Birth plan? Doula? Natural birth? Not here you don’t.

A sign posted at the Aspen OB/GYN Women’s Center in Provo, Utah has many women up in arms. What’s so offensive? Read for yourself.

The sign reads as follows:

Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doulah Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.

I first learned of this sign from Naomi, the Denver Doula, who posted it on Facebook. Being a doula (which is misspelled on the sign) herself, she took a particular interest in it. When she called the Center and inquired with the receptionist as to why the sign was posted she was told, “in case there is an emergency we don’t want anyone to get in the way of the doctor doing what he has to do.”

Annie from PhD in Parenting was inspired by the sign to write How Not To Have a Natural Birth and believes the center might as well have said:

Because Physicians at Aspen Women’s Center care only about doing things their own way and making as much money as possible from unnecessary birth interventions, even if it poses greater risks to the welfare and health your baby, we will not participate in a “Birth Contract”, a doula-assisted, or a Bradley Method delivery. For all patients who have done any research into having the safest birth possible, please notify the nurse so that we can transfer you to a facility that cares less about control and money.

Annie added, “I guess we can at least credit them with warning women in advance. Many hospitals with the same attitude don’t have a sign hanging out front.”

Amber responded, “I always thought the big ‘trust birth’ poster in my midwives office was a little cheesy. Now that I’ve seen the alternative, I think it’s truly marvelous. Really.”

Miriam Zoila Pérez of Radical Doula wrote a post called Signs You Don’t Want to See at Your OB-GYN’s Office. She believes the sign could be translated to say:

We don’t care at all what you want as a parent, or a person in labor. We want a patient who will sit quiet and do what we say–no matter what. Oh and if you have a partner you want involved, tough. Your desires don’t matter.

Miriam adds, “They should change the name of the center to the ‘Unborn Children Center’ since they don’t seem to care too much about the women involved.”

A commenter named Janna responded saying, “That’s what bothered me most about this hateful little sign–not once is the “welfare and health” of the MOTHER mentioned, just the “welfare and health” of the “unborn child” and the “quality” of the “deliveries.” Who would want to give birth in a place where they’re the lowest priority on their caregiver’s list? I hope women in this area have other options and the opportunity to have safe, healthy, supportive births.”

Does no doula, Bradley Method birth or birth “contract” equal no women’s rights?

Summer who writes at Wired for Noise says signs like this one and stories like the lack of choice with regard to our reproductive health and doctors’ personal “birth plans” make her sometimes think Doctors Hate Women.

What does it say when women have to escape, have to run away in order to do something as normal as give birth? What does it say when women are treated like children, talked down to, insulted, lied to, and handed letters telling them what the god-head doctor will allow or not allow. When all you want to do is give birth and you’re doctor is more concerned with telling you to sit down and shut up, what is that if not hatred?

I have to agree with Annie that at least some doctors are upfront with what they will and won’t “allow” as part of their practice. Kudos to them for being honest. Hopefully that will allow women to look for another care provider while she’s still early in her pregnancy.

Rest assured if the OB/GYN I had at my daughter’s birth would have given me a piece of paper with her “rules” or had a sign posted like that at the Aspen Women’s Clinic, I would have found another care provider pronto. Instead, however, she paid me lip service and acted like she cared about my birth plan (though she didn’t act very well and that should have been a big clue for me) and said we could “try” Hypnobirthing, etc. However, when push came to shove (no pun intended), it was her way or the highway. I had my healthy baby girl at the end of it and for that I am truly thankful, but I also got a lot more than I bargained for (and not in a good way). Then again it was that experience lead me to pursue a home birth for my second child and become a home birth advocate.

Although I admire the Aspen Women’s Center’s honesty, I find it truly offensive that they imply that if a woman wants a doula, natural birth, or has a birth plan, she is not concerned with the welfare and health of her baby (so much more personal than “unborn child” don’t you think?) or is even putting her baby’s life at risk. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. And how exactly is choosing a Bradley birth not good for the health or welfare of the baby? “Bradley® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient.” What about a birth plan or “contract?” Is that harmful to the “unborn child?” The American Pregnancy Association suggests, “Creating a birth plan can help you have a more positive birth experience.”

There are other things I find offensive as well, like Janna mentioned above, the mother does not seem to be included in the equation at all. Is there any concern for her “welfare and health?”

Who’s time money welfare are they really concerned with? I’ll let you draw your own conclusions. I’ve obviously already drawn mine.

Cross-posted on BlogHer.

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Home birth advocate’s baby dies during free birth, prompts questions

Janet Fraser, a home birth advocate and founder of the site Joyous Birth, recently experienced a personal tragedy when her baby died at her home in Australia on March 27 during her free birth or unassisted childbirth (where a woman gives birth at home without the aid of a midwife or doctor).

When a tragedy like this occurs, people are often left scratching their heads wondering how something like this could happen, what went wrong, and lastly, who’s to blame? I don’t know if we need to point a finger to make ourselves feel better, but it seems to be human nature to ask, “why did this happen?”

While I did not consider giving birth at home without a midwife in attendance for my home birth, I know a handful of women who chose an unassisted birth and I respect them for it. I believe these women did a great deal of research in advance, knew what they were doing, trusted their bodies and their babies and were prepared to go to the hospital if any issues arose. Although I don’t know her, I trust that Janet Fraser would fall into this category as well. Not everyone agrees with me though and some, like Amber Watson-Tardiff, are suggesting that what Fraser did by having her baby unassisted was “reckless, neglectful and borderline criminal.”

Jessica Gottlieb of Eco Child’s Play says, “I support women who chose a home birth. But a free birth? I cannot see the wisdom in it. Neither can Ms. Fraser’s baby.”

Watson-Tardiff goes on to say, “I hope she is at least subject to an investigation for child endangerment.”

Ronda Kaysen of MomLogic says she sees the value of home birth as a way of reducing medical intervention, but believes giving birth without medical assistance is “absurd.”

Fraser’s “free birth” argument, which on the surface appears feminist, is actually the opposite. It doesn’t empower women to take control of their own bodies. It sends them and their babies into the dark ages of medical care – where women give birth with no medical care at all and face the very real possibility of death as a consequence.

For the record the police are investigating the death and have said “it was not clear whether the baby was stillborn or died after delivery. If a baby is stillborn, there is no autopsy. If a baby is alive at birth and dies soon after, it is considered a matter for the coroner.”

I guess I give Fraser the benefit of the doubt and assume that like most mothers she was doing what she thought was in the best interest of her baby. Although she coined the term birth rape (birth interventions done against the woman’s wishes), I don’t believe she would put her child in harm’s way rather than accept a potentially life-saving intervention. Then again I don’t know Fraser and have not spoken to her, so I can only speculate just as others are doing, but I prefer to give her the benefit of the doubt. However, I do believe that whenever a child dies, there should be an investigation into the death.

While many are blaming Fraser for her baby’s death since she did not have a doctor or midwife in attendance, no one seems to mention the fact that babies die in the hospital, where doctors are present, all the time.

Laura Shanley, author of the book Unassisted Childbirth and owner of the Bornfree! website who blogs at Letters from Laura – Thoughts on Unassisted Childbirth, brought up that point and shared another perspective many of us may not have thought of when she shared the following statement with me:

I don’t know Janet, but of course my heart goes out to her. An Australian friend of mine has told me that despite what the media is saying, Janet’s baby was stillborn and the outcome wouldn’t have been different had the baby been born in the hospital. Regardless of whether or not this is true, I find it sad that so many people are blaming Janet for her baby’s death. A baby is stillborn in an American hospital every fifteen to twenty minutes. According to a story on my local newscast, this is double what it was ten years ago. Yet almost no one blames hospital birth mothers (nor should they) for these babies’ deaths. This is because it’s assumed that if a baby dies or is stillborn in the hospital, everything possible was done to save the baby’s life. The possibility that at least some of these deaths might have been caused by early inductions, c-sections and other interventions is rarely discussed.

I can tell you, however, that as a homebirth advocate I have received numerous letters over the years from grieving mothers who wonder if their hospital born baby might have survived (or avoided injury) had they been born at home. The fact is, in most cases we may never know. Sometimes medical intervention saves lives, and sometimes it takes them. This is why I encourage parents to do their own research and decide for themselves where and with whom they want to give birth. In my case, I chose to give birth at home unassisted because from the research I had done I felt that the majority of problems in birth – both now and in the past – could be traced to three main causes: poverty, unnecessary medical intervention, and fear which triggers the fight/flight response and shuts down labor. Despite what most people believe, the act of birth itself is not dangerous. But our cultural beliefs and practices can make it so. In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home. Regardless of the outcome of this case, I will continue to speak out about unassisted childbirth as I believe that in most cases it’s the safest and most satisfying way to give birth.

Genie, an Australian blogger who writes at Home Is Where the Heart Is, blogged extensively about her thoughts regarding Janet Fraser and defends her choice to have her baby unassisted at home. She feels the insinuation that women who birth at home do it to feed their own ego at the expense of their child is “a crock.”

Women choose to homebirth with their baby’s best interest at heart. They do it FOR the baby, not in spite of the baby. Yes they want to feel empowered and blissed out, but the lack of trauma and the satisfaction a mother gets after a natural birth all benefits the baby too. A mother’s health and well being has a HUGE impact on the baby. So why should we ignore the interest and well-being of the mother?

In the wake of this tragedy and surrounding media coverage, some feel the need to point out that there is a difference between home birth and free birth. Dr. Meredith Nash of The Baby Bump Project says homebirth and freebirth are not the same.

The media has failed to differentiate between freebirth or unassisted birth (no midwife or doctor) and homebirth (a birth at home, usually with a midwife or homebirth doctor). For the most part, for low-risk births that are attended properly, homebirth has been proven to be a safe alternative to hospital birth. Freebirthing is significantly more risky (sorry, I’m a supporter but also a realist). It is essential to make this differentiation. Now that homebirth is on the precipice of being banned given that independent midwives are likely going to be denied indemnity insurance from next year, the suggestion that all women who homebirth are crazy radicals or that homebirth represents the majority of birthing women in Australia (only about 2%) is ridiculous. If anything, midwives and their ability to attend homebirths will be the saving grace of the Australian maternity system. Rather than convincing the small proportion of women who avoid a medicalized birth, why not support these women in their choices by making homebirth safe and easy?

Summer Minor, who blogs at Wired for Noise and gave birth to her daughter at home a little over a week ago, references the recent Nederlands study that says home birth is as safe as hospital birth. “A new study is out from the Netherlands that gives us home birthing mothers a nice little pat on the back. Despite the labels of ‘dangerous’ and ‘unsafe’ by some, once again it’s been found to be just as safe as giving birth in a hospital.” From the BBC:

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

I think that Shanley said it best when she said, “In the end, it’s a personal decision. And just as the death of a hospital-born baby doesn’t mean that no baby should ever be born in the hospital, the same should be said for babies born at home.” We all must do our research and make the choices that we feel are the best for ourselves and our babies and then, find peace with our decisions.

I offer Janet Fraser and her family my deepest sympathy. My thoughts are with them.

Cross-posted on BlogHer.

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The dangerous overuse of antibiotics and creation of superbugs

For nearly the past month, my family and I have been battling a doozy of an upper respiratory infection, also known as a cold or the flu. It started with my daughter and quickly spread to my son and husband and finally to me all within about a week’s time. The coughing, the phlegm, the runny nose, the aches, the fever, the gastrointestinal issues – we shared it all. Isn’t family great?!

Throughout the several weeks of what was pretty much hell for me, all I wanted was something that would make it all better – a magic pill, an elixir, anything. Yet as I had suspected, when I saw the doctor (both for myself and later for my son), she confirmed that it was a viral infection not a bacterial infection, which means antibiotics won’t do a darn thing to make it better. (More about virus vs. bacteria.) With viral infections, you just need to wait out the illness (usually one to three weeks) and do whatever you can to make the symptoms more bearable – drink lots of liquids, get lots of rest, etc. I was disappointed there was no quick fix (it’s seriously hard to care for your sick family when you feel like the walking dead yourself), but I accepted it and focused on doing what I could naturally to help us all feel better.

It seems not everyone is as accepting of a viral diagnosis as I was. According to the blog Antibiotic Misuse and Resistance, “Seven out of ten Americans receive antibiotics when they seek treatment for a common cold!” because the patient “pressures the doctor into prescribing an antibiotic to get a quick fix to his/her illness.” The problem with this, of course, is that “antibiotics won’t cure a cold because colds are caused by viruses, not bacteria.”

The overuse of antibiotics is a real problem. Jane Collingwood from Psych Central notes in The Common Cold: Facts and Myths, “antibiotics usually do not help a cold. Antibiotics work against bacteria, while most colds are viral.The overprescription of unwarranted antibiotics has caused our bodies to develop antibiotic-resistant bacteria. When you really do have a bacterial infection, antibiotics may not be able to treat it. They may actually make colds worse by killing the ‘friendly’ bacteria and creating an environment more hospitable to the virus.”

If that doesn’t convince you and you are still wondering why you can’t take an antibiotic “just in case,” here’s why.

There are big problems with the cavalier use of antibiotics. When bacteria are exposed to an antibiotic, while many are killed, subsequent generations of others may develop characteristics that allow them to resist being killed. While the antibiotic kills off the weakest bacteria, antibiotic resistance allows the stronger, resistant bacteria to continue multiplying. The eventual result can be “superbugs,” which are very hard to kill and may only succumb to extremely powerful antibiotics. Such antibiotics pose a greater risk of significant side effects that may require hospitalization and are much more costly. Some superbugs go on to cause devastating and even fatal infections that are incurable with current antibiotics.

Another tip to remember that’s helpful in preventing superbugs is that if you are prescribed an antibiotic for a bacterial infection, be sure to take the full course of it as directed. “Don’t stop the medicine just because you begin to feel better. Not taking the entire prescription may allow resistant bacteria to thrive and not be completely killed off.”

Nurse Barb sums it all up nicely when she says, “the next time you go to see your health care provider and they tell you that you don’t need an antibiotic, be grateful, this could ultimately save your life in years to come.”

Some of the things I did for myself and my family that helped us deal with our virus were:

  • Cut out all dairy products (to reduce mucus) and greatly reduce sugar and flour consumption
  • Drink a lot of fluids, especially hot tea with honey (honey has been proven effective in treating coughs, especially in children though should never be given to children under 1 year old)
  • Use a vaporizer or humidifier at night
  • Eat a lot of homemade chicken noodle (or rice) soup
  • Rest as much as possible
  • Spend time in the steamy bathroom to help break up phlegm
  • Normally I prefer using cloth handkerchiefs (better for the environment), but I finally broke down and started using disposable tissues so we wouldn’t reinfect each other with dirty hankies lying around the house
  • Use a neti pot to clean out the sinuses (BlogNosh has a humorous tutorial on how to use a neti pot)
  • Frequently wash hands with regular soap (not antibacterial) and water
  • Use herbal and homeopathic remedies

More tips can be found at the Crunchy Bunch for treating colds naturally and Kelly the Kitchen Kop has a list of Home Remedies for a Cold & Ear Ache / How to Avoid Colds, Flu, Ear Infections & Antibiotics.

Disclaimer: Please note that I am not a doctor, nor am I giving medical advice here. If you or your child is sick, I recommend visiting your doctor to get the correct diagnosis and then using your best judgment.

Cross-posted on BlogHer

Anxiety & anemia, but is there more?

On Dec. 31 of last year I wrote that my big goal for 2009 was to take care of my mental and emotional health. I knew I needed to do this for a few reasons. Not only was I treating my children and husband with the love and respect they deserve, but I felt my physical health was starting to suffer as well. I had started having anxiety or panic attacks – again.

I thought they were a thing of my past. I had experienced anxiety attacks while Jody and I were trying for month after month after month to conceive Ava. It was a difficult time in my life. I so wanted to be pregnant and to be a mom. I was charting using the Fertility Awareness Method and we seemed to be doing everything right, but it was not happening for us. It obviously eventually did happen (with a little help) and the anxiety attacks went away. That is until several months ago.

I don’t remember exactly when they started up again and because the symptoms weren’t consistent with what I’d experienced in the past, I wasn’t entirely sure they were anxiety attacks. My heart would start racing which would make breathing a little more difficult. I was also feeling dizzy at times, tired, lethargic and sometimes depressed.

Over the past month, the frequency of the attacks increased dramatically. I started having several anxiety attacks a day or ones that would last for a long, long time. I started getting worried that this was more than just anxiety. After consulting Dr. Google and my favorite resource, Twitter, ;) I thought I might have a thyroid issue or even a heart problem. After a particularly bad attack, I finally called my doctor’s office and scheduled an appointment. It was five days out. Five very. long. days.

During those five days the attacks continued. I debated about going to urgent care once or twice. I thought about going straight to the ER. And then, the night before my appointment, as I tried to go to sleep I had one of the worst attacks ever. My heart would not stop racing no matter what I tried to tell my brain to calm myself down, no matter how much I focused on my breathing. I told Jody I was doing really bad and that I wanted to call the doctor on call (while I was really thinking, “maybe you should call 911”). I had all of these fears that I would die the day before my appointment because I had put it off too long. That I was going to leave my children motherless and my husband a widower. It was too much.

I called the doctor’s office and spoke to the woman at the answering service. She told me to stay on the line and she would try to call the on-call doctor (not my doctor, but one in the same practice). To my relief the doctor answered the phone (even though it was 12:30 a.m.). I talked to the doctor for about 20 minutes. She reassured me, based on the symptoms I was describing that it was likely anxiety and not a heart issue, but she was also glad I was scheduled to come in for an appointment. I felt better the longer we talked and had calmed down a fair bit by the time we hung up. Of course, my heart started racing again after we were off the phone and there was no way I was going to sleep any time soon, but after watching Scrubs with Jody for an hour, I felt better and was able to go to sleep at 2 a.m.

Photo courtesy of Neeta Lind
Photo courtesy of Neeta Lind

The next morning I happily went to see my doctor. I told her my symptoms, she examined me and said she felt I was likely experiencing anxiety. My blood pressure was normal and my heart sounded, in her words, “perfect.” She did want to rule out thyroid and heart issues just to be sure, so she sent me for blood work and an EKG.

I had told her that I did not want to go on medication unless absolutely necessary, but I was looking for natural ways of treating this. She recommended a therapist, acupuncture, a $300 biofeedback video game called The Journey to the Wild Divine (it looks really cool, but pricey!), as well as fish oil (double the amount recommended on the bottle). She gave me a prescription for Xanax too, just in case I really needed it. (I haven’t taken it, although I was tempted to today.) She said she felt confident that we could get this under control and she wanted to see me back in two weeks.

In the meantime, I had my blood drawn and my first EKG. The EKG came back normal, but the bloodwork revealed that I am mildly anemic, so it was recommended that I go on an iron supplement and increase my green leafy vegetables.

It’s been nearly two weeks since my appointment and while the anxiety attacks do not seem to be happening as often, they are still happening – some worse than others (like last night’s when I was up until 2 a.m.).

I really want to believe that everything I’ve been experiencing is just from anxiety and anemia but honestly, I feel like it could be something more. And I don’t think I will be satisfied until I’ve ruled out those other possible issues.

This week I’m going back to my doctor for a follow-up appointment and I have a therapy evaluation scheduled. I might be making an eye appointment with the doctor who did my strabismus (eye muscle) surgery several years ago and revisiting my old neurologist too. I just want to get to the bottom of all of this. While I feel like there have been improvements in how I feel just in these two weeks, I still have a long way to go before I’m back to feeling like my old self. I miss my old self and am going to keep trying to get her back.