Pregnancy, Parenthood & Playtime

The nice weather is upon us, and everyone is enjoying this May like atmosphere.
One thing I think we all forget in light of the nice weather is that once again, we will be sharing the road with motorcycles.
We often start to hear about a number of car vs. motorcycle crashes this time of year.

Please, if you are out and about, keep your eyes, and ears open for the two wheeled motorists you share the road with.
One mess up by you could cause a motorcyclist their life!

I often hear women talking about disliking the practice they are seeing for prenatal care, or even only going there because a friend recommended them, or not wanting to switch practices during their pregnancy. These same women I have noticed a trend with, at least in my circle of friends, all have had a negative birth experience when remaining under the care of a practice they did not care for.

Switching practices, whether it is an OB/GYN office with multiple Doctors, or a practice of a few midwives, or even a solo practice, it is amazingly simple to switch to someone you may be more comfortable with for the duration of your pregnancy.
My first suggestion in deciding to make the move to another practice is to research, and interview other providers before making the final choice to move. You do not want to go through the paperwork and move to a practice you do not like, or do not want to stay with either.

Once you have made the active choice to switch, it is a simple form to request your records be transfused. By law, your previous provider has 30 days to provide your records directly to the new practice.

Sounds simple? It really is!

It is not as scary as some women seem to think, so why stay trapped with a provider you can’t stand?

When Theresa Shebib and I embarked on a small survery about cesarean section mothers, we never imagined it would skyrocket so nearly 861 mothers worldwide.  Starting as a simple project of two cesarean mothers, and a passion for internet blogging we threw together a survey with 16 questions that peaked our own interests about other mothers experiences.

Over night the project grew a mind of its own multiplying in size a number of times. The information, numbers, and comments.  Much to our surprise many women were more open and honest than we expected. It was amazing to see the impact of social media today on this project.

What became even more shocking to us were the replies, numbers and information we were able to obtain with this project.  I will go question by question reviewing and sharing some of the results through various posts, but first before getting into each individual question, and the comments and experiences listed, I would like to give a general overview and release of the actual poll results.

Starting with question #1 : How many Cesarean Births have you had?
1 Cesarean – 67.4%   580 mothers
2 Cesareans – 23.5%   202 mothers
3 Cesareans – 6.5%    56 mothers
4 Cesareans – 2.6%   22 mothers
1 mother skipped this question
Question #2 – Your Cesarean Birth was :
Elective or Planned : 14.8%   118 mothers
Unplanned : 39.5%  316 mothers
Emergency : 21.0%   168 mothers
Repeat Cesareans :  15.1%   121 mothers
(First was unplanned cesarean, scheduled subsequent cesareans)
First Birth was Cesarean, VBAC attempt or other births : 5.6%   45 mothers
Always attempted vaginal birth, always ended in cesarean : 3.9%   31 mothers
62 mothers skipped this question

Question #3 – If Elective or Planned, What was the reason?
Previous Birth was Cesarean, Doctor Recommended :  33.9%   112 mothers
Knew what to expect, was the birth I wanted: 10.3%  34 mothers
Fear of labor & Natural childbirth : 2.4%  8 mothers
Previous Traumatic Birth, Cesarean was Less risky : 6.4%  21 mothers
No VBAC Support or availability : 5.5%  18 mothers
Other : 56.1 %  185 mothers
531 mothers skipped this question

Question #4 – What Support did you have During Labor?
Midwife : 18.2%  152 mothers
Doula : 9.3%   78 mothers
Spouce/Partner : 90.7%   758 mothers
Family/Friend : 37.0% 309 mothers
Hospital Staff : 49.2%  411 mothers
25 mothers skipped this question
*Note, mothers were allowed to choose more than one option

Question #5 – Would you describe your experience as :
Wonderful : 27.7%   227 mothers
Empowering : 7.4%  61 mothers
Frusterating : 26.7%  219 mothers
Traumatic : 46.8% 384 mothers
Disappointing : 45.5%  373 mothers
41 mothers skipped this question
*Note, mothers were allowed to choose more than one option

Question #6 – Do You feeling like you were in control and respected through the process?
Yes : 37.4%   318 mothers
Somewhat : 35.3%  300 mothers
No : 31.4%  267 mothers
10 mothers skipped this question

Question #7 – Were you happy with your birth support team?
Yes: 71.1%  601 mothers
No : 28.9% 244 mothers
16 mothers skipped this question

Question #8 – Do you feel adequately informed about interventions, medications, and complications during labor?
Yes : 41.1%   350 mothers
No : 28.3%  241 mothers
Somewhat : 21.6%  184 mothers
Does not apply : 8.9%  76 mothers
10 mothers skipped this question

Question #9 – Do you feel you were adequetely informed about the risks of a Cesarean section?
Yes : 51.5%   434 mothers
No : 48.5% 408 mothers
19 mothers skipped this question

Question #10 – How do you feel now about your cesarean section?
It was necessary, greatful we are all ok : 48.2%   406 mothers
It could have been avoided : 25.4%   214 mothers
I wish I had made difference choices that may have not resulted in a Cesarean : 30.6%  258 mothers
Neautral/No strong feelings : 6.0%   51 mothers
It was a traumatic experience : 31.8%   268 mothers
I am angry : 22.8%   192 mothers
18 mothers skipped this question

Question #11 – Did you discuss your experience with family and friends?
Yes : 90.8%  768 mothers
No  : 9.2%  78 mothers
15 mothers skipped this question

Question #12 – Please rate your physical recovery in 1 – 10 scale.  1 being easy, 10 being difficult, painful, with compications.

1 – 16.0 % 136 mothers
2 – 12.9%  110 mothers
3 – 12.2%  104 mothers
4 – 7.0%   60 mothers
5 – 8.7%  74 mothers
6 – 8.1%  69 mothers
7 – 9.9%  84 mothers
8 – 11.5%  98 mothers
9 – 7.0%   60 mothers
10 – 6.7 %   57 mothers
9 mothers skipped this question

Question #13 – Please rate you emotional recovery in 1 – 10 scale. 1 being no issues, 10 being difficult, or PTSD.
1 – 17.9%  152 mothers
2 – 10.2%  87 mothers
3 – 7.5%   64 mothers
4 – 5.5%  47 mothers
5 – 8.7%  74 mothers
6 – 7.1%  60 mothers
7 – 11.8%   100 mothers
8 – 13.5%  115 mothers
9 – 7.7%  65 mothers
10 – 13.3%   113 mothers
12 mothers skipped this question

Question #14 – Did you seek counseling or other support?  (Support group)
Yes : 27.8%  234 mothers
No : 66.7%  561 mothers
N/A : 5.5% 46 mothers
20 skipped this question

Question # 15 – How do you plan on birthing your future children?
Elective/Repeat Cesarean : 23.3%  196 mothers
VBAC : 49.3%  416 mothers
Home Birth : 22.8%  192 mothers
Water Birth : 12.1%  102 mothers
No more children : 26.6%  224 mothers
18 mothers skipped this question

Question # 16 – Would you consider having a VBAC?
Yes : 77.5%  628 mothers
No : 22.5%  182 mothers
51 mothers skipped this question

On top of all the questions we included a box to add any additional comments, in which 302 women used to comment about their experiences and even made comments about the survey itself.
In the following posts, we will start to break this information down question by question providing quotes and comments from the real mothers who took the survey, and opinions on the numbers, and what they say for birth, especially cesarean birth today.

I do not have much to write about this show, but I wanted to share the link with my readers because this is such an important show regarding maternity care, safety, and health care reform.

Dr. Marsden Wagner on a Labor of Love

Back in January I read an article in the Washington Post about the decrease in birth weights in the United States in the past two decades, and how it is basically mind boggling because of the rise of diabetes, and other complications during pregnancy that may aid in making larger babies. But for someone who pays attention to the birth trends in this country, I was not surprised at all. I thought to myself “We are finally realizing this?”

“U.S. newborns are arriving a little smaller, says puzzling new Harvard research that can’t explain why. Fatter mothers tend to produce heavier babies, and obesity is soaring. Yet the study of nearly 37 million births shows newborns were a bit lighter in 2005 than in 1990, ending a half-century of rising birth weights.”

A couple things I think attribute to this problem :

• The increase in labor induction for non medical reasons before estimated due dates
• The scheduled cesareans before 40 weeks gestation
• The inaccuracy of estimated due dates
• The lack of access to appropriate pre natal care

It is estimated that 1/3 of elective or scheduled cesarean births are scheduled, or delivered before 39 weeks gestation, meaning those babies could very well be born as early at 35 or 36 weeks gestation, depending on the accuracy of their estimated due date. Recent studies on ultrasound dating for pregnancies still show a large window for error, even first trimester ultrasounds which are supposed to be the most accurate in dating a pregnancy, show to be 7-10 full days off in some cases. Those 7 to 10 days, could very well the difference between a baby with mature lungs and going home with their parents, and a late term preemie who has a stay in the NICU.

From 1996 to the present we have seen a 20% increase in women electing for scheduled cesarean’s after having one cesarean birth.

Money is another factor in this equation. We are seeing many medical choices today being made for monetary and liability reasons, not because they are best for the baby, and mother. We saw this in detail from the National Institute of Health’s VBAC Panel statement this past week.
Hospitals are businesses no matter how we look at it.
Adding pitocin, constant monitoring, an epidural, or surgical costs to a bill is going to benefit the hospital in an increase of the bill when compared to a mother who wishes to have a birth without these types of interventions.

Not many people know but this past week, The National Institute of Health in Maryland took on the issue of Vaginal Birth after Cesarean, better known today as VBAC. Since 1996 The United States has seen the VBAC rate drop steadily, as well as the cesarean birth rate increasing to what some experts call “scary numbers” as well as dangerous.

Now as someone who has worked in the activism community, as well as advocacy community to not only promote VBAC but help lower the local cesarean birth rates, I have been met with a lot of resistance, as well as ignorance on the subject. Many people have been lead to believe that the safest option after having a cesarean section is to repeat the surgery for all subsequent children, but as I have shown in several of my posts, as well as the information that the National Institute of Health provided this week that age old myth is simply not the case.
In their presenters, it was found that the safest option after having one cesarean section, is to have a vaginal birth with your next, or all subsequent children.

In the end, not only did the panel who tackled these issues say that women should not only be encouraged to VBAC, but that ACOG should re-visit their recommendation’s about VBAC which is essentially what caused the decline in this process (many called a procedure, but giving birth the way a woman’s body is made to give birth simply is not a procedure in my eyes) and re-write them. While I do not expect ACOG to do this, what has come in the past few days is nothing short of a miracle for the childbirth community in what we have been saying for years.

Now we are seeing loads of attention on a National level on the subjects such a VBAC Bans in hospitals (which this panel has encouraged end), the criticism in the rising number of cesarean sections, and the drastic rise in Maternal Mortality rates in our country. Something that the grassroots organizations have been discussing and screaming from hilltops for a very long time.

Will we see a change in the tides?  I certainly hope so, for the future, and safety of our mothers and babies.

There are so many choices when it comes to pregnancy, birth, and parenting. It is almost overwhelming for most first time parents, not just mothers. I can certainly say all the baby stuff we had with my first my husband was completely overwhelmed, and sometimes had no idea what some of the baby flair was for, or what half of it even did.

One of the biggest choices you will make happens before your baby is even born, but will impact the way that they are born, and that is where you choose to deliver your baby, and that is what I will talk about today.  There are several options for delivering your baby.
Some more popular than others, and some even unknown.

Hospital Birth
Birthing in the hospital is really the choice that most people make, because of course, that is what most people do and in many cases Moms do not know they have any other choices regarding their birth place.
Hospitals in a sense offer a “one size fits all” birth for most people. Their policies, and protocols really dictate the options you have, and the choices that you will be able to make. If you want to make an alternative choice, you can prepare to bump heads with the staff in most cases. There are some awesome hospitals out there, especially here in Connecticut that are not as difficult to deal with, but make sure you are educated about the hospital and their policies before you step foot in to give birth.
Ask around, ask other mothers about their experiences, ask the staff about your provider and their experience with them.
Investigate to ensure your experience is what you want it to be.
Many women have the need for hospital care because of high risk pregnancies, pre term babies, or other various medical needs, and for their care, the hospital is the best option.

Freestanding Birth Center
What a freestanding birth center is, really, is a home like environment with medical professionals (midwives) and medical equipment (to an extent) designed to handle natural births. If you are interested in having an epidural, or pain relief provided by medication, then a free standing birth center probably isn’t for you.  The rooms tend to look like bedrooms with glorious giant tubs for birth, and showers that can be used to help provide pain relief during labor.
This is a great alternative to a home birth if you are not comfortable with that option.
Connecticut currently only has ONE freestanding birth center, which is located in Danbury. The Connecticut Childbirth Center.

Homebirth
Most people are unaware, but home birth is a valid and legal option here in the state of Connecticut. In late 2009 I wrote an interview with a local Connecticut homebirth midwife by the name of Nancy Farr. In recent studies, home birth is shown to be just as safe as a hospital birth with a trained medical professional in low risk mothers. Which is often a concern to mothers or parents.

All options depend on what the mother would like, or envision for her experience bringing her child into the world. If you feel as though birth is not an emergency or medial event, home birth or a freestanding birth center may be the best option for you. If you would like medical interventions, medications, and the overall hospital experience, then clearly a hospital birth may be the best option for you.

As many know, in the upcoming year I have a lot of personal goals that I am working towards accomplishing. One of those goals is to become a childbirth educator to be able to offer reasonable childbirth classes for women in the area, and be able to schedule classes around my childcare availability. Which seems to be the most difficult these days.

But this summer, I decided to take the step to host a Passion for Birth Lamaze childbirth educator training here in Connecticut. Which is completely exciting, but what is most exciting about it all is the instructor I have booked!  The rather popular Robin Elise Weiss.

The Passion for Birth workshop is a 3 day course, July 30- August 1st going from 8am till 5pm each day.
In the end you will be a Lamaze Trained/educated childbirth educated.
To become certified you will still need to take the Lamaze certification exam, but this is the first step in the right direction if it is something you are interested in.

Space is limited, there are 14 slots open.