s overkill, and generally speaking, normal birth just isn’t exciting enough for them.  Plus, most of them have never seen a normal birth – especially the younger OBs.

anderzoid: #ICAN2011 #ppdchat Henci Goer: it’s hard to get #PTSD on radar bc TRAUMA is centered in Institution. DEPRESSION is centered in women.
This is a very interesting statement and one that I’d like to have fleshed out for me.  I can almost grasp it but not quite.  I will say that people seem to be aware of PPD and acknowledge it but are less able to grasp PTSD as it relates to childbirth (or pregnancy loss).

Want to read more conference hi-lights?  Here is part 2 and part 1 of my Impactful Tweets “coverage.”

DH & I have a big to do list for the weekend, so I don’t know how thorough future posts will be.  Enjoy the weekend!

EDITED to add “Birthing Beautiful Ideas’s” wrap-up of the day’s presentations at the ICAN 2011 Conference.  Have a look!

Impactful Tweets (pt 2) from ICAN Conference

Looks like @DeepSouthDoula is the winner of cool tweets, part 2.  I’ll have to tell her the amazing news, LoL!  Looks like there will have to be a part 3 tonight.  Henci Goer has already made some great points, and she’s only just gotten started!  w00t!!  Here’s the link to part 1 if you missed that post.

DeepSouthDoula Abdominal scars can change your overall body mechanics for the worse. #ICAN2011
Interesting how people don’t consider what happens to the muscles and especially the connective tissue as a result of this major abdominal surgery.  I’m a professional opera singer and rely on the entire abdominal complex to support my sound.  This includes the pelvic floor.  This entire structure has been permanently altered.  Have you considered how your cesarean might (will) affect you physically?

poderyparto Herrera: People should see a c/s. Once they ser it they’ll start asking more questions. #ICAN2011
This is an interesting statement.  I just don’t imagine your average woman would be interested or even willing to watch a cesarean surgery.  And really, it’s different being in the room when one is happening versus seeing it on TV or YouTube.

Preparing4Birth: #ICAN2011 @ICANtweets Insurance company should not mandate how doc works. Write congressman. A state issue
This is HUGE.  I was aggravated to learn from my OB that his malpractice insurance doesn’t cover vaginal breech delivery.  He’s an older doctor, so of course, he knows how to do it.  I think it is incredibly unfair that my second birth was dictated by someone else’s friggin’ insurance!!!

Ethologicmom #ICAN2011 amazing that dice didn’t realize that women choose or are forced into hbacmom by bans and lack of support!
Dice?  I have no idea.  But yes, women increasingly choose homebirth and unassisted birth because they ultimately feel unsupported by some (or all) careproviders.  A woman who feels forced into homebirth or unassisted birth are not ideal candidates for those settings.  A woman should have access to the care she desires.  We’re the ones paying for it!!!

DeepSouthDoula The only true way to know if you will have a successful VBAC is to try. #ICAN2011
I just can’t imagine not trying . . . even though people would try to scare me out of it.  Fearmongering is not the way to go, folks . . . studying the evidence is!

drpoppyBHRT How do we “grow” supportive providers? #VBAC @BirthingKristin #ICAN2011 #NIHVBAC
I imagine that since newer docs are typically less willing to recommend VBAC (based on NIH VBAC consensus report), that now that the ACOG recommendation has been revised, perhaps the new generation of OBs will be less resistant.  This doesn’t mean we shouldn’t be doing everything we can to positively affect our local birth culture!

DeepSouthDoula Any person pregnant or not has the right to refuse medical treatment – even in an emergency. Goes for refusing CS. #ICAN2011
One of my friends is having her 3rd VBAC after cesarean.  We were performing out of town, and she thought the local hospital didn’t allow VBACs.  She was relieved to learn (from me . . . yay me!) that she did NOT have to consent to a cesarean if she had the misfortune of going into labor in that town.  On the other hand, it would have been an opportunity for us to ‘educate’ that particular hospital on the rights of childbearing women! ;)

DeepSouthDoula Have the NIH & ACOG statements ready & use them to our advantage. #ICAN2011
Great advice!  I’m on Spring Break right now, and honestly, I’m just now getting around to reading the NIH VBAC Consensus report.  Eye opening, really.  I’ve “clipped” out the conclusion summary and points within the detailed section of the statement that directly apply to my situation or to issues that seem most critical to me.  I will be bringing some of this information with me as I interview an OB regarding VBA2C.

DeepSouthDoula SHARE – ORGANIZE – PROMOTE – CHANGE. Make connections through social media. #ICAN2011
Following the #ICAN2011 channel has shown me that a lot of birthies are now quite active on twitter.  I guess I’ll pay more attention to twitter . . . at least for a while.  Birthies and moms are welcome to request to follow me – @labortrials.