Bug, as you may remember, was born at a free-standing birth center, in a tub, with midwives. The first time, I wanted to trust my medical people were providing only necessary interventions, because I had no idea what I was doing, on account of I'd never had a baby before. They didn't, and it was no more scary than births generally are (moderate amount of pain, blood, and confusion, followed by BABY!, and what-do-you-mean-golfball, but that's normal too).
Tatoe, due to insurance changes, was born in a hospital. I asked for an epidural ("They can come whenever you want." "NOW. Five minutes ago."*) and was very happy to have it and got pitocin and a lot of monitoring. I ignored everything everyone was telling me unless it had to do with the baby's safety (don't tell me when to push, but yes, I will let you readjust the heart monitor seventeen times) and made them give me a pacifier for the kid. (He spit it out immediately. Nipple confusion my FOOT!)
You know what? Both my children were - thank God! - born healthy, their births were relatively easy, everyone was safe, and I am perfectly content with all the things that were my choices to make. Both completely different times.
So what I'm trying to tell you is that I now find myself equally annoyed by people who maintain that unmedicated homebirths are the only way to go, AND by people who maintain that everyone should be continuously monitored in hospitals.
*In no small part because I had been in labor FOR A WEEK.
Showing posts with label Birth. Show all posts
Showing posts with label Birth. Show all posts
Monday, May 27, 2013
Friday, May 17, 2013
Book Review: ALL NATURAL by Nathanael Johnson
I reserved our public library's copy of this book because the author is a friend of a friend, who told me I might like it. Here's the verdict: I do! I like it immensely! I am thinking of buying a copy for my mother, since she would also enjoy it!
(Nobody paid me anything to write this. I sent the author a message once, but we are largely unacquainted.)
The book starts out with a very amusing recounting of the author's childhood, being raised bywolves radical back-to-nature types. (They make my mother's Vegetarian Nut Loaf look positively mainstream.) He meets his future wife, the daughter of a surgeon, and they marry and are soon expecting a child, at which point we segue into a chapter on birth in America.
I could have written this chapter. My favorite line: "I was looking for something more like No Nonsense Evidence-Based Midwifery." Ah, Bug's midwives, of "a zero-transfer C-section rate is unrealistic and dangerous" fame! He goes into the statistics of C-sections, maternal morbidity and mortality, and ensuing complications carefully, in detail, and in a very understandable manner - and also talks about the bad outcomes that can happen in the absence of medical care, and the fine line between lifesaving interventions and overcautious practices that harm patients (like routine continuous fetal monitoring).
The next chapters are about raw milk, nutrition, vegetables, sugar (really, doesn't affect immunity; nicely dissected and taken down, with a fine understanding of the phrase "There is no evidence."), pork farming, immunity, vaccines, the environment. These subjects are all handled delicately and in a very neutral manner with no proselytizing.
The last chapter is about medicine, and how to balance lifesaving treatments with unnecessary testing and intervention. The author shares an anecdote from his mother, who intelligently researches a possible hepatitis infection, and insists on a second test because the first one has a high false-positive rate. He also relates his own bout of appendicitis. He talks about primary care, emergency medicine, and end-of-life care, our problems with dealing with the root causes of... well, everything - and one of medicine's great failures, that of treating the symptoms. The last chapter is a nice bookend to the first- C-sections and suicides, birth and death.
There are 19 pages of closely-spaced endnotes. A lot of research went into this book. I would like to add I've found no inaccuracies in this book, which is high praise from this pedantic, proofreading-maniac of a scientist. In some cases, I would perhaps have liked to see a stronger opinion come through (if you want to read about vaccines go look up Andrew Wakefield's financial interest in scaring people, and the reasons for his medical license being revoked in Great Britain). Some subjects could perhaps use a bit more depth; for example, the author talks about the 'immunity hypothesis', that more dirt and germs prevent autoimmune disease, and cites the rise of things like asthma in developed countries- but he doesn't mention the role of pollution, or of cheap and accurate sequencing in diagnosis. On the other hand, there's only so many pages in a book, and the author clearly doesn't want to be prescriptive or evangelical. He is leading you through his journey of exploration.
If you have a friend who thinks that ridiculous, stupid, inaccurate, dangerous Sears book is the gospel, this will not convince him or her. If you know someone who has an actual inquring mind - especially people who are not trained as scientists- this is perfect. As for you, dear readers, you should all go read it immediately.
* Did you know this strain has a stable plasmid with a horizontally-transferred Shigella toxin, which binds to ribosomes, and that's why it's so toxic? I wrote a paper about it in college.
(Nobody paid me anything to write this. I sent the author a message once, but we are largely unacquainted.)
The book starts out with a very amusing recounting of the author's childhood, being raised by
I could have written this chapter. My favorite line: "I was looking for something more like No Nonsense Evidence-Based Midwifery." Ah, Bug's midwives, of "a zero-transfer C-section rate is unrealistic and dangerous" fame! He goes into the statistics of C-sections, maternal morbidity and mortality, and ensuing complications carefully, in detail, and in a very understandable manner - and also talks about the bad outcomes that can happen in the absence of medical care, and the fine line between lifesaving interventions and overcautious practices that harm patients (like routine continuous fetal monitoring).
The next chapters are about raw milk, nutrition, vegetables, sugar (really, doesn't affect immunity; nicely dissected and taken down, with a fine understanding of the phrase "There is no evidence."), pork farming, immunity, vaccines, the environment. These subjects are all handled delicately and in a very neutral manner with no proselytizing.
The last chapter is about medicine, and how to balance lifesaving treatments with unnecessary testing and intervention. The author shares an anecdote from his mother, who intelligently researches a possible hepatitis infection, and insists on a second test because the first one has a high false-positive rate. He also relates his own bout of appendicitis. He talks about primary care, emergency medicine, and end-of-life care, our problems with dealing with the root causes of... well, everything - and one of medicine's great failures, that of treating the symptoms. The last chapter is a nice bookend to the first- C-sections and suicides, birth and death.
There are 19 pages of closely-spaced endnotes. A lot of research went into this book. I would like to add I've found no inaccuracies in this book, which is high praise from this pedantic, proofreading-maniac of a scientist. In some cases, I would perhaps have liked to see a stronger opinion come through (if you want to read about vaccines go look up Andrew Wakefield's financial interest in scaring people, and the reasons for his medical license being revoked in Great Britain). Some subjects could perhaps use a bit more depth; for example, the author talks about the 'immunity hypothesis', that more dirt and germs prevent autoimmune disease, and cites the rise of things like asthma in developed countries- but he doesn't mention the role of pollution, or of cheap and accurate sequencing in diagnosis. On the other hand, there's only so many pages in a book, and the author clearly doesn't want to be prescriptive or evangelical. He is leading you through his journey of exploration.
If you have a friend who thinks that ridiculous, stupid, inaccurate, dangerous Sears book is the gospel, this will not convince him or her. If you know someone who has an actual inquring mind - especially people who are not trained as scientists- this is perfect. As for you, dear readers, you should all go read it immediately.
* Did you know this strain has a stable plasmid with a horizontally-transferred Shigella toxin, which binds to ribosomes, and that's why it's so toxic? I wrote a paper about it in college.
Tuesday, November 01, 2011
Really, Not That You Asked (3)
7:30 AM: My contractions slow down to every ten minutes again. "Pitocin!" the nurse chirps, and hangs a bag. I don't care.
Until 10 AM: I think nothing is happening because the intensity never goes past 20 on the LYING BASTARD of a contraction monitor.
10 AM: I start feeling pressure. I don't mention it because I don't want anyone to BOTHER me.
10:45 AM: I decide that perhaps I should mention it. Also, I decide that the contraction monitor has been LYING. The nurse and midwife have a genteel tiff: the midwife is upset that the nurse checked me; the nurse points out that she paged the midwife five times with no response. I ignore them all, including when the midwife tries to coach my pushing.
The rest is pretty mundane. At about 11:15, the baby popped out in the usual eel-like fashion, looked around, and screamed.
The thing is, I already did a drug-free childbirth; this time, I felt like I had nothing to prove to anyone, including myself, and I didn't want to be in that much pain any more. Having done it the other way, I didn't feel like I was missing anything by getting an epidural and a little pitocin. And you know what? It was great.
And I had been in labor for SIX DAYS, too.
Until 10 AM: I think nothing is happening because the intensity never goes past 20 on the LYING BASTARD of a contraction monitor.
10 AM: I start feeling pressure. I don't mention it because I don't want anyone to BOTHER me.
10:45 AM: I decide that perhaps I should mention it. Also, I decide that the contraction monitor has been LYING. The nurse and midwife have a genteel tiff: the midwife is upset that the nurse checked me; the nurse points out that she paged the midwife five times with no response. I ignore them all, including when the midwife tries to coach my pushing.
The rest is pretty mundane. At about 11:15, the baby popped out in the usual eel-like fashion, looked around, and screamed.
The thing is, I already did a drug-free childbirth; this time, I felt like I had nothing to prove to anyone, including myself, and I didn't want to be in that much pain any more. Having done it the other way, I didn't feel like I was missing anything by getting an epidural and a little pitocin. And you know what? It was great.
And I had been in labor for SIX DAYS, too.
Friday, October 28, 2011
Really, Not That You Asked (2)
4:00 AM: Someone comes and gives me narcotics. I immediately feel a little high.
4:30 AM: I get into the tub to hang out. My contractions slow down. A lot. I can't be bothered to care.
5:45 AM: The narcotics start wearing off. I can't have more yet. Back to sobbing and pain. We call the nurse and talk about epidurals. "I feel so bad!" I weep. "About the epidural? Oh, honey, you don't need to feel bad," she says. "No I just feel awful," I say. I get out. Every three fucking minutes again.
6:00 AM: Anesthesia shows up. I've drawn a resident and her attending. She hits something the first time and tries again. Even in my haze, I think, sweetie, you get ONE more try and then so help me that ATTENDING is sticking me in the spine. She gets it the second time.
6:45 AM: The epidural finally kicks in. Bliss! I can still move, but I'm not in excruciating pain any more. I fall asleep.
7:00 AM: A hammer drill, a circular saw, and a drill start simultaneously outside my window.
4:30 AM: I get into the tub to hang out. My contractions slow down. A lot. I can't be bothered to care.
5:45 AM: The narcotics start wearing off. I can't have more yet. Back to sobbing and pain. We call the nurse and talk about epidurals. "I feel so bad!" I weep. "About the epidural? Oh, honey, you don't need to feel bad," she says. "No I just feel awful," I say. I get out. Every three fucking minutes again.
6:00 AM: Anesthesia shows up. I've drawn a resident and her attending. She hits something the first time and tries again. Even in my haze, I think, sweetie, you get ONE more try and then so help me that ATTENDING is sticking me in the spine. She gets it the second time.
6:45 AM: The epidural finally kicks in. Bliss! I can still move, but I'm not in excruciating pain any more. I fall asleep.
7:00 AM: A hammer drill, a circular saw, and a drill start simultaneously outside my window.
Thursday, October 27, 2011
Really, Not That You Asked (1)
When Bug was born, I was at a birth center with a couple midwives and a tub and one (1) ibuprofen. I don't know why I feel the need to share Baby Bug's birth with you, but I do. So here we go:
Sunday, 1 AM: I am woken up by contractions every ten minutes.
Monday: Repeat above. Walking around makes it worse, which only makes me want to lay down.
Tuesday: More of same. 40 weeks. The midwives do a stretch-and-sweep; I am 2 cm dilated, i.e. HA HA HA.
Wednesday: Nothing is changing. I am exhausted.
Thursday, 11 AM: My water breaks in an entirely undramatic, dribbly fashion. I go for a sulky 90-minute walk. Every five minutes.
Thursday, 7 PM: Every five minutes, lasting almost a minute. Still sulky. If I lay on the couch, I can pretend this is happening to someone else.
Thursday, 1 AM: Every three minutes for a minute. Instead of being afraid of giving birth in a hospital, I actually want to go. I call the midwife again and decide to meet her at L&D triage.
1:45 AM: Every three minutes and I am doubled over with pain. Back labor! Again! The midwife examines me, but thinks my water has not broken. 2 cm. I am in intense pain and clearly, it is doing NOTHING. What the hell? She suggests that I walk around for a while.
We see a young`couple come in. "I just don't like this leaking, it's so gross!" she says cheerfully. A first child, I think: if you think a little clear fluid is gross, wait for childbirth! And after! Also, she is waaay too cheerful to be in labor enough to be admitted.
2:30 AM: I hear them sending the cheerful lady home with polite instructions to come back when she is in real labor.
2:45 AM: I am walking up and down the corridor, doubled over and sobbing my eyes out every time I have a contraction (every three minutes). "Should I call the midwife?" the nurse asks. "No, [SOB SOB SOB], I'll just keep walking [SOB SOB SOB noisy nose-blowing]", I say. "Er... I think I'll give her a call," the nurse says.
3:15 AM: The midwife examines me again. 3 cm. Again, what the hell? She looks at me having a nervous breakdown and vanishes. Five minutes later, she comes back and says, "Your water definitely broke! Let's admit you." I wonder if she has written "Reason for admission: 3 cm, ROM, completely losing it."
(More to come.)
Sunday, 1 AM: I am woken up by contractions every ten minutes.
Monday: Repeat above. Walking around makes it worse, which only makes me want to lay down.
Tuesday: More of same. 40 weeks. The midwives do a stretch-and-sweep; I am 2 cm dilated, i.e. HA HA HA.
Wednesday: Nothing is changing. I am exhausted.
Thursday, 11 AM: My water breaks in an entirely undramatic, dribbly fashion. I go for a sulky 90-minute walk. Every five minutes.
Thursday, 7 PM: Every five minutes, lasting almost a minute. Still sulky. If I lay on the couch, I can pretend this is happening to someone else.
Thursday, 1 AM: Every three minutes for a minute. Instead of being afraid of giving birth in a hospital, I actually want to go. I call the midwife again and decide to meet her at L&D triage.
1:45 AM: Every three minutes and I am doubled over with pain. Back labor! Again! The midwife examines me, but thinks my water has not broken. 2 cm. I am in intense pain and clearly, it is doing NOTHING. What the hell? She suggests that I walk around for a while.
We see a young`couple come in. "I just don't like this leaking, it's so gross!" she says cheerfully. A first child, I think: if you think a little clear fluid is gross, wait for childbirth! And after! Also, she is waaay too cheerful to be in labor enough to be admitted.
2:30 AM: I hear them sending the cheerful lady home with polite instructions to come back when she is in real labor.
2:45 AM: I am walking up and down the corridor, doubled over and sobbing my eyes out every time I have a contraction (every three minutes). "Should I call the midwife?" the nurse asks. "No, [SOB SOB SOB], I'll just keep walking [SOB SOB SOB noisy nose-blowing]", I say. "Er... I think I'll give her a call," the nurse says.
3:15 AM: The midwife examines me again. 3 cm. Again, what the hell? She looks at me having a nervous breakdown and vanishes. Five minutes later, she comes back and says, "Your water definitely broke! Let's admit you." I wonder if she has written "Reason for admission: 3 cm, ROM, completely losing it."
(More to come.)
Sunday, October 16, 2011
Birth Stories
I have just been traumatized by hearing yet another birth story from a woman in her seventies. All the ones in my vicinity feel the need to share about giving birth in the fifties and sixties. Oy! I barely know you people! We make polite conversation about the weather, and then this? (Though tonight, the husband said "And he was nine pounds, six ounces!" The wife: "Nine pounds, SEVEN ounces! And I still remember all the havoc he wreaked on my parts!" Me: "...ow.")
It reminds me of Dr. S's female relatives telling me about all their reproductive difficulties at our second wedding reception. Look, I am all for shining a light on the facts of life, but I had met them all, for the very first time ever, not five minutes previously.
It reminds me of Dr. S's female relatives telling me about all their reproductive difficulties at our second wedding reception. Look, I am all for shining a light on the facts of life, but I had met them all, for the very first time ever, not five minutes previously.
Sunday, October 09, 2011
Unanswered Questions
Q: Am I nauseous, in pain, and miserable because BABY is imminent, or... not, waaaah?
Q: Why is my toddler suddenly peeing in his pants all the time?
Q: Are we going to survive this?
Q: What was I thinking?
A: Who knows.
Q: Why is my toddler suddenly peeing in his pants all the time?
Q: Are we going to survive this?
Q: What was I thinking?
A: Who knows.
Thursday, September 15, 2011
Booooooring
And without even pictures to amuse you, because my camera is giving up the ghost. (I dropped it on a tile floor; strangely, it hasn't been the same since.)
- Dr. S is applying for academic jobs. Perhaps I should also buy a lottery ticket.
- I have been editing teaching statements, manuscripts, research proposals, and cover letters for him until my eyes are ready to bleed. (And if I say "Why do we care?" one more time, you may shortly hear about my divorce.)
- I made Bug finger paint today. It was the best Bug thing ever.
- I also made a paint smock, nine dryer balls, a Cold-State-weight winter baby hat, another changing pad cover, a car blanket, and two kick-a-ball fabric balls. Since Sunday.
- The ice-pick headache has mainly disappeared, with regular applications of narcotics. (Thank you, midwives!) The sparkly things are worse, but mainly annoying. I'll take it.
- Tonight I went to a mandatory water-birth class. Had I not already had a water birth, it would have been more enlightening. Instead, I was reminded that I want to never watch another birth ever again. Possibly even if I am giving birth.
- Dr. S is very amused at my touching faith in people's scientific knowledge. This manifests as continual disbelief that People Don't Know Things.
- The people at this class (not the instructor, mercifully) were all under the mistaken impression that humans are sterile. (Edit: As in germ-free.) Like, ever. After we're born and all.
- Two words: IMMUNE SYSTEMS.
- One more word: SOAP.
Wednesday, August 31, 2011
Nervous
Today we toured the Newly! Renovated! Hospital Birth Center! I suppose... it used to be more depressing.
I guess they're trying. But a class before you can even think about a waterbirth? Anyone for a rousing chorus of LIABILITY? And that inevitable hospital-antiseptic smell. And a model of care that involves being wheeled about whilst in labor. And... and... and... I want someone to take away the scary surgical-looking lamps and the ugly hospital bed and the weird birthing tub thing. I want my other midwives and their big comfy bed and jacuzzi and jangly ankle bracelets and peculiar love of moxibustion.
I expect, when the time comes, I'll be too busy having the baby to really care. And I like these midwives.* They are doing their best to provide low-intervention care in a high-intervention environment. I understand that they can color inside the lines, or take their toys and go get fired.
I am also, I confess, a tiny bit nervous about this labor. With Bug, my water broke at 2 PM, I was having serious contractions about 5 PM, and he was born at 10 PM. "Faster" doesn't sound like a whole lot of fun.
Whine, whine, whine.
(It could be a lot worse.)
* With current insurance: other midwives $4000, these midwives $0.
I guess they're trying. But a class before you can even think about a waterbirth? Anyone for a rousing chorus of LIABILITY? And that inevitable hospital-antiseptic smell. And a model of care that involves being wheeled about whilst in labor. And... and... and... I want someone to take away the scary surgical-looking lamps and the ugly hospital bed and the weird birthing tub thing. I want my other midwives and their big comfy bed and jacuzzi and jangly ankle bracelets and peculiar love of moxibustion.
I expect, when the time comes, I'll be too busy having the baby to really care. And I like these midwives.* They are doing their best to provide low-intervention care in a high-intervention environment. I understand that they can color inside the lines, or take their toys and go get fired.
I am also, I confess, a tiny bit nervous about this labor. With Bug, my water broke at 2 PM, I was having serious contractions about 5 PM, and he was born at 10 PM. "Faster" doesn't sound like a whole lot of fun.
Whine, whine, whine.
(It could be a lot worse.)
* With current insurance: other midwives $4000, these midwives $0.
Saturday, July 16, 2011
Birth Memories, 5
The midwives fish the placenta out of the birth tub and show it to me. It looks like a cooked jellyfish mated with a large steak. "Do you want it?" they ask.
"NO!!" I say, and completely involuntarily, I put out my hand to push away the idea. I am grateful that it functioned well for nine months; now we are both done with it. Please, go set it on fire somewhere else.
"NO!!" I say, and completely involuntarily, I put out my hand to push away the idea. I am grateful that it functioned well for nine months; now we are both done with it. Please, go set it on fire somewhere else.
Friday, July 15, 2011
Birth Memories, 4
I am having back labor, because the baby is posterior. I am sitting in the tub, in a great deal of pain. My mother is somewhere in the room, crying. My spouse is sitting next to the tub, looking worried, possibly also crying.
I cannot possibly handle anyone else but me being upset in this moment.
I wrap myself in three towels, ask the student midwife for some ice cubes, and hide in the bathroom, where I stay for the next two hours. I come back out right before the baby is born.
I cannot possibly handle anyone else but me being upset in this moment.
I wrap myself in three towels, ask the student midwife for some ice cubes, and hide in the bathroom, where I stay for the next two hours. I come back out right before the baby is born.
Thursday, July 14, 2011
Birth Memories, 3
I am in the neuro-ophthalmologist's office, waiting to be squeezed in between 80-year-olds with cataracts. People almost never have neuro-opthalmological emergencies without pointy objects or head trauma. However, I have managed! I am SPECIAL.
I am having contractions every ten minutes... nine. Eight and a half. Dr. S asks if he should tell the receptionist that I am in labor. "I don't KNOW!" I say, and bend over the chair. I am, like most women in labor, neither fully rational nor fully there. He looks at my mother, who says YES! Now! Nownownow!, then goes and talks to the receptionist.
Thirty seconds later, the doctor and all five nurses pour out of the exam rooms, looking extremely worried. They offer me food, water, a washcloth, a chair, and some tylenol. They bite their nails. Thirty minutes later, we walk back out the door, reassured that I am not, at least for now, going blind.
I am having contractions every ten minutes... nine. Eight and a half. Dr. S asks if he should tell the receptionist that I am in labor. "I don't KNOW!" I say, and bend over the chair. I am, like most women in labor, neither fully rational nor fully there. He looks at my mother, who says YES! Now! Nownownow!, then goes and talks to the receptionist.
Thirty seconds later, the doctor and all five nurses pour out of the exam rooms, looking extremely worried. They offer me food, water, a washcloth, a chair, and some tylenol. They bite their nails. Thirty minutes later, we walk back out the door, reassured that I am not, at least for now, going blind.
Wednesday, July 13, 2011
Birth Memories, 2
The baby's been born. I'm laying in bed with him, and the midwife asks, "How's your vision?"
"I can see my hand, and I can see you, and I can see the canopy outside the window, but I can't focus past that," I say. And everyone laughs, because apparently, it's foggy as a London pea-souper and nobody can see outside.
Later, I don't even remember this.
"I can see my hand, and I can see you, and I can see the canopy outside the window, but I can't focus past that," I say. And everyone laughs, because apparently, it's foggy as a London pea-souper and nobody can see outside.
Later, I don't even remember this.
Tuesday, July 12, 2011
Birth Memories, 1
I once promised Belle I wouldn't post a birth story (plus, it's pretty boring: I went into labor, eight hours later my kid came out, then there was a lot of lidocaine, the end). But I keep reading Bionic Mama's highly entertaining and only mildly horrifying birth story and remembering bits and pieces. So here's one:
I'm in the giant tub at the birth center. Or maybe I'm leaning on the bed, or in the shower, or hiding in the bathroom; I wasn't exactly present, if you know what I mean. There is a midwife, in her late forties, immensely experienced and a little sarcastic, and a sweet, blonde student midwife. "Is the baby coming soon?" I ask the older midwife.
"No," she says, "it's going to be a little while."
"Can't you just LIE to me?" I say, exasperated.
"No," she says, "I generally make it a practice not to lie to my patients."
"You could make an exception here," I say.
Much later, I ask her again. "Yes," she says, "very soon."
"Well, now I know it's true, if you finally said it."
I'm in the giant tub at the birth center. Or maybe I'm leaning on the bed, or in the shower, or hiding in the bathroom; I wasn't exactly present, if you know what I mean. There is a midwife, in her late forties, immensely experienced and a little sarcastic, and a sweet, blonde student midwife. "Is the baby coming soon?" I ask the older midwife.
"No," she says, "it's going to be a little while."
"Can't you just LIE to me?" I say, exasperated.
"No," she says, "I generally make it a practice not to lie to my patients."
"You could make an exception here," I say.
Much later, I ask her again. "Yes," she says, "very soon."
"Well, now I know it's true, if you finally said it."
Subscribe to:
Posts (Atom)