Feeling Overwhelmed . . . hmm

I’m feeling overwhelmed this week.  Icky.

A couple of things have thrown me off my center, perhaps.  Like my good friend’s threatened labor now at 30w gestation.  Like my sister-in-law’s straight-forward CBAC yesterday – don’t get me wrong, I’m thankful, but it’s still affecting me.  Like having to go back to work in less than two weeks – survival mode.  Like all of the projects that I haven’t accomplished this winter break.  Like my birthday coming tomorrow – gross late-30s number!  Like CBA2C vs. VBA2C vs. CBA2C vs. VBA2C and on and on.

Ack.

What do you do when you’re feeling overwhelmed and ineffective?  Any suggestions?  It’s really causing me to stagnate and procrastinate.

It’s not like I’m doing absolutely NOTHING.  It’s just that I feel like I’m hiding in my birth research and stressing about a lot of different things and not actually accomplishing things in a timely fashion.  I just need to break the cycle.  I probably need a to do list – maybe a reward chart?!  Haha!

Fiction gives me unexpected confidence

This may sound strange, but I’m reading Dan Brown’s The Lost Symbol at my husband’s suggestion, and it’s really helping me . . . at this moment . . . find peace with my path to successful birth at the end of this pregnancy.

This book introduced me to noetic science.  Huh?  According to Wikipedia, noetic theory is “the study of mind and intuition, and its relationship with the divine intellect.”  That is just right up my alley in some ways.  I’m more prone to read a research study about pregnancy than I am to delve into Birthing from Within, but part of my non-fiction pursuits in the past have focused on theology and mysticism, and this book (and a recent talk with a trusted friend, a “straight up” talk with a midwife who doesn’t live in my area, and some soul searching) has helped remind me of the mystical aspect of birth.  Birth is a divine gift and one bestowed on women.  Should it surprise us that the male-dominated world would try and rob us (think gender subversion, think hegemony, heck think Marxism) of this unique gift?!

Ok, so back to my unexpected fiction-induced fervor and confidence in my ability to birth:

  • “Our untapped potential is truly shocking.” (p. 27)
  • “We have barely scratched the surface of our mental and spiritual capabilities.” (p. 67)
  • Our thoughts have physical mass & can interact with the physical world, “. . . whether or not we [know] it, effecting change all the way down to the subatomic realm.” (p. 67)
  • Intention requires practice! (see http://www.theintentionexperiment.com/how-to-intend)
  • This seems to coincide with what I’ve already learned about Bodytalk (see http://www.bodytalksystem.com/learn/bodytalk/) – that the body can rebalance and repair itself.

Gosh, what does this have to do with natural birth?  Well, in my case, I’ve had a lot of experience with programming myself in the medical model of women’s health.  I have benefitted from this model, surely, but when it comes to natural physiologic birth, the medical model has its severe limitations.  I feel like a hostage to the medical model – and sometimes victims are oddly attached to their captors.  I am one of those victims.

I need God to work with me BIG TIME during this pregnancy.  He continues to keep me safe even though I fall flat on my face every day.  He never forsakes me.  He will protect me and this baby too, if it’s his divine Will.  God’s plan may not be my plan, but I have to believe that no matter what my and my husband’s decision may be for this birth, that His Will will be done.

“Lo, children are an heritage of the LORD: and the fruit of the womb is his reward.” ~ Psalm 127:1

“Peace I leave with you; my peace I give you. I do not give as the world gives. Do not let your hearts be troubled and do not be afraid.”  ~ John 14:27

“Commit everything you do to the Lord. Trust Him, and He will help you. Be still in the presence of the Lord, and wait patiently for Him to act.” ~ Psalm 37:5,7

Clearly, I’m still working all of this out and how it connects, and how it may or may not be useful to me.  But I am excited to share this renewed faith with you.  I’ve always been interested in the spiritual aspect of science, and now I’m discovering even more connections to and evidence of God’s presence in modern science.

Here’s to a peaceful and powerful 2011!

Breaking up with OB?

So, if you read this blog at all or know me, you know that I had an unnecessarian in 2004 for “CPD.”  (Umm, I’m 5’10″ and only had an 8lb baby.)  I suffered three consecutive first trimester losses.  I had a repeat cesarean in 2009 for double footling breech twins.  And now I am pregnant again with a singleton and planning to HBA2C in June or July.

So, my childbirth years have been heavily governed by the medical model of care.  I’ve been wanting a homebirth since 2007, but the opportunity evaded me until now.  I need to break up with my OB, and if you have any suggestions for when and how, I’d love to hear from you.

Should I wait until after the 20 week ultrasound?  (I want this ultrasound to confirm where the placenta has attached.  I already know that it is anterior, so I am concerned about accreta.)

Or should I do it now that I’m out of the 1st trimester?  I already have a relationship with a midwife and will be seeing her in the next couple of weeks.

I see benefits for doing it now and for waiting.  If I do it now, I have more time to trust my body, my baby, and my midwife without the temptation of ultrasound machines and other interventions.  I’ve become somewhat dependent on the “bells and whistles” of obstetric care, and I don’t think they help me build that internal trust I still lack. 

These are just the 8am Saturday morning musings of the over-thinking fence sitter!

Flashbacks

2007 – 2008 were really tough years.  I suffered three consecutive pregnancy losses.  I nearly lost myself.  I look back on those years and shudder.

I was driving down the road the other day and couldn’t get these losses out of my mind.  I gave birth to twin girls in August 2009, but this doesn’t mean that I don’t still grieve for those lost souls.  Ugh, I don’t like thinking about it.

Perhaps these losses are on my mind because I had that evil Mirena IUD taken out last month.  My cycle has returned.  I had my first real menses since 2008.  The blood reminds me of all I have lost and all I have gained.

I’ve just ovulated.  The lovely CM and pains of mittelschmerz remind me of all I could lose and all I could gain.

My heart craves another child.  My body begs to be useful . . . and to be complete . . . and to bring my childbearing years full circle in the comfort of my own home with my husband and perhaps a midwife or doula.

Undue Burden and Access to Evidence-Based Maternity Care

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.

Things Do Change or Welcome to Waffling

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.

Stressed: Woulda Shoulda Coulda

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.