Archive for the ‘C-Section & VBAC’ Category

A Message About Preeclampsia to Every Mother

Wednesday, June 4th, 2014

If your care provider is seeing a slight increase in your BP, a bit of protein in your urine, and asks you questions about headaches, swelling in your hands and face, pain under your ribs on the right, and if you’ve been seeing spots, they may tell you that you are turning preeclamptic. The Preeclampsia Foundation website can help clarify a lot of what they are telling you, and give you some tools to partner with your care provider in making sure of your diagnosis. Before you can proceed, having a good understanding of what you are facing is important for you and your baby’s health. A preeclampsia diagnosis is nothing to sneeze at, and therefore, it behooves you to learn what you can in order to participate fully in your care, and to make decisions based on information and instincts, rather than fear.

However, it is important to note that, if you do have preeclampsia, you are in a situation where the benefits of certain interventions (such as induction or occasionally cesarean section) very likely outweigh the risks of waiting it out. Preeclampsia doesn’t play fair. It is imperative that you speak clearly with your provider, and make sure you understand why they are suggesting certain procedures. Even if they are necessary, they can be hard to take in if you were planning an unmedicated vaginal birth. Knowing really is half the battle in this case. Do not be afraid to learn about preeclampsia, learn about the way your care provider treats it, and walk forward in confident awareness of the power you still have to choose rightly for you and your baby.

Some things to consider if your blood pressure slightly elevated during only one prenatal visit, and in the absence of other symptoms:

  • What is your stress level like?
  • Have you been sick lately?
  • Are you dehydrated?

Some questions to ask if you have more indicators and/or symptoms:

  • “Am I being diagnosed with preeclampsia, or are these numbers borderline?”
  • “Could this be pregnancy-induced hypertension? If so, how do you normally treat it? Can it lead to preeclampsia?”
  • “What other symptoms might come to light if it is preeclampsia?”
  • “Do I have the option of monitoring BP at home, and being checked every couple of days, or does this need to be taken care of now?”
  • “Is the protein in my urine shown via a reagent strip, and if so, can we double-check it with a 24 hour catch?”
  • “What are my options for induction if it becomes necessary? What are the benefits/risks/alternatives of each method? Which do you prefer, and why?”
  • “How soon do you typically decide to move on to a cesarean section if the induction does not work?”

Preeclampsia is not the end of the world, though it is serious. It is just one of several curve balls that get thrown at some women. It is not something that we currently know how to prevent with any degree of scientific certainty. We have a lot of ideas of what seems to help, but nothing we can hang our hats on just yet. One thing that I think is so important to understand is that we can do everything “right,” have a textbook healthy pregnancy, and still end up with preeclampsia or other problems. We are never guaranteed a “good” outcome when it comes to anything in life, and we should not expect our births to be any different.

What matters most is to do the best we can with what we have, and to be flexible when we are handed something unpleasant, difficult, or even downright terrifying. We face our fears and challenges head-on, and make the best decisions we can within our circumstances. We do not lose our power just because of a medical diagnosis. We just lose a few options we otherwise would have had. Never be afraid to ask your care provider, “Why?” The more you understand, the less scary it will be for you, and the better you will be able to process your birth after the fact.

Preeclampsia or no, your birth is still your birth. You are already a good mother. You can do this.

What do you know about preeclampsia? Where did you get your information? Have you had preeclampsia before? What was your experience with it? What did you learn from it? What advice would you give to someone facing a similar situation? Share your story in the comments…

Grace & Peace,
Tiffany

 

Birthy Weekend Links

Saturday, September 7th, 2013

This weekend is coming up fast! What plans do you have? I have family coming in for a five-day visit, I’m on call for a midwife, and I’m trying to put together some bouquets for my sister’s upcoming wedding. In the meantime, here are a few things worth reading this weekend.

Interested in reading more? “Like” my Facebook page, since I tend to share a lot more of these on my Facebook page, almost daily!

Happy weekending to you!

Grace & Peace,
Tiffany

Question CPD

Sunday, June 27th, 2010

April is Cesarean Awareness Month

Friday, April 2nd, 2010

About a third of women giving birth today do so by cesarean. (1) According the World Health Organization, the rate for cesareans to be optimally beneficial for mothers and babies is between 10-15%. (2)

This issue is far from cut-and-dried, but it merits careful thought by each woman who ever wants to have children. I urge you, as a mother myself, and as a doula, to educate yourself to the best of your ability. Seek out good resources, like the ones found at the International Cesarean Awareness Network (I-CAN) website for starters.

Realize that your birth choices are your responsibility, and that you and your family are the ones who must live with the ramifications of those choices for the rest of your life. Your care provider does not. Know your facts, and choose wisely, based on what is best for YOU, and YOU ALONE.

Don’t put more time into choosing your cable package, cell phone, or new car than you do into the birth of your child. You don’t have to be a doctor to understand birth. As a woman, created by God to do this, you already understand it more than you know. Learn to trust that instinct, paired with accurate, evidence-based knowledge, and you will walk away from your birth with an “I did it!” sense of achievement, no matter how your birth manifests itself.

This experience of empowerment and meaning is not reserved only for those who birth vaginally with no drugs. It can be true for cesarean births too – if you are informed and have full confidence that the choice of a cesarean was right for YOU. That is critical.

Here are some things you can do to get started:

  • Choose your care provider wisely.
  • Hire a doula.
  • Take independent childbirth classes that focus on building your confidence the normalcy of birth.
  • Read books like this, this, and this.
  • Read positive birth stories of all kinds. Start here.
  • And more…

There is so much more to birth than method. It’s a rite of passage, and you cannot separate the emotional or spiritual from the physical. It’s not possible. You’ll remember it for the rest of your life.

Remember: You cannot fail at birth, but you can be failed by others. So, take responsibility for your birth choices, own it, and you will come out stronger on the other side.

1: Cesarean rate jumps to record high – Up 53% since 1996.
2: World Health Organization. Appropriate technology for birth. Lancet 1985; 2: 436-7.

Book Review: Cesarean Voices

Thursday, January 21st, 2010

I have never had a cesarean. I have several friends who have, and they all have very different stories to tell. Some were happy with their experiences, others less so. One even grieves deeply over hers, and wonders if things could have been different.

I have learned that, like normal birth, each woman’s cesarean experience is different.

I have learned that probably half of all cesareans performed in the U.S. are probably unnecessary.

I have learned all kinds of facts and statistics about cesareans, and have studied how I can best support women through their cesareans as a doula.

One piece I have always felt was missing from my knowledge about cesareans, and the reasons they are performed, is the human factor. Most women I know are fairly reluctant to talk about their cesareans with me, because my personal births are at the opposite end of the spectrum. I often wonder if they feel I will condemn or judge them harshly for having a cesarean. Of course, that is not the case, but how are they to know that?

I will not pretend to understand what it’s like to undergo major surgery in order to birth my babies. I have no idea what it’s like, but I sometimes wish I did.

I mentioned this desire to a woman I admire greatly, who has a remarkable tale to tell of her own. Desirre Andrews, of whose birth stories I have heard only snippets, has experienced both cesarean births and natural VBAC’s (Vaginal Birth After Cesarean). She recommended this book to me in order to help me see the struggle many cesarean moms go through, no matter how well or how necessary their cesarean was. Of course, not all women feel this way about things, but many do.

This book opened my eyes.

It shares, verbatim, the stories women posted online in response to a first-time mother’s question: “Why shouldn’t I have a cesarean?”

It was a hard book to read, and my heart physically ached for these women who are still hurting years after their cesareans – physically, emotionally, and even spiritually.

As a doula, I was taught that telling a struggling cesarean mom that she should be “grateful for her healthy baby” is like a slap in the face. Though I could understand why intellectually, this book helped me take that to heart. How callous and hurtful that statement is to a mom who is obviously NOT healthy in the face of her cesarean!

Overall, I would definitely recommend this book to all childbirth professionals – especially if you have never had a cesarean. I would also recommend it to moms who find themselves hurting after their cesareans, and have had trouble articulating what they need. I think it has the potential to be a reassurance to these women that they are not alone. Plus, since it points women to the International Cesarean Awareness Network (ICAN), it also has the potential to bring women to a wonderful resource where they can find practical support in whatever area they need it most.

I will caution you though, it can be rough reading. It’s very raw, very real, and very emotional. If you are sensitive to these kinds of things, it might be a very difficult read.

Linkage

Thursday, December 17th, 2009

This week, I attended my first meeting with the Pikes Peak Regional Doula Association, and will be an official member after next month’s business meeting. I also just signed on with the local Birth Network chapter, and will have a listing in their 2010 resource guide for Colorado Springs.

I am really excited about joining PPRDA! I’ve met several of the doulas, and hope to join the mentoring program, so I can learn from all of the wise women who belong to this organization. I’m also incredibly thrilled about the opportunities for Continuing Education Units (CEU’s), since I’ll need to obtain at least 15 in the next three years to maintain my labor doula certification.

The reality of all of this is finally hitting me. Pretty soon, I hope to be attending at least two births a month, and teaching independent childbirth courses. I especially can’t wait for the opportunity to teach at the local pregnancy center. After all, this is one of the top three reasons I have for becoming a doula in the first place.

In the meantime, I have an over-abundant number of links I want to share with you, but I decided to limit it to five tonight.

Links for Your Birth Junkie Fix

Friday, September 18th, 2009

Disclaimer: The views expressed in anything I link to, while I may agree with the position, I am not always in line with the words and tone chosen to express the position. So, if you read something you disagree with – don’t slam me. Be open to new information. Thank you.

Avoiding C-Sections in Stalled Labor

Thursday, September 17th, 2009

C-Sections, Pelvises, and Breastfeeding Toddlers (How can you resist?)

Wednesday, April 15th, 2009

Make sure you watch this video to the very end – it has a wonderful message for ALL mothers, not just those who choose to breastfeed their toddlers.

Interesting Concept

Wednesday, February 18th, 2009

Human beings react differently from other mammals to interference with the birth process. When delivery of non-human mammals is disturbed, the effects are immediate and easily detected. For example, when animals give birth by c-section or with an epidural, the general rule is that the mother is not interested in the baby. Among humans, on the other hand, we need extensive statistics to detect what are mere tendencies and risk factors. These are much more complex in our species: We speak and we create cultural milieux. In certain situations, particularly in the perinatal period, human behavior is less directly under the effects of the hormonal balance than the effects of the cultural milieu. For example, a human mother knows when she is pregnant and can anticipate maternal behavior, while other mammals must wait until the birth when they release a flow of love hormones to kindle their attachment to their newborns.

Today, we understand that to have a baby, a woman—like any other mammal—has been programmed to release a cocktail of love hormones. Today the number of women who actually “give birth” to babies and placentas thanks to this hormonal release is ever-decreasing. First, because many women give by birth by cesarean. Second, most of those who give birth vaginally receive pharmacological interventions. Unfortunately substitutes block the release of the natural hormones and do not create the same behavioural benefits. We have to wonder what will happen, in terms of civilization, if this trend continues in future generations. Can humanity survive the safe cesarean?

— Michel Odent
Excerpted from “The Future of Obstetric Technology,” Midwifery Today, Issue 85