Pregnancy, Parenthood & Playtime

There seems to be a pretty large, and equally frightening epidemic sweeping our nation, and it is not something that has started over night, it has been working towards this for a couple decades at the least.

we are upon a generation of women who have little to no self esteem. They allow men to walk all over them, cheat, abuse, and really do whatever a man says. Now before you go on about how this is not new, I am aware that there have been situations like this taking place as long as men and women have been on earth, but the extent it is to today has taken a whole new toll on society.

My realization of this started while scanning through posts on a website called Cafe Mom over the weekend. I came across a post from a woman, pregnant, mother of two children already, all her children are under the age of 5, and her husband has been cheating on her (sleeping with other women) for the past 6 years. A light over my head went off, Huh? He is sleeping around, yet you have made the choice to have 3 children with him, and now want to know what you should do?
Now, I am not one for putting down women who are in abusive situations because I have close people in my life who have been through that type of a situation and slowly broke out over a period that spanned almost 4 years, but in the end she left. Which was a big boost to her self esteem.

Now lets really look at what self esteem is,

Self Esteem is defined by Webster’s Dictionary as : a confidence and satisfaction in oneself

Which in the above situation, and other situations that may mirror as similar situation show a lack of self esteem. Someone who allows a man to talk down to them, cheat on them, or any other type of abuse clearly is suffering from a back of confidence or satisfaction in their self. But how as women have we come to these situations in such large numbers? Go back 50 years and we were burning our bras, demanding equality, and saying we don’t need no stinking man!

A new book by author Sharlene Azam focuses on the problem and how we have got there. “Oral Sex is the new Goodnight Kiss”  which is described as

This book and documentary film by Sharlene Azam, are about the recent emergence of teenage prostitution rings in affluent suburbs. Attractive, white, high school girls – 13, 14 and 15 years old – are having sex with up to 7 men a night, several times a week, so they can go shopping. Other girls are selling their virginity for $1000. These are not street prostitutes. ”They are the prettiest girls from the most successful families,” explains one expert. “Your daughter’s best friend is recruiting her right out of your house, right under your nose,” says Detective Randy Wickins of the Edmonton Vice Unit. Oral Sex Is The New Goodnight Kiss is a wake up call for parents, showing them girls who have been recruited, their mothers, their “friends” who recruited them (the new pimps), and the vice cops and experts who are trying to make sense of this new middle-class phenomenon.

I went to my local borders over the weekend after reading these posts, but also seeing a clip about this book on The View, which I have linked below.

The View : Oral Sex is the New Goodnight Kiss

This is where I take the time to sneak my opinion in about how we are raising our children. In a society where most families need a two parent income to even make ends meet, we have to make sure we are taking the time to talk to our daughters about their self worth, and the value of their own self. While also showing a good example of this at home through our relationships. Not only with our husbands, but also with other family members, and even strangers when we are out in public. But this does not stop with our daughters. This also extends to the young men that we are raising. As a mother of two boys, one of my biggest parenting goals is to teach them how a woman, or other young lady should be spoken to, and treated. I see so many children today blatantly disrespecting other children and even their parents (which I believe is directly connected to lack of parenting, time with children, and parents pre-occupied with other things).

We need to make a change with our generation before this continues and women end up back on the bottom of the totem pole like we started.

In the past two weeks, I have seen several postings in various forums, blogs, and on birth related news sites about the show Mad Men which depicted the shows character Betty Draper giving birth to her third child with something called “twilight sleep” which unfortunately was very common during this period of time.  A great description of the episode itself was from Science and Sensibility writer, Amy Romano :

Last week, the main character’s wife, Betty Draper, gave birth to her third child. While her husband, Don, sits in the waiting room drinking scotch with another nervous expectant dad, Betty is subjected to 1960’s “standard of care” obstetrics. Left alone in a labor room, she is shaved, given an enema, and then receives the crown jewel of her modern childbirth experience: medications to induce twilight sleep, which also induce a mad stupor and land Betty in restraints because of her erratic, combative behavior. As a midwife and a mother, the most difficult part for me to watch was when Betty awoke from her stupor, swaddled baby in arms, with no memory of the experience. You can watch all of the birth-related clips from the show at Jezebel.

But why don’t we take a closer look at the way some of our mothers, and grandmothers gave birth with this drug called “twilight sleep”. In reality it was not a sleep at all, it was a combination of morphine and scopolamine , not only did it aid in taking away the pain of childbirth for the mother, but it also took away a mothers memory of the event as a whole, while also taking away her self control. Because of the loss of control women were often tied to beds for not only their own safety, but for the safety of the hospital staff, but they made sure to use soft materials like lambs wool that would not leave marks on the arms and legs of these women, because then their husbands (who mind you were not allowed into the delivery room) would question what the hospital did to their wife.  But mom’s were not the only ones who suffered from this drug, it also had an impact on the infant, as do many pain relief drugs still used today. Babies born to mothers who had twilight sleep often suffered from

One of the rare pictures of twilight sleep births.

Moreover, the drugs had depressive effects on the central nervous system of the infant.^[2] This resulted in a drowsy newborn with poor breathing capacity.

This drug combination known as “twilight sleep” came to replace the use of chloroform as a method of pain relief during childbirth. But who in their right mind would have wanted to be subject to the use of chloroform while in labor?  EEEK!

While we have made strides in pain relief during childbirth, we are still seriously lacking and it makes me question how much better off we are from the days of twilight sleep.Back then there were less interventions, less inductions, less cesarean sections. Our cesarean section rate has increased for 11 years in a row, and it shows no sign of slowing down.

But going back to Betty, Sarah Seltzer on RH Reality Check also wrote a great piece and she included some great points about gender roles during this time period.

Incidentally, as several feminist bloggers have pointed out, the fact that Don and the other expectant fathers were always relegated to the waiting room was ostensibly because of gender roles or social customs. But this practice conveniently meant that women had no one to witness the awful side effects of procedure, or demand that it stop. So “Twilight Sleep” remained “the thing to do.”

Another great quote from her article includes a great quote from British Author Grantly Dick-Read :

British author of “Childbirth Without Fear” to speak to American women. “His premise was that women could have babies without going through the horrors of twilight sleep,  screaming and writhing in pain,” says Corry. “He felt women need to be educated and they could deal and cope with childbirth if trained to do so.”

Backlash started shortly after women really started to put two and two together and realize they had no memory of their child being born, which was the beginning of the end of the twilight sleep days, but not before thousands of women were victimized like Betty Draper was, which was not until the late 1960’s or early 1970’s.  While her experience may have been a television episode used for ratings, the most unsettling part is that this actually happened, some less dramatic and some far more traumatizing, and just like we think today that all our strides in medical technology are fantastic, in another 50 years we will be looking back thinking….

“Wow, I can’t believe we let doctors and hospitals do that to us”

Just like the women of the twilight sleep era do today.

Many people who read here know I am heavily involved in a maternity care campaign here in Connecticut called Worst to First. We have been researching the hospitals in the entire state for statistics such as their cesarean section rates. The World Health Organization recommends a cesarean rate of NO higher than 10% for healthy low risk women, and 15% for high risk pregnancies, and some of the hospitals in Fairfield county almost triple that, and some are even higher.

I know as a mother, and someone who would like to consider herself an educated consumer, I would like to know these kind of numbers coming out of these hospitals. But the problem is, they are not easy to get. It took me a full month, and pulling teeth to get these. Many hospitals would not give them out, saying they are “not public record”. Now you would think there would be some kind of law saying the hospitals need to share the information. NOPE!
Not here in Connecticut. Only New York and Massachusetts. Which is why it is important to get the same kind of law in Connecticut.

With that being said, here are the numbers for Fairfield county. For a full list of all the hospitals in Connecticut, please click on the link provided.

Bridgeport Hospital – 39.07%
Danbury Hospital – 30.21%
Greenwich Hospital – 34.20%
Norwalk Hospital – 32.12%
St. Vincent’s Medical Center – 44.50%
Stamford Hospital – 37.99%

These are some huge numbers. In the majority of these hospitals, with the exception of Danbury hospital, 1 in ever 3 women that go into the hospital to give birth, will be subject to major surgery. Whether it is necessary or not.

I think we as consumers really need to not only have access to these numbers, but research carefully where we choose to give birth to our children!

Number provided by The Connecticut Office of Health Care Access.

“More than 9 out of 10 births following a C-section are now surgical deliveries,” a recent article in Time magazine, “The Trouble with repeat Cesareans,” reported. What’s more, the International Cesarean Awareness Network, recently called 2,850 hospitals that have labor and delivery wards and found that 28 percent of them don’t allow VBACs, up from 10 percent in its previous 2004 survey. The grass-roots group, which strives to reduce the number of unnecessary surgical deliveries, discovered that another 21 percent of hospitals have no formal policies against VBACs but no obstetricians on staff who will perform them.

My first Cesarean Section, delivering my son Camden

Lets evaluate this epidemic as a consumer. Because in reality our medical care is our choice, we are consumers, we pick and choose which doctors we will pay, or our insurance will pay right?
If I see another woman say “Well my doctor doesn’t do VBAC” or using something like that to schedule a repeat cesarean without evaluating the real risks, I am going to hurl.
OB/GYN’s and Midwives (especially CNM’s) are a DIME a DOZEN!
Why aren’t we interviewing these providers before blindly choosing them to care for us during one of the most emotionally vulnerable moments of our life?
People literally are researching CARS more than who is going to deliver your baby!!

Women are not getting accurate information about the risks of a cesarean section. They are not being told that with a cesarean or repeat cesarean section you have risk of uterine rupture at ANY time during subsequent pregnancies, not just during a VBAC or repeat cesarean.
They are ONLY being told about the risk of rupture in relation to VBAC. Nor are they being given ACCURATE statistics regarding rupture for VBAC and the LOW risk it holds.
You are more likely to get struck by lightening and die than have a uterine rupture during a VBAC.
You are actually more likely to have an IMPOSTER doctor (1 in 50) than suffer a uterine rupture!!!!
So let that sit and fester a little in your mind.
Women are not being told about the increased risk for infertility after a cesarean, risk of re-hospitalization, risks of infection, blood loss, blood transfusions, bladder damage, bowel damage, or even the risk of placental issues in future pregnancies.

Now, if someone told you all the facts would you choose all of the above for convenience or simply because Dr. Slice doesn’t “do” VBAC?
Or would you flip him the bird and go else where?
Lets compare…
You want to purchase a 2009 Mazda 5 in Black.
“Well we only offer the 2009 Mazda 3 in black here, so you can have that instead”

You would say no and go else where right?
Why not DEMAND the same from our doctors?
YOU ARE PAYING CUSTOMERS!

Lastly before I sign off of my rant today I will leave you with this.

1 out of every 10,000 women in America die from a vaginal delivery (including VBAC)
1 out of every 2,500 women in America die from a c-section. Primary or repeat.

Let’s start making demands for our health care, and make it actual HEALTH care, not sick care like we are used to in America.

Today, many mothers find a Doctor or Midwife for their pregnancy care through friends or word of mouth, and often enough women end up with negative feelings towards this provider, but continue under their care because of the trouble of changing providers during the middle of a pregnancy.
Well when I was looking for a provider for my second pregnancy, I wised up and made a list of questions to ask when “interviewing” a provider, which most people do not realize you can do. You do not have to automatically go with a specific provider because you have met with them.
The answers to your questions are key!  After my first pregnancy, and the care I got, it was very important to me to not only have a provider who was like minded to the care I wanted, and expected, but also a provider that would do more than pop into a room for 5 minutes, listen to the babies heart beat, talk to me for a minute, and then scoot me out. I found during my interview process that midwives spent far more time, and also took the time to educate me, as well as answer any questions I had.

With that being said, here is a great way to help when choosing a health care provider.

• Find out where your provider stands on issues that are important to you.
  • If having a Vaginal Birth after Cesarean is something that is important, find out if your provider does them, or if they have special rules or requirements of their patients that would like a VBAC.
  • If having a natural unmediated birth is important to you, find out how your provider feels about that, as well as pain management.
  • If having a doula present at your birth is important to you, find out your providers perspective on labor support such as doula’s.
  • You get the hint…
• Interview the provider
  
  • Ask questions that you feel are important to your care, and pregnancy.
  • If you at any point feel rushed, or like this provider is frustrated by your questions, this is probably the treatment your pregnancy will get also.
• Some great sample questions
  • How many birth’s have you attended?
  • What is your cesarean section rate?  (If they tell you they are not aware of this number, they are most likely not being honest, all providers are required to keep track of this, as well as report this annually.)
  • How many Vaginal Birth After Cesarean Sections have you attended?
  • How do you usually manage a postdate pregnancy or suspected Cephalopelvic Disproportion?
  • How long do you “allow” women to labor without intervention?
  • How many inductions do you do yearly?
  • Are inductions routine for your practice?
  • What is a reason you would induce a pregnancy?
  • What percent of your patients receive and epidural or some kind of pain medication?
  • What is your episiotomy rate?
  • How do you feel about allowing the vagina to rip instead of cutting an episiotomy?
  • What percent of your patients births do you attend?
  • What is the on call schedule for your practice?
  • How many other providers are in your practice?
  • How many people can I have in the room with me when I deliver?
  • What is your usual recommendation for IVs, Pitocin, prostaglandin gel, amniotomy, epidurals, confinement to bed, EFM (and so on)?
  • What is your appointment schedule?
  • What kind of positions will you allow me to give birth in?
  • What hospitals do you have privileges at?
  • What books to you recommend I read?
  • What would you suggest for a breech baby?

These are all very important questions when working on finding a provider that is right for you. Remember also, in the state of Connecticut there are other options besides birthing in a hospital with an OB/GYN. If hospital birth is the route you would like to take, there are many Certified Nurse Midwives that attend births in hospitals across the state.  If an out of hospital birth center is what interests you the most, there is one located in Danbury, directly across the street from Danbury Hospital. There is also a birth center located inside the hospital in Waterbury.
Then there is always the option of birthing at home. There are Certified Practicing Midwives that practice across the state, as well as Certified Nurse Midwives that do attend home births.

Good luck on your journey!

For anyone with youngsters looking to do something this weekend head over to the Woodruff YMCA on Orange Avenue in Milford.
On Saturday, September 26th from 1-4pm there will be a “Family Fund Day” that will have tons of free activities for you and your family.
Some include a bouncy house, Fire Trucks, Ambulances, and Police cars, open swimming for the whole family, face painting, and the most important, free child id’s will be made and provided by the Free Mason’s.  I cannot stress the importance for a child to get an ID for their safety, and in case there is ever an emergency with your family.

For more information about the Family Fund Day, click on the link!

Not many people know that home birth is an option when you find out you are pregnant here in the state. Others think that home birth is as primitive as it was in the 1800’s and the midwife just shows up with a rolled up towel for you to bite on and you are on your own. Which is completely the opposite of home birth today in the year 2009.
Recently I was fortunate enough to speak with a local home birth midwife and pick her brain on the details of home birth since I personally have never had one, but definitely would be interested in one.

Nancy Farr is a Certified Practicing Midwife here in the State of Connecticut who has caught (in her own words) more than 540 babies in the past 24 years since she started her schooling to become a midwife. While we all are mostly familiar with Certified Nurse Midwifes that traditionally work in hospital settings, Certified Practicing Midwives have had an alternative type of education. Nancy shared with me the story of her training.

My original degree is in Early Childhood Education.  I joke that I didn’t know then how early I wanted to be involved.  I began studying midwifery through a home study course while my children were little, called Apprentice Academics.  I then took what used to be called “The Basic Course” in MA.  It was the only formal, systematic midwifery training available in New England at the time.  It was a combination of classroom seminar, skills training opportunities and independent study.  It was a perfect adjunct to my apprenticeship in progress.  I have also attended hundreds of seminars and conferences on various topics pertinent to women’s health care, birth, parenting issues, herbal healing, massage and midwifery skills.  Part of maintaining high standards in midwifery care is continuing education.

When a woman starts to consider having a home birth, attended by a Midwife, one of the first things to do is sit down and talk with a Midwife that does deal in home births and discuss if they are a good candidate for birthing at home. Normally women who are healthy, low risk, with no complications in their pregnancy, or as Nancy described to me

A woman that is physically and emotionally healthy.  She is free from any pre-existing or developing health problems and has a belief in birth as being a normal process.  We like our clients (not patients) to be educated regarding pregnancy and birth and take an active role enabling her to make informed choices.

Something that is important to know when thinking about this choice, recently new studies are showing that home births attended by medical professionals, such as midwifes, are as safe as hospital births. For more information feel free to click the text, which is linked to an article about the study.

Another huge question always is, Will my insurance cover it?  And if they do not how much does it cost?   Many women are willing to pay out of pocket for this type of birth experience or to simply stay out of the hospital while they are giving birth, but the average going rate is $3000, and if your insurance covers out of network providers, sometimes they will actually reimburse you for the birth!  But when you compare $3000 for all your pre natal care, and the birth, when you would be spending at least double that for the birth alone to birth in a hospital, you can see which is economically wiser. Especially if you are going to be paying for your pregnancy out of your own pocket.  The pre natal care includes the same that you would get if you were to see a provider that delivered in a hospital, except you will get a little more time per appointment, no in and out in 5 minutes. One visit a month until 32 weeks gestation, then the visits are every 2 weeks until you hit the 36 weeks gestation mark, then like every other woman your visits will become every week until you give birth. Once the baby is born, Nancy, and any average home birth midwife in the state will spend far more time than the normal provider will.

The postpartum care is extensive and we return to your home within 24 hours, back again for a 3 day visit, a 5 day visit to attend to the PKU test and a 2 or 3 week visit, then the final 6 week visit.

Currently across the state there are about 6 home birth midwives currently attending births. There were more, but over the years there has been a horrible witch hunt in our state, and we truly need to act together to help make a change so all women have the option to birth in whatever setting is best for them. Lastly I would like to include why Nancy felt the need to become a midwife because I really enjoyed what she had to say.

I wanted to become a midwife so I could give back the type of care that I received with my third baby.  She’ll be turning 27 in November.  I had two previous hospital births that went well with minimal intervention.  They were beautiful experiences but I knew something was missing.  Planning a homebirth with a midwife, the care I received was outstanding.  I was treated like a whole person and what was going on in my head was given equal attention as my growing belly.  The continuity of care, seeing the same person at each visit is so important to the health and well being of Mama.  Having my baby at home with her father, siblings (then ages 5 and almost 3) and grandmothers there to welcome her was a peak life experience.  Letting labor and birth unfold in your own environment makes a lot of sense and I believe the body works better!  I wanted to let this secret out about homebirth and help people achieve it!  I knew then I’d either want to have 10 kids or become a midwife.  I love helping to educate and empower women during this important passage.  Realizing the uniqueness of each and every family, I hold a deep commitment as a resource to clients as they make decisions regarding health care that meets their individual needs.

If you would like to learn more about home birth or are interested in having a home birth, you can contact Nancy Farr at 860-742-6911, or email her at motherwise@earthlink.net

A lot of women are not familiar with their legal rights for care and popular procedures and tests that most pregnant women are advised to undergo.
Recently I have been meeting a lot of women that were not or are not familiar with their rights as a patient, especially when they do go into the hospital to give birth to their children. Hospital policies are not laws, they are rules that hospitals make, and procedures suggested by organizations like ACOG to make the jobs of hospital staff easier. But these same rules and policies have turned hospital births into a one size fits all type birth. I like to think of it as an assembly line. So here are a couple tips taken from the ICAN White Paper for Legal Rights of Pregnant women.

When a woman becomes pregnant, whether the pregnancy is planned, or not, she does not lose any of her constitutional rights. She is still a full citizen that is entitled to every right she was entitled to before she became pregnant.

• The consent of a competent woman’s husband is never required for her treatment. No matter what anyone tells you, the mother is always the authority in her care unless she is unable to make informed decisions about her care.
• Women have a right to have another woman present during a physical examination. Whether this be a sister, doula, mother or partner.
• Women can refuse to be examined to treated by anyone. If you do not like a certain nurse, doctor, or provider, you do not have to be seen by them simply because they maybe the “on call” at the hospital for the evening or there are “no other nurses” available at that time.
• Women have the right to have the father of the child, or any other advocate, present during childbirth and delivery. Whether this be a doula, or family member.
• Pregnant women have the right to refuse any medical treatment or drug including a cesarean section, episiotomy, anesthesia, induction drugs, or pain medication. Remember, all medical choices do need your consent.
• A woman has a right to change her mind about any decision made before or during labor or child birth. Sometimes things do not go as planned, or as we would have liked so having back up ideas, or plans or simply changing your mind is alright.
• A woman and her newborn have a right to remain in the hospital for 48 hours after a vaginal birth, and 96 hours after a cesarean section, however your goal should be to to leave the hospital as soon as safely possible to be able to get back into the comfort of her own home.

Today, people who understand these rights as patients are more likely to successfully negotiate the health care system, use health insurance and managed care plans, and work with physicians and other health care professionals. Most important, a just health care system requires respect for the rights of patients. (Taken from the Patient Rights Program, Health Law Department of the Boston University School of Public Health)

These are not tools to argue and fight with hospital staff, or your doctor. But if you do not feel comfortable with your medical care provider, or if they do not respect your choices or rights, you should immediately seek a different provider. I know it is very scary to switch health care providers especially in the middle of or at the end of a pregnancy, but if you do not have a good relationship, or trust, that can and most likely will impact your birth experience.