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:

What Will This Home Birth Summit Look Like?

The upcoming Home Birth Summit, supported by funding from the Transforming Birth Fund, is raising numerous questions in my mind, and for numerous others, such as: 

  • How are the agreed-upon ‘stakeholders’ being represented?  How are consumers, in particular, being chosen?
  • What percentage of invited participants have direct experience with home birth?  In my opinion, a representation of 1/3 HB midwives, 1/3 CNMs, and 1/3 OBs would not be an appropriate proportion from the practitioner group.
  • Why exactly is the American College of Nurse-Midwives interested in the issue of homebirth considering that very few actually attend home births?
  • Given the above question, I’d like to know if the home birth midwifery organizations (NARM, MANA) submitted a grant application?
  • How will the outcomes make home birth more accessible and more safe?  Will an outcome be that hospital systems and serving on-call OBs will be more respectful toward homebirth transfers?  Will OBs begin offering back-up services to homebirth midwives?  What might that look like?
  • What are the potential positive outcomes of this summit?
  • What are the potential negative outcomes of this summit, especially considering that the need for this summit originated outside of homebirth midwifery?

With permission, I share the following e-mail from retired homebirth midwife, Linda Bennett:

Are you invited? Who is going?

I have concerns about this “Summit”. I want to encourage communication with invited participants the same way I have encouraged communication with our elected representatives. These participants have been appointed to represent the interests of mothers, families, and, coordinated by a midwifery group, I also assume the interests of midwives. I have every hope this will be the case. My long experience with some of the groups that have been invited raises some doubt.

The “Home Birth Summit”, scheduled for some time and some place in the Fall of 2011, is being coordinated by the organization called “Future Search”. The ACNM originated and identified a need to hold this “Summit”.

The American College of Midwives has many CNM members who actively support families and mothers who want a low-tech physiologic labor and birth in the hospital, in birthing centers and at home. CNMs have demonstrated over and over the value of personalized physiologic management that dramatically reduces unnecessary major surgery while improving outcomes. Their work continues to be overlooked, ignored and impeded by Obstetric professionals in overt and subtle ways. If this summit was only held with these particular participants I would have little concern for the outcome.

Unfortunately the ACNM also has very vocal and politically active members who oppose home birth and/or non-nurse midwifery on local and national levels. Here in Oregon we have the “Home Birth Safety” committee organized by L&D nurses and CNMs in Portland at OHSU for instance. Nothing they have done has improved home birth safety in Oregon, rather their actions have polarized the birthing community and has caused even more mothers to consider unassisted home birth for their VBAC attempts after multiple cesareans.

It should not surprise the ACNM and Future Search organizers that home birth families, midwives with home birth practices, and long-standing Birth Activist groups and individuals feel uncertainty about the outcome of a “Summit” top-heavy with groups who have a history of opposition to maternal choice as well as to the independent practice of midwifery.

We have a vested interest in this “Summit” as its pronouncements will be used against maternal choice at every possible opportunity. Statements made in any documents released as a result of this “Summit” will be entered into testimony for or against legislation affecting mothers, families, home birth and midwives across the USA.

Amy Tuteur is an example of a vociferous emotionally-charged tea-party-esque commentator on the subject of home birth. She is not an expert on home birth. She has never been to one. In order to be allowed to deliver another baby in the hospital she would be required to re-train. If she is in any shape or form part of this “Summit” then it will be obvious that it will not represent the interests of mothers, families or address the real concerns of home birth.

Is Lynn Paltrow invited? Her work with NAPW has been as one of the most effective advocates for mothers in the USA in the tradition of  Doris Haire.

The reality is that home birth exists in the form it is currently functioning in the USA because of what it offers mothers and families AND because of what hospital-based ACOG-controlled maternity care does not.

Please communicate to individuals carefully selected for participation in this “Home Birth Summit”. They have been selected to represent you.

Future Search
4700 Wissahickon Ave, Suite 126
Philadelphia PA 19144
800-951-6333 or 215-951-0328
fsn@futuresearch.net

Here are additional links you might find interesting:

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?

Warning: FDA May Inspect and Destroy Your Bathtub!

I find it interesting, perplexing, ridiculous, and absurd that the FDA seized a shipment of birth tubs from a Portland, OR dock, claiming that they’ve been ordered to “inspect and destroy” them.  According to Barbara Harper, the founder of Waterbirth International, “They claim they are unregistered medical equipment, but they are not providing a way or means to get them registered. In other words, if the medical authorities can’t stop waterbirth, then just have the FDA take away the birth pools.” [emphasis mine]

feel free to reuse this image; please pingback if applicable

What’s more, the FDA believes this to be their jurisdiction because childbirth is . . . an . . . ILLNESS.  Yes, that’s right . . . I’m ill; ill with child.  VERY ill with child actually.  So ILL with child, that I might just any day now crawl into my bathtub for relief, medical relief of course, from my nearly 10 month ILLNESS.  Harper was told: “Pregnancy is an illness and birth is a medical event. Therefore, a pool that a woman gives birth in should be classified as medical equipment.”  Now, I will say that the FDA isn’t the only institution that believes pregnancy and birth to be an illness, but that’s another story for another day.

So, when I say that the FDA may want to come into your home and inspect your bathtub, hot tub, pool, pond, toilet, sink, whatever . . . hopefully you can see that I’m not really that far off the mark for these are all things water containers that women may use to facilitate childbirth.

More info can be found on this blog as well as Barbara Harper’s Facebook notes.  Please spread the news and watch for news of a petition that Harper may be starting on Change.org.

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!