Why oh WHY would you say that to a pregnant woman?

I’m ready to lighten the mood just a little bit, I suppose.  I found a link to this serious but cheeky post about what pregnant women really think when you say ridiculous things to them via @DarleneMacAuley on Twitter.  Ok, so maybe I should add the caveat that not all pregnant women react like this, but at least Mama Birth and I do!

Here’s one of hers:

Quote 5:
(Said when out in public with ‘gasp!’ all three kids and pregnant belly.)
“Wow. You are going to have your hands full.” ~Must be said in a voice that is a mixture of shock and horror.~

What I say:
“Oh….haha!”
(Why is my response almost always a smile and nervous laughter?! Seriously, my parents are not this polite!)

What I am thinking:
(On a bad day.)
“Are you kidding me, my hands ARE full. I am secretly freaking out, wondering if my sanity will survive and more importantly, if my kids will turn out to be functional adults. Can you get the door for me, load the groceries in the car (even after I say I don’t need help) and then help push me into my Suburban that conveniently has a four inch lift?”

(On a good day.)

“I love my kids! I couldn’t imagine life without them! They are the best thing that every happened to me and in no way a burden. Why does everybody seem so afraid of children? They are awesome.”

This is often said to me, especially when my big pregnant self is carrying a toddler twin on each hip!  (Mama Birth, I don’t have a Suburban; thankfully, a very practical Honda Odyssey!)

Here are a few more in my own voice:

Random persons: “Oh, you’re really carrying high.”

My responses:  (1) “Not really – here are my hip bones.” (2) “Really?  I haven’t thought about it.”

What I’m thinking: “That’s the last freaking thing I need to hear because what I do hear (it’s that small little nasty voice) is ‘yeah, the baby will never drop, never engage, never descend, mwhahaahahaaaa!‘”

Random persons (with my twin pregnancy): “Wow, you’re smaaaaallll for carrying twins!”

37.5 weeks with the twins

My response: “Huh, thanks?”

What I’m thinking: “I imagine she thinks that’s a compliment, but I don’t really appreciate having my twin pregnancy minimized.  I’m friggin’ huge but thankfully handle it well.”

Random persons (with my current singleton pregnancy): “Wow, you’re biiiiiiiiiiiiig!”

27weeks

My response: “Well, most women look bigger sooner when they’ve been pregnant before.”

35 weeks

What I’m thinking: “Eff you I do not either!!  I look fantastic!!!”  I also then think that people shouldn’t ever make comments about how big or small they think you are for whatever stage of pregnancy you’re in.

Various friends: “You’re not going to the hospital?  Wow, you’re brave!”

My response: “Hmm, well I think women who go to the hospital are brave.”

What I’m thinking: Unfortunately, most women take it for granted that they’ll be safe in the hospital and that their births will go normally.  I’m thinking that women don’t really consider their choice of birth venue as seriously as they should.  In my town, low risk women have access to a regional hospital (with a cesarean rate reflective of the national trend), a birth center (run by a CNM), and home birth.  Do women really know the pluses and minuses of each of these birth venues?

Random & Non-Random people: “Well, my baby would have died if we hadn’t been in the hospital because he/she was in distress!”

My response: “Wow, I’m sure that was really scary!”

My thoughts:  Normal, physiologic birth usually (sure, not always) does not lead to distressed babies.  When someone tells me their babies were in distress, I immediately wonder if they had: (1) AROM? (2) non-medically indicated induction? (3) non-medically indicated augmentation of labor? (4) epidural (which most hospital births involve epidurals).  We all usually study the “cascade of interventions” in childbirth education classes, but in the heat of the moment, lots of us forget that information and do whatever is required of or recommended to us.

These are a few of the random and usually not appreciated comments directed at me when I’m pregnant.  What are yours?

Hispanic Female Pelvises are Better?

My OB said the most bizarre thing today.  At first it didn’t really strike me as bizarre, but the more I’ve thought about it, the more I’ve realized it’s a crock of shit.

I’m not exactly sure how we got onto this topic this morning, but he stated that the Hispanic female pelvis is bigger than the average white woman’s pelvis.  The best birthers are short hispanic women according to the doc.  And then said something about a study in Southern California that I didn’t really pay any attention to.

Let’s just break this down a bit.  According to this post over at The Unnecessarean (July 2010), the cesarean rate in Mexico’s private hospitals is 70% and 40% in public hospitals.  If Mexican women are so much more physically capable of using their pelvises, then why does their cesarean rate exceed ours?  Perhaps pelvimetry is not as much a factor as OBs would like us to think?

The Unnecessarean post, an article written by Cinthya Sanchez that appeared in El Universal on July 18, 2010, further points out:

A 2002 study based on public health data from 126 countries found that the estimated rate of cesarean sections in the world was 15%, while in Latin America and the Caribbean, the average rate was 29.2%: Mexico (39.1%), Brazil (36.7%), Dominican Republic (31.3%) and Chile (30.7%).

None of these cesarean rates support my doctor’s assertion that a woman’s genetic structure has anything to do with achieving a vaginal birth.  According to Jesús Lujan, an obstetrician-gynecologist specializing in human reproductive medicine and the director of Clínica Pronatal, other factors are at work here.

“Women are marked in advance by previous cesarean section, any uterine scar in general, and cephalopelvic disproportion, which is almost always an imprecise measure because not all professionals use the same parameters for diagnosis. Mothers are told that are too short and that we are sure your pelvis is smaller than the baby’s head, that they are too old and will be unable to handle birth, that the cord is tangled, that sex will never be the same, and many other lies,” says Lujan.

Aha!  I knew it.  I wonder if some jackass OB in Mexico is currently telling his patient that you need to be tall with a Nordic bone structure (my genes) to have a baby fit through the pelvis?  What do you think?

For more information on CPD (cephalo-pelvic disproportion) diagnoses (and what it probably doesn’t mean for you) and pelvises, I recommend:

The Bestest VBAC of All

So I got an epidural for my VBAC.  Get over it.”  What a great title!  You know exactly what kind of story you’re going to read and can even take a guess at the spectrum of responses to such a post.

I think this is an important post to read.  A VBAC doesn’t have to be a fully unmedicated waterbirth at home to be a ‘success.’  Yet, we run the risk of presenting a set of demands on VBAC mamas, and for many if not most this might be obstructive.

My sense of this woman’s story is that she got the epidural knowing what risks and benefits are involved.  If not, then yeah, maybe she got lucky.  My sense of other women’s stories who have had epidurals, is that even though in most women, the risks may outweigh the benefits . . . some women just don’t dilate or labor well without them.  Perhaps we can hindsight quarterback their birth preparation process, but I think that’s a fruitless discussion.

I agree with Andrea’s point that fighting about the best way to VBAC isn’t constructive.  Ideally, we wouldn’t even need to address the “best way to VBAC” if we had a medically-appropriate cesarean rate in this country.  And if “normal birth” (and I do mean natural) has a high degree of variability, so much so that we insist women be left to labor in peace without clock pressure, then we must be willing to accept variability in the way women pursue their VBACs.

Most of us, I would assume, who consider ourselves to be VBACtivists, are working so hard to re-educate women about patient autonomy, patient choice, informed consent, and participating in health care choices, that we start from the position that a woman who requests an intervention such as an epidural during a VBAC labor doesn’t know the risks.  And this is probably how the squabbles begin.

Further, plenty of “die hard” VBAC gals make “natural choices” that I find potentially risky.  I’m pretty specifically talking about the use of EPO for home induction and tonics such as 5w or PN6.  And some women say NO to induction but YES to augmentation.  And some women agree to AROM (having their waters broken).  Some women have their membranes stripped.  And I get it . . . because as soon as you get to 40 weeks, you’re treated as a ticking time bomb.

What will I do this time?  Only time will tell.  But you bet your butt that if I get exhausted laboring at home but think an epidural will help me regain the strength to birth this child vaginally, we’ll hop in the car and accept the the bad with the good.

Toilet Watch

I noticed something this evening . . .

I spent the first 6 weeks that I knew I was pregnant, examining the potty after doing any business.

I’m spending the last 6 weeks that I will likely be pregnant, examining the potty after doing any business.

Are #1s and #2s ever more interesting, exciting, and scary than when you are pregnant?

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!

Choosing the care provider or not…

Unassisted birth (UC, UB) seems like an all or nothing adventure.  “Either you’re in or you’re out,” says Heidi Klum of Project Runway.  No smile.  Somewhat smug too.  I’m trying to sort out my feelings about UC because even though it’s not something I’m likely to do, it is a birth choice and therefore should be studied at the very least.  I read a lot of unassisted birth posts/forums and have gained so much knowledge and strength from it.  I wish I had that kind of confidence and peace.

So, like I said, it seems like UC is an all or nothing thing.  Most care providers (CP) won’t continue to see you for prenatals if they know you’re planning a UC.  (Maybe that’s not universally true, but that’s the impression I’m getting.)  And if you decide to have a UC then it also means that you’re providing immediate care for your newborn.  That seems a lot to ask of myself much less my husband.

My feelings on care providers seem to change by the second.  One minute I’m ok midwife only.  Then I’m ok with planning for homebirth and hospital birth simultaneously.  And then I’m ok with MW and ‘shadow care.’  And then these plans seem so unsatisfactory in different ways.

 The only ‘universal’ is that I want to have this baby as ‘naturally’ as possible.  But I still don’t have any idea how to accomplish this.

I have lots of wishes for me and our baby.  I want it all, and none of it seems like having it all because ‘having it all’ was stolen from me in 2004 with that first cut.  I know even that is still just a perception, not a ‘truth,’ but for me it feels like a ‘truth.’

  • Ideally, I would continue prenatal care with someone – the midwife or OB, whatever.
  • Ideally, I would birth this baby with my husband and maybe a close friend or two but no one acting as a ‘care provider.’
  • Ideally, someone else would swoop in and take care of the baby.

My ‘ideal’ may have to remain on a pedestal.