Friday: I heart homemade clothes August 21, 2009
Lilliths new skirt and peasant shirt, fleece and wool diaper covers (yes, I actually found a pink and orange striped wool sweater) and the BOY showing mama his eyes.
So much for the pretty pictures I wanted to take of them in their new clothes today. *sigh*
OH NO, it’s an outbreak of MARKER POX! AHHHH!
Wednesday: The Domestic Arts August 19, 2009
Well, I got my fix on birth statistics and research. That Monster Obstetrical Malpractice Article is just going to have to be put on hold for a while because I’ve been bitten by the sewing bug again. Today I made no less than three, YES THREE, fleece soakers AND a skirt for Lilli. That’s right, months and months of nothing and then BAM! I happened to glance at my fabric stash today and it was all over. Lilli is sleeping in one of the soakers now, and the sewing monster is temporarily sated.
Brian and I are getting more serious about buying a house. The father of a high school friend of mine came by about a month ago to drop off some books for the kids (the ones I posted about before) and I mentioned in passing that we hoped to be buying a house soon. He told me about Neighbor Works, and we filled out an application on Friday. We’ve been told we’ll be receiving a letter and setting up an appointment in two weeks. We’d love to be into a house by the end of the year, but we were told that it may not happen that fast, but there’s no reason we can’t try. The idea that we could own a home by the end of the year is extremely exciting to me. I went to the fabric store with open eyes, thinking about how every single thing would make lovely curtains or tablecloths. I know, it’s so sad… Poor Sunsong, the fabric addict. That girl needs some help. *sigh*
The survey is done! August 16, 2009
In the 24 hours since the survey was opened, we’ve had 34 respondents. The survey will remain open for at least a couple of more days, depending on the turn out. I’d like a minimum of 50 responses, but will close it early if it takes more than a week.
Quick stats (but keep in mind that this is not a scientific survey and the vast majority of surveys were solicited from a natural family living community.)
One set of twins.
78% enter into labor or are induced between 38 and 41 weeks
65% IV use, 35% no IV (those who had heplock or no IV until c-section or Epidural are counted as “no”)
35% monitored continuously by belts, 15% internal, only participant without monitoring was c-section before labor.
6% c-section before labor, 24% induction rate,
One cytotec induction, 44% of inductions were with pitocin only, 33% with cervidil followed by pitocin
43% augmentation with pitocin (this includes inductions)
43% of pitocin recipients were started at 3-4 cm, only one received pitocin after 8 cm but before birth.
56% reported pain of 3 or less before pitocin (scale 1-10) 19% reported pain of 3 or less after pitocin. 64% report pain of 7 or more after pitocin. (this includes those who received an epidural with pitocin)
40% epidural use. (those who received spinal right before c-section are not counted)
3% received other chemical pain relief, but not an epidural.
44% of epidural recipients got it after receiving pitocin
31% labored in bed, 57% had a doula, 43% used a birthball
74% pushed while reclining or on the back, 10% while squatting (the survey failed to account for pushing while standing, kneeling, and side-lying positions. In addition, some participants did not push because of cesarean, and some women pushed but also had cesareans.)
34% did not tear, 44% tore, 16% episiotomy. 62% were 2nd degree
one vaccum extraction
seven cases of fetal distress, three of shoulder dystocia
18% cesarean rate
76% report no pressure to perform a c-section
one court-ordered cesarean
one stillbirth (that was noted, there was no question about fetal outcome on the form)
three labors > 40 hours
At some point this week I’ll get started on Birth Survey II and correct the construction flaws, but that one is going to take me more then a couple of hours.
Everyone jump in, the more the better! Please let me know if anything is missing. Elaborate as much as possible.
ETA: Well, thinking about this survey kept me up nearly all night. I realized that I needed to make a note here that the survey is designed and intended to analyze hospital births. In addition, I realise now that the survey is woefully incomplete. I failed to include any questions about maternal-fetal morbidity or mortality, amniotomy, multiple births progress and results, and plenty of other things that came to me last night that I now can’t remember. Please keep in mind I created the survey all in one sitting, over the course of a couple of hours, while also trying to get my kids to sleep, and it was pretty late too. Please allow me some mistakes. Needless to say, I believe there will be a “Birth Experiences Survey II” at some point in the future. I’d like a few results of the current survey to help give me ideas as to what other parts of the puzzle I may be missing.
Friday: The kettle is boiling over August 15, 2009
I must’ve lost my damn mind this week. I don’t know what prompted me to watch that train wreck “Deliver Me”, but I watched it, and after about ten minutes I was screaming at the TV and my kids were looking at me funny.
Let me throw out and define some terms for you.
- ACOG stands for American College of Obstetricians and Gynecologists; essentially, ACOG tells your OB what is and is not an appropriate standard of care. The “Ruling Body” of Obstetrics, if you will.
- Macrosomia is a fetus weighing more than 4000 grams (8 lbs 13.1 oz) and sometimes defined as 4500 grams (9 lbs 14.7 oz). Keep in mind my children were 9 lbs 2 oz (4139 grams) and 10 lbs 4 oz (4650 grams) each and both delivered vaginally, the larger with shoulder dystocia which resolved itself without intervention.
- Suspected fetal macrosomia is when the OB guesses (usually with the aid of ultrasound) the weight of the fetus and predicts it to be over one of the two previously outlined weights.
Before I get into my little rant here just read this: ACOG Practice Bulletin No. 22
Since I don’t expect any of you to be able to read that and remember the parts which are about to become relevant to my case here, I’ll just recap what ACOG has to say about macrosomia, induction and c-sections:
First of all: Macrosomia (all emphasis is my own):
“The term fetal macrosomia implies fetal growth beyond a specific weight, usually 4,000 g (8 lb, 13 oz) or 4,500 g (9 lb, 4 oz), regardless of the fetal gestational age. Results from large cohort studies support the use of 4,500 g as the weight at which a fetus should be considered macrosomic.”
Just to prove to you that I do know the definition of macrosomia. Anyway continuing:
“Weighing the newborn after delivery is the only way to accurately diagnose macrosomia, because the prenatal diagnostic methods (assessment of maternal risk factors, clinical examination and ultrasonographic measurement of the fetus) remain imprecise”
What’s that you say? The doctor does NOT have a magic crystal ball that magically tells him/her the weight of the baby before it is born? You mean the only way to actually KNOW how big it is, is to weigh it AFTER it is born?! I guess that’s why there is never a prenatal diagnosis of macrosomia, only of suspected fetal macrosomia. Hmmm… At this point let’s just cut to the chase here and I’ll copy their
“Summary of recommendations” at the bottom. AHEM:
- Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.
- Labor and vaginal delivery are not contraindicated for women with estimated fetal weights up to 5,000 g in the absence of maternal diabetes.
Got all that? Just becuase the OB thinks the baby might be big is no reason to dose the woman up with labor drugs, cut her open, or threaten to do either of the above.
So here’s what gets me about this show then. (Season 1 Episode 3 “Size Matters”) A lesbian couple is seeing these doctors when the ultrasound indicates that the baby might be approaching 8 lbs, (Possibly nine, I’m not entirely sure.) So the OB starts talking about induction and/or c-section. The pregnant lady in question really wants a natural labor and indicates that her mother had four natural, vaginal births. Eventually the lady lands in the hospital with an induction for macrosomia. The woman is laboring on her back the entire time. I believe she is given cervidil then pitocin and eventually asks for an epidural. Keep in mind, also, what was said by Dr. Jacques Moritz, who was in the documentary “The Business of Being Born”. He is quoted here from Pushed be Jennifer Block (which I will comment on later.): “These are bad-ass contractions. I personally think it’s cruel and unusual punishment to give somebody pitocin without an epidural.” So essentially this woman is induced by her doctor who KNOWS that the woman wants a natural birth, and yet goes against ACOG standards of care for macrosomia and all but ensures that the woman cannot have a drug-free labor. In addition, twice I counted during labor the OB is speaking to the woman and telling her all kinds of stuff that she’s not progressing enough and that “Maybe the baby isn’t going to fit.” or “Maybe it is that you just can’t dialate.” Way to go, doc; completely undermine the first-time mothers’ confidence in herself. First you pit her until she begs for an epidural and then start plating seeds that she can’t do it anyway and might “need” a c-section. Are you @#$%^! kidding me?! And the worst part of the whole thing is ACOGS expectations are very easy to see, anyone can look them up. HOW IS THIS WOMAN PRACTICING MEDICINE ON NATIONAL TV AND GETTING AWAY WITH THIS?! She is quite clearly not following guidelines designated by the ruling body of obstetrics or practicing evidence based care, failing to do so on a national television program, and yet is not being stopped. WTF?
Ok, rant over. Just another show that is total and utter garbage. Unfortunately what pisses me off the most is, it is also probably a very realistic picture of American obstetrical care. UGH! /vomit /wrist /wrist /wrist!
About Pushed. I checked this book out from the library and ATE IT. I read it in less than 24 hours and will probably read it a couple more times before I give it back and then buy a copy of it. Every woman, no, every person in America should read this book, (along with a half-dozen other eye openers.)
The book brings up some things to think about for me, as a training doula. On the one hand I’m incredibly depressed by some of it. But then there is a passage in the book about how the primary job of a doula is to help the mother have a positive perception of the birth, even if it all went horribly wrong in ways that could have been prevented, or never should have happened. I used to hold with this same philosophy, especially when it came to women who would not experience birth again. I always told myself, why bother to tell them how their labors could have been better? But the more I thought about it, the more it didn’t sit right with me and my current philosophy is that women need to know what is happening to them. They need to get angry about it. Nothing is ever going to change if we keep convincing them that everything is ok, or refusing to tell them that the horrible things that happened to them could have been prevented. How can we fix it if we’re not telling anyone that it’s broke? Once I get to know some of these doctors, I WILL tell a woman if the OB she has chosen has a high rate of episiotomy. If I know a doctor likes to pull the rug out from under naturally laboring women or VBACS, I’m not going to “be a good doula” and keep quiet about it. I’m sorry but I believe in an informed decision and I believe it’s more important to a good, safe birth than faith (especially misplaced faith) in ones’ practitioner. Maybe that makes me a bad doula, I dunno.
Well, this is getting a wee bit long-winded and I haven’t even talked about half the things I’ve had on my mind this week, like trying to figure out this very strange man I live with. More on that next time, maybe. I also want to do some polls, really a survey. Too often when I hear a woman make a comment about her birth, I have questions. If you think women who go without epidurals are nuts based on your experience with natural labor, what position were you laboring in? were you eating and drinking? using EFM or an IV? I’m genuinely curious. Did you have pitocin? What pain-control methods did you try before you tried the epidural? If your c-section was necessary because you were pushing for hours and the baby just wasn’t coming, what positions did you push in? did you have an epidural? how long did you push? were you eating and drinking or did you have an IV? Did you push with the urge, did your body push involuntarily, or did you push when told to while someone counted to ten? What station was the baby when you started pushing? I need to make a really good survery and method for obtaining results, my interest is piqued beyond containment.
Garage sales of Saturdays’ passed July 11, 2009
Ok, so first, the’s the beautiful cabinets I found for the play room. I found them for $5, for BOTH! The picture doesn’t really do them justice, they are so nice! They hold all of our toys so much better then the shelf we were using before. That shelf is now kept on top of the cabinets and holds our books. Speaking of which, our collection was suddenly greatly expanded thanks to a gift from the parents of a high-school friend of mine. Thank you Mr. and Mrs. Young! We love our new books!
My other great finds: A solid wood toddler bed: $5. Replacing the hardware: $5. Those are $80+ when you buy them new! Now the kids each have their own beds!
A top-loading VCR: $2.50, and it WORKS just fine! Not even any scratches on the front, like someone just put it by their TV and never used it. Very heavy, not made out of plastic like the stuff you buy nowadays. (Yes, that’s Return of the Jedi sitting on top of it. /duck. What can I say? It’s like Nerd Porn.) Please ignore my half-dismantled VHD/DVD player on top. It’s broken and I tried (unsucessfully) to fix it before I bought this one.
I also found this nifty chair for $1, and a little baby bed for the kids’ dolls for fifty cents! We also went to a church garage sale where a grocery-bag of clothes was $1, and there I hit the motherlode of wool sweaters. I’ve since made two diaper covers and one pair of longies from them, and still have lots left over. I guess I’ll probably get six pair of longies and maybe ten short covers before I run out of wool. My more recent obsession with wool and other fiber arts is juicy, fiber-loving fodder for another post entirely. I’ll probably write that one when I get the 4 oz alpaca and 1 oz bamboo that I’ve ordered in the mail.