You can fight and be fierce and never surrender your power...and still not win. Sometimes they are stronger, sometimes they have power you do not. Sometimes, they take what is yours from you, without your consent. You still need to fight- we are counting on you. Your children, your partner, your self, are all counting on you. You can be loud, or quiet, you can fight actively or resist passively, whatever suits your heart and the situation.
Our world is one that does not respect the autonomy of women as mothers.
When we are pregnant, we are offered threats and fear tactics. We are not given evidence based health care.
When we are birthing, we are cut- more than 1 in 4 of us are cut. We are threatened with the lives of our babies. We are not given evidence based health care.
Some of us choose midwives, who are threatened by the medical system as well. Increasingly, they cannot provide evidence based care, when they must answer to the traditional standards of care provided by OB/GYNs.
Wishing to avoid those threats, some of us choose freebirth. We are threatened with the removal of our children from our homes. We are punished when we seek appropriate care from mainstream practitioners.
We try to breastfeed our babies- most of us do not succeed in breastfeeding them to recommendation. We struggle to receive proper care in a system that does not want us to nurse our babies.
If any of the above sound extreme, they are. Some of us have great experiences, others are raped, abused, punished, lied to. Some of us go home with no baby, victim of the infant mortality rates. Some of us do not go home, victim of the maternal mortality rates.
As long is it is happening to one, it is happening to us all. It is happening to us all. We need to fight- quietly or loudly, with the weapons we have at hand- the love for our children, our sisters, our friends, our selves.
Wednesday, May 26, 2010
Wednesday, May 5, 2010
Young Punks.
Punk: A young person, especially a member of a rebellious counterculture group.
Anarchist: It seeks to diminish or even abolish authority in the conduct of human relations.
I am raising punks. Anarchist punks. 3 of them. Maybe more.
The alternative parenting bubble I live in seems to be mostly inhabited by 2 groups- punks (& other alternative types appropriate to the era during which they came of age) & conservative people devout to various religions. Seems like an odd convergence, but it really isn't. We all live outside the largely secular, conformist mainstream that encompasses most of North America. We all believe that mainstream society & culture has more potential to hurt our children than to help them grow safely. We all want better for our families & are finding better, more often than not, on the fringes of society.
The punk scene has always centred around questioning &/or rejecting authority, so it should come as no surprise that as they become parents, those in the counterculture will question & reject the norms around birth & parenting too. Hospital birth? Fuck that. Public school? Fuck that too. And fuck your vaccines, your processed garbage food and your behaviouralist parenting too.
Wow, I sound angry, don't I?! That's because I am. I am angry that in order to birth my babies safely, to feed them in a healthy way, to educate them in a way that respects their individuality, I have to say fuck so much. Really. I am angry that it is so much work. Why do I have to be fierce to protect my kids? You mean society won't do that for me? Hell no, they won't. It is up to me & their dad. So I choose to raise tiny little anarchist punks.
I don't make them share. I don't make them go to school. I don't make them eat junk food that will kill them before their time, making them sick on the way there. I don't subject them to public health policy that I am nowhere near convinced is in their best interest. I don't make them follow rules that don't make sense. I let them choose their own birth day.
I am teaching them to question authority. Yes, even mine. I certainly do say "Because I am your mama & I said so!!" more often than I ever intended to, but I also am ok with them standing up to me. I am fierce, I can get over that. We talk about how to be safe in the world, how to make their own choices & be responsible for those outcomes. I let them fall, cry, hurt. I help them get back up.
I am teaching them that the world is good, despite the negative aspects. I point out how many people love them, how we can always count on friends to be there for us. I make sure our door is always open & that there is always food & drink & friendship to share with anyone who shows up at it.
I am teaching them to rock out- to sing and scream and dance their joys & frustrations loudly enough that the heavens will hear them. I am teaching them to love art, music, the land, everything that holds beauty. I want them to trust the earth we stand on, the plants & animals & people that grow on it. I want them to travel, so they see that our culture, our political system, our way of being is not the only one.
I am teaching them to take care of themselves. To eat, sleep, make good food from scratch, to move their bodies as much as they need. I want them to care for their souls by having integrity. I want them to be intuitive, spiritual beings who know God. Whoever that is. I want them to love; themselves & others.
I want them to stand up, to speak up, when they see something wrong. I want them to say "shut up" when they hear bigotry, to say "fuck that" when they see violence. I want them to always be willing to help those being marginalised. I want them to know they are perfect beings worthy of everything good this life has to offer them. I want to empower them to take it if no one is giving that to them.
I am raising punks. Maybe you should too.
By Arie Brentnall-Compton
Anarchist: It seeks to diminish or even abolish authority in the conduct of human relations.
I am raising punks. Anarchist punks. 3 of them. Maybe more.
The alternative parenting bubble I live in seems to be mostly inhabited by 2 groups- punks (& other alternative types appropriate to the era during which they came of age) & conservative people devout to various religions. Seems like an odd convergence, but it really isn't. We all live outside the largely secular, conformist mainstream that encompasses most of North America. We all believe that mainstream society & culture has more potential to hurt our children than to help them grow safely. We all want better for our families & are finding better, more often than not, on the fringes of society.
The punk scene has always centred around questioning &/or rejecting authority, so it should come as no surprise that as they become parents, those in the counterculture will question & reject the norms around birth & parenting too. Hospital birth? Fuck that. Public school? Fuck that too. And fuck your vaccines, your processed garbage food and your behaviouralist parenting too.
Wow, I sound angry, don't I?! That's because I am. I am angry that in order to birth my babies safely, to feed them in a healthy way, to educate them in a way that respects their individuality, I have to say fuck so much. Really. I am angry that it is so much work. Why do I have to be fierce to protect my kids? You mean society won't do that for me? Hell no, they won't. It is up to me & their dad. So I choose to raise tiny little anarchist punks.
I don't make them share. I don't make them go to school. I don't make them eat junk food that will kill them before their time, making them sick on the way there. I don't subject them to public health policy that I am nowhere near convinced is in their best interest. I don't make them follow rules that don't make sense. I let them choose their own birth day.
I am teaching them to question authority. Yes, even mine. I certainly do say "Because I am your mama & I said so!!" more often than I ever intended to, but I also am ok with them standing up to me. I am fierce, I can get over that. We talk about how to be safe in the world, how to make their own choices & be responsible for those outcomes. I let them fall, cry, hurt. I help them get back up.
I am teaching them that the world is good, despite the negative aspects. I point out how many people love them, how we can always count on friends to be there for us. I make sure our door is always open & that there is always food & drink & friendship to share with anyone who shows up at it.
I am teaching them to rock out- to sing and scream and dance their joys & frustrations loudly enough that the heavens will hear them. I am teaching them to love art, music, the land, everything that holds beauty. I want them to trust the earth we stand on, the plants & animals & people that grow on it. I want them to travel, so they see that our culture, our political system, our way of being is not the only one.
I am teaching them to take care of themselves. To eat, sleep, make good food from scratch, to move their bodies as much as they need. I want them to care for their souls by having integrity. I want them to be intuitive, spiritual beings who know God. Whoever that is. I want them to love; themselves & others.
I want them to stand up, to speak up, when they see something wrong. I want them to say "shut up" when they hear bigotry, to say "fuck that" when they see violence. I want them to always be willing to help those being marginalised. I want them to know they are perfect beings worthy of everything good this life has to offer them. I want to empower them to take it if no one is giving that to them.
I am raising punks. Maybe you should too.
By Arie Brentnall-Compton
Friday, April 23, 2010
How Every Mother Can Improve the U.S. Maternal Mortality Rate
Christine Sheets-Nutile
In January of this year, the Joint Commission issued an alert1 to U.S. hospitals which stated, “trends and evidence suggest that maternal mortality rates may be increasing in the U.S.” The national rate is currently three to five times GREATER than that of European countries.2 Unbelievably, a woman giving birth in the U.S. today has a greater risk of dying than a woman birthing in 40 other countries.2
The Commission (which is the leading health care accreditation and standards group in the United States) went on to state that between 28-50% of maternal deaths were PREVENTABLE. In fact, half of the most common errors were related to post-operative care following caesarean sections.1
Recent reports also show that, in the U.S.,3 rates of both labor induction and c-section are TWICE the World Health Organization’s recommendations.2 As we are seeing, these medical interventions (while common) are not without risk.
Labor induction typically involves the use of synthetic oxytocin. This artificial substitute interferes with a woman’s own oxytocin receptors and can lead to postpartum hemorrhaging, delayed or inhibited bonding with her newborn and difficulty establishing breastfeeding.4 A medically induced labor also significantly increases a woman's chances of having an unplanned c-section.5
The risk of a mother’s death after a c-section is more than three times greater than a mother who gave birth vaginally.6 Over a 10 year period, California had a 50% increase in c-sections AND a 50% increase in maternal mortality.7
A Climate of Coercion
The current mainstream birth culture in the U.S. is simply appalling. Pregnancy and birth are treated as a disease and acute trauma-waiting-to-happen. Many women are not given complete information about the birth process. More and more cases are being reported of maternity patients being coerced into submission; their basic human rights are ignored or even revoked through the courts.
Serious medical interventions are presented as a matter of course and focus exclusively on the expected benefits. Risks and adverse effects are usually not even acknowledged! The provider states whatever he or she believes will result in the mother's compliance with the provider’s desired course of action.8
According to “Evidence-Based Maternity Care” (Sakala and Corry), a truly informed choice “requires access to a range of options, good understanding of best evidence about benefits and harms of offered care and of alternatives and solid support for the choices women make.” This rarely occurs among U.S. maternity patients. 4
In a 2009 interview, Dr. Debra Bingham, Executive Director for the California Maternal Quality Care Collaborative and a member of a Maternal Mortality Review Committee, told Amnesty International that the process of gaining an obstetric patient’s consent is highly variable and can depend on who provides information, what information is shared, and how that information is presented to a pregnant woman. “For example, someone who will benefit financially from the woman’s decision may provide information differently than someone who is not financially affected by her decision. Currently, there is limited documentation on what information is shared, how and by whom.”9
Astonishingly, this behavior is not limited to maternal care providers for disadvantaged, low-income or uneducated women. Time and time again, I’ve seen high-powered, confident, educated women become completely submissive. They forgo asking questions and just trust their doctors to make decisions for them, and then accept whatever course of treatment may result.
The Alternative Birth Movement (or What’s “Normal” for the Rest of the World)
83% of women in the U.S. have low-risk pregnancies.10 In most countries, these low-risk women would receive their maternal care from midwives or family practice physicians and often give birth at home. Outside of the U.S., the goal is to minimize risks and maximize good outcomes for mothers and babies, rather than maximize income for a provider and facility. So most obstetricians limit their practice to treating women with high-risk pregnancies and those who develop unexpected complications.11 Ironically, many OB’s in the U.S. no longer have the aptitude or knowledge possessed by their predecessors for such uncommon procedures as: external version to manually turn a baby, vaginal breech birth or vaginal birth of twins.4
It’s interesting to note that groups of maternal care providers identify their roles very differently. OB’s feel it is their responsibility to actively manage childbirth. Midwives and other physicians perceive their function to be facilitators in the birthing process.12 This fundamental distinction is evidenced in the care and treatment of their patients: 4 Midwives possess more hands-on skills and are better able to support a woman in labor and assist her during birth than OB’s; midwives use medical intervention more judiciously than OB’s; and midwives understand that a woman’s individual mind-set, desires and personal history play an important part in her birth, while OB’s deny these influences. 12
In low risk situations, intervention can, in fact, actually impede the birthing process and create those life or death situations that doctors claim to be trying to avoid. Despite their lengthy and expensive educations, far too many U.S. care providers have little or NO experience in observing a normal, natural birth. Therefore, they have no idea what a normal birth looks like, much less what a woman in that situation may need.
Not surprisingly, across the nation, low-risk women and their babies have better outcomes when attended by a midwife, rather than an OB.4, 8
Loss of Faith, Rise of Fear
In contrast to the rest of the world, almost all pregnant women in the U.S. choose to receive their care from an OB and give birth in a hospital. When it's truly needed, medical intervention can, of course, mean the difference between life and death.
But women’s bodies are designed to give birth -- without any interference! It’s only been in the past 100 years13, that birth was appropriated from women and transformed into a paternalistic, medical, mechanized event.14 As such, women lost the knowledge that comes from witnessing and assisting their mothers and sisters give birth. And women lost faith in their bodies’ innate abilities.
Today’s mother-to-be has probably heard more birth-related horror stories than she can count. From the time she was a young girl, she may have heard her mother, her aunts, and even her friends discuss childbirth as a painful, frightening injury. Unfortunately, these misconceptions are perpetuated and reinforced through popular culture of television and movies. In reality, a normal birth wouldn’t bring in big ratings or box-office dollars.
Follow the Money
The U.S. spends more on health care than any other country.15 And more money is spent on maternal health than ANY other form of hospital care.8 Unfortunately, the majority of OB policies, routine procedures and official recommendations are woefully out of date in regards to evidence-based care.4
Outside of the U.S., hospitals typically have a variety of low-tech equipment to aid a woman giving birth – tubs, birthing balls, robes, birthing stools, squatting bars, etc. Any of these can help make birth safer and more comfortable. Unfortunately, very few U.S. hospitals can offer anything besides pharmaceuticals. For the hospital administrator, a birth free of medical interventions is a lost billing opportunity.11
The vast majority of births do NOT require any intervention; but 50-80% of births in U.S. hospitals have AT LEAST one. In reality, any one of these procedures is truly medically necessary in fewer than 20% of all births.8 Ergo between 30-60% of women giving birth in U.S. hospitals are having unnecessary medical procedures performed upon them! But, necessary or not, all of these medical procedures and interventions allow physicians to maximize their billing opportunities.11
In some parts of the country, it’s extremely difficult to find a provider willing to intervene ONLY when truly medically necessary -- especially if the woman has had a previous c-section. Fewer and fewer facilities are willing to accept VBAC (Vaginal Birth After Cesarean) patients.
After years of increased c-sections, most hospitals have reconfigured their maternity units to accommodate more surgical deliveries: more services scheduled during weekday hours, and more post partum beds – needed for the longer stays required after c-sections. These changes required costly capital investments. Now administrators need to see a return on those investments. So it’s not surprising that hospital policies reflect the facility’s increased dependence on the revenue generated by c-sections. After all, a c-section brings in TWICE the revenue of a vaginal birth.4 A surgical birth is also easier on the doctor. It takes less time and is much more predictable than a normal labor and delivery.
For years, the medical establishment has been working to limit birthing options. They've fought against birthing centers, homebirth, midwives, even against their own accountability.
Many believe that they’re more interested in protecting their revenues than improving outcomes for our mothers and babies.11
Rather than abolishing choices, vilifying alternatives and criminalizing their competition, I'd prefer to see them working for other, more worthy goals – such as educating their patients, encouraging normal/natural births and working with facilities to update protocols to reflect evidence-based medicine, all of which will ultimately reduce maternal mortality.
Until then, it’s up to us to change the birth culture!
Improve Your Own Chances of Survival
If you are pregnant or planning to become pregnant:
* Examine your pre-conceived ideas on birth. How were these formed? From stories of women of previous generations? From fictional or sensationalized movies and tv shows? YouTube is awash with amazing, joyous videos of women experiencing normal, natural births. Use these to visualize the kind of birth YOU want.
* Take responsibility for your own education on birth! While pregnant, you have months to prepare and can seek out accurate, complete information. Labor is a time of extreme, internal focus. It would be difficult to absorb and comprehend a significant amount of new information. So preparation is key, in case you need to make decisions quickly. Research common interventions such as: ultrasounds, fetal monitoring, induction of labor, epidurals, extractions and c-sections. Learn the risks and what factors determine when each may truly become necessary. Insist that your provider obtain informed consent for each procedure.
* Read books on natural birthing options. Consider alternatives to the standard OB-attended hospital birth. Choosing a high-tech OB at a high-tech hospital doesn’t guarantee you a safe birth. But it WILL increase your risk for high-tech interventions which may or may not be medically necessary.16 Certified Nurse Midwives (CNM’s) are licensed in all 50 states and can attend births in hospitals, birth centers or even your home. Don’t be afraid to make an unusual choice when it comes to what’s best for you and your baby!
* Don’t choose your provider or facility simply based on location or insurance coverage. Seek out like-minded mothers and local doulas and get their recommendations.
* Schedule a consultation with potential providers before committing to one. Get their rates of various interventions – fetal monitoring, inductions, episiotomies, forcep delivery, vacuum extraction and c-sections. Ask how much freedom you’ll have during labor – particularly on movement, eating/drinking and positioning for birth. Are there limitations on who is allowed to attend your birth? If they’re anything less than forthcoming with these answers, find another provider. Tour the facility. Ask questions there as well, specifically regarding their procedures for newborn care, policies on rooming-in and breastfeeding support.
* Listen to your instincts. More women are educating themselves and seeking providers based on their shared philosophies of birth. Unfortunately, medical professionals can also offer the all too familiar “bait-and-switch.” The provider will agree with everything the mother-to-be wants for her birth throughout her pregnancy, but has NO intention of letting the birth happen on those terms. Shockingly, some will even go out of their way to make SURE it doesn’t, regardless of what’s in the best interest of the mother and her baby. So if you have any reservations about your provider or facility, especially if you feel they are patronizing you, don’t be afraid to make a change – no matter how far along you are.
* Surround yourself with others who have had intervention-free births. Listen to their stories. Ignore those who tell you that you won’t be able to handle it.
* Take a childbirth class, preferably one OUTSIDE of a hospital setting. (Too often, classes hosted by the hospital are more about “How to Be a Good Patient.”) Bradley and Hypnobirthing are excellent choices.
* Choose your labor support team wisely. While your partner, family members and friends may want to be present at the birth, consider hiring a doula. She can provide physical and emotional support throughout your pregnancy, birth and post-partum period. She is knowledgeable about the process of birth, familiar with area providers and facilities and can facilitate communication with staff to help you make informed decisions. A woman in labor is vulnerable – both physically and emotionally. A doula can help protect your space and your choices.
Empower yourself to have the birth YOU desire! Birth is a business. As more mothers demand normal, natural births, providers and facilities will be forced to adapt to attract consumers. Reducing unnecessary interventions will lead to healthier mothers and babies!
Christine Sheets Nutile is a mother of three. She was supported by a doula and used Hypnobirthing for each of her midwife-attended hospital births. She is the co-founder of an Attachment Parenting group in the south suburbs of Chicago. She is also an advocate for natural childbirth, breastfeeding, babywearing and home education.
REFERENCES
1 The Joint Commission, Sentinel Event Alert, Issue 44 from January 26, 2010, “Preventing Maternal Death”; available at http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_44.htm
2 WHO, UNICEF and Wellstart International, “Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care”, 2009; available at http://www.who.int/nutrition/publications/infantfeeding/9789241594967_s1/en/index.html
3 J. A. Martin et al, Centers for Disease Control, Births: “Final Data for 2006”;
National Vital Statistics Reports, Volume 57, Number 7, from January 7, 2009; available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf
4 C. Sakala and M. P. Corry, “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” Childbirth Connection and the Reforming States Group, 2008, pages 37, 47, 62-67; available at http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf
5 K. E. Kaufman, “Elective Induction: An Analysis of Economic and Health Consequences”.
6 C. Deneux-Tharaux et al, “Postpartum Maternal Mortality and Cesarean Delivery”, Obstetrics & Gynecology, Volume 108, Number 3, Part 1, September 2006; available at
http://www.acog.org/from_home/publications/green_journal/2006/v108n3p541.pdf and
J. Villar et al, “Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study”, BMJ, 2007; 335; 1025; page 5; available at
http://www.bmj.com/cgi/reprint/335/7628/1025?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Caesarean+delivery+rates&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
7 California Maternal Quality Care Collaborative, www.cmqcc.org/maternal_mortality and www.cmqcc.org/maternal_disparities
8 R.M. Andrews, “The National Hospital Bill: The Most Expensive Conditions by
Payer, 2006”, Healthcare Cost and Utilization Project, Statistical Brief 59, 2008, page 7;
available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb59.pdf
9 Amnesty International Publications, “Deadly Delivery: The Maternal Health Care Crisis in the USA”, 2010, page 1 and 79, available at http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf
10 National Center for Health Statistics. 2006. 2003 Natality Data Set. SETS 2.0, Rev. 805. Vital and Health Statistics. CD-ROM Series 21, Number 17, May.
11 S. Goodman, “Piercing the Veil: The Marginalization of Midwives in the United
States”, Social Science & Medicine, 65, 2007, pp. 610–21; available at
http://www.collegeofmidwives.org/Citations%20or%20text%2002/Marginalizing_NurseMfry_May07.pdf
12 B Reime et al, “Do Maternity Care Provider Groups Have Different Attitudes Towards Birth?” BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 12, Pages 1388-1393; available at http://www3.interscience.wiley.com/cgi-bin/fulltext/118813477/HTMLSTART
13 Y. Lapp Cryns, “Homebirth: As Safe as Birth Gets” The Compleat Mother Magazine 1995; available at http://www.compleatmother.com/homebirth/hb_safety.htm
14 J.J. Mathews and K. Zadak, “The Alternative Birth Movement in the United States: History and Current Status”, Women Health, 1991, Volume 17, Number 1, Page 39; available at http://www.ncbi.nlm.nih.gov/pubmed/2048321
15 Organisation for Economic Co-operation and Development, OECD Health Data 2009–
Frequently Requested Data; available at http://www.oecd.org/document/16/0,3343,en_2649_33929_2085200_1_1_1_1,00.html
16 M. Wagner, “Technology in Birth: First Do No Harm”, Midwifery Today, 2000;
available at http://www.midwiferytoday.com/articles/technologyinbirth.asp#sources
In January of this year, the Joint Commission issued an alert1 to U.S. hospitals which stated, “trends and evidence suggest that maternal mortality rates may be increasing in the U.S.” The national rate is currently three to five times GREATER than that of European countries.2 Unbelievably, a woman giving birth in the U.S. today has a greater risk of dying than a woman birthing in 40 other countries.2
The Commission (which is the leading health care accreditation and standards group in the United States) went on to state that between 28-50% of maternal deaths were PREVENTABLE. In fact, half of the most common errors were related to post-operative care following caesarean sections.1
Recent reports also show that, in the U.S.,3 rates of both labor induction and c-section are TWICE the World Health Organization’s recommendations.2 As we are seeing, these medical interventions (while common) are not without risk.
Labor induction typically involves the use of synthetic oxytocin. This artificial substitute interferes with a woman’s own oxytocin receptors and can lead to postpartum hemorrhaging, delayed or inhibited bonding with her newborn and difficulty establishing breastfeeding.4 A medically induced labor also significantly increases a woman's chances of having an unplanned c-section.5
The risk of a mother’s death after a c-section is more than three times greater than a mother who gave birth vaginally.6 Over a 10 year period, California had a 50% increase in c-sections AND a 50% increase in maternal mortality.7
A Climate of Coercion
The current mainstream birth culture in the U.S. is simply appalling. Pregnancy and birth are treated as a disease and acute trauma-waiting-to-happen. Many women are not given complete information about the birth process. More and more cases are being reported of maternity patients being coerced into submission; their basic human rights are ignored or even revoked through the courts.
Serious medical interventions are presented as a matter of course and focus exclusively on the expected benefits. Risks and adverse effects are usually not even acknowledged! The provider states whatever he or she believes will result in the mother's compliance with the provider’s desired course of action.8
According to “Evidence-Based Maternity Care” (Sakala and Corry), a truly informed choice “requires access to a range of options, good understanding of best evidence about benefits and harms of offered care and of alternatives and solid support for the choices women make.” This rarely occurs among U.S. maternity patients. 4
In a 2009 interview, Dr. Debra Bingham, Executive Director for the California Maternal Quality Care Collaborative and a member of a Maternal Mortality Review Committee, told Amnesty International that the process of gaining an obstetric patient’s consent is highly variable and can depend on who provides information, what information is shared, and how that information is presented to a pregnant woman. “For example, someone who will benefit financially from the woman’s decision may provide information differently than someone who is not financially affected by her decision. Currently, there is limited documentation on what information is shared, how and by whom.”9
Astonishingly, this behavior is not limited to maternal care providers for disadvantaged, low-income or uneducated women. Time and time again, I’ve seen high-powered, confident, educated women become completely submissive. They forgo asking questions and just trust their doctors to make decisions for them, and then accept whatever course of treatment may result.
The Alternative Birth Movement (or What’s “Normal” for the Rest of the World)
83% of women in the U.S. have low-risk pregnancies.10 In most countries, these low-risk women would receive their maternal care from midwives or family practice physicians and often give birth at home. Outside of the U.S., the goal is to minimize risks and maximize good outcomes for mothers and babies, rather than maximize income for a provider and facility. So most obstetricians limit their practice to treating women with high-risk pregnancies and those who develop unexpected complications.11 Ironically, many OB’s in the U.S. no longer have the aptitude or knowledge possessed by their predecessors for such uncommon procedures as: external version to manually turn a baby, vaginal breech birth or vaginal birth of twins.4
It’s interesting to note that groups of maternal care providers identify their roles very differently. OB’s feel it is their responsibility to actively manage childbirth. Midwives and other physicians perceive their function to be facilitators in the birthing process.12 This fundamental distinction is evidenced in the care and treatment of their patients: 4 Midwives possess more hands-on skills and are better able to support a woman in labor and assist her during birth than OB’s; midwives use medical intervention more judiciously than OB’s; and midwives understand that a woman’s individual mind-set, desires and personal history play an important part in her birth, while OB’s deny these influences. 12
In low risk situations, intervention can, in fact, actually impede the birthing process and create those life or death situations that doctors claim to be trying to avoid. Despite their lengthy and expensive educations, far too many U.S. care providers have little or NO experience in observing a normal, natural birth. Therefore, they have no idea what a normal birth looks like, much less what a woman in that situation may need.
Not surprisingly, across the nation, low-risk women and their babies have better outcomes when attended by a midwife, rather than an OB.4, 8
Loss of Faith, Rise of Fear
In contrast to the rest of the world, almost all pregnant women in the U.S. choose to receive their care from an OB and give birth in a hospital. When it's truly needed, medical intervention can, of course, mean the difference between life and death.
But women’s bodies are designed to give birth -- without any interference! It’s only been in the past 100 years13, that birth was appropriated from women and transformed into a paternalistic, medical, mechanized event.14 As such, women lost the knowledge that comes from witnessing and assisting their mothers and sisters give birth. And women lost faith in their bodies’ innate abilities.
Today’s mother-to-be has probably heard more birth-related horror stories than she can count. From the time she was a young girl, she may have heard her mother, her aunts, and even her friends discuss childbirth as a painful, frightening injury. Unfortunately, these misconceptions are perpetuated and reinforced through popular culture of television and movies. In reality, a normal birth wouldn’t bring in big ratings or box-office dollars.
Follow the Money
The U.S. spends more on health care than any other country.15 And more money is spent on maternal health than ANY other form of hospital care.8 Unfortunately, the majority of OB policies, routine procedures and official recommendations are woefully out of date in regards to evidence-based care.4
Outside of the U.S., hospitals typically have a variety of low-tech equipment to aid a woman giving birth – tubs, birthing balls, robes, birthing stools, squatting bars, etc. Any of these can help make birth safer and more comfortable. Unfortunately, very few U.S. hospitals can offer anything besides pharmaceuticals. For the hospital administrator, a birth free of medical interventions is a lost billing opportunity.11
The vast majority of births do NOT require any intervention; but 50-80% of births in U.S. hospitals have AT LEAST one. In reality, any one of these procedures is truly medically necessary in fewer than 20% of all births.8 Ergo between 30-60% of women giving birth in U.S. hospitals are having unnecessary medical procedures performed upon them! But, necessary or not, all of these medical procedures and interventions allow physicians to maximize their billing opportunities.11
In some parts of the country, it’s extremely difficult to find a provider willing to intervene ONLY when truly medically necessary -- especially if the woman has had a previous c-section. Fewer and fewer facilities are willing to accept VBAC (Vaginal Birth After Cesarean) patients.
After years of increased c-sections, most hospitals have reconfigured their maternity units to accommodate more surgical deliveries: more services scheduled during weekday hours, and more post partum beds – needed for the longer stays required after c-sections. These changes required costly capital investments. Now administrators need to see a return on those investments. So it’s not surprising that hospital policies reflect the facility’s increased dependence on the revenue generated by c-sections. After all, a c-section brings in TWICE the revenue of a vaginal birth.4 A surgical birth is also easier on the doctor. It takes less time and is much more predictable than a normal labor and delivery.
For years, the medical establishment has been working to limit birthing options. They've fought against birthing centers, homebirth, midwives, even against their own accountability.
Many believe that they’re more interested in protecting their revenues than improving outcomes for our mothers and babies.11
Rather than abolishing choices, vilifying alternatives and criminalizing their competition, I'd prefer to see them working for other, more worthy goals – such as educating their patients, encouraging normal/natural births and working with facilities to update protocols to reflect evidence-based medicine, all of which will ultimately reduce maternal mortality.
Until then, it’s up to us to change the birth culture!
Improve Your Own Chances of Survival
If you are pregnant or planning to become pregnant:
* Examine your pre-conceived ideas on birth. How were these formed? From stories of women of previous generations? From fictional or sensationalized movies and tv shows? YouTube is awash with amazing, joyous videos of women experiencing normal, natural births. Use these to visualize the kind of birth YOU want.
* Take responsibility for your own education on birth! While pregnant, you have months to prepare and can seek out accurate, complete information. Labor is a time of extreme, internal focus. It would be difficult to absorb and comprehend a significant amount of new information. So preparation is key, in case you need to make decisions quickly. Research common interventions such as: ultrasounds, fetal monitoring, induction of labor, epidurals, extractions and c-sections. Learn the risks and what factors determine when each may truly become necessary. Insist that your provider obtain informed consent for each procedure.
* Read books on natural birthing options. Consider alternatives to the standard OB-attended hospital birth. Choosing a high-tech OB at a high-tech hospital doesn’t guarantee you a safe birth. But it WILL increase your risk for high-tech interventions which may or may not be medically necessary.16 Certified Nurse Midwives (CNM’s) are licensed in all 50 states and can attend births in hospitals, birth centers or even your home. Don’t be afraid to make an unusual choice when it comes to what’s best for you and your baby!
* Don’t choose your provider or facility simply based on location or insurance coverage. Seek out like-minded mothers and local doulas and get their recommendations.
* Schedule a consultation with potential providers before committing to one. Get their rates of various interventions – fetal monitoring, inductions, episiotomies, forcep delivery, vacuum extraction and c-sections. Ask how much freedom you’ll have during labor – particularly on movement, eating/drinking and positioning for birth. Are there limitations on who is allowed to attend your birth? If they’re anything less than forthcoming with these answers, find another provider. Tour the facility. Ask questions there as well, specifically regarding their procedures for newborn care, policies on rooming-in and breastfeeding support.
* Listen to your instincts. More women are educating themselves and seeking providers based on their shared philosophies of birth. Unfortunately, medical professionals can also offer the all too familiar “bait-and-switch.” The provider will agree with everything the mother-to-be wants for her birth throughout her pregnancy, but has NO intention of letting the birth happen on those terms. Shockingly, some will even go out of their way to make SURE it doesn’t, regardless of what’s in the best interest of the mother and her baby. So if you have any reservations about your provider or facility, especially if you feel they are patronizing you, don’t be afraid to make a change – no matter how far along you are.
* Surround yourself with others who have had intervention-free births. Listen to their stories. Ignore those who tell you that you won’t be able to handle it.
* Take a childbirth class, preferably one OUTSIDE of a hospital setting. (Too often, classes hosted by the hospital are more about “How to Be a Good Patient.”) Bradley and Hypnobirthing are excellent choices.
* Choose your labor support team wisely. While your partner, family members and friends may want to be present at the birth, consider hiring a doula. She can provide physical and emotional support throughout your pregnancy, birth and post-partum period. She is knowledgeable about the process of birth, familiar with area providers and facilities and can facilitate communication with staff to help you make informed decisions. A woman in labor is vulnerable – both physically and emotionally. A doula can help protect your space and your choices.
Empower yourself to have the birth YOU desire! Birth is a business. As more mothers demand normal, natural births, providers and facilities will be forced to adapt to attract consumers. Reducing unnecessary interventions will lead to healthier mothers and babies!
Christine Sheets Nutile is a mother of three. She was supported by a doula and used Hypnobirthing for each of her midwife-attended hospital births. She is the co-founder of an Attachment Parenting group in the south suburbs of Chicago. She is also an advocate for natural childbirth, breastfeeding, babywearing and home education.
REFERENCES
1 The Joint Commission, Sentinel Event Alert, Issue 44 from January 26, 2010, “Preventing Maternal Death”; available at http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_44.htm
2 WHO, UNICEF and Wellstart International, “Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care”, 2009; available at http://www.who.int/nutrition/publications/infantfeeding/9789241594967_s1/en/index.html
3 J. A. Martin et al, Centers for Disease Control, Births: “Final Data for 2006”;
National Vital Statistics Reports, Volume 57, Number 7, from January 7, 2009; available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf
4 C. Sakala and M. P. Corry, “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” Childbirth Connection and the Reforming States Group, 2008, pages 37, 47, 62-67; available at http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf
5 K. E. Kaufman, “Elective Induction: An Analysis of Economic and Health Consequences”.
6 C. Deneux-Tharaux et al, “Postpartum Maternal Mortality and Cesarean Delivery”, Obstetrics & Gynecology, Volume 108, Number 3, Part 1, September 2006; available at
http://www.acog.org/from_home/publications/green_journal/2006/v108n3p541.pdf and
J. Villar et al, “Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study”, BMJ, 2007; 335; 1025; page 5; available at
http://www.bmj.com/cgi/reprint/335/7628/1025?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Caesarean+delivery+rates&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
7 California Maternal Quality Care Collaborative, www.cmqcc.org/maternal_mortality and www.cmqcc.org/maternal_disparities
8 R.M. Andrews, “The National Hospital Bill: The Most Expensive Conditions by
Payer, 2006”, Healthcare Cost and Utilization Project, Statistical Brief 59, 2008, page 7;
available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb59.pdf
9 Amnesty International Publications, “Deadly Delivery: The Maternal Health Care Crisis in the USA”, 2010, page 1 and 79, available at http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf
10 National Center for Health Statistics. 2006. 2003 Natality Data Set. SETS 2.0, Rev. 805. Vital and Health Statistics. CD-ROM Series 21, Number 17, May.
11 S. Goodman, “Piercing the Veil: The Marginalization of Midwives in the United
States”, Social Science & Medicine, 65, 2007, pp. 610–21; available at
http://www.collegeofmidwives.org/Citations%20or%20text%2002/Marginalizing_NurseMfry_May07.pdf
12 B Reime et al, “Do Maternity Care Provider Groups Have Different Attitudes Towards Birth?” BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 12, Pages 1388-1393; available at http://www3.interscience.wiley.com/cgi-bin/fulltext/118813477/HTMLSTART
13 Y. Lapp Cryns, “Homebirth: As Safe as Birth Gets” The Compleat Mother Magazine 1995; available at http://www.compleatmother.com/homebirth/hb_safety.htm
14 J.J. Mathews and K. Zadak, “The Alternative Birth Movement in the United States: History and Current Status”, Women Health, 1991, Volume 17, Number 1, Page 39; available at http://www.ncbi.nlm.nih.gov/pubmed/2048321
15 Organisation for Economic Co-operation and Development, OECD Health Data 2009–
Frequently Requested Data; available at http://www.oecd.org/document/16/0,3343,en_2649_33929_2085200_1_1_1_1,00.html
16 M. Wagner, “Technology in Birth: First Do No Harm”, Midwifery Today, 2000;
available at http://www.midwiferytoday.com/articles/technologyinbirth.asp#sources
Tuesday, March 30, 2010
An Essay on Circumcision
Making recent provincial and international headlines, the topic of male infant circumcision (herein referred to as MIC), brought up in any forum, is considered by some one of the most controversial debates of the century, with personal views ranging from dead set against it to why wouldn’t you. Many say it is a personal decision, but people are now asking whose decision is it: the boy’s or his parents’? According to a Men’s Health article, MIC became popular in the late 1800s after Lewis Sayre, MD claimed it could cure many diseases including epilepsy and TB; MIC soon became routine after John Harvey Kellogg, MD stated it was a successful remedy for masturbation, considered a major problem in those days.
There are many arguments for leaving a baby boy intact and here are four of the most common. First, MIC is a surgery, even though it is routinely done without sedation or local anaesthetic, with surgical side effects including bleeding and severe pain and surgical risks such as infection, various types of deformities and dysfunctions of the penis, and of course, death. Second, MIC frequently interferes with mother-child bonding and early breastfeeding. Third, recent studies, including Taddio’s, have shown it has detrimental effects of the developing brain and alters pain perception, decreasing pain thresholds in circumcised males. Finally, in later life, MIC causes significantly reduced sexual pleasure.
The four of the most common arguments for MIC are as follow. First, religious reasons including the covenant between Abraham and his descendants and God as written in Genesis 17:10-14 are often cited. Second, there are generations-old family traditions where boys are circumcised and the decision is not questioned as to why. Third, there is a belief that MIC results in decreased urinary tract infections, sexually transmitted infections including HIV and penile cancer, which has recently been disproved by newer studies. Finally, there is the thought that if done early enough in life the boy will not feel the pain or remember the procedure.
More and more research is coming out, or becoming public, about circumcision. Since 1975, the Canadian Association of Paediatricians has recommended against routine circumcision. Their US counterpart had taken a lighter approach until 1999 when they too, began recommending against routine MIC. According to the Canadian Paediatric Society's statement on circumcision in 1975 (and restated in 1982, 1989 and again in 1996), there is no medical indication for circumcision during the neonatal period.
Most of the commonly known reasons for routine circumcision are misunderstood or blown out of proportion. For example, the rate of UTI (urinary tract infection) for an intact baby boy is about 7/1000 and for a circumcised baby is about 2/1000. BUT, the rate of complication from the circumcision surgery is 20-30/1000 with 2-3/1000 being serious complications. Approximately 10/1000 circumcised babies need to have the surgery repeated in later life and only 10/1000 intact boys need to be circumcised in later life.
There is also a belief that the boy should look like his peers, but according to recent studies, Canada has a 31.9% circumcision rate, meaning 68.9% of new baby boys are intact. Currently, Alberta is the highest province with approximately 44% circumcised and Nova Scotia is the lowest with only 6%.
One cannot forget that foreskin has a purpose. It is designed to protect the glans, keeping it soft, moist and warm; it protects the boy from UTIs; it provides the extra skin needed for an erection; it reduces friction during sex and it maintains sexual sensitivity. Every circumcised male experiences an estimated 15% decrease in sexual sensitivity.
I am so glad that I am cheap and questioned getting my son circumcised because it cost so much (almost $400 is Alberta after doctors fee and tray fee). This led me to start researching why they charge for it, and, in turn, led me to question it in general. I have found that circumcision is one subject that the more I read and learn, the more against it I become. Therefore, yes, I am very pro-intact, anticircumcision. I intentionally did not use the word uncircumcised in any of my writing because that makes it sound like circumcision is the norm, which it is not. I also had a little difficulty getting in the opposing arguments, because some are no longer backed by fact and I do not want somebody to believe that some of the old arguments are valid.
While this debate rages on, more research is being done in hopes of ending the controversy. In the meantime, many are choosing to delay the procedure until the boy can decide for himself.
Jenkins, Mark. Separated at Birth. Men’s Health, July/August 1998, pages 130-135,163
Taddio, A. et al. Effect of neonatal circumcision on pain responses during vaccination in boys. The Lancet Volume 345, Number 8945: Pages 291-292, 4 February 1995.
Taddio, A. et al. Effect of neonatal circumcision on pain response during subsequent routine vaccination The Lancet, Volume 349, Number 9052: Pages 599-603, March 1, 1997.
Canadian Paediatric Society’s webpage: www.cps.ca
American Paediatric Society’s webpage: www.aap.org
Peaceful Parenting’s webpage: www.drmomma.org,
Circumcision Information and Research Pages: www.cirp.org
By Alicia Farvolden
There are many arguments for leaving a baby boy intact and here are four of the most common. First, MIC is a surgery, even though it is routinely done without sedation or local anaesthetic, with surgical side effects including bleeding and severe pain and surgical risks such as infection, various types of deformities and dysfunctions of the penis, and of course, death. Second, MIC frequently interferes with mother-child bonding and early breastfeeding. Third, recent studies, including Taddio’s, have shown it has detrimental effects of the developing brain and alters pain perception, decreasing pain thresholds in circumcised males. Finally, in later life, MIC causes significantly reduced sexual pleasure.
The four of the most common arguments for MIC are as follow. First, religious reasons including the covenant between Abraham and his descendants and God as written in Genesis 17:10-14 are often cited. Second, there are generations-old family traditions where boys are circumcised and the decision is not questioned as to why. Third, there is a belief that MIC results in decreased urinary tract infections, sexually transmitted infections including HIV and penile cancer, which has recently been disproved by newer studies. Finally, there is the thought that if done early enough in life the boy will not feel the pain or remember the procedure.
More and more research is coming out, or becoming public, about circumcision. Since 1975, the Canadian Association of Paediatricians has recommended against routine circumcision. Their US counterpart had taken a lighter approach until 1999 when they too, began recommending against routine MIC. According to the Canadian Paediatric Society's statement on circumcision in 1975 (and restated in 1982, 1989 and again in 1996), there is no medical indication for circumcision during the neonatal period.
Most of the commonly known reasons for routine circumcision are misunderstood or blown out of proportion. For example, the rate of UTI (urinary tract infection) for an intact baby boy is about 7/1000 and for a circumcised baby is about 2/1000. BUT, the rate of complication from the circumcision surgery is 20-30/1000 with 2-3/1000 being serious complications. Approximately 10/1000 circumcised babies need to have the surgery repeated in later life and only 10/1000 intact boys need to be circumcised in later life.
There is also a belief that the boy should look like his peers, but according to recent studies, Canada has a 31.9% circumcision rate, meaning 68.9% of new baby boys are intact. Currently, Alberta is the highest province with approximately 44% circumcised and Nova Scotia is the lowest with only 6%.
One cannot forget that foreskin has a purpose. It is designed to protect the glans, keeping it soft, moist and warm; it protects the boy from UTIs; it provides the extra skin needed for an erection; it reduces friction during sex and it maintains sexual sensitivity. Every circumcised male experiences an estimated 15% decrease in sexual sensitivity.
I am so glad that I am cheap and questioned getting my son circumcised because it cost so much (almost $400 is Alberta after doctors fee and tray fee). This led me to start researching why they charge for it, and, in turn, led me to question it in general. I have found that circumcision is one subject that the more I read and learn, the more against it I become. Therefore, yes, I am very pro-intact, anticircumcision. I intentionally did not use the word uncircumcised in any of my writing because that makes it sound like circumcision is the norm, which it is not. I also had a little difficulty getting in the opposing arguments, because some are no longer backed by fact and I do not want somebody to believe that some of the old arguments are valid.
While this debate rages on, more research is being done in hopes of ending the controversy. In the meantime, many are choosing to delay the procedure until the boy can decide for himself.
Jenkins, Mark. Separated at Birth. Men’s Health, July/August 1998, pages 130-135,163
Taddio, A. et al. Effect of neonatal circumcision on pain responses during vaccination in boys. The Lancet Volume 345, Number 8945: Pages 291-292, 4 February 1995.
Taddio, A. et al. Effect of neonatal circumcision on pain response during subsequent routine vaccination The Lancet, Volume 349, Number 9052: Pages 599-603, March 1, 1997.
Canadian Paediatric Society’s webpage: www.cps.ca
American Paediatric Society’s webpage: www.aap.org
Peaceful Parenting’s webpage: www.drmomma.org,
Circumcision Information and Research Pages: www.cirp.org
By Alicia Farvolden
Sunday, March 28, 2010
The Start of a Food Revolution
I watched Jamie Oliver's show "Food revolution" on TV the other night. I was shocked and horrified, but frankly not very surprised. Watching the show (and if you haven't yet you should) really made me think about how we (as a culture) feel about our food and what we know about our food. I wasn't at all surprised that the lunch ladies didn't feel that there was anything wrong with serving the kiddos processed chicken nuggets, and when Jamie asked them to read the list of ingredients on the package, the were not at all concerned about the paragraph of ingredients with unpronouncable names. "The first ingredient is chicken, it's fine". One lady said that if it wasn't ok to eat, the government wouldn't serve it to us right? Right.
This is what got me going. We expect the government to stand up for us little guys and protect us from the big bad corporations, but what we are expecting isn't reality. This is just not happening. AT ALL. Not in North America. We are all fools if we sit idly by and expect the government to save us from making choices that are killing us. In the food biz it may be hard to get at good information about the real value of what we are eating, but it is out there. We need to be responsible to ourselves and our families about what we put in our mouths. When we get this information we need to shout it from the roof tops.
This is the challenge. This is what Jamie is trying to do, and this is what I want you to do too. It might be hard, and we might feel regretful or even guilty examining some of the choices we have made in the past, but I feel like this is very necessary because we are KILLING ourselves and our children, and we should be FIGHTING for their health.
"I believe that every child in America has the right to fresh, nutritious school meals, and that every family deserves real, honest, wholesome food. Too many people are being affected by what they eat. It's time for a national revolution. America needs to stand up for better food!" - Jamie Oliver
Makes you think doesn't it? I love that Jamie is starting in the schools, and educating the children who don't even know what a potato is. I myself, being of a certain lactivist bent, wonder if we don't need to address the fact that this lack of real wholesome food starts with babies, how we feed them and how we feel about how we feed them.
So now I'm gonna start shouting. You may want to cover your ears, because it might hurt, but I feel that this is really vitally important.
We cannot ignore the connection between starting our children's lives on ultra processed food from a can and the growing inability to recognize healthy natural foods. A quick google search reveals over 300 referenced journal articles citing the increased risk of obesity associated with feeding artificial baby milks. One meta study published in the International Journal of Obesity finds a conclusive risk of obesity associated with not breastfeeding.
Another thing to consider is that breastmilk changes in taste, dependent on the mother's diet. So a normally fed baby experiences different flavors with each feed, while an artificially fed baby tastes the same processed mixture day after day. Consider the impact of sensitizing our children in this way from birth. It makes sense to me that if we start them off with mass produced unhealthy food from a can, children will have little or no choice to continue their life in this way. Especially if you consider how we feel about it.
"Formula is the same as breast milk" (or the next best thing)
"I was fed that way and I turned out fine." (with your glasses, obesity and asthma?)
It's terrifying to consider that our inability to feed our children NORMALLY as infant translates to an inability for them to eat normally as children. We do need to consider this, so that we can grieve, give our heads a shake and start to shout. Join me.
Lee-Ann Grenier
This is what got me going. We expect the government to stand up for us little guys and protect us from the big bad corporations, but what we are expecting isn't reality. This is just not happening. AT ALL. Not in North America. We are all fools if we sit idly by and expect the government to save us from making choices that are killing us. In the food biz it may be hard to get at good information about the real value of what we are eating, but it is out there. We need to be responsible to ourselves and our families about what we put in our mouths. When we get this information we need to shout it from the roof tops.
This is the challenge. This is what Jamie is trying to do, and this is what I want you to do too. It might be hard, and we might feel regretful or even guilty examining some of the choices we have made in the past, but I feel like this is very necessary because we are KILLING ourselves and our children, and we should be FIGHTING for their health.
"I believe that every child in America has the right to fresh, nutritious school meals, and that every family deserves real, honest, wholesome food. Too many people are being affected by what they eat. It's time for a national revolution. America needs to stand up for better food!" - Jamie Oliver
Makes you think doesn't it? I love that Jamie is starting in the schools, and educating the children who don't even know what a potato is. I myself, being of a certain lactivist bent, wonder if we don't need to address the fact that this lack of real wholesome food starts with babies, how we feed them and how we feel about how we feed them.
So now I'm gonna start shouting. You may want to cover your ears, because it might hurt, but I feel that this is really vitally important.
We cannot ignore the connection between starting our children's lives on ultra processed food from a can and the growing inability to recognize healthy natural foods. A quick google search reveals over 300 referenced journal articles citing the increased risk of obesity associated with feeding artificial baby milks. One meta study published in the International Journal of Obesity finds a conclusive risk of obesity associated with not breastfeeding.
Another thing to consider is that breastmilk changes in taste, dependent on the mother's diet. So a normally fed baby experiences different flavors with each feed, while an artificially fed baby tastes the same processed mixture day after day. Consider the impact of sensitizing our children in this way from birth. It makes sense to me that if we start them off with mass produced unhealthy food from a can, children will have little or no choice to continue their life in this way. Especially if you consider how we feel about it.
"Formula is the same as breast milk" (or the next best thing)
"I was fed that way and I turned out fine." (with your glasses, obesity and asthma?)
It's terrifying to consider that our inability to feed our children NORMALLY as infant translates to an inability for them to eat normally as children. We do need to consider this, so that we can grieve, give our heads a shake and start to shout. Join me.
Lee-Ann Grenier
Monday, March 22, 2010
Hospital Birth?
Just yesterday I was talking to a mom just for a couple minutes. Somehow the conversation turned to childbirth and she said her first baby was an emergency c-section. Her second was a c-section, too. I said something like, "You know you can have a natural birth after a c-section." She got this look of disgust and said, "I know, but I didn't find out until after my second, and then they told me no way." I haven't known this mom for very long, but her story is so familiar. A mom who was told she couldn't have something that she wanted for herself and her baby and felt she had no choice otherwise.
I have avoided for the most part being a mom with that story. Sometimes I think it's luck, but then I consider the decisions I've made along the way that have led to three beautiful, perfect, and natural labor and delivery stories. The decisions seemed small at the time, but in the end, they were of great magnitude. And I'm convinced that most of it had to do with the professionals I chose to help me along the way. I'm also convinced that knowing what I didn't want and listening to my gut also played key roles in my experiences.
I chose to have my babies in the hospital. I chose this because I was confident that I could do it on my terms. The midwife I was seeing for my first baby (the third one I had seen in my first few months of pregnancy because I just wasn't comfortable with the first two) was very supportive of my choices and even advocated for me when the OB wanted to induce me because I was overdue. I called my mom crying when we were told we would need to report to the hospital the next morning for an induction, even after the NST had shown everything was normal. My husband was furious because the OB hadn't even seen me. I resolved that if they felt that strongly about inducing me, they were going to have to come find me with sirens and flashing lights. Then my midwife called me and said, no, we had a plan and she would see me on Tuesday for our appointment.
But I didn't make it on Tuesday. Contractions started early Monday morning and after 11 ½ hours of un-medicated labor, we met our beautiful, perfect little girl. She showed no signs of being nearly two weeks overdue and nursed like a champ from the very beginning. My husband commented that I was much more pleasant while I was in labor than I had been in the weeks leading up to it. And even minutes after our baby girl was born, I remember saying, "I could do that again." (I had to laugh because when I got my charts a few years later, the mother/baby nurse had written that I was confident in my ability to nurse my baby, "maybe too confident?" I nursed that baby without any trouble for 22 months, as well as every baby after that.)
After our first was born, I was honored to be asked to be a friend's birth partner. I went to all the birth classes with her and I remember sitting there thinking that there was so much this nurse was not telling these new parents. I'll never forget the look on her face when I announced that if you are the pregnant woman, you still have a say in what they do to you, whether it's induce you or simply what drugs they put in your body or the tests they want you to take. And the same went for your baby. You can ask questions, ask them to wait, or just plain say no. The nurse was horrified. And I was equally as horrified at how horrified she was. It was like she was going to lose the control she had over that class because I had just told them they had choices.
Two years later, I was pregnant again. And my midwife was fantastic enough to write in my chart that I didn't need a hep-lock during labor (the first time it was just in the way) and that after the baby was born I didn't need pitocin to shrink my uterus since I planned to nurse my newborn. When we checked in, the triage nurse was pretty set on poking me. But after I insisted, she left, came back and announced it was okay. Thank you, midwife, for writing it in my chart.
This time I was in labor for 6 ½ hours before our second beautiful and perfect baby girl was born. During labor everyone was so nice and helpful making it a beautiful experience. My husband was again amazed at how pleasant I was during labor. He was a big advocate and super support during the whole process. And everyone just went with it because it was going so well. I remember at one point feeling as if I was stalling out, and I looked up to see the midwife just sitting in the rocking chair waiting so patiently. Then my water broke and we had a baby soon after that.
By the time I was pregnant with baby number three, our insurance had changed and I needed to find a new provider. I asked around and heard the name of one OB from several people. So I set an appointment and made my list of "I needs". At the first appointment I rattled my list off and he looked at me, smiled a goofy smile and said, "You sound like my wife." I could have hugged him.
My new OB was my best advocate and wrote everything in my chart. Everything from not poking me to my request for the placenta. He approved of all my requests, including the fact that I didn't want to take the glucose test, and I am forever thankful for him.
When I did go into labor and went to the hospital, the nurse looked at me kind of sideways when I told her I didn't want the hep-lock. Then I said, "I'm not a hysterical woman in labor. You can poke me later if you need to." I could tell she was somewhat confused by my statement, but as labor progressed, she was quite verbal with her observations of how the whole experience was unfolding. No, I wasn't hysterical (she actually wrote in my chart that I was "very pleasant") and my husband was super supportive and helpful. I've come to learn that all of these things are very rare in that hospital.
In the end, I went from 7 centimeters to my water breaking in two contractions. The next contraction the baby crowned, and the next contraction she was born-less than four hours after active labor had started. And the nurse who was originally hesitant about my requests got to catch my baby. She was thrilled.
My OB missed it by twenty minutes. I had to giggle when he walked in. "You know," he said with that same goofy grin he had given me at the beginning, "ninety percent of women can give birth at home."
After my baby was born, we suddenly had a room full of people busily doing what they were supposed to do. But one of them was pushing on my tummy in a not-so-gentle manner. Someone must have noticed because my baby's nurse came up to me after that nurse had left and said very gently, "I think I'll just be your nurse, too." I don't know what went down, but I didn't see the not-so-gentle nurse again. And I was thankful for it.
I had caused quite a stir in the birth unit. I got all sorts of questions about what I was going to do with the placenta, questions about babywearing, and comments on how labor and delivery went. Our delivery nurse was so thrilled to be a part of our experience, and I think she was talking to everyone about it. (Three days later when we came in for a post-partum baby and mommy check, they were still talking about us. We also have a picture of baby #3 with the nurse.) They let me walk to the recovery room and even when we were on our way home, they let me wear our baby out the door in my wrap rather than carry her or have her in the car seat, even though they weren't supposed to. I think they liked us.
I'm not saying everyone should have their baby in the hospital. I'm not against birth centers or home birth. What I am saying is that if you know what you want (or at least you know what you don't want), if you are a little picky, a little insistent, and you find the right people, (and you are nice about it in the mean time) chances are that you can have a really great experience giving birth in a hospital if that's where you choose to be. You should not have guilt for changing providers when you are uncomfortable. Yes, there are pregnancies that need special care due to special circumstances, but even then you can insist on what you deem your best educated choice is. And good providers will help and support you along the way and not make you feel that you are a crazy person.
By Heidi Donnelly
I have avoided for the most part being a mom with that story. Sometimes I think it's luck, but then I consider the decisions I've made along the way that have led to three beautiful, perfect, and natural labor and delivery stories. The decisions seemed small at the time, but in the end, they were of great magnitude. And I'm convinced that most of it had to do with the professionals I chose to help me along the way. I'm also convinced that knowing what I didn't want and listening to my gut also played key roles in my experiences.
I chose to have my babies in the hospital. I chose this because I was confident that I could do it on my terms. The midwife I was seeing for my first baby (the third one I had seen in my first few months of pregnancy because I just wasn't comfortable with the first two) was very supportive of my choices and even advocated for me when the OB wanted to induce me because I was overdue. I called my mom crying when we were told we would need to report to the hospital the next morning for an induction, even after the NST had shown everything was normal. My husband was furious because the OB hadn't even seen me. I resolved that if they felt that strongly about inducing me, they were going to have to come find me with sirens and flashing lights. Then my midwife called me and said, no, we had a plan and she would see me on Tuesday for our appointment.
But I didn't make it on Tuesday. Contractions started early Monday morning and after 11 ½ hours of un-medicated labor, we met our beautiful, perfect little girl. She showed no signs of being nearly two weeks overdue and nursed like a champ from the very beginning. My husband commented that I was much more pleasant while I was in labor than I had been in the weeks leading up to it. And even minutes after our baby girl was born, I remember saying, "I could do that again." (I had to laugh because when I got my charts a few years later, the mother/baby nurse had written that I was confident in my ability to nurse my baby, "maybe too confident?" I nursed that baby without any trouble for 22 months, as well as every baby after that.)
After our first was born, I was honored to be asked to be a friend's birth partner. I went to all the birth classes with her and I remember sitting there thinking that there was so much this nurse was not telling these new parents. I'll never forget the look on her face when I announced that if you are the pregnant woman, you still have a say in what they do to you, whether it's induce you or simply what drugs they put in your body or the tests they want you to take. And the same went for your baby. You can ask questions, ask them to wait, or just plain say no. The nurse was horrified. And I was equally as horrified at how horrified she was. It was like she was going to lose the control she had over that class because I had just told them they had choices.
Two years later, I was pregnant again. And my midwife was fantastic enough to write in my chart that I didn't need a hep-lock during labor (the first time it was just in the way) and that after the baby was born I didn't need pitocin to shrink my uterus since I planned to nurse my newborn. When we checked in, the triage nurse was pretty set on poking me. But after I insisted, she left, came back and announced it was okay. Thank you, midwife, for writing it in my chart.
This time I was in labor for 6 ½ hours before our second beautiful and perfect baby girl was born. During labor everyone was so nice and helpful making it a beautiful experience. My husband was again amazed at how pleasant I was during labor. He was a big advocate and super support during the whole process. And everyone just went with it because it was going so well. I remember at one point feeling as if I was stalling out, and I looked up to see the midwife just sitting in the rocking chair waiting so patiently. Then my water broke and we had a baby soon after that.
By the time I was pregnant with baby number three, our insurance had changed and I needed to find a new provider. I asked around and heard the name of one OB from several people. So I set an appointment and made my list of "I needs". At the first appointment I rattled my list off and he looked at me, smiled a goofy smile and said, "You sound like my wife." I could have hugged him.
My new OB was my best advocate and wrote everything in my chart. Everything from not poking me to my request for the placenta. He approved of all my requests, including the fact that I didn't want to take the glucose test, and I am forever thankful for him.
When I did go into labor and went to the hospital, the nurse looked at me kind of sideways when I told her I didn't want the hep-lock. Then I said, "I'm not a hysterical woman in labor. You can poke me later if you need to." I could tell she was somewhat confused by my statement, but as labor progressed, she was quite verbal with her observations of how the whole experience was unfolding. No, I wasn't hysterical (she actually wrote in my chart that I was "very pleasant") and my husband was super supportive and helpful. I've come to learn that all of these things are very rare in that hospital.
In the end, I went from 7 centimeters to my water breaking in two contractions. The next contraction the baby crowned, and the next contraction she was born-less than four hours after active labor had started. And the nurse who was originally hesitant about my requests got to catch my baby. She was thrilled.
My OB missed it by twenty minutes. I had to giggle when he walked in. "You know," he said with that same goofy grin he had given me at the beginning, "ninety percent of women can give birth at home."
After my baby was born, we suddenly had a room full of people busily doing what they were supposed to do. But one of them was pushing on my tummy in a not-so-gentle manner. Someone must have noticed because my baby's nurse came up to me after that nurse had left and said very gently, "I think I'll just be your nurse, too." I don't know what went down, but I didn't see the not-so-gentle nurse again. And I was thankful for it.
I had caused quite a stir in the birth unit. I got all sorts of questions about what I was going to do with the placenta, questions about babywearing, and comments on how labor and delivery went. Our delivery nurse was so thrilled to be a part of our experience, and I think she was talking to everyone about it. (Three days later when we came in for a post-partum baby and mommy check, they were still talking about us. We also have a picture of baby #3 with the nurse.) They let me walk to the recovery room and even when we were on our way home, they let me wear our baby out the door in my wrap rather than carry her or have her in the car seat, even though they weren't supposed to. I think they liked us.
I'm not saying everyone should have their baby in the hospital. I'm not against birth centers or home birth. What I am saying is that if you know what you want (or at least you know what you don't want), if you are a little picky, a little insistent, and you find the right people, (and you are nice about it in the mean time) chances are that you can have a really great experience giving birth in a hospital if that's where you choose to be. You should not have guilt for changing providers when you are uncomfortable. Yes, there are pregnancies that need special care due to special circumstances, but even then you can insist on what you deem your best educated choice is. And good providers will help and support you along the way and not make you feel that you are a crazy person.
By Heidi Donnelly
Monday, March 8, 2010
For International Women's Day: Advocacy vs Encouragement
I am still stunned by many of the comments in response to last week's Let Your Feet Do The Shopping. While many understood the point of Lee-Ann's post, others did not. There seems to be a strong feeling among some lactivists that anything other than gentle persuasion will only harm the cause of breastfeeding. At an individual, mother to mother level, I agree.
BUT...at an activist, changing public perception & policy level, I call bullshit.
Why are we more concerned about the feelings of one store owner who behaved horribly & freaked out than about the feelings of the mothers (dozens? hundreds?)for whom the formula freebies will destroy their breastfeeding relationships? Why are we not raging that a store owner is unknowingly (I give her the benefit of the doubt with this) endangering the lives & health of infants with her freebie? Why do some defend her, instead of getting angry?
2 reasons.
First, because they are concerned about creating change at the individual level. From that perspective, clearly, the battle of the store owner has been lost. More on that concept later.
Second, because deep deep down, most do not really believe that infant formula & the marketing thereof is dangerous. Yes, yes, yes, of course: Breastmilk is best (it isn't. Not even close. It is in fact just normal.), but formula is just fine, really.
If you are harbouring that notion, deep down, let me disavow you of it.
2 things.
Babies are born expecting to be breastfed. If they aren't, they will not develop as they were supposed to. Period. That translates to a 30% increased risk of death (yes, in North America!) when babies are not breastfed. This is in addition to the myriad health problems caused that do not result in death.
Second, infant formula is a consumer product that is at risk of contamination, misproduction, etc, etc etc. Google formula recall if you don't believe me. So babies can be harmed by the not breastfeeding &/or by the formula itself.
Back to idea of change at the individual level.
We need to differentiate between offering dialogue to individual mothers about breastfeeding & large scale activism.
Large scale activism is what Fierce Mamas is engaged in. We want to effect change with public policy & perception both. We believe that only once that has taken place will individuals understand why, even if they have chosen to not breastfeed, it must be supported as policy.
Before I go farther, I want to point out that as individuals, the 3 major contributors to Fierce Mamas are all professionally supporting breastfeeding mothers. We have a total of more than 20 years between us, providing counselling , information & support to thousands in a variety of capacities. We know of what we speak, here.
Large scale activism. What does that mean? It means getting angry, it means forcing political & perceptual change until breastfeeding as a public health initiative is seen in the same light as similar public health concerns. Smoking & seat belt laws are 2 great examples of this, as delved into in The Problem With Breastfeeding by James Akre.
A current example I can think of is with the idea of extended rear facing toddlers in carseats. Study after study has clearly established that toddlers are 5 times safer rear facing in their carseats. Europeans have long known this & seats there are designed for it. Well respected bodies, such as the AAP, recently made recommendations to that effect. Law moves slower than science, though, so in most (if not all) North American jurisdictions, the law is still stuck at requiring rear facing only to 1 year of age.
Those of us early adopters have long kept our children rear facing, going out of our way to track down the few seats with high enough weight limits to allow the practice.
We post the research & recommendations on Facebook, telling everyone we know about the dangers to their children.
It stuns me to see how many responses to those posts can be negative!! "Why are we infantilising toddlers?" "I turned mine forward at a year & they are fine." "If it is so important, why isn't it law?"
The law moves slower than the science.
What moves the law??
We do. Activists, lobbyists, angry people screaming from the rooftops. Protest, in all its forms. Policy does not change unless we demand it so. Perception does not change unless it becomes socially important to agree with the new line of thinking. Both of those concepts require us to speak out.
So we will keep respectfully, kindly & thoughtfully supporting women who do & do not breastfeed. Everyone deserves that consideration & respect.
And we will keep protesting those practices which hurt women & children, especially today, on International Women's Day.
By Arie Brentnall-Compton.
"The fastest way to change society is to mobilize the women of the world."
-Charles Malik
"Well behaved women rarely make history" -Eleanor Roosevelt
"Nobody can make you feel inferior without your permission." -Eleanor Roosevelt
"Women are the real architects of society." -Harriet Beecher Stowe
BUT...at an activist, changing public perception & policy level, I call bullshit.
Why are we more concerned about the feelings of one store owner who behaved horribly & freaked out than about the feelings of the mothers (dozens? hundreds?)for whom the formula freebies will destroy their breastfeeding relationships? Why are we not raging that a store owner is unknowingly (I give her the benefit of the doubt with this) endangering the lives & health of infants with her freebie? Why do some defend her, instead of getting angry?
2 reasons.
First, because they are concerned about creating change at the individual level. From that perspective, clearly, the battle of the store owner has been lost. More on that concept later.
Second, because deep deep down, most do not really believe that infant formula & the marketing thereof is dangerous. Yes, yes, yes, of course: Breastmilk is best (it isn't. Not even close. It is in fact just normal.), but formula is just fine, really.
If you are harbouring that notion, deep down, let me disavow you of it.
2 things.
Babies are born expecting to be breastfed. If they aren't, they will not develop as they were supposed to. Period. That translates to a 30% increased risk of death (yes, in North America!) when babies are not breastfed. This is in addition to the myriad health problems caused that do not result in death.
Second, infant formula is a consumer product that is at risk of contamination, misproduction, etc, etc etc. Google formula recall if you don't believe me. So babies can be harmed by the not breastfeeding &/or by the formula itself.
Back to idea of change at the individual level.
We need to differentiate between offering dialogue to individual mothers about breastfeeding & large scale activism.
Large scale activism is what Fierce Mamas is engaged in. We want to effect change with public policy & perception both. We believe that only once that has taken place will individuals understand why, even if they have chosen to not breastfeed, it must be supported as policy.
Before I go farther, I want to point out that as individuals, the 3 major contributors to Fierce Mamas are all professionally supporting breastfeeding mothers. We have a total of more than 20 years between us, providing counselling , information & support to thousands in a variety of capacities. We know of what we speak, here.
Large scale activism. What does that mean? It means getting angry, it means forcing political & perceptual change until breastfeeding as a public health initiative is seen in the same light as similar public health concerns. Smoking & seat belt laws are 2 great examples of this, as delved into in The Problem With Breastfeeding by James Akre.
A current example I can think of is with the idea of extended rear facing toddlers in carseats. Study after study has clearly established that toddlers are 5 times safer rear facing in their carseats. Europeans have long known this & seats there are designed for it. Well respected bodies, such as the AAP, recently made recommendations to that effect. Law moves slower than science, though, so in most (if not all) North American jurisdictions, the law is still stuck at requiring rear facing only to 1 year of age.
Those of us early adopters have long kept our children rear facing, going out of our way to track down the few seats with high enough weight limits to allow the practice.
We post the research & recommendations on Facebook, telling everyone we know about the dangers to their children.
It stuns me to see how many responses to those posts can be negative!! "Why are we infantilising toddlers?" "I turned mine forward at a year & they are fine." "If it is so important, why isn't it law?"
The law moves slower than the science.
What moves the law??
We do. Activists, lobbyists, angry people screaming from the rooftops. Protest, in all its forms. Policy does not change unless we demand it so. Perception does not change unless it becomes socially important to agree with the new line of thinking. Both of those concepts require us to speak out.
So we will keep respectfully, kindly & thoughtfully supporting women who do & do not breastfeed. Everyone deserves that consideration & respect.
And we will keep protesting those practices which hurt women & children, especially today, on International Women's Day.
By Arie Brentnall-Compton.
"The fastest way to change society is to mobilize the women of the world."
-Charles Malik
"Well behaved women rarely make history" -Eleanor Roosevelt
"Nobody can make you feel inferior without your permission." -Eleanor Roosevelt
"Women are the real architects of society." -Harriet Beecher Stowe
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