I digress but

It looks like Clinton did NOT . . . I repeat . . . did NOT win Texas.  However, now she’s threatening legal action?  Really?  I’m not sure why . . . the process is going how it has always gone in Texas as far as I can tell.  Don’t miss the comments – some of them are quite funny and others are spot on (at least from my Obama-lovin’ perspective).

GenXforObama

So now that she didn’t win Texas isn’t she supposed to drop out of the race?

I don’t understand

I don’t understand why people who would kill or abuse children are able to get pregnant and maintain their pregnancies and so many wonderful people are infertile.  You hear stories of babies found dead in dumpsters or sexually abused or beaten or abandoned, and these stories hit me so hard these days.  It’s so unfair!!!

I saw something horrible on CNN this evening and found it again through digg.com.  A woman was caught on tape POWER WASHING HER 2 YEAR OLD CHILD at a car wash.  Thankfully the baby wasn’t physically damaged, but I can only imagine what this toddler has endured at home and how emotionally damaged the child is.  It just breaks my heart.

ORLive Sensationalizes and Marginalizes Childbirth

This really creeps me out!  I’ve known for a while that OR Live will feature a planned cesarean birth at the Shawnee Medical Center.  Is this an attempt to further normalize cesarean birth?  Is it a response to America’s voyeuristic preoccupation with “reality” shows?  Is this yet another way to marginalize and trivialize natural childbirth?

The press release points out that “[a]ccording to the Centers for Disease Control, every year more than 1 million women in the United States deliver by Cesarean Section, commonly known as a C- section.”  (See it’s ok.  It’s normal.  It’s safe because mom and baby are in a hospital.)  It’s like watching Little Red Riding Hood.  You don’t know if it’s the version where little red gets away or the one where the wolf eats her.  This is an apt means for normalizing technologically-manipulated childbirth.

Notice the technorati tags at the bottom of the page: OR-Live   surgical video   medical video   C-Section   Cesarean Section   fetal distress   breech position   
There is nothing here that indicates a medical need for a cesarean.  Fetal distress (a subjective and often misleading diagnosis) cannot be predicted far in advance.  Breech position would not have been determined at the time I first heard about this event.  So how did this mother and baby get selected for major abdominal surgery, I wonder?  The press release states that cesareans are reserved for babies that cannot be born vaginally.  The title claims that cesareans are performed during “complicated” or “high-risk” deliveries.  How has that been determined in this case?

Or is it that some lucky gal and her innocent child will be selected sometime during this week preceding or on the day of the big show for a 7:00 pm cesarean?

Ugh, if this don’t make yer skin crawl . . .

Avoiding Tomorrow

It’s 11:10pm and I’m still awake.  Ludicrous – I suffered a miscarriage and endured surgery a mere day-and-a-half ago, and I know my body and mind need rest.  After hours of surfing the internet and spending time on fringe subjects, it dawned on me – I’m avoiding tomorrow.

I am avoiding tomorrow because I need to get back to work.  Life needs to go on.  I can’t stay in bed forever.  I can’t continue doping up on hydrocodone, anti-anxiety meds, and wine.  I can’t keep avoiding family responsibilities.  I can’t refuse phone calls forever.  So, I’m still awake spending time on insignificant things (like this post) because as soon as I shut my eyes, I’ll have to face tomorrow.

My “work” today has been interesting.  I watched a Bill Moyer lecture captured on video a few weeks before his death.  I learned about “cultural creatives” and decided that Obama must be one.  (What really helped me put this together was a recent Hillary Clinton rant which I can no longer find but had something to do with his supposed pie-in-the-sky rhetoric.)  I tried – and failed – to find a good diagram of Toffler’s * wave theory to share on an on-line forum and came across a thought-provoking futurist post about something called “future shock.”  I surfed digg.com, compared it to reddit.com, and decided that I prefer digg.  I thought about how I can incorporate social activism discourse into the philosophy of music education course I’ll teach on-line next spring.  I started watching an interview with Naomi Wolf, author of The Beauty Myth (which I haven’t read) and The End of America (which I am now interested in reading).

And now it is 11:40pm and I must face going to sleep.  My DH is still upstairs playing World of Warcraft.  That’s how he escapes the horrid reality of our current situation.  And I go to bed again alone . . .

* Evidently the neutrality of this wikipedia entry is disputed to which I respond, “when is communication ever truly ‘neutral’?”

Too Late for Natural Birth?

In my google alerts today, one headline stuck out: “Too late to reverse rise in c-sections?” from the Boston Globe.  It is a letter to the editor from Lois Shaevel, co-author of “Silent Knife.

Shaevel states:

For eons we females had been capable of giving birth with very little medical intervention. Then childbirth went into the hospital, and the process became a medical and increasingly surgical event.

It’s sad really.  I’m not saying that all women don’t need a hospital and that all births can be achieved non-medically, but what makes me sad is the shift in how pregnancy and childbirth are viewed by our society.  Pregnancy and birth used to be normal and expected events in a woman’s life.  Now when you tell someone that you are pregnant they ask you if you have a first trimester ultrasound scheduled yet.  When you respond by saying that you don’t plan to utilize ultrasound technology unless it becomes medically necessary, they cock their heads, look at you funny, and respond with a suspicious “huh!”

Shaevel continues: 

When Nancy Wainer and I wrote “Silent Knife” in 1983, we hoped our work would reverse the trend and give women confidence in their bodies’ innate ability to birth their babies. If this trend of surgical intervention in the natural process of childbirth continues, the only women who will birth their babies naturally 50 years from now will be those who don’t make it to the hospital in time for their caesareans.

Some women are finding ways to become more confident in their bodies.  I joined the International Cesarean Awareness Network (ICAN) which greatly increased my confidence and understanding that a repeat cesarean would likely be unnecessary.  However, the doctors will always find a way to rob us of our confidence.  One ICAN list member was told early on in her pregnancy that s/he was supportive of her choice to VBAC.  Now at 36 weeks she’s been told to schedule a repeat cesarean.  This is not an uncommon story.

Here are my thoughts on how/why this keeps happening to women who desire vaginal birth after a cesarean (VBAC).  Perhaps the doctor just wants the business and thinks s/he will be able to change the patient’s mind along the way?  Perhaps the doctor believes in a woman’s choice but loses confidence along the way?  Perhaps in losing confidence in the mother along the way, the doctor is thinking about the legal consequences of not performing an elective repeat cesarean?  Perhaps the doctor, losing confidence along the way or thinking s/he can coerce the patient into surgery, also has the $$ in his/her eyes since surgical birth costs so much more than vaginal birth?  Perhaps the doctor knows that VBAC labor can take longer, and since s/he will have to be more readily accessible thanks to ACOG directives, s/he pushes for the quicker solution – major abdominal surgery?  Perhaps the doctor is more afraid of the uncertainty of normal (as in natural) birth because s/he is not familiar with it versus that which s/he is trained to do – perform surgery?

Shaevel’s letter was formed in response to this recent Boston Globe article.  Here are a couple of important points to consider from the article:

“It’s important for us to step back and say, ‘Why is this happening, and is it in the best interest of the public?’ ” said [the state’s secretary of health and human services, Dr. JudyAnn] Bigby, whose research before entering state government had focused on women’s health issues at Brigham and Women’s Hospital. “This is not a minor surgical procedure; it’s a big deal. We need to understand why this trend continues.” [emphasis mine]

She is “sufficiently alarmed” that her state’s cesarean rate now eclipses the national average of 31.1%.

Obstetricians’ fears of lawsuits may also fuel some of the increase.

“There’s no doubt about the medical-legal burden; the litigious nature of society has an impact on this,” said Dr. Fred Frigoletto, chief of obstetrics at Massachusetts General Hospital. “Very few obstetricians have been litigated because they did a C-section. But they’re always litigated because they didn’t do one.”

Fear of litigation is NEVER an appropriate motivator for medicalized childbirth.  Interventive practices are only appropriate when there is sound evidence of need.  Basing medical opinion, advice, and practices on a fear of litigation is unethical and violates the oath and creed to “first do no harm” that all doctors agree to when they become registered practitioners.

It once was popular to deliver subsequent babies [following a cesarean] by vaginal birth, but by the late 1990s the practice began to fall out of favor because of potential risks.

Potential risks – yes, it is possible that a woman’s uterus may rupture during labor.  The risk of rupture may be as low as .5%, and any doctor who puts forward a rate of greater than 1% should be asked for the research to support such a statistic.  Avoiding induction and augmentation of labor and having continuous labor support (an experienced doula and/or midwife) will help VBAC moms achieve their goals.

Anyone who doubts the importance of natural childbirth for both mother and child should register for the “What Would Mammals Do” webinar through Conscious Woman

Midwifery legislation called for in Idaho

Homebirth midwives in Idaho have asked for legislation that would put in place a licensing mechanism and give homebirth midwives the ability to offer broader services. 

According to the recent Times-News article (2/22/08):

Proponents say midwives have provided safe birthing assistance for centuries and that expanding their privileges when it comes to dispensing medications, including intravenous fluids, antibiotics, painkillers and emergency oxygen, will boost the value of their services. They say this will especially help people in less-populated areas around the state.

The debate, [Connie Wolcott, CNM] said, is especially important given that 40 percent [sic.]* of births in the U.S. are done by cesarean section. Licensing, she said, would make it easier for people to become midwives and ease what she described as a huge backlog of patients.

“As a woman, that terrifies me,” Wolcott said of the cesarean rate. “As a scientist, I am appalled.”

I agree with Wolcott.  It is terrifying to know how easily a woman can end up with a cesarean section even when she thinks she’s done all of the preparation necessary to avoid an unnecessary cesarean.  As a researcher (qualitative) and educator it is appalling to witness it happening every day in my community and across the United frickin’ States. 

And this is what the opponents had to say, according to the article:

Idaho medical doctors and nurses who testified against the bill said creating a licensing system that still allowed uncertified birth assistants to practice could confuse unsuspecting members of the public who wouldn’t know the level of training of their care provider.

Confuse the public?  Because expectant parents aren’t smart enough to check a midwife’s credentials and history of experience?  Moooooooo?

They also said that the rules would allow midwives to do things that registered nurses aren’t allowed to do on their own.

Ah, here we go.  The nurses are mad because they don’t get the same priviledges that would be extended to midwives serving a small portion of the birthing population?  They’re jealous because they’re governed by doctors whereas homebirth midwives operate independently unless obstetric back-up is needed.

I’ll be interested to see how things progress in nearby Idaho.

* The national cesarean rate (projected, 2006) is 31.1% though certain areas of the country have cesarean rates more than double the national rate.  The cesarean rate is not expected to decline any time soon.

Contrast these homebirth news stories!

I have followed homebirth legislation news in Utah and South Dakota with interest and concern.  I don’t want Montana getting any stupid ideas. 

UtahI blogged about their nonsense recently.  Yesterday, the Utah Senate voted to restrict homebirth practices.  The bill was supposed to have been a compromise, but what resulted was something restrictive and punitive.  Women will be forced to attempt VBACs in hospitals or on their own.  Were this the case in my state, I would have an overwhelminly large chance at “failure” since my hospital’s VBAC rate is a pitiful <1%.  They only had 16 successful VBACs at the hospital in 2006.  Utah legislators have chosen a path that makes homebirth less safe.  To search for Senate Bill 93, click here.

South DakotaI also blogged about their homebirth “situation,” and it appears that both the SD House and Senate have approved a homebirth bill. 

The bill would require midwives to become registered nurses, get master’s degrees in nursing, and pass additional tests. Certified nurse midwives wanting to attend home births would need approval of both the Nursing board and the Board of Medical Examiners.

Allowing certified nurse midwives to attend home births in South Dakota would be allowed on a trial basis until 2013.  (click here for source article)

My concern is that CNMs were previously required to have OB back-up, and evidently no OBs were agreeing to provide back-up services.  What will be different?  And I’m not sure that having a Masters Degree makes anyone particularly qualified to attend labor.  Shouldn’t these homebirth midwives have assisted on “x” number of births before they become licensed?  Why is it always about the piece of paper??

Also, the bill states that CNMs will be able to attend homebirths “under certain circumstances” but doesn’t clarify what those circumstances may be.  I suppose we must find the Board guidelines to find more clear language.  To read the bill, click here.