Empowering Birth Blog

Deadly Delivery

"Deadly Delivery, The Maternal Health Care Crisis in the USA," was just released by Amnesty International. Did you know that more than two women die every day in the USA from pregnancy-related causes?  Read this report to find out the shocking story of maternity care in the US.

Maryland's State maternal mortality ranking is #48!  We are one of the wealthiest states and have one of the worst ranking for maternal mortality.  There is work to be done!

We Cannot Eliminate Risk

I was thumbing through Anne Frye's "Holistic Midwifery Volume I, Care During Pregnancy" when I came across a fantastic passage.  Frye deftly illustrates the interesting attitudes we have regarding safety and birth in this country.  There seems to be a belief in our culture that if we work harder and add a bit more technology, we can eliminate infant mortality.  She offers an analogy, what if physicians decided to eliminate all death from choking?  Anne writes (page 533):

Suppose physicians everywhere suddenly decided to focus on eliminating choking deaths resulting from the ingestion of food.  The medical focus would become :avoid death by choking.  To that end, public areas would be set up so that people could be observed by health professionals while dining.  Standards of "normal" eating would be established; perhaps times of the day, blood sugar levels, and chewing patterns would all be calculated in relation to the number of people who choked.  Some, who had choked before or who were especially at risk (the very young or very old) would be hospitalized during meals to be more carefully monitored.  Foods would undoubtedly be mashed or pureed. Eventually, no doubt, doctors would advocate nutritive I.V.s as a solution for the high risk and those who didn't want to risk eating the more careless way.  Of course, to completely eliminate this choking problem, everyone could receive nutritive I.V.s. A lot of time, money and effort would be spent developing various nutritive I.V. fluids to meet everyone's needs. People would discover where they stood as far as risk was concerned and those who ate at home unobserved would be seen as reckless and irresponsible.

Out of curiosity, I looked up the top accidental causes of death in the US according to the National Safety Council (http://agsafety.tamu.edu/ACCIDENTAL%20DEATHS%20IN%20THE%20UNITED%20STATES.pdf). Choking is actually number six on the list. Of far greater concern are deaths by motor vehicle accidents and falls.  Perhaps physicians could set up programs to monitor walkers?

Blaming Women

Did you know that the "increasing number of c-sections can be linked to an older and more obese population of pregnant women as well as the increased number of multiples?" At least that is what was quoted by Dr. Erin Tracy, an OB-GYN at Massachusetts General who is ACOG's delegate to the AMA in the September 20 issue of the Washington Times, "Hospital stay not part of process for some moms." The article is, over-all, more positive then negative towards home birth but I really wish we could stop blaming women for the increasing cesarean rate.  I am going to go out on a limb now but I wonder if the increase in cesareans might be due to the overuse of interventions such as the fetal monitor or to OB's making decisions based on liability rather than what is best for mom?

Reducing Infant Mortality

Check out this must-watch film on Vimeo: Reducing Infant Mortality. 

And while we are on the subject of reducing infant mortality, please knit a hat. 

You can download easy patterns here: http://www.BirthingHandsDC.com/hats/index-NEW.html.

I must admit that I don't know how to knit or crochet (and feel a tiny bit intimidated by the process) but I will be gathering with a group of women on September 5th to learn (I've already bought yarn and a knitting friend gave me two needles!) and to crochet some hats.

My Wife Died After Giving Birth

Please read this article, the feature article in Harper's Bazaar, and share with friends, "My Wife DIed After Giving BIrth."  According to the article, "the rate of maternal death related to pregnancy or birth almost doubled between 1990 and 2005."¹  Midwives help lower the rate of maternal death by checking in on mom regularly during the immediate post-partum period (and by having a low cesarean rate!).

Jenna Gabrial Gallagher, "My Wife Died After Giving BIrth" Harper's Bazaar, online, http://www.harpersbazaar.com/magazine/feature-articles/wife-died-after-childbirth-0909.

Fitting Birth Into Health Care Reform

Check out this great article on why midwives NEED to be a part of health care reform by Jennifer Block, Where's the Birth Plan?  This isn't an easy job when most women in the U.S. don't give birth with midwives, despite the fact that the "best available research suggests that low-risk women and infants who work with midwives have comparable and possibly better outcomes and receive fewer interventions than similar women who work with physicians" (Childbirth Connection, "What is the Bottom Line"?)  We need more midwives!

That's Not MY OB! (Or is it?)

This story was recently told to me by a doula friend (info below) with years of experience.  The OB in the story backs a well-loved midwifery practice.  Moral of the story, know your back-up doctors!

At a hospital birth in 2007, a stressed out OB stormed into a laboring
mother's room. She had been in labor for 9 hours and pushing for just over 1
hour. The RN left to get the OB who stormed in screaming and pointing
fingers at both the doula and the father not to talk. The he took a deep
breath and turned towards the mother telling her he was unhappy at what he
saw on the monitor (nothing was unusual). He thought there was cord
entrapment.  And did an exam. Upon exam he took he thumbs and pushing the
baby back up the vaginal canal and rushed her off for an emergency
C-section. 

Mom had general anesthesia (as she had a history  of poor drug reactions and was
scared of the epidural). Upon recovery was nursing and doing fine.  Two hours
after I (the doula) left and the father laid down for a nap, mom started to
hallucinate on the post OP pain meds. She was eventually strapped down as
she was persistently trying to use a spoon to remove something that she
'thought' was stuck deep in her throat. All post op drugs were stopped and
mom recovered and was able to nurse and bond with her child.

When I asked the nurse in post-op what was noted at section. She said
nothing, no cord, perfect presentation and the baby was fine. So I said there
was no reason then? And She said no, just that office hours are starting in
an hour and the OB is a _____.

Mom says that she feels like she gave birth twice. But is happy that
everyone is ok.

Thanks for sharing your story Ursula!

Ursula Sabia Sukinik, AAHCC,

Childbirth Educator, Birth Doula and Midwife Assistant

BirthYouDesire.com
301.231.5122 

 For another eye-opening OB story about a VBAC Consultation (mom is working with midwives but has to "consult" with an OB), visit No Womb Pods blog.

A Great New Nursing Blog!

A mom just sent me the link to a new nursing blog. I especially love this post,"Don't let this happen to you, #25, Sarah and John's Unnecessary Induction."  Don't forget to read both parts 1 and 2!  The sad thing about Sarah and John's story is that this story is repeated over and over and over again and too often the couple doesn't realize how unnecessary the induction/intervention is and how ridiculously hard the labor and delivery nurse or doula has to work to bring some sense of normalcy to the birth process. Birth SHOULDN'T be a battle that must be fought every step of the way.  Labor and delivery nurses and doulas should not have to double as soldiers in a war for normal birth and yet this is often a requirement if the couple they support intends to have a vaginal birth.  

For me the moral to Sarah and John's story is that if you can, it is better to birth at home or in a birth center then to risk the chance that you will end up with a doctor on call who does not support your birth plan and a labor and delivery nurse (unlike the author of the blog Nursing Birth) who does not support normal birth.  Sarah and John's story, without the incredible support of their fantastic labor and delivery nurse, would have been vastly different and not at all empowering.  Do you really want your birth story to hinge on who is on call?  

I look forward to reading the "Injustice in Maternity Care" series.  Thanks for a great new blog!

The Story of My First Pregnancy

I am ready to tell the story of my first pregnancy.  I found the file on my computer with my lists for the baby, for the hospital, my birth plan, the story of my labour experience.  It will be a good reflection on how much I have learned, a humbling experience.  Perhaps someone reading it will say, hey, me too, and perhaps they will take away from it the realization that they aren't as prepared for the birth as they thought they were.  I would like to say that in our country you can just walk into a hospital, with your birth plan and lists, and have a physiological birth, that is certainly what I had planned to do, but that is not the case.  I will try to begin tomorrow.

More New York Moms Choosing to Birth at Home

A parenting blog is hosting a poll about home birth.  Let's up those numbers a bit shall we (smile).  You can check it out at More New York Moms Choosing to Birth at Home.  Not sure I understood the point about germs and cleanliness, however.  After learning some pretty scary facts about MRSA (methicillin-resistant Staphylococcus aureus), I would choose the germs I know at home over the germs I don't know (and which are often very resistant to antibiotics and can cause nasty infections).  Although I've heard the small space concern from several moms I've worked with I don't know many apartments that are smaller then a hospital room.  That said, you do have to feel safe at home to birth at home.