Strollerderby : natural birth

They Say: Planning to Work Until the First Contraction? Plan for Surgery.

Miriam Axel-Lute — Thu, 08 Jan 2009 20:00:00 GMT

Women who worked up until their due date had four times the rate of c-sections as women who started their maternity leave at 35 weeks, a new study from UC Berkeley has found.

Now, I'm not sure how you can control for self-selection in that kind of study. I imagine that women starting their maternity leave early are both more likely to be placing a priority on their birth experience and better off financially, each of which could affect their outcomes. (I'm assuming they excluded people with scheduled c-sections from the study.)

On the other hand, the results were is four times as likely, not a titchy 10 to 15 percent or something. That, as Dr. Seuss might say, is a whopping number, and it makes me inclined to think there really is something going on here.

It's not really hard to imagine what either: On the one hand, there's the stress of trying to do your job with an open-ended question of whether you might have to leave at a moment's notice, trying to have things ready and yet still work, with bosses and people who are going to step into your shoes watching you anxiously. And other hand, there's the stress of trying to decide when/if you have to leave when contractions start, whether you're up for driving yourself home, when to call the family, and then changing gears in an instant from worker to woman-in-labor. Hardly optimal conditions.

I was lucky: Since I was leaving my job instead of taking maternity leave, it was easier for me to choose to set my last day at 35 weeks. And I have to say, since my daughter came early (37 weeks and 2 days), I'm extremely glad I did. Even though you never exactly feel prepared, having tied up loose ends, cleared out my desk and said my goodbyes and then taking those two weeks free of deadline pressure and office details to sleep/nest/prepare felt wonderful. It may be the closest thing to taking a complete vacation without traveling I've ever done. Can I prove that that helped with my fairly uncomplicated birth? Of course not, but I wouldn't be surprised.

I know how much of a luxury that sounds like to so many people. I sure as hell couldn't blithely skip five (or even two) weeks of work now. In general, it's hard enough to get maternity or paternity leave at all, and the UC Berkeley researchers, while advocating strongly that maternity leave start earlier, note that people who choose to work up to their due date (or up to their labor as the case often is) are usually doing so because they can't afford maternity leave after the birth otherwise, and clearly that trumps.

I guess for now we can add the health advantages they've identified to the list of casualties of our work-over-family culture.

Image from Take Back Your Time.

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The Problem with "Orgasmic Birth"

Miriam Axel-Lute — Sat, 20 Dec 2008 16:14:00 GMT

The documentary Orgasmic Birth is coming to 20/20 in early January. I have mixed feelings about this.

First, unlike some of my fellow bloggers, I have no trouble believing orgasms can occur during the birth process, and this fact neither creeps me out nor makes me angry. I even think that it's cool that a documentary on the phenomenon is out and about.

However, it does creep me out that in the accompanying print article, people seem to be holding up orgasmic birth as somehow central to or representative of the messages of the natural birth movement, especially the very very important message that things like atmosphere, position, how safe a woman feels and how afraid she is will (along with a bunch of other stuff) affect her experience of labor pain, and the amount of it. They keep linking the idea of orgasmic birth being this big "best-kept secret" directly with such basic concepts as how it matters that women be allowed to labor in comfortable positions. I find this to be a troubling leap.

For my part, I think I had about as good a set-up as could be asked for. I was at home, I had a tub, I was never on my back, I felt safe and well cared for, I didn't go in particularly afraid. In fact, I knew of the existance of orgasmic birth, and while I didn't expect it, I was fully open to the idea that I might experience contractions as "rushes" instead of "pains."

I didn't. It hurt. A lot. I know this is no big surprise to most of you. It was not intolerable, and it was, as some call it, "pain with a purpose." It was worth it. But it sure was pain, and I sure didn't feel sexy or like an earth goddess or any of that.

Luckily, I hadn't been expecting to, and so I look back on my birth experience as a positive, empowering one.

But I'm afraid that if this orgasmic birth stuff is presented in the wrong light it's going generate a lot of "damn hippie" sentiment about natural birth, or even worse, a bunch of angry women who feel they were misled into thinking if they just breathed right and weren't afraid, it definitely wouldn't hurt.

The film's website says "Filmmaker Debra Pascali-Bonaro reveals a revolutionary approach to birth that is statistically safer for both mother and child than the birthing and delivery methods that are standard in many parts of the world today." Maybe she does. I think most of what the folks involved in the film would advocate would in fact do that. But surely orgasmic births are a happy side effect of that, not the revolutionary approach itself?

My take is that orgasmic birth is like simultaneous orgasms when two virgins have sex. Possible? Sure. Cool? Hell ya. Likely? Hardly. But more importantly, focusing on it as the goal makes a lot of people feel like a failure. You can just as easily up the odds by doing a lot of things you should be doing anyway: making sure people are well educated about sex and anatomy, happy with their bodies, not pressured into sex, etc.

Photo by Irannis.

Should You Take a Risk on Orgasmic Birth? (With Video)

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C-Sections Go "Natural"

Amy Kuras — Mon, 08 Sep 2008 19:38:00 GMT

As someone who had two, I am a pretty staunch defender of C-sections if that's the best thing for the mother and the baby (and for the record, I feel the same way about homebirth and whatever other options are out there to give mothers and babies the birth experience they wish for). But I'll acknowledge one criticism of them as valid – they don’t give the mother and baby very much of a chance to bond immediately after birth.

Salon's Broadsheet wrote last week about the idea of "natural" C-sections, which is gaining ground among some doctors. In short, if a c-section is non-emergency, they let the birth partner watch, uterine contractions (versus lots of pulling OUCH) can help deliver the baby, and babies are placed on the mother immediately for skin to skin contact.

I love this idea, although I wouldn’t want things to go so far as an unmedicated c-section (OMG). With my first baby, she was born by emergency c-section after a pretty terrifying labor experience (anyone who would like to trash me for having a c-section doesn’t get to judge unless they got to hear their baby's heartbeat slow almost to a stop while they lay petrified and helpless to save her). I couldn’t touch her right away, or even for a few hours, and really the whole thing left me kind of shocked and numb.

With my little guy, it was planned and the whole thing was different emotionally – not least because our hospital had, in the three-plus years between kids, instituted a "bonding nurse" program after surgical births. Also, the nurse anesthetist that was by my head during the procedure put up a mirror so I could see my son emerge and she helped my husband put the baby's head on my shoulder right away, so I could kiss him and snuggle him.

That in and of itself was so much more wonderful than my daughter's birth, but the other thing that was great was that my husband got to leave the room with him and carry him off to the nursery, and bring him to me in recovery when I arrived. The bonding nurse stripped him down and let me encourage him nto urse right away and just let me hold him for as long as I liked, which I think had everything to do with how great I felt right after his birth.

Circumstances surrounding my two birth experiences were so different I can’t say that my son's was so much better just because of the attention paid to bonding with him, and I am pretty strongly bonded to my girl as well. But I know I am awfully glad I had the chance, and I wish everybody did. Let's hope this catches on.

Top OB: Keep Men Out of Delivery Room

Madeline Holler — Wed, 16 Apr 2008 19:02:00 GMT

Michel Odent is a big name French obstetrician among natural and homebirth advocates. He's attended more than 15,000 births and written lots of books. He thinks midwives should be present for most births and that homebirth is better than hospital birth in most situations. He's all love, touch, peace, quiet, bond, bond, bond when it comes to women and birth -- a definite shift from the way things were when he started in the biz a half a billion years ago.

However! He has recently come out against one of the hallmarks of modern, evolved, woman-centered birth as we know it today. He thinks men should be nearby -- but not present -- at birth.

Huh.

Here's a bit of what he wrote in the Daily Mail:

... That there is little good to come for either sex from having a man at the birth of a child.

For her, his presence is a hindrance, and a significant factor in why labours are longer, more painful and more likely to result in intervention than ever.

As for the effect on a man - well, was I surprised to hear a friend of mine state that watching his wife giving birth had started a chain of events that led to the couple's divorce?

Okay, there, Dr. Odent. First, I think you need to settle down -- that divorce has got you totally freaked out. Second, you complain later that there hasn't been any scientific study on the effect of men's presence, so your anecdotes aren't exactly meaningful. Third, a couple of divorces/mother-child abandonments after 15,000 births? That's actually pretty good, non?

He goes on to say that men in the delivery room might be responsible for the increase in interventions and c-sections, because labor is being delayed or prolonged since women aren't relaxed enough to give birth with a man in the room.

Look, I'm not about to argue that watching your partner crap on the bed or push out a placenta is every (any?) person's form of fun. I'd even say that for some it's a real dread. Those people should be allowed to opt out. And knowing their husbands won't be comfortable seeing all that is certain to make some women uncomfortable or hesitant, and all that is just fine. Men who don't want to attend a birth shouldn't be stigmatized (which, my guess is, they are to some degree). And women who don't want their husbands/partners present shouldn't feel bad about making other arrangements.

But I still wouldn't discount every guy's presence as a hindrance to labor.

For me, my husband was a presence I can't imagine having been without. Who else but him knows that a subtle lift of my left eyebrow means shut the fucking midwife up (I was transitioning)? Who else knows to not laugh at my "jokes" during labor and instead give me looks of pity (but not too long or too pitiful).

Odent says the high-adrenalin response of a husband's fear is contagious and affects the moms and the labor. That might be true, but is every man scared of birth? Panicky? Not even.

All that said, I wonder if there aren't some women who think their births would have gone better without their husband/partners but didn't dare say anything. Any men feel like they had no choice but to stand there on the business end feeling totally uncomfortable?

Also, anybody find it weird that Odent's reporting these reactions of women due to men in the birthing room -- they sound like firsthand accounts -- and, well, Dr. Odent himself is a guy? How does that square with his argument?

Photo: BabyandPregnancy.co.uk

Weekly Check-Up: Natural Birth Like the Dutch

Kelly Mills — Thu, 27 Mar 2008 17:29:00 GMT

There's an interesting report on the Dutch tradition of giving birth from the perspective of a Reuters reporter. Basically, the Dutch believe birth optimally happens at home (30 percent of births happen this way, compared to a tiny fraction in the U.S.,) no pain medication is necessary, and that labor pains are part of the way the mother bonds with the baby. (If so, I ought to be practically fused to my child.) The bottom line is that birth is not seen as a medicalized process. Oh, and get this: A maternity nurse takes care of the family at home for a week and does cooking, cleaning, and infant care. Sign me up for that part!

While I've never been a convert to the notion of natural birth as essential--at least, not since the epidural became my BFF--I will freely admit that the Dutch system makes the whole thing sound kinda nice. However, it does sound like some feel that pain relief should be more readily available to moms in labor. As it stands now, there's no guarentee an anesthesiologist will be available, since it isn't seen as necessary. However, even those who want more options for women say it would be a shame to lose the Dutch perspective and practices in labor and delivery. But this is nice from an ob-gyn professor: "Giving birth at home, a unique Dutch tradition, should not be a goal in itself. What really matters is a good result of the pregnancy for mother and child." You said it.

Scream-Free Births

Madeline Holler — Fri, 01 Feb 2008 20:20:00 GMT

My husband and I took a six-week childbirth class about a month before my due date. The instructor was unquestionably pro-drug-free labors. So, in addition to going over all the anatomy charts and talking about our fears and how we handle pain, etc., we also watched a ton of birth movies. Tons and tons and tons. Her goal was to bore the fear out of us, I think. In fact, by the end of the six weeks, we'd seen birth from all angles -- you know, except the angle of actually experiencing it, which by then felt a little beside the point.

There was one video in particular, shot some time in the early 80s judging from the hair/hiked up jeans on the dad, that really stuck with me. The woman was so calm and checked out and focused on the birth. She didn't even mind writhing around naked with her legs wide open during her minister's quick visit to say "hi." She kind of got on my nerves.

While I was laboring and eventually pushing out my first kid, I thought of this woman. I reasoned that if this insane preacher-flasher could stay calm and have a baby, so could I. And I did!

But since nobody goes to childbirth classes anymore, I'll give you a YouTube version of mine -- it's not me, she's reaching the level of calm like I tried to and like the 80s mom did. I've come across some others with laboring women who are just as calm -- no, calmer! -- than my inspiring/annoying laborer. You won't want to watch them at work, as the camera captures EV.ER.Y.THING. Happy labors!