Vyky Staples
(professional body piercer and fierce mama)
Informed consent is something I see discussed ad infinitum on blogs, message boards and in print in magazines. Informed consent is a powerful tool to have in our journeys as Fierce Mamas- being able to make an educated decision in regards to our health and wellbeing and the health and wellbeing of our babies. We are their advocates, and it's a duty I hold with utmost importance. We choose for our babies who are not able and ready to choose for themselves.
I want to share with you an event I experienced recently that radically shook me and cemented my beliefs. I was shopping. Seeking retail therapy, actually, as a way to relieve myself of some pent-up stress and to soften the blow of leaving my baby in the care of someone else as I am enrolled in school. My shopping trip was winding down, and I was making my way to the food court to grab a coffee to enjoy on the way home. I was approaching a jewelry store and as I neared it, I witnessed something that made my heart jump into my throat.
A very young baby, I'd guess to be around 3 months old, thrashing and screaming as her mother held her arms with one arm and immobilized her head with the other as a store employee was piercing her earlobes. I noticed the mother herself had tears in her eyes.
I was absolutely shocked and appalled. The whole scene had reduced me to tears, an I quickly had to flee the building where I sat in my car and sobbed over what I had just seen. I couldn't make sense of why the mother of that poor baby would subject her to such a thing. She was clearly acting against her maternal instincts- she herself was in tears- she knew what she was doing to her child was wrong.
Yes- WRONG.
It is absolutely, without a doubt wrong to modify the body of a person unable to consent- whether it be female genital mutilation, male circumcision or piercing the earlobes of a young girl. When a child or baby is unable to make informed consent, you are violating their bodies and you are violating their trust. Children are vulnerable and inherently rely on their parents to make decisions on their behalf. And by making permanent changes to their bodies when they are unable to understand the risks, the procedure, the aftercare and the permanent affects, you are revoking their right to choose for themselves.
Furthermore, the stress respond to the stimulus in question can have devastating effects on the infant. When put under extreme duress, the hypothalamus excretes cortisol. When the brain excretes large amounts of cortisol or is forced to excrete it chronically (such as when a parent allows the child to "cry it out"), it can increase the risk of SIDS, and can, in the long term, affect the memory, attention, and emotional wellbeing of the child. Studies also suggest that this can manifest in adulthood into anxiety and depressive disorders.
This brings me to the question of why anyone would subject their child to such a procedure? Is it that important that complete strangers that you'll never speak to or see again know the sex of your baby? Children are not born with a sense of vanity- that is instilled in them by their surroundings as they grow. Baby girls have no need for bedazzled earlobes- they have a need for parents she can trust unconditionally to make sound decisions on her behalf until she is able to utilize informed consent of her own accord.
Wednesday, September 8, 2010
To Induce or Not to Induce?
Tegan Vanden Bosch
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Wednesday, August 25, 2010
Freebirth FAQ
Fierce Mamas support the choice to freebirth! We have been persecuted for it, sometimes very publicly, so it is essential that we keep talking about it to make sure women understand it as a valid birthing option.
We need audience participation to do this well!! Please post your questions about freebirth in the comment section here. Over the next few days, 3 freebirthing women will answer your questions; we will reassemble the entire thing to create an FAQ here on Fierce Mamas. No question is too big or small, although I will be deleting questions of the disrespectful variety ;)
-Arie
We need audience participation to do this well!! Please post your questions about freebirth in the comment section here. Over the next few days, 3 freebirthing women will answer your questions; we will reassemble the entire thing to create an FAQ here on Fierce Mamas. No question is too big or small, although I will be deleting questions of the disrespectful variety ;)
-Arie
Tuesday, August 10, 2010
Rowan’s Birth Story
by Laurinda Reddig
Two years ago today, I gave birth to a beautiful 8lb 11oz baby girl named Rowan. She never breathed on her own, and lived for just one day, so I never felt up to writing her birth story. Now, with my second daughter Willow asleep on my chest, I will try to write Rowan’s story…
My second pregnancy was much more difficult than the first. We had decided not to find out the gender but everyone thought that since my morning sickness was much worse than with my son, continuing throughout the pregnancy, it was a good chance she was a girl. Unlike my first birth, I had a lot of Braxton Hicks and regular early contractions every evening for weeks before my due date. After the fourth false alarm, we headed back home on Friday morning to wait for the real thing.
When I woke up from a nap on Saturday evening, my due date, I told my 3 year old son Griffin to tell the baby it was time to come out. He did just that, and about 15 minutes later my water broke. We headed to the birth center, stopping for ice cream to share with the midwives. Things progressed slowly, as we watched a movie and enjoyed the ice cream. I perched on a birth ball, crocheting a cocoon for the precious life we awaited.
Once the battery ran out on our laptop the movie was over, so we tried to get things moving. I started walking up and down the stairs, pausing for contractions, and realizing the difference between these and the ones I had been feeling for weeks. As things intensified, I went into the birthing suite to try the tub. After a little while I got a little overheated and decided to get out to go to the bathroom.
As I sat in the bathroom, I suddenly felt my baby drop and engage. My son had also not dropped until I was almost ready to push. But this time was different. I could feel my baby struggling, thumping on my pelvic bone repeatedly. My midwives immediately checked her heart rate and discovered it was erratic. They moved me to the bed, trying all sorts of different uncomfortable positions, but her heart rate did not improve. All of the strange positions flared up my asthma, so they gave me an oxygen tube. Meanwhile, they had called the paramedics who were in the lobby of the building. They checked inside to be sure that the cord was not tight around the baby’s neck and gave me the option to try pushing.
As soon as I was in position on the birth stool, which helped to open the way, the baby’s heart rate went back up. After just 3 or 4 long, hard pushes, our baby was born into the waiting arms of her father who handed her to me. As he handed me this tiny slippery baby, my first thought was to check the gender, a girl. Then I held Rowan to me and realized that she was not breathing.
My midwife immediately gave her oxygen from the tube, and began CPR. As I knelt next to them, still attached by the umbilical cord, my midwife and I saw a spot where the cord appeared to have been kinked at some point. As soon as the cord was cut, the paramedics loaded the gurney with our precious baby. My midwife and one assistant went along to continue CPR, and my husband stayed with them and Rowan.
I was left with the second apprentice midwife and my doula. We were informed that another ambulance was there, “to take mom to be with her baby”. We tried to push the placenta out, but it was not coming, so we went along to the hospital.
When we arrived in the hospital ER, I could not even see my baby. No one would give me any answers. They finally explained that Rowan’s organs were in severe failure, and they needed to cool her body down to slow it down and transport her to a hospital with a NICU for further tests. I was finally able to see Rowan when they wheeled her incubator into my room on her way to the ambulance which would transfer her. She looked so small, connected to so many tubes which were all that were keeping her alive. For a few moments, they opened the incubator so I could hold her cold, motionless hand.
My midwives tried to help me get my placenta out, but after the adrenaline of the situation and the ambulance transfer it may not have been possible. Apparently the OBs upstairs chose not to answer their calls and the ER guy actually asked the midwives if they could help. I was left bleeding in the ER for several hours, nearly passing out more than once. It was also during this time that the ER guy pulled off what was left of the umbilical cord and tossed it out with the rest of the waste, so we will never know exactly what the kink we saw was. It may have been caught when her head engaged, or been a kink that had gradually cut off her oxygen over the course of time, or even an aneurysm at some point. We will never know.
When an OB finally deigned to see me, I was put under full anesthesia for a D&C. When I came to in the recovery room, I choked on the oxygen they shoved into my throat raw from a breathing tube. Again, no one would answer my questions. The nurses would not even look me in the eye. I could not stand their looks of pity, when no one would tell me what was going on.
I was relieved to be greeted by a smiling nurse who brought me to my room and made me as comfortable as she could. I will never forget that nurse. As soon as I was settled into the room I was told that my husband needed to talk to me on the phone. He tried to explain to me what the doctors had said, but it basically meant that they were waiting for me to get there before they took our little Rowan off life support. He also asked if we should bring Griffin to the hospital, but at the time I did not see the point and thought it would scare him. The same kind nurse discovered that they could not send me because the other hospital was short staffed. She offered to drive there on her own to transfer with us so I would not have to wait any longer.
My mother rode in the ambulance with me, feeding me the chocolate chip oatmeal cookies she and my son had made when I first went in to labor. The same recipe we have made during each of my labors. I did not taste the cookies at all. The trip was slow as the bridges were blocked off for a bike race. The paramedic asked if they were waiting for me to make decisions about our baby and I said yes. I actually smiled when they used the sirens to pass the blocked traffic, even though we were not technically an emergency.
I finally arrived at the hospital where my baby was, but I still could not see her. They wheeled me into a postpartum room, complete with nursing gown hanging in the bathroom and large print of a father laying with his baby on his chest, much like the first picture we took of my husband when we came home with our son. I immediately asked them to take the picture down, and noticed that the next time we came back to the room it was gone.
Eventually I was wheeled into the NICU to see my daughter. My family was all there, gathered around our poor baby who lay motionless except for the small movement of her chest from the machines that kept her breathing. The doctor explained again, the second time for my husband and my father. Even if they could repair the damage to her body, at some point her oxygen was cut off too long, damaging her brain too severely for normal functioning.
Once the decision was made, I was wheeled back to my room to eat and rest. As we passed through the postpartum ward, I saw older children there to meet their new siblings. I suddenly realized how important it was for Griffin to come meet her. My sister had had a baby just 4 months before and he had been in the waiting room when her son was born. At three years old, he knew what was supposed to happen, and would be very confused if we just did not come home with a baby. But that is another story*.
When I returned to the NICU they wheeled me into a large closet to choose a handmade quilt to wrap Rowan in. That quilt, and the crocheted afghan she was wrapped in are some of the few things we were able to bring home to remember our baby. Looking through the pile of handmade quilts to choose a bright pink and green one for Rowan, I began to think of how Rowan’s short life could make a difference to other parents going through the same thing. As we prepared to say goodbye to our first born daughter, I was envisioning the Remembering Rowan Project*, donating blankets in her memory.
My husband and I got the chance to bathe our baby, wash her hair, and dress her in a simple white gown. My father played his harp, something beautiful for Rowan to experience during her short life. They removed the tubes pumping oxygen and medicine which was all that kept her body going. They had a large double rocking chair where we sat with Griffin to introduce him to his baby sister and explain why she was not coming home with us. Then he took a walk with his uncle while the rest of the family gathered together to each have a chance to hold her, kiss her, and say goodbye to our precious baby. Then the nurse took her vitals and recorded her time of death.
I had to stay overnight in the hospital after all of the blood loss. As they wheeled me back to my room, it felt so strange to leave our baby in the NICU knowing we would never see her again. They told us we could bring her back to the room with us, but that just seemed creepy. We had already said goodbye. It was only her body and holding it longer would not have brought me any comfort. I am not sure her spirit ever really inhabited that body. I have come to believe that there is a small spark that comes at the moment of birth, seems to me babies would get really bored in there for nine months. Call it the soul or the spirit or whatever. But I have to believe Rowan’s tiny spark just never connected, and instead she is everywhere, in everything.
* Read more about the Remembering Rowan Project and her other crafty ventures on Laurinda's Blog. She also wrote an essay on helping her three year old understand the loss of his sister.
Two years ago today, I gave birth to a beautiful 8lb 11oz baby girl named Rowan. She never breathed on her own, and lived for just one day, so I never felt up to writing her birth story. Now, with my second daughter Willow asleep on my chest, I will try to write Rowan’s story…
My second pregnancy was much more difficult than the first. We had decided not to find out the gender but everyone thought that since my morning sickness was much worse than with my son, continuing throughout the pregnancy, it was a good chance she was a girl. Unlike my first birth, I had a lot of Braxton Hicks and regular early contractions every evening for weeks before my due date. After the fourth false alarm, we headed back home on Friday morning to wait for the real thing.
When I woke up from a nap on Saturday evening, my due date, I told my 3 year old son Griffin to tell the baby it was time to come out. He did just that, and about 15 minutes later my water broke. We headed to the birth center, stopping for ice cream to share with the midwives. Things progressed slowly, as we watched a movie and enjoyed the ice cream. I perched on a birth ball, crocheting a cocoon for the precious life we awaited.
Once the battery ran out on our laptop the movie was over, so we tried to get things moving. I started walking up and down the stairs, pausing for contractions, and realizing the difference between these and the ones I had been feeling for weeks. As things intensified, I went into the birthing suite to try the tub. After a little while I got a little overheated and decided to get out to go to the bathroom.
As I sat in the bathroom, I suddenly felt my baby drop and engage. My son had also not dropped until I was almost ready to push. But this time was different. I could feel my baby struggling, thumping on my pelvic bone repeatedly. My midwives immediately checked her heart rate and discovered it was erratic. They moved me to the bed, trying all sorts of different uncomfortable positions, but her heart rate did not improve. All of the strange positions flared up my asthma, so they gave me an oxygen tube. Meanwhile, they had called the paramedics who were in the lobby of the building. They checked inside to be sure that the cord was not tight around the baby’s neck and gave me the option to try pushing.
As soon as I was in position on the birth stool, which helped to open the way, the baby’s heart rate went back up. After just 3 or 4 long, hard pushes, our baby was born into the waiting arms of her father who handed her to me. As he handed me this tiny slippery baby, my first thought was to check the gender, a girl. Then I held Rowan to me and realized that she was not breathing.
My midwife immediately gave her oxygen from the tube, and began CPR. As I knelt next to them, still attached by the umbilical cord, my midwife and I saw a spot where the cord appeared to have been kinked at some point. As soon as the cord was cut, the paramedics loaded the gurney with our precious baby. My midwife and one assistant went along to continue CPR, and my husband stayed with them and Rowan.
I was left with the second apprentice midwife and my doula. We were informed that another ambulance was there, “to take mom to be with her baby”. We tried to push the placenta out, but it was not coming, so we went along to the hospital.
When we arrived in the hospital ER, I could not even see my baby. No one would give me any answers. They finally explained that Rowan’s organs were in severe failure, and they needed to cool her body down to slow it down and transport her to a hospital with a NICU for further tests. I was finally able to see Rowan when they wheeled her incubator into my room on her way to the ambulance which would transfer her. She looked so small, connected to so many tubes which were all that were keeping her alive. For a few moments, they opened the incubator so I could hold her cold, motionless hand.
My midwives tried to help me get my placenta out, but after the adrenaline of the situation and the ambulance transfer it may not have been possible. Apparently the OBs upstairs chose not to answer their calls and the ER guy actually asked the midwives if they could help. I was left bleeding in the ER for several hours, nearly passing out more than once. It was also during this time that the ER guy pulled off what was left of the umbilical cord and tossed it out with the rest of the waste, so we will never know exactly what the kink we saw was. It may have been caught when her head engaged, or been a kink that had gradually cut off her oxygen over the course of time, or even an aneurysm at some point. We will never know.
When an OB finally deigned to see me, I was put under full anesthesia for a D&C. When I came to in the recovery room, I choked on the oxygen they shoved into my throat raw from a breathing tube. Again, no one would answer my questions. The nurses would not even look me in the eye. I could not stand their looks of pity, when no one would tell me what was going on.
I was relieved to be greeted by a smiling nurse who brought me to my room and made me as comfortable as she could. I will never forget that nurse. As soon as I was settled into the room I was told that my husband needed to talk to me on the phone. He tried to explain to me what the doctors had said, but it basically meant that they were waiting for me to get there before they took our little Rowan off life support. He also asked if we should bring Griffin to the hospital, but at the time I did not see the point and thought it would scare him. The same kind nurse discovered that they could not send me because the other hospital was short staffed. She offered to drive there on her own to transfer with us so I would not have to wait any longer.
My mother rode in the ambulance with me, feeding me the chocolate chip oatmeal cookies she and my son had made when I first went in to labor. The same recipe we have made during each of my labors. I did not taste the cookies at all. The trip was slow as the bridges were blocked off for a bike race. The paramedic asked if they were waiting for me to make decisions about our baby and I said yes. I actually smiled when they used the sirens to pass the blocked traffic, even though we were not technically an emergency.
I finally arrived at the hospital where my baby was, but I still could not see her. They wheeled me into a postpartum room, complete with nursing gown hanging in the bathroom and large print of a father laying with his baby on his chest, much like the first picture we took of my husband when we came home with our son. I immediately asked them to take the picture down, and noticed that the next time we came back to the room it was gone.
Eventually I was wheeled into the NICU to see my daughter. My family was all there, gathered around our poor baby who lay motionless except for the small movement of her chest from the machines that kept her breathing. The doctor explained again, the second time for my husband and my father. Even if they could repair the damage to her body, at some point her oxygen was cut off too long, damaging her brain too severely for normal functioning.
Once the decision was made, I was wheeled back to my room to eat and rest. As we passed through the postpartum ward, I saw older children there to meet their new siblings. I suddenly realized how important it was for Griffin to come meet her. My sister had had a baby just 4 months before and he had been in the waiting room when her son was born. At three years old, he knew what was supposed to happen, and would be very confused if we just did not come home with a baby. But that is another story*.
When I returned to the NICU they wheeled me into a large closet to choose a handmade quilt to wrap Rowan in. That quilt, and the crocheted afghan she was wrapped in are some of the few things we were able to bring home to remember our baby. Looking through the pile of handmade quilts to choose a bright pink and green one for Rowan, I began to think of how Rowan’s short life could make a difference to other parents going through the same thing. As we prepared to say goodbye to our first born daughter, I was envisioning the Remembering Rowan Project*, donating blankets in her memory.
My husband and I got the chance to bathe our baby, wash her hair, and dress her in a simple white gown. My father played his harp, something beautiful for Rowan to experience during her short life. They removed the tubes pumping oxygen and medicine which was all that kept her body going. They had a large double rocking chair where we sat with Griffin to introduce him to his baby sister and explain why she was not coming home with us. Then he took a walk with his uncle while the rest of the family gathered together to each have a chance to hold her, kiss her, and say goodbye to our precious baby. Then the nurse took her vitals and recorded her time of death.
I had to stay overnight in the hospital after all of the blood loss. As they wheeled me back to my room, it felt so strange to leave our baby in the NICU knowing we would never see her again. They told us we could bring her back to the room with us, but that just seemed creepy. We had already said goodbye. It was only her body and holding it longer would not have brought me any comfort. I am not sure her spirit ever really inhabited that body. I have come to believe that there is a small spark that comes at the moment of birth, seems to me babies would get really bored in there for nine months. Call it the soul or the spirit or whatever. But I have to believe Rowan’s tiny spark just never connected, and instead she is everywhere, in everything.
* Read more about the Remembering Rowan Project and her other crafty ventures on Laurinda's Blog. She also wrote an essay on helping her three year old understand the loss of his sister.
Tuesday, August 3, 2010
A Lesson In Security
When I was a freshman in high school, my grandpa died. And as a family we made the 12+ hour car trip to go to the funeral and be a part of the family.
We stayed at my grandma's house. My parents and brothers slept upstairs and I slept downstairs in the livingroom on the couch. One night I woke up to a guy rubbing my leg. Twice. I kicked him. Twice. And then I went upstairs to sleep with my parents.
Yes, as a freshman in high school, I went and slept with my parents. Why? Lots of reasons.
I knew the difference between good touch and bad touch. Not necessarily because I was "told" the difference, but because I grew up with good touch. Lots of it.
Also, I was obviously secure enough in my relationship with my parents that I could, even as a teenager, seek them out in the middle of the night in a strange house because something was wrong.
Why am I telling you this? Because it's important.
Recently one of my facebook friends asked how to get his five-month-old to sleep on his own. My response was that he shouldn't have to sleep on his own. Mom and dad are their children's security. And as they grow older, even if they aren't sleeping with you, you are still their security. And if the roots of security are there, your children, even as teenagers, will know even in the middle of the night in their grogginess that they can come to you if they need to. Period.
I taught high school for four years. Several times each year I had a girl come to me with a boy problem. It's just how it is. But of those several times, I remember a select few and their reactions when I said, "You know you dont' have to . . . " The stunned silence and then the anger that suddenly flooded her face made me cringe. I distinctly remember one storming out of the room, not mad at me, but mad. And another one responded with, "Why didn't anyone tell me that?!"
Things could have been so much different that night when I was sleeping in that livingroom. But I knew that I didn't have to.
No, we did not co-sleep with our parents, but their bed was not off limits. We were always close to our parents, physically and emotionally, and our needs were always met in a timely manner. We knew that we could count on them and it was as simple as that. We were their priority. They were our security.
Before we had children, my husband and I took a vacation and went to the coast for a week. I distinctly remember walking up a path behind a family with two girls who looked to be about age 10 and 13. Both of them were holding hands with their dad on the way up the trail. I remember thinking that is how I wanted it to be when we had our kids.
Now, watching our girls attack their daddy when he gets home and seeing them pile on him to read books every night, I know that they are getting their fill of appropriate touch. And to me, that is one fo the very best ways to build their security and protect them from the realities of this world. They are still little, yes. We do our best to keep them safe. But some day they won't be little any more. And when they are big, I want them to be able to come to us, even in the middle of the night, crawl in bed and feel safe.
Please don't push your children away. They need you. You are their security. They are your priority.
By Heidi Donnelly
We stayed at my grandma's house. My parents and brothers slept upstairs and I slept downstairs in the livingroom on the couch. One night I woke up to a guy rubbing my leg. Twice. I kicked him. Twice. And then I went upstairs to sleep with my parents.
Yes, as a freshman in high school, I went and slept with my parents. Why? Lots of reasons.
I knew the difference between good touch and bad touch. Not necessarily because I was "told" the difference, but because I grew up with good touch. Lots of it.
Also, I was obviously secure enough in my relationship with my parents that I could, even as a teenager, seek them out in the middle of the night in a strange house because something was wrong.
Why am I telling you this? Because it's important.
Recently one of my facebook friends asked how to get his five-month-old to sleep on his own. My response was that he shouldn't have to sleep on his own. Mom and dad are their children's security. And as they grow older, even if they aren't sleeping with you, you are still their security. And if the roots of security are there, your children, even as teenagers, will know even in the middle of the night in their grogginess that they can come to you if they need to. Period.
I taught high school for four years. Several times each year I had a girl come to me with a boy problem. It's just how it is. But of those several times, I remember a select few and their reactions when I said, "You know you dont' have to . . . " The stunned silence and then the anger that suddenly flooded her face made me cringe. I distinctly remember one storming out of the room, not mad at me, but mad. And another one responded with, "Why didn't anyone tell me that?!"
Things could have been so much different that night when I was sleeping in that livingroom. But I knew that I didn't have to.
No, we did not co-sleep with our parents, but their bed was not off limits. We were always close to our parents, physically and emotionally, and our needs were always met in a timely manner. We knew that we could count on them and it was as simple as that. We were their priority. They were our security.
Before we had children, my husband and I took a vacation and went to the coast for a week. I distinctly remember walking up a path behind a family with two girls who looked to be about age 10 and 13. Both of them were holding hands with their dad on the way up the trail. I remember thinking that is how I wanted it to be when we had our kids.
Now, watching our girls attack their daddy when he gets home and seeing them pile on him to read books every night, I know that they are getting their fill of appropriate touch. And to me, that is one fo the very best ways to build their security and protect them from the realities of this world. They are still little, yes. We do our best to keep them safe. But some day they won't be little any more. And when they are big, I want them to be able to come to us, even in the middle of the night, crawl in bed and feel safe.
Please don't push your children away. They need you. You are their security. They are your priority.
By Heidi Donnelly
Wednesday, May 26, 2010
Sometimes, we do not win.
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.
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 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
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