My archives might be a little outdated especially the older blogs. My links above are all new and current.

I have only positive things to say about Permission to Mother, an autobiographical account of a thoughtful mother and clinician who courageously writes from her heart, soul, brain, and personal experience; who is open to change in her views and opinions and is not guided by the safety of rules of any group or the status quo; she is guided by love and openness to the experiences life brings her and her family. Her process benefits her and those around her and those who read her words. And to add to that, the writing style and story telling ability here make it a very enjoyable read speckled with both the humor and seriousness of life. ~Laura Keegan RN FNP, author of Breastfeeding with Comfort and Joy

Readers enjoy your feedback and Reviews (82!) on amazon. Kindle Version Available!

Please Join me on Facebook at Punger Family Medicine.

Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts

Saturday, January 10, 2009

Are Doulas Necessary at Unassisted Births?

Question from Tophat:

I bought your book last month and in it you really promote the use of a doula and said something on the lines where you think everyone should have a doula.

I (Unassisted Childbirth) UCed last March. I did end up calling a friend for emotional support once the labor hit somewhere around 30 hours and it was wearing on me, but had I had a labor shorter than 30 hours, I wouldn't have called her.

Because of that, I'm inclined to not get a doula in the future. If a woman is UCing, what would the advantages of a doula be? I'm interested in your thoughts.

I love your book, though. :)

On a side note: the labor ended up being 44 hours, wonderful healthy pink little girl.

Answer:

Thank you for noticing my emphasis on the benefit of having a birth doula. I know you really read carefully and with interest. This is a great question.

Yep, I pretty much think all birthing woman should have an experienced doula. I am so tired of women being in denial about the amount of effort and focus it takes to get through labor and birth. I am so tired of hearing labors gone badly and observing the emotional scars and separation. Tired of hearing women aren't researching birth. Tired of women thinking that the first birth was easy and the second (or third, etc...) will come easy, too (you never know). Tired of hearing women emphasize unimportant details like nursery themes and token ultrasounds. Tired of hearing the same women complain they can't afford a doula (but they could afford the nursery and ultrasound). Women need to be prepared and arm themselves with all the support possible in this horrendous birth climate we have. I must recognize the value of an experienced doula. I also recognize the value of a student doula or any loving, caring women who serves in this role (which is what you had).

While writing the book, I anticipated getting asked your question by an "UCer." I admit my main concern or intended audience for my statement was the uninformed mother making no decisions for herself. I want to wake that woman up.

OK- So what do I think about unassisted birth (UC) and doulas? First of all, I commend anyone who researches birth like you do, prepares themselves for complications and emergencies and how to handle them independently, and doesn't give in to hostile and anti-intuitive birth practices and wants privacy. If one has done all that research and trusts that they can have a hands-off birth, and has meticulous nutrition, I fully support them. The woman who has done all this preparation may be the exception to my "everyone should have a doula" rule.

Most women haven't done this research and most women don't know their bodies. Just look at our full maternity wards.

BUT, the fact is, you never know how your labor will be and how you will emotional respond to it. Nor do you know how helpful your partner will be if you haven't birthed together before. You did the right thing. You DID prepare and have a "doula" available to you and you called her when you needed her.

If my labor was short and easy the first time, I would not have had a doula the 2nd time. I suppose I could also say if my labor was real quick the second time, my doula may not have made it. Perhaps, I could say the same for my 3rd birth. I am certain my 2nd and 3rd labors stayed focused with the doula support I planned for. Wouldn't it be great if we could all have short, easily managed labors?

It makes me wonder, if perhaps you called your friend/doula sooner for the physical support and emotional and spiritual reassurance could it have helped your wear. That's just a rhetorical thought and it may help give another woman perspective and something to consider. I am not really directing it at you. Chances are really great your next labor won't be 2 days.

Personally, as part of the "back-up" plan for UC, it's a great idea to have a support person on-call and call if your intuition tells you too. Discuss ahead of time under what circumstances you will be calling. Discuss if you do call them, do you want physical (touch, massage) support or perhaps just verbal support, or perhaps just to pass cool rags and drinks only. Having a doula supported birth doesn't mean you failed at "medically unassisted childbirth." Having someone available in the doula role can keep your birth clinically hands-off if your labor becomes more difficult than you thought. You can even discuss ahead of time, if they should leave the room after a bit or leave the house if you regain your focus.

I would like to point out that the term "Unassisted Childbirth" is used very lightly and to mean a lot of different things. When I think of unassisted birth, I think of someone who has read, researched, found like-minded support during pregnancy, had no midwifery/obstetrical care during pregnancy and intended to have a totally hands off delivery. No pregnancy ultrasound. Knows their plan to handle (or ignore) GBS, meconium, bleeding, lacerations, etc… Relying on their partner for support.

Is that what others think UC birth means?

I have heard it used in so many other contexts:

  • Precipitous delivery before getting to the hospital (and possibly transferring to hospital)
  • Precipitous delivery before midwife arriving
  • prenatal care and staying home without ever intending to call the provider
  • midwife arriving just after the birth
  • medically unassisted, but with an active involved birth doula
  • medically unassisted, but with or without the partner

One recent woman in my practice planned an unassisted birth, but with "prenatal" visits to me. I've included two women in the book who had unassisted birth. One was a quick labor, unplanned(page 35). The other had left several OB groups who wouldn't agree to VBAC(page 79). By including these women it was one way to give balance to my statement "everyone needs a doula." Obviously I accepted and learned from both births (and encouraged it!). The first example actually had hired a doula, which arrived after the baby delivered. The latter tried to hire a doula. I don't know the details of how it fell through. I also helped support a unassisted home birth after cesarean, that ended up transporting and being a repeat C. Having a doula isn't a guarantee of anything. But this transfer occured on her own terms.

Since the book, I have several readers who have birthed unassisted. I am especially interested in comments and feedback on this topic.

Friday, November 21, 2008

Waiting For David

I wrote this poem at the end of my third pregnancy. I was just cherishing my upcoming birth. I thought I would include it in Rockstar's Flashback Friday. (Note the slope on the fence. That was our yard in Georgia)

Waiting For David

Tonight or tomorrow we could be five
None of us know when you will arrive
It could be next week or go over due
Today we can barely imagine you
Tomorrow we won’t remember
being just four
When we share love with one more
What will I be doing
Sleeping, shopping, reading
When I get that first contraction
Signaling our newest addition
Dad’s off to work wondering if he’ll
get that call
Scott doesn’t want to give up being
“Little Small”
To settle in the middle
He knows you will need to cuddle
And nurse, frequently
William is as curious as any
brother would be
How will you pop-out
And what you will be about
Our family of four
Can’t wait to be one more

Wednesday, November 19, 2008

Orgasmic Birth (My Over-analysis)

I went to see the movie Orgasmic Birth this past weekend. Indeed it is a movie that everyone should see to discover the potential and pleasure to be found in the birth experience. John was concerned that I might be pregnant. He was suspicious of why I insisted on going.

Previously, I watched the trailer to the movie which involved a lot of moaning and groaning as one would expect from such a title. I expected to see a movie with a lot of explicit acts requiring your lover to be present at birth.

I--to personalize this--determined after my first birth that my husband was not good for labor support and that I would be better off at my future births surrounded by like-minded birthing women and let John go do his own thing. I was concerned that this movie might contradict my mature and experienced conclusions.

I would have been disappointed if the movie only supported the notion that a sensuous partner was required for birth. So I was glad to see that the movie valued the role of midwives, doulas, and best friends in the support of birth. I was glad to see, what I already know, that birth can be exhilarating without literally "climaxing." Many levels of joy can be found in birth. Perhaps if you don't mind (and I could not imagine) being kissed and caressed during birth, you can have a sexual-type and a birth-type climax. I certainly feel that my 2nd and 3rd births were positively transforming (emotionally, physically, spiritually) and couldn't imagine them being any better. As I have found, each time I look back at my births (even now) I seem to gain additional insights as the years pass. The fact that birth can be a positive experience and you can be in control of your birth (and not one filled with pain) is the main point of this film with many good examples and situations.

My two favorite examples of the births shown is one birth taken place on the couples deck outside. My other favorite is of a sexual abuse survivor looks back on the transformative experience she found through birth. These lovely supported births are contrasted with a typical hospital birth where the helpless non-affectionate husband is sitting on the side of the hospital bed without a clue what to do. His partner gets an epidural and a vacuum assisted delivery. The images of this birth are graphic unlike the other beautiful births. Also unlike all the other babies born outside of the institution, this particular hospital baby comes out bloody and disturbed.

This movie is a must see for the woman/couple and their providers who only knows the typical hospital birth which is most of America. The movie provides the tools to re-examine birth interference and plan for the next birth.

All the babies went to mother's chest. Although this movie wasn't about breastfeeding you could assume all the newborns were going to the breast. Just one of the mothers looking back on her birth put her baby (a few months old) off by keeping her finger in the babies mouth while she was discussing her feelings about her birth. The baby was obviously squirming for the breast. I just wanted to reach in and lift her shirt. How can you have an orgasmic birth filmed and then be shy to breastfeed in front of the camera?

This is not the first birth documentary I've seen. There are several others like the Business of Being Born. Turn off the Baby Channel and TLC influenced by prime-time media and get real with these documentaries.

Just as I analyzed this from a personal perspective it was great to see the pregnant woman who were there watching reconsider what their birth means to them. I know it's very hard to achieve a positively transforming birth in a hospital and one woman to my right said she was going home to tell her husband they were not going to be birthing in the hospital as planned. Yeah for her!

When I arrived home John wanted nothing to do with my movie high. :(

Wednesday, October 29, 2008

Mary's Birth Workshop

I enjoyed Mary Rainer's Birth Workshop. She and two other childbirth educators shared information on doulas, Bradley, hypnobirthing, Birthing From Within (BFW) and other labor techniques for coping with pain. I like how children were free to be themselves. Another speaker Diane Wiessinger came to Mary's class. Diane is very well known among lactation consultants for teaching how to watch your language. Its not just what you know, but its how you say it! It's worth checking out Diane's handouts.
The Birthing From Within Instructor brought a few projects for us to do. I read BFW after Scott was born. I wasn't going to be pregnant for a few years. I loved the art/expressive part of BFW. My pregnancy photos went from snaps shots to art after I read her book and I was AWARE.

Everyone was shown how to draw a labyrinth. I chose to take photos and not draw. Anne and Jen are in this workshop. Can you see them? What was interesting about this was that some woman's labyrinths was OPEN and Free and I noticed others were TIGHT and perfect. I won't mention any names, but you know who you are and I want an OPEN labyrinth from you soon. :)
Perhaps if you click on the photos you can see what a labyrinth is. What does it say about me, since I didn't even attempt one. Yikes.

Here I am sneaking in another meet the author photo.
Thank you Mary for an informative and relaxing childbirth class.

Thursday, July 10, 2008

Sugar-free (or elimination diet) and Pregnancy

Another food post! Are you sick of my food rantings yet ? Now I coming full circle because now I am going to tie this topic in with pregnancy.

I have given a lot of thought how far my sugar sensitivity goes back for. If you have read Permission to Mother, you know that I flunked my glucose challenge test in my first two pregnancies (p 55). I feel fairly certain my sugar problem goes back to at least then. During that first pregnancy I also got painful scarring acne on my right shoulder. Much of it has faded, but I didn't wear sleeveless shirts for years in public because of it.

I never had diabetes in pregnancy. I was told to monitor glucose and watch what I eat, but I was not given any specific guidance. If I was offered nutrition counseling (I don't remember), I didn't go (I probably didn't think a dietitian could help me.) Way back then, I loved Raisin Bran for breakfast. I have been eating Raisin Bran for breakfast for years. When sugar would be in my urine on spot checks near the end of my pregnancy, I couldn't imagine why. Raisin Bran is healthy? right? Check again look at the label. It is loaded with 2 scoops of sugar in every box. :) I also ate a lot Breyer's mint chocolate chip ice cream while pregnant.

By my third pregnancy, I was a little smarter. I switched to Total and added my own raisins. I am so stubborn. I had to have my raisin cereal. Total still had plenty of sugar in it. I still had sugar in my spot urine checks. With the birth community influence I was eating better overall than compared to the first 2 pregnancies.

Kathy has written a blog about glucose testing in pregnancy. My third pregnancy, I opted out for the reasons Kathy gives. I don't eat cereal for breakfast everyday anymore. If I do, I have juice sweetened millet or corn flakes and can add my raisins, oats, flax, blueberries, etc....

Back to pregnancy in general. If I had known then what I know now, I'd probably have really, really good pregnancies. Knowing how to eliminate preservatives and additives, and knowing how to shop and prepare for the good stuff would be a tremendous asset to pregnancy. I got away with vaginal birth, no yeast infections. None of my sons had hypoglycemia. Our own nutrition sets us up for so many potential problems. I got away lucky.

One disclaimer, when I received my first alcat test results, I was in a state of disbelief, shock, denial and withdrawal. I did not eat well at first. I did not know how to find the good food. That would not be good for a pregnancy. A good nutrition coach in place would of been necessary. It's good to start prior to conception incorporating good nutrition into your routine.

Saturday, June 14, 2008

Pregnancy Photos of Rockstar's Wife

I've been watching Rockstar's wife's belly grow through the photos on her blog and I told her I was going to swing by her place one day to take some photos. (I've been dying to get my camera out.) I saw Lulu on my schedule and there was no one after her, so I happily took advantage of this time to get some photos. She said she didn't come prepared! I am so much better at taking impromptu photos when the opportunity is right. Lulu and mom are natural beauties and no preparation is needed. And how could you resist that polka dotted dress? Dino, my office manager, got a few shots with me in it. (Watch out for the droopy eye-lid. I forgot to glue it up this morning. :) ) You can see more photos of today on Rockstar's blog and you can see Dino's photography talents here. I love being able to celebrate pregnancy through photography!




I still want to go by her house and get some photos with the other children. Watch out for more photos soon!

Monday, May 26, 2008

Low Milk Supply in Pregnancy

Welcome to the Motherwear's 16th Carnival of Breastfeeding! This month's theme is pregnancy and breastfeeding. Be sure to check out the great posts from other bloggers at the bottom of this post.

This post, previously published 4.5.08, has been Selected to Participate in Motherwear's Carnival of Breastfeeding and has been bumped to the top of the blog. The theme is Pregnancy and Breastfeeding!


~~~~~~~~~~~~

My first impression on reviewing my schedule in the morning when I saw I had an expecting mom, 3 months along and her 9 month old coming in for low milk supply was that I probably couldn't do anything to help her supply. I am not recommending herbs and pills to boost supply in pregnancy because they don't work then.

But like everything, you need to sit down, get your facts, and watch the mother and the baby, their interaction and nursing.

So, I have mom sit in my rocking chair with the foot stool and I make sure her 9 month old is relaxed and then she can relax and talk. The baby latched and stayed latch the entire time we talked. The baby reached for mom's long hair with her free hand and massaged and fingered moms hair as she nursed. She made soft little "happy" sounds the entire time. Looks pretty good to me so far. She was normal weight, happy, alertness, and otherwise thriving. Doesn't look like low milk supply to me.

This is where the problem came in. The PEDIATRICIAN told mom to start formula. Why? Because that's what pediatricians typically say when they don't understand breastfeeding. Mom interprets this as something is wrong with her milk supply. Who wouldn't?

My Plan to maximize the duration of breastfeeding:
1. Encourage the skin-to-skin, co-sleeping, co-bathing, the lifestyle stuff that will keep mom and baby together.
2. Let her know that Reglan, Domperidone, herbs are not used in pregnancy. Fenugreek is not recommended in pregnancy at all.
3. Emphasized mom's vitamin, nutrition and water intake.
4. Emphasize the 9 month olds nutrition. At 9 months old, what she doesn't get at the breast, she can get in whole food! (why formula?)
5. LLL has a great book for Mother's who are breastfeeding through a pregnancy. It's called "Tandem Nursing and Beyond." It's subtitle explains why it would be a good book for this mom, "Breastfeeding through a Pregnancy." This is a perfect book if you are contemplating continued nursing while concieving or being pregnant. This is a mother at the right stage for this book. I have it in my lending library.
6. Consider her birth provider. We do have several local midwives that would support her continued nursing.
7. Reconsider her choice of pediatrician. HELLO! Family physician's can provide wellness care. ;)

All-in-all nothing was wrong with her milk supply.
~~~~~~~~~~~~~~~~


We have some great posts from other bloggers on the topic of breastfeeding and pregnancy. Check them out! (List will be updated throughout the day).

Natural Moms Talk Radio - Carrie shares practical information on breastfeeding while pregnant.
Permission to Mother - Dr. Denise writes about a milk supply mystery.
Crunchy Domestic Goddess - Amy writes about her experience with nursing during pregnancy.
Breastfeeding Mums - Sinead shares advice on preparing for breastfeeding.
Motherwear - A Breastfeeding Friendly Birth Plan.
Breastfeeding 123 - 10 tips to prepare for breastfeeding while pregnant
Milk Donor Mama - I speak from Experience

Saturday, February 9, 2008

My Pregnancy Portraits

This series of photos is of my third pregnancy. I was 2o0 pounds at the beginning of my 3rd pregnancy (if I recorded my weight right and wasn't lying to myself at the time). I thought I would never be able to get attractive pregnancy photos. I thought I was fat and awkward. I put my mind to getting good photos, because I saw the value in a positive self image when it came to a successful birth outcome. E-mailing and sharing the photos was a part of my outward plan to mentally prepare for labor. If I couldn't be comfortable sharing photos with my friends, how could I ever be comfortable laboring in front of them?

This is my beautiful mother pregnant with my sister. This is the only pregnancy photo we have of her. In 1967 she said, you were to hide your secret for as long as possible under a tent.


This is my pregnancy portrait during my second pregnancy. I "learned" how to hide my pregnancy too. My sister took this photo. It's a cute photo, but I didn't really think much of my belly.




Now, in my third pregnacy, I want to free myself. I don't show much here. It is just the beginning of a series of e-mailing photos to my supportive friends and doulas. Photo taken at Berry College in N. Georgia.


Here I am about to take the Jet Ski out. We are in NE Alabama now! I am always going to wonder if the Jet Ski jolted David into a breech position ;)


Now I am in Seattle around 28 weeks. I saw the glow in the "light" and ran out with my sister so she could snap this shot. My sister is a terrific photographer. I could have had all the beautiful photos I wanted in my earlier pregnancies, if I would have only let her....


Here I am again with Scott and my niece. My sister took this photo also at 28 weeks after she casted my belly. I am making an effort to be more comfortable with my changing pregnancy shape, be comfortable with others seeing my body... and feel beautiful and special.



Now at 32 weeks, I let my sons participate in the rest of my photography. ( I really didn't have anyone else around who could oe would photograph.) William took this photo. I also felt most "comfortable" letting my boys take photos--finally unveiling my growing belly.
Scott, as goofy and as he was that morning took this photo of William. I am so amazed at all the great photos, that the boys took.
William even took this silhouette!



Another shot by Scott. the boys were 4 & 6 at the time.

Near the end of my pregnacy, William cooperated and took this.


Here is John. He had something to do with all this. We were in N. Georgia.


My baby safe and secure. He's in the safest place he could be. No pressure by anyone to induce early. I had no idea he was going to present feet first. What a difference one day in my life made. My imagery, my mental preparation, working on my inner confidence to trust and believe in my body got me past my obstacles. It took 9 months of positive preparation.
Now, look back at my mom in the first photo who represents how many women feel about their pregnancy. Can a mom-to-be that feels like her pregnancy should be hidden under a tent, labor uninhibited and successful?
How are you showing off and coping with your pregnancy? Behind the words, your photos (or lack of pregnancy photos) and icons/tickers tell alot how you feel about yourself and your growing baby!
I can't help but hope I passed on my good attitude on to my boys. We also have the memories of taking the photos. As a result, my boys are also published photographers. I love my pregnancy photos. They accomplished a lot.
Here is a recent photo of my beautiful mom.

Wednesday, February 6, 2008

Time to Deal with ACOG

My comments in red to this new ACOG statement.

ACOG NEWS RELEASE
For Release: February 6, 2008
Contact: ACOG Office of Communications
(202) 484-3321
communications@acog.org

ACOG Statement on Home Births

Washington, DC -- The American College of Obstetricians and Gynecologists (ACOG) reiterates its long-standing opposition to home births. While childbirth is a normal physiologic process that most women experience without problems, monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center is essential because complications can arise with little or no warning even among women with low-risk pregnancies. Monitoring of of both mother and the unborn do occur at home. Complications are more likely to arise following the medical interventions introduced by the medical team in the hospital.

ACOG acknowledges a woman's right to make informed decisions regarding her delivery oh, really... and to have a choice in choosing her health care provider, but ACOG does not support programs that advocate for, or individuals who provide, home births. Nor does ACOG support the provision of care by midwives who are not certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB).

Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Hospital birth is trendy. Babies have been born at home and in fields with and without midwives long before hospitals and physicians participation in birth. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby. following intervention, that is. Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Attempting a VBAC, immobile, tied down to monitors and receiving pharmaceuticals is far more dangerous. Surgical birth is almost always more dangerous than vaginal birth. Unless a woman is in a hospital, an accredited freestanding birthing center, or a birthing center within a hospital complex, with physicians ready to intervene quickly if necessary, she puts herself and her baby's health and life at unnecessary risk. Why won't OBs just cooperate and back up homebirth midwives?

Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, What are you doing to reduce it? Nothing that I can see.but there is no scientific way to recommend an 'ideal' national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age My age has nothing to do with it. Why are young women having so many cesareans, then? , overweight, obesity and diabetes what is ACOG doing to help women with nutrition. NOTHING. Most women tell me their OB never mentioned nutrition except for prescribing vitamins. Most women tell me, I am the first physician to mention pregnancy nutrition and referral to the Brewer Diet.

The availability of an obstetrician-gynecologist to provide expertise and intervention in an emergency during labor and/or delivery may be life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG believes that the safest setting for labor, delivery, and the immediate postpartum period is in the hospitalof course, it does!, or a birthing center (So kind of ACOG to extend their support to a birth center)within a hospital complex, that meets the standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.
It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous. Moreover, lay or other midwives attending to home births are unable to perform live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child. Most OBs in America would have not been able to deliver my third son feet first safely in my own bed.

ACOG encourages all pregnant women to get prenatal care and to make a birth plan Most OBS don't look at birth plans. . The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby. I'd like to know what ACOG member has attended a homebirth, ever? For women who choose a midwife to help deliver their baby, it is critical that they choose only ACNM-certified or AMCB-certified midwives that collaborate with a physician to deliver their baby in a hospital, hospital-based birthing center, or properly accredited freestanding birth center.
# # #
The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.

I am so glad I am not an OG/GYN.
~~~~~~~~

More responses from the natural birth community can be read at The True Face of Birth

Sunday, February 3, 2008

My Near-Collision with Cesarean

(When I turned in my manuscript, I thought I was done with everything I could ever say about my births--guess what, I was wrong!)

I was most vulnerable the first pregnancy. I was professionally educated and not at all empowered.

The first threat of a C was with the diagnosis of a partial placenta previa (placenta overlying the edge of the cervix) during my first pregnancy. "If it doesn't move, you'll need a C." The OB knew it would likely move (and not a big deal to him) and was just an automatic comment to let me know what I might be faced, but his verbalization caused me to worry. The OB's also insisted I stop working. I remained anxious, sendentary and bored for the rest of that pregnancy.

The placenta moved up as it usually does. With another US, they told me it had move. I was cleared for vaginal birth.

After three hours of pushing and exhaustion, I pleaded for the labor to be over. I begged for anything to get William out. I thought that I would be better off dead, then to have one more contraction. This is when I came the closest to a C. Had a cesarean been performed on me, I would have been convinced that my body was abnormal and malfunctioned. At least at the time, I would have been convinced that birth was risky and OBs were necessary. I think that I would have eventually figured out that a C was an end-result of a fearful birth culture. In anycase, even with a vaginal birth, I was left feeling humiliated and very unempowered.

I have wondered why he didn't do the C. I didn't have an epidural, so "easy anesthesia" wasn't on board. Physicians have high rates of C's, so I can't say being a physician protected me. Since 12 years the C rate has exponentially gone up. Today the same labor would no doubt end in a C. Who waits three hours for a primigravida to push? No one.

I was so close to that C. I have wondered how it would have impacted my future healing births, if I would have been allowed to have them. One birth has such long term implications. My second birth occured before the VBAC ban. VBAC wouldn't have been the huge issue it is today.

The next worry was with my second pregnancy. At some point Scott was positioned breech. I again heard the threat, "If he doesn't turn, then C!" Probably no one took it a serious as I did. I worried. I was not given breech turning techniques or anything active to do. Scott did turn and I had a very nice birth with my heaven-sent doula. The first time I heard about breech turning techniques was during my third pregnancy. I was editing an article written by a chiropractor on the Webster technique for our locally published Mother to Mother... I was sure I didn't have to worry about breech.

There was no C threat during my third pregnancy. When I had abnormal triple screen results my husband demanded that I go to an OB. I resisted. He then requested "just a ultrasound." I refused. The morning labor started he reminded me "to get that US." Let's make sure the placenta is out of the way. Can you imagine if I did get that US and found the placenta clear but the baby breech (if indeed he was breech early in labor)? I would have been sent in for my C right then. I never imagined breech could happen to me and I wouldn't have been prepared to explore last minute other possibilities. I'm glad we didn't know. By Trusting birth, I was Rewarded.

Most women have to put up with the threat of Cesarean several times through pregnancyand labor, it's a wonder anyone has a Vaginal birth.

Saturday, February 2, 2008

What My Next Birth Plan Would Be...

No! I am not P! Then why even consider what the next pregnancy & birth plan would be? BECAUSE so few woman have healthy images of pregnancy and birth plan, if I don't tell you, who will?

Plus, I can always hope, that there will be another baby. Pregnacy and birth planning should start prior to pregnancy. Once pregnant, it's often too late to know your options and prepare emotionally.

I'd follow the Tom Brewer Diet from the beginning. ( I am already eating like that for the most part.)

I'd have no Ultrasound-I didn't have one with my third. The first time around the doctor wanted way too many. The second I capped it. I knew way back then they were unnecessary. I am frequently requested to order a pregnancy US by my patients for their own reassurance of fetal well-being. I am not sure I understand why they are so reassuring to moms. As a physician they tell ME nothing about well-being except for that moment there is a heart beat. (You don't need a whole US for that!) One mom requested it for placental position. Since she may be having an unassisted birth that reasoning made sense. On my subsequent research more recently, a midwife told me she could determine placental position by listening AND she could use an US only to confirm her suspicion if the placenta sounded low. To give the mom credit I scheduled an US for her, she doesn't have a midwife and I don't have a doppler. I guess she had a good reason to have an US. Women want to know the sex of the baby by US. I didn't mind waiting for David's birth to find out he was a boy. It made me feel strong and Trusting that I could wait.

I am concerned that one US leads to more ultrasounds to follow "problems" that don't exist. This causes maternal worry and anxiety. They cause due dates to change, even when a mom knows her conception and dates exactly.... I'm sure I can write a whole post on the problem with US and how they are interpretted.

NO triple screen, NO amnio. I made a big mistake having triple screens. It was positive for Down's and Spina Bifida in my third pregnancy. I refused amnio. I never had an amnio. Fortunately with a granny midwife and no OB, there wasn't much pressure on me to have an amnio. There is no need to have the blood screening tests if you aren't following through. As my readers know, my sons are healthy without Down's or Spina Bifida. (whole chapter on this in the book that better be published soon)

NO routine vag exams prenatal or labor (a whole topic in itself) just to see "what's happening." Preferably no vag exams period. I declined GBS at 36 weeks with David.

NO herbs or OTCs (over the counters) as a 5 week pre to tone and prepare my uterus for labor. (another topic in itself). No herbs in labor. Herbs, OTC and pharmaceuticals to induce and augment labor are very dangerous in labor.

I'd have a low profile midwife if one would have me since I'd refuse US and Vag Exams.

Membranes rupture by themselves.

Surrounded by doulas and birth friends at HOME.

NO pregnancy ticker to make me paranoid and obscessed with my dates. Discussed in a previous post.

Labs I would have, include blood count, HIV (for attendants benefit). The intracellular vitamin analysis (worthy of another post) and Urine dips and blood pressure.

If I had another breech baby, I know I can do it. Twins wouldn't scare me from vaginal birth at home. Provider or no provider. Could I say this before my first birth? No way. Not even before my 2nd or third birth would I be so confident. It took having a breech birth and then going to a twin homebirth to be so confident.

A placenta previa is the only reason I could think that I would have to have a C in my imaginary birth plan.

I could write so much more on all these topics.....

Thursday, January 24, 2008

My Pregnancy Belly Cast

While pregnant with David (my 3rd) , mental and spiritual preparation for my homebirth and getting comfortable with my body, included my creative expression. This is my second belly cast. My doula, Dawn, plastered me the day I went into labor. She decorated it in the following days. (Remember, we didn't know he was breech.)


Dorion Stanger, sculpture and owner of Pregnant Memory Sculpture says:

"The pregnancy memory sculpture is a declaration to your child of the pride you felt when mother and child were one."
My sister made a belly cast for me when I was about 28 weeks. It is so much fun to make a cast. It's a very healthy outlet and a great way to connect with your birth team.
I have one cast in my exam room. This one is in the office, but too big to be in the room. I'd be glad to show it off if you ask.

Wednesday, January 23, 2008

Self-Responsibility


This is an excerpt from my sons Language Arts Assignment. Originally, I was hoping he would answer, "Yes," and explain who inspires him:

Topic: Can one person or one incident transform (change) the life of another?
Date of entry (22/01/08)
Entry#1

No one can inspire you. Only you can inspire yourself. If someone says, "Come on. Keep going to the top" or "Don't give up," This would be called "motivation.” If you don't want to do it you won’t. They could try to inspire you and make you think you could do it. You might realize you can't and think it’s too frustrating and hard. If you really want to do it, you have to inspire yourself.


After, I got thinking about it. I realized his wisdom. People need to do it for themselves.

How many times do I hear (in regards to wellness):

"My insurance doesn't cover it."
"It's too expensive."
"I had a doula and I still had a cesarean."
"My husband doesn't support it."

or MY favorite:

"I saw Dr. Punger for breastfeeding and she couldn't help me. "

My son is absolutely correct in his rationale. You can surround yourself with encouraging, like-minded and informative people....

But if you want it bad enough, take on self-responsibility. It must come from within.

Way to go, William!!
(William, recieved a perfect score on this assignment.)

Thursday, November 29, 2007

Maternal Confidence and Subsequent Children

Wife of a Rockstar, posted about homecoming, bringing her older adopted kids home, and the lack of enthusiasm and interest among her social circle as compared to when a new baby is born. As I followed the comments, it was suggested that the lack of enthusiasm was more related to the number of children she has and not an adoption issue: less celebration for subsequent children

I only have three boys. That's a lot less than Rockstar and his wife and many of the families that replied to her. I noticed my first son was/is showered in gifts from everyone we know. My second son also tends to be showered, too (at his birth and subsequent birthdays and holidays). I did notice a major decrease in material gifts for the third son.

But my third son benefited in many intangible ways. Along the way, I became a more confident mother. My third son didn't have to deal with my new mother anxiety: should I hold him or will I spoil him. I was a confident breastfeeding mom, confident in co-sleeping and committed to babywearing.

My third son never had to put up with me doubting my own instincts, testing how long he could cry and being trained to be an independent sleeper. By the time I had my third son I knew not to let him cry. I knew to carry him. We had a family bed and didn't expect him to sleep through the night. My third son got the "best" pregnancy and birth. I was confident that ultrasound, amniocentesis, vag exams and other invasions of the womb were not the way to go. I was confident to stay home and birth. I was confident to surround myself with people who valued a non-materialistic pregnancy (doulas, midwife and friends) and provided me with emotional and spiritual support. By my third son I was more spiritual aware and concerned with passing on our heritage. He was my only son to be honored with a traditional welcoming ceremony to the Jewish community. After his birth, I didn't report to work for 7 months. And, he came with me when I finally did go to an office. I returned to work by 12 weeks with the first two.

My third son may not have had as many gifts, but he reaped the benefits of my prior maternal experience!

PS-He has plenty of toys because we never toss out anything and he may be the most appreciative.

Tuesday, November 27, 2007

Late November Book Update

I am still working out final details in the design of the book. "The Book" is written, but it sure is tedious getting the layout details done. To top off the interior formatting, if there is any blank pages, I am going to resubmit it, to add more photos! There will be over 65 photos of a variety of women showing lots of bf (of course), doula support at birth, breech birth, pregnancy, babywearing, cloth diapers, and more.

I was really hoping to get the book done by the holidays. I think it may be done by the end of the year, but I don't think it will be done within the next few weeks for ordering holiday gifts.

However, print-on-demand publishing is quick. You never never know. Once I give the OK, the printing part my be real quick. I am sure you will hear a big cyber-hurrah when the book is finally published.

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