• What is wrong with obstetrics in the US

    Date: 2014.05.29 | Category: Uncategorized | Response: 2

    Over at the feminist philosophers‘ blog, questions are being raised about why the recent Wax meta-analysis, which concluded that hospital births were less safe for mothers than homebirths, did not lead to a discussion about the shortcomings of modern obstetrics in the United States. The study  has been used as a launchpad to criticize homebirth, and is flawed in many ways (read more about why here). It has largely served the purpose of anti-homebirth advocates to illustrate their opinions that homebirth is not a safe childbirth choice. Indeed, we’ve seen no questions about what is wrong with the maternity care system in the United States. Let’s take a look at that now.

    I’m not suggesting that the Wax meta-analysis, which this data is based on, is reliable. What is clear, however, is that the maternity care system in the United States is often doctor-centered and designed to make the system as a whole run smoothly, as opposed to patient-centered and designed to provide the best possible individualized care to mothers and babies. Policies that state that labors must be pitocin-augmented if labor fails to progress according to a certain, predetermined timeline is one example of this. Continuous electronic fetal monitoring (EFT) which prevents the laboring mother from changing positions and walking as she wishes is another. Policies that discourage laboring mothers to eat and drink can also be added to the list.

    Then there is the fact that many mothers are pressured to accept pain medication, and that nearly every mother giving birth in a hospital still does so lying flat on her back (the lithotomy position). This narrows the pelvic opening and makes pushing a baby out more difficult. Then there are the epidemic c-section rates, which even professional bodies of obstetricians and gynecologist condemn. While I have no seen a break down of reasons for c-sections, I have no qualms about saying that I am sure the majority of cesareans are not medically warranted.

    More than anything else, what is wrong with modern obstetrics in the US is that, apparently, the opinions, instincts, and wishes of the laboring mother herself are inferior to just about anything else. Mothers arerelevant, mothers want the best for their babies, and are people with brains who are generally competent to decide what that is. It is not the role of modern obstetrics to “save” babies from their mothers’ crazy wishes to move around freely during labor, have a little privacy, or squat during birth.

    Making hospital births a safer and more pleasant, relaxed experience for mothers and babies is a valid goal, that everyone should be on board with.

    What are your opinions?

  • What is a “natural” cesarean section?

    Date: 2014.05.29 | Category: Uncategorized | Response: 0

    Many natural childbirth advocates agree on this – the c-section in the US is way too high at 32 percent. But there will always be cases in which a cesarean section is truly medically necessary. Some of these will be emergency c-sections that were not planned in advance. In the case of cesareans that were planned in advance (for women who have placenta previa, for instance), there are options that make the c-section more pleasant for the family. Just what are these “natural” or “family-centered” cesarean sections?

    Your typical, every day planned cesarean may include such experiences as the mother’s hands being strapped down to prevent her from touching the “sterile field” around the incision. The actual extraction of the baby is probably over with rather quickly, and the surgical team may be talking about the weather, their family, or even other patients with each other. The mother may feel like she has no control over what is happening to her at all.

    Enter the family-centered c-section, that is designed to give families a better experience and more opportunity to bond. If you are going to have a c-section, it may not have to mean that Total Surrender is your only option. Families who managed to find doctors that provide this kind of cesarean have had great experiences, including immediate skin-to-skin contact with their babies.

    Here are some things that could change your c-section experience for the better:

    • Medical staff behaving respectfully, aware that this is a special moment for you and your family. No talk about cars or horrible patients, etc.
    • Being informed of what is going on the whole time.
    • The drape can be lowered while your baby is born, so that you can see his entrance into the world.
    • The procedure can be carried out more slowly, allowing the baby more time to “autoresuscitate”, in other words to start breathing alone. A slower delivery allows the baby’s lungs to be compressed by the uterus in contractions, squeezing out fluids stuck in there.
    • Your hands will be free, and the baby will be handed to you immediately upon birth.
    • Newborn exams can be carried out on your chest.
    • One of the parents can cut the umbilical cord.
    • Some parents have successfully requested music and more people at their births.
  • Childbirth and feminism

    Date: 2014.05.29 | Category: Uncategorized | Response: 1

    Childbirth has a bad reputation. Many people, including women, and including women who have given birth, see labor and birth as a painful ordeal that may just be the most painful experience in a woman’s life. Women in labor are portrayed as hysterical, in pain, and afraid. Actors often hurl insults at their “husbands” during labor scenes, and are shown as nearly having lost their ability to think rationally.

    Is labor really that painful? And if it is, as some women have certainly experienced, why are women portrayed as not being able to cope with the pain? It is, I believe, because of the fact that women are seen as weak and incompetent. Childbirth, one of the few acts that are truly unique to women, is marketed as something that that women cannot handle alone – as something that requires medical professionals, and most often men, to save the day.

    Although painless or nearly painless childbirth is indeed possible, here I am not addressing the issue of pain itself. Instead, I am talking about the notion that pain is not something women – because of their perceived weak nature – can cope with very well. Likewise, the belief that women in the throws of labor all but lose their minds is misogynist in nature.

    Childbirth may be painful for many women, and many may even turn into themselves to concentrate on the task at hand. Women are more than strong enough to deal with labor and birth, however, and even if large numbers will opt for pain relief, that does not mean they are too weak to deal with a little pain, that lasts for a relatively short time.

    It’s funny; women dealing with tough pregnancy symptoms are often told to “suck it up” because it’s normal, and even women who are so sick they can barely function due to hyperemesis gravidarum are told they are whining. Childbirth is different, for some reason.

    Let me tell you, women in labor don’t suddenly lose their intelligence or their ability to act, and women generally handle pain in a much more “manly” way than men. Childbirth is not something that requires men to save helpless, incompetent, desperate women. We can do it!

  • Welcome to After Forty Mom!

    Date: 2014.05.29 | Category: Uncategorized | Response: 0

    If you are pregnant after forty, hoping to be or had a baby in your forties you’ve arrived at a special place just for you!

    This site came to be after the birth of my daughter when I was 42. During my pregnancy I had a difficult time connecting with younger moms and locating research and resources to support having a baby a little later in life. My goal with After Forty Mom is to provide just that; the latest research, nutrition, lifestyle and parenting ideas along with some blog posts on everyday life as an older mom.

    Please join in this collective journey by sharing your ideas and experiences at this special time which is, in my humble opinion, the best time to have a baby.