Staci Bishop

Tuesday, December 27, 2011

Going For It!

Today, I'm enrolling to receive my doula certification. I'm finally going for it! I say finally because I've known that I want to work with moms and babies for a while now. More like years. I rolled around the idea of becoming a midwife but I'm not 100% certain that this is the best fit for our family right now. However, I can no longer fight the urge to support women in a more official role.

I've been handing out information and advice for quite some time. It's no secret that I'm a wealth of information when it comes to pregnancy, childbirth, and babies. I love talking about all of those things. I love comforting anxious new moms, hearing about their prenatal appointments, and explaining common pregnancy ailments. I love when moms ask me questions and giving them resources to research on their own. I love birth stories. I love settling down a fussy newborn and seeing that baby snuggled up to their momma. I love encouraging moms to breastfeed and sharing tried-and-true parenting tips. I love coaching moms to trust their instincts. I love it all!

About 6-8 months ago I thought I was finally ready to proceed with training. I researched several different programs and settled on the one I felt was best. I planned to complete certifications for labor doula, post-partum doula, and breastfeeding counselor. I was still working out how to pay for it but went ahead and started on the assigned book list. Through reading, I had to face my own issues with the pregnancy, labor, and the delivery of my own 1st born. It was emotional and, ultimately, I decided I wasn't ready. Ironically enough, not long after this, my husband lost his job so everything got pushed to the wayside.

Fast forward until recently where 3 of my closest friends are pregnant at the same time. These past couple of months have been so joyous as we have talked through their pregnancies, their fears, their desires. Two have asked me to be at their birth and I am so deeply honored. To be trusted in such an intimate way is an amazing feeling. My third friend just delivered her sweet baby last week. I absolutely could not wait to go and visit them. That encounter confirmed that I have to do SOMEthing. I just can't resist it any longer. I started contemplating how I would pay for my certification. I decided that I would just start with my labor doula training and go from there. At least it was a start. Then, for Christmas, my in-laws gave us a rather generous gift with the instructions to "use it wisely." It's like all the stars aligned. Pursuing my passion is probably the wisest thing I know to do.

I am beyond thrilled to begin training. This has been a long-time goal of mine and I'm actually going for it. Whoo Hoo!

Monday, December 26, 2011

REVIEW: Pregnant In America (Documentary)

  • Overview
I was recently able to watch Pregnant In America and I cannot say enough positive things about this documentary. I honestly wish every expectant mother and father in the U.S. could watch it. It exposes some very interesting pieces to the American maternity care puzzle.

I love that this film was directed, filmed, and produced by a father-to-be simply seeking out the truth. On his wedding day, he vowed to protect his wife. When she became pregnant, they began a journey to know their options for childbirth. The result is a very powerful disclosure of what is going wrong with the maternity system in the U.S. Below you will find direct quotes from the movie, which pretty much sum up everything I wish the general public knew.

I think the worst thing we are doing to women is not telling them the truth. -Barbara Harper, RN

There are 4 million births each year in the U.S and 98% of them occur in hospitals. Yet, our country is 28th on the list of infant mortality rate.

We aren't saving any more babies with all this technology.

We have, for 50 years, been brainwashing American women about childbirth, about how dangerous it is, how all the terrible things that can go wrong, and how you need to be in the hospital where all the doctors are, where all the machines are, and all the operating tables so that we can take care of those horrendous emergencies when they occur. It is absoletely not true. - Dr. Marsden Wagoner
  • Induction
In my opinion, induction is the #1 barrier to a healthy, happy delivery for mom and baby. An induction commonly leads to one intervention after another. In fact, 50% of inductions end in a C-section. The main reason for induction is convenience, for parents, for doctors, for hospitals, which I think is absolutely absurd.

The pharmacological induction of labor is one of the most serious, drastic and dangerous interventions that you can make. - Dr. Marsden Wagoner

The main drug to facilitate an induction is Pitocin, which is basically man-made oxytocin, the chemical your body releases to start and maintain contractions. The problem with Pitocin is that it can make labor more painful by causing overly strong contractions. This also may be detrimental to the baby.

We don't know the long-term effects of Pitocin. - Barbara Harper, RN

Another popular drug used for induction is Cytotec, which is not indicated for this purpose. In fact, the literature clearly states that this drug should NOT be used on pregnant womenbecause of a huge potential for uterine rupture leading to maternal and fetal death. Yet, hospitals across the country continue to use it regularly.

This drug is not approved by the FDA for this purpose.
This is a humongous obstetric emergency.
The hospital pays a lot of money [lawsuit] but the women pay the price.
- Dr. Marsden Wagoner
  • Epidural
For some reason, in America, we think we are entitled to avoid experiencing pain in childbirth. Yet, this is just another intervention that can cause long-term side effects. Still, 80% of women in labor receive an epidural. Did you know that there are 58 (yes, FIFTY EIGHT) risks to having an epidural? Because the medication crosses the placental barrier, there are even studies which are linking epidurals to behavior problems, obesity, suicide, drug addiction, cardiovascular disease, and cancer. The effect is seeded as an infant only to manifest itself as an adult.

Mother and baby are both designed to work together in labor and, when drugs are used, they are both drug impaired so they are not working together.
  • Interventions
In the United States, childbirth is not seen as a normal event at all and women are not allowed to let it take its natural course. Pregnancy is closely monitored and labor & delivery are scrutinized and micromanaged. In turn, the interventions make more of a mess than what they aim to fix not that the process needs to be "fixed" to begin with.

In countries where they do not use [interventions] just as a normal management of labor technique or protocol, they have much better statistics, much better outcomes, and we can learn from that. - Kerry Tuschhoff

Doctors use the intervention and then have to save the baby because they have used the intervention. - Barbara Harper, RN
  • Cesarean Section
In 1975 the C-section rate in the United States was 7%. It is now well above 30% and continuing to rise. The World Health Organization recommends a maximum rate of 15%.

FYI: All OB/GYNs receive surgical training.

It's kind of a no brainer to say how come the U.S. has a high Cesarean section rate. Well, it has a high surgical rate because the people you ask to take care of it are surgeons. - Barbara Katz Rothman, PhD

To a surgeon, every problem looks like a surgical problem.

There are more than 42 risks of Cesarean section. Most of these risks are not discussed with patients. One doctor in the film goes as far as to say this nondisclosure is ethically inappropriate. I would whole-heartedly agree.

It's MAJOR abdominal surgery. - Dr. Marsden Wagoner {emphasis mine because I know first hand}

From the mother's point of view, if she didn't want the Cesarean, she has just been robbed of the chance to have the kind of empowering birth that she wanted. She may have been robbed of her change to bond with the baby and she may have been robbed of the chance to successfully breastfeed. - Robbie Davis Floyd, PhD
  • Vaginal Birth after Cesarean (VBAC)
This is where things get even more complicated. Most Cesareans are unnecessary to begin with and it is becoming increasingly more difficult be given a chance for a VBAC. Many hospitals forbid VBACs and some insurance policies refuse to pay for them. In some states it is even illegal.

There are women right now in this state [Washington] that are getting cut open because everybody around them is telling them that is their only option. - Betsy Chasse.

The above quote is from a mother whose insurance company refused to pay for her VBAC so she chose to cross the border and deliver her baby in Canada instead.

We are victims of our insurance.

Less patients are taking an active role in what they want. Some are even requesting surgery when it doesn't need to be done. - Dr. Sancetta (Miami, FL)
  • Homebirth
The filmmakers traveled to other countries to examine how maternity care and childbirth are handled in those areas. I was most intrigued by Holland, where 87% of women deliver at home. In fact, if a low-risk woman shows up to a hospital to deliver her baby, then send her right back home. In Holland, home births are covered by insurance and are drastically less expensive. Plus, contrary to popular belief, there is less bacteria at home compared to the hospital.

Women continue to be disappointed in hospital births.
  • Midwives
Here are some statistics on a very well-known Tennessee midwife, Ina May Gaskin. She has a mere 1.5% C-section rate in over 2000 deliveries where 95% of women delivered outside of a hospital. Impressive!

It is interesting to note that women using midwives in other countries may receive daily visits for up to three weeks post partum.

We don't say patients, we say clients, because they are not ill. - Dr. Tom Kreuning (Holland midwife)
  • Conclusion
There were many more topics covered in this movie and several topics not covered that I think are important. The film also includes the story of Steve & Mandy and you follow them throughout the pregnancy and through delivery. However, this movie is great for getting your brain thinking about the current state of affairs regarding childbirth in the U.S. The bottom line is that we need to take control of our own births, do the research, and determine what options are appropriate for us.

Doctors in America do not want any significant change in the present system. They have all the power, they have all the control, and they are making the big bucks. - Dr. Marsden Wagoner

It's so sad what women are missing and they don't even know that they are missing it.

We skip the sense of empowerment.

There are really only two ways to improve obstetrics; 0ne is litigation and the other one iseducation. - Dr. Marsden Wagoner

The goal of Steve Buonaugurio (director) was to inspire families to reclaim control of their birth experience. I want to encourage you to do the same.

If you would like to watch Pregnant In America, you can view it online or rent it from Netflix. It is also available for purchase.

Have you seen the movie. What are your thoughts?

Sunday, December 25, 2011

REVIEW: The Thinking Woman's Guide to a Better Birth (Goer)

I feel that the author, Henci Goer, did a great job with this book. She makes it clear from the very beginning (page 6) which side of the fence she stands on in regards to childbirth. I appreciated her forthright honesty. She even admits to wanting to sway the reader to her way of thinking. However, she goes about in two ways. First, she has research and studies to back up what she feels is optimal care. She even goes so far as to include the studies in their entirety in the appendices. Secondly, she compares several options side by side, which encourages the reader to draw their own conclusions.

I enjoyed that the book was broken down into specific categories with only one issue/procedure/subject specifically addressed per chapter. While I preferred to read the book chronologically, she sets it up in a way that it could be read out of order with page references directing you to the other topics within each chapter.

I found it encouraging that she addresses the Cesarean epidemic straight away because she feels it is "the most pressing issue in maternity care." She does a nice job explaining why our C-section rate is on the rise, the procedure itself, as well as both short and long-term side effects. I was slightly disappointed that she didn't go into more detail about how to prevent this major abdominal surgery but this is addressed in the remainder of the book.

In the very next chapter she addresses a breech birth which, in this day and time, almost 100% guarantees a Cesarean delivery. Here, she discusses the different types of breech presentation and risks associated with both a vaginal birth or C-section. The author presents different methods for trying to turn a breech baby as well as their associated risks. I found this chapter the most informative.

The remaining chapters of this book explain common procedures and interventions that are common to childbirth in the United States, most of which the author frowns upon. She goes into great detail to explain why most of these tactics are unnecessary and can potentially cause more harm that good. She gives her recommendations for how to avoid such procedures but also explains the pros and cons of each should your provider want to proceed with a certain course of action.

While I whole-heartedly agreed with the author's viewpoints, I am afraid this book could potentially put off a first time mom. The writer concludes her book with her preference for all women to deliver at home with a midwife if possible. While I believe this option lends itself to fewer interventions and healthier outcomes, I would only recommend her book for a client with a healthy pregnancy who has expressed interest in as few interventions as possible. I would also recommend this to a mom who had a less than ideal hospital birth and is looking for a better birthing experience overall.

It's definitely a book for a birth professional to add to their lending library solely based on the evidence-based conclusions and I rather enjoyed reviewing her material and suggestions.