Sunday, July 26, 2009

Oral History...A lost art of sharing birth confidence.

Once upon a time there was a woman and she was going to have a baby, and she was glad.


She had knowledge. Her knowledge came from a life time of experiencing birth. The first time she saw a baby born was when her little brother came into the world. It was also the first time she experienced death, as this wee child was soon gone and had never made it to the mother's breast. But she learned. She learned over the years that birth can take many turns and it is not always the glorious event it is deemed to be. As time passed she saw more sisters and brothers born and nieces and nephews and a few neighbors enter the world and she was there to witness. She wiped brows, she tore cloths, she ran for the midwives and some times she went for the doctor. But she was witness and now it was her time and she was aware. She saw the ups and the downs. She knew when the first pains came that "the women" would be there and she could turn to them. She knew them and she knew they had wisdom and they had kind hands. She just had to let happen what would happen and the support would be there to guide her. She would hope for the best.

Fast forward to now. Women have the option to inform themselves or not. They have the Internet to find information. Too bad there is a lot of bad information as there is good. They can post on question boards and get answers that are so wrong it makes any birth advocate cry and want to post the truth, all the while knowing the date of the birth is long past, hoping that the querant did not return to read the advice of someone who was so wrong in their information. and standing in horror that some other women may read such misinformed information and act on it. Many women birth without even having seen a birth (THANKFULLY we have Youtube! where the oral history has turned to visual history). The birth outcomes in today's culture are dependant on where you birth and your primary caregivers and not on your desires. Women leave the hospital with cuts that drive deep into their bodies and sometimes into their souls. Women leave feelings ranging from "who cares how the baby got out" to births that lead to PTSD. For many women, the American Way of Birth is go to hospital as soon as possible, get your epidural, get pit, and hope for the freaking best! If you choose to not expereince any intervention then you got a big fight ahead of you and labor is not the best time to advocate for your birth desires with people you have never met before. It really is just not a good thing....not unless you are me and can tune it all out and get on with birthing that baby.

So this all leads me to the oral history of birth. When I first began to post stories about breech birth my intensions were to help women understand the mind set and choices that lead women into the births they eventually experienced. Without hearing the good stories you can never know that birth can be amazing. We need to know how to get from point a to point B and we need to understadn what can interfer with a normal trajectory.

So here they are, the surviving stories from the Heads Up! site. I hope it helps.



Home Breech Births

Psalm and Zoya are born - "This was easier said than done. We interviewed several yet ... most of the midwives had fear about the birth of the second twin and I did not feel comfortable having that attitude around me during birth. We decided to simply go it alone."
Morgan's Birth - "if I wanted to go to the hospital...I would probably have a c-section since Morgan was breech. If I wanted to have the baby here at home, I would have to face the demons (you know, those of my own birth) and work for this baby."
Home Breech Birth of Baby Jeremy - After one really strong push I asked ‘is the head out?’ The midwife said ‘soon it will come’. Then I looked down and saw two tiny legs dangling – to my surprise my baby was breech!
Breech Birth on the Families for Natural Living website- "My husband and I had been apprehensive about having a home birth, but we felt we had no choice. "
James' Birth - "I don't think there was anything risky about it. In fact I believe that home is the safest place of birth for most babies."
Planned Breech at Home - a midwife's story about a mother's desire...to birth at home.
Samantha's Birth - "About three weeks before my due date we realized that the baby was breech and started trying to turn her...".

Hospital Breech Births
Blair Vaughan - baby Blair is born after all the right cards fall in this mom's favor. Un-medicated breech birth with an audience.
Mark's Birth - the birth of a 9 pound 8 ounce breech, a story with an edge. (Baby is transported to NICU)
Miss births her surprise breech - "No one could believe it. The doctor was walking on air for the two days I was there, and we were the talk of the hospital that week. I love sharing this story with people." If you want to chat with me about this or anything, feel free to e-mail me.
Delia births breech - "At 32 weeks, my midwife said she could feel the baby's butt deep down in my pelvis. I thought "Oh god, no!" ".

Courtney's birth - "I had been examined the midwife said I was 7cm dilated and that she felt something like peas. I went into panic mode. I kept repeating "that's my baby's toes, it's upside down". (gas, stirrups, and episiotomy mentioned)
Colin's Birth - "The dr. arrived and checked me. He looked shocked and angry. I wondered if I was still just 4 cms and they called him early. He announced that I was 10 cms and breech!" (membranes ruptured, pitocin, epidural, forceps mentioned)
Mitchell's Birth - I believe that God allowed me to find the only doctor in town that assisted breeches to be my doctor when I just happened to be carrying a breech baby. (Induction with pitocin, epidural, birth in OR).
Birth Story of Alessandra Jeanine -"everybody I told about this looked at me with incredulity because most people seem to think a C-section is automatic with breech babies." (epidural, urinary catheter, stirrups, forceps, second degree episiotomy, painful recovery)
Mark - "When I got to 38 weeks, she did a vaginal exam and told me she thought that the baby was presenting breech... a few days later I felt the baby turn again ... Then, I felt him turn again (!!), so he was once again vertex... now 40 weeks, he turned again (!!!). " (very interventive birth, baby to NICU).
Jim - "a beautiful 10 pound, 22 inch rounded head boy" is born breech"

VBAC Breech
VBAC Breech Birth- "My husband left me to get on his scrubs thinking he had plenty of time, because they would do a C-Section. At this point I told my doctor I had to push really bad. He said, "We're going to deliver this baby vaginally."

Twins With Breech
Psalm and Zoya are born - "This was easier said than done. We interviewed several yet ... most of the midwives had fear about the birth of the second twin and I did not feel comfortable having that attitude around me during birth. We decided to simply go it alone."
Birth Surprise in Jerusalem (twin breech birth) - "I had had no labor, no warning. I couldn't fight the urge to push, so I quickly put a towel on our bed, lay down on my side and simply let my body work."
Double Breech Twins - Their birth was really the fastest of all my labors, ..., I don't believe the birth would have been any "better" had I gone to a hospital.
Twins born (second is breech) - "I look at Cathy and say..."Nicki's coming breech" and I begin to push, long and hard and not stopping. I don't feel anything. " (this starts at the beginning of the whole story use the site links to get you to the birth story)

Losing the domain name for the site meant that a lot of stories I had on the server that were not links are not listed here. I will post them on the new Facebook group I'll be creating later today.

Thank you all for your support over the years. You are the ones that made Heads Up! all it is and give me the desire to carry on sharing after it was gone.

I tip my hat to you.

Saturday, July 11, 2009

Rant on Choice

(original essay was written in 1999)
The first intervention in birth, that a healthy woman takes, is when she walks out the front door of her home, in labour. From that first intervention, all others will follow".
Dr. Michael Rosenthal - Obstetrician
One of the hardest mental exercises I ever had to do was complete my practical rotation during my perinatal nursing. I had a few run ins with my instructor when it came to understanding that *we* as nurses must respect the woman's choice when it comes to her birth and breastfeeding experience, regardless of how we feel about the issues of routine interventions and lack of "real" education regarding those birth choices.

I've learned that women come to birth with a variety of objectives (cope as best is possible, hope for the best and leave with a healthy baby), how they meet these objectives is where the nurse comes in. The woman that is uneducated about birth, and dependant upon unknown persons to see her through her travail, is guided by policies set up in hospital to ensure that she and baby are kept as safe as possible. Most often the mother makes choices based on word of mouth education and has an imperfect understanding of obstetrical intervention and those that apply them. Knowledge of things like: narcotics do not kill the labor pain, or mothers must reach active labor before the epidural is given to ensure that labor has a chance to progress, a slowed labor will get pitocin/syntocinon to speed it up and so on is usually not discovered until the mother is well advanced in labor and admitted to the labor room.
I'll admit I graduated my preceptorship with the lowest mark I have ever had during my ten years of full and part-time nursing education (I am sure this was because the nurses marking me saw that I was a rebel and did not conform with the *ways* a nurse should be (made me want to puke some days)). Speaking up and voicing my concern for the status quo in the current maternal care system made me furious.
In the end I did see that my trying to educate was a bit more up front than some nurses could handle. I eventually kowtowed (really I did, *gag*) to my instructor and *saw the light* and *the error of my ways*!!! I decided on my last day that there was no way I could work in hospital if it meant supporting interventions practiced on women with a loose sense of informed consent. I have been told that there are many women that need someone like me to help them through labor and that I could help many by working in an L and D unit. Unfortunately I *choose* not to. This is not an easy choice. But personally it would be too difficult to know that the epidural queen is my client because I'm next on the list to receive a "patient", and the nurse that pushes epidurals rather than support the mother gets the mom wanting a normal birth. It would kill me by the end of the first week.

I recently spent an evening with a girl that was due in a couple of weeks. She was pretty easy going about the whole pregnancy/birth thing, until week 36 came along and those old hormones kicked in. She began to question exactly what was to happen (yeesh!!). Well I spent all of 3 hours with her educating her on the emotions of birth and what to look for, some of the things that would indicate a quick trip to the hospital and what hoops she was probably going to have to jump through to birth with no drugs (which was her wish). Well this little girl had her baby last Sunday. She headed to the hospital in such early labor (10pm) that they gave her a shot of morphine and sent her home to sleep. After her water broke (@ 2 am) she started to feel pushy, so off to the hospital they went. They luckily are placed into a birthing room (3 am) PDQ, and the nurse dons her glove. She assess the mom at 3.5 cms. HHHHHmmmmmmm you say??? pushy at 3.5 cms... posterior baby??? what could it be. Well this girl described the nurse as an old cow and slightly incompetent as to what she was doing. The nurse is "crabbing" at the girl to not push or you'll swell the cervix, blah blah blah... (these were the moms exact words.) the doc arrives about 15 minutes later and the mom tells him she feels pushy. Doc checks her to make sure...and guess what!!!! the mom is at 8-9 cms Now if the doc had not arrived and the mom was to continue in labor with this nurse what do you think would have happened? the mom was so uptight with this nurse she tightened up, now if the nurse were to stay in the room all the time to support this young girl that did not know enough to ask for another nurse...how well do you think she would have dilated. I truly believe that this case was a perfect case of mom relaxing and dilation progressing swiftly. Once the doc had arrived and the mom felt comfortable and safe (yes safe), she let go and her true dilation showed through. I would have been scared for her if he had not shown up on the scene. As it went, she took another shot of Morphine when she was almost fully dilated, (I think if this mom had had a doula she would not have needed it). This gals only non-medical support was the father of the child who she had broken up with during the pregnancy). She only pushed for 1/2 hour until she began saying she wanted it over (her words), yup out comes the vacuum and baby born minutes later. Mom has a second degree laceration. Baby is dopey and having a hard time breathing because of the morphine, they want to give Narcan (morphine antidote) mom refuses because she doesn't know what it is!!!!!!!!

Okay I do have a point some where in here....let me find it...

Oh yeah...choice!!!!

Where were the choices during this birth? What was affecting them? Is it ethical to have a mom who is in the throes of a perfectly normal labor to make decisions that she may later regret. Do we stand by and say "you can do it, you are doing it you just have a bit more to go!!! Hang on there girl!!! Think of the baby!!!", or do apply the interventions and then we make sure that we have all the rescue measures on hand to counter-act the adverse affect the decisions have on the baby.

Do yourself a favor. trust yourself, trust your body. Don't take the chance of waiting and seeing if your birth is good, and then make different choices the next time. All births are as different as the child that is born. Place yourself in the company of familiar faces and surroundings. Don't take your chances. If you are unsure then go to a birth center. If your pregnancy is healthy seek out the advice of a wise woman (midwife, doula, alternative care physician, etc), or at least just consult with one and see the difference in attitude. It just might make a different to not just your experience, but your baby's too.

The choice is yours, but when you make that choice, please understand it will effect your baby in all ways. Educate understand and believe. That is what makes birth good.