Cesarean Birth or Cesarean Surgical Procedure?

At work the other day one of the birth assistants corrected a midwife when she said "c-section," she said we should call it a cesarean birth. I have in the past accepted this terminology, but now that I have contemplated it further I feel that calling it a "birth" does not express the seriousness of it. In school I attended this surgery and it did not look, or "feel" (in an energetic way), at all like a "birth" in the sense that I have felt births in the past. It was surgery and that's it.

Maybe down-playing the seriousness of a cesarean is not helping anyone. If women accept these too easily, even ask for it, and then call it a birth it is equating a cesarean to a vaginal birth, and they shouldn't at all be equated. They are not similar for mother or child. Risk of death with a c-section is 1 in 2,500; risk for death with a vaginal birth is 1 in 10,000. Those odds are not at all similar and should not be taken lightly.

As I shadowed the nurse assisting in the c-section I witnessed, she was explaining the procedure to the woman on the way to the OR room. It was very matter-of-fact and she explained that "the doctors and nurses would be chit-chatting and even if it feels like we forget that your there, don't worry we don't. We know that you are lying there and your welcome to talk and ask questions." They put up a barrier and strapped down her hands as she lay there shivering. And then the surgery began and a baby was removed. That was that, it was nothing even remotely like a birth. And everyone in the room did pretty much ignore the mother and the baby.

Circumcision...

The biggest suggestion out of the 2006 AIDS conference is circumcision, you can check out a clip on the news here. There have been some studies done in Africa that showed circumcised men were %60 less likely to contract the HIV virus. I don't know what else to really say about this except this is not going to help people that are on the fence about circing. Who knows, this may even change the AAPs recommendations.

On a side note, a friend of mine had her son circed last week. I was over visiting her and her mom and I watched as my friend changed the babies diaper. Her mom said "look, it looks like a real little penis now." I wanted to say 'NO, it was a real penis before you modified it!' God, people are stupid.

My Day Off...

Well, sorta. I volunteered to go in and help out because two multips were coming in and the midwife thought they may have their babies at the same time. She wanted some extra help and me being the nice person (sucker) that I am, I volunteered. So much for a day off.

This was a rough birth. I don't know exactly why, but it was just rough on this mama. I felt bad for her, she looked shell-shocked afterwards. I think it was really a combo of things-- a lip that came down with a posterior, big, baby. That makes for a really hard pushing stage. We tried quite a few different positions in the tub, in the bed, squatting on the floor while holding the lip back finally did the trick. Luckily this worked as this mom was talking of giving up, of going to the hospital regardless of how much support and encouragement we were giving her.

Immediately after the baby was born mom said "I am never doing this again." I've heard other moms say this, but this time I actually believed it.

On a side note, I am absolutely dying to have a baby. Even if my birth was just as difficult or long or whatever. I am so tired of watching others experience what I am longing to experience. I feel like I have no idea when this will happen for me-- I feel like I have no idea how I'm going to ever get my boyfriend to agree.

I went to visit the midwife I used to apprentice with the other day. She is taking a break right now so she can garden (her real passion) and write. Being a midwife for years can take its toll, in fact, almost everytime I see her she tries to talk me out of this career, but I'm stubborn.

Now that I have worked with about five midwives I can really appreciate differences. I am trying my best to hold onto what I believe is right, picking and choosing the techniques I agree with, and I'm hoping that I don't pick up bad habits. I told my past preceptor that the new midwives I work with have more hemorrhages (of course my whole conversation with her took place in her garden while she weeded). She asked me if I had an idea why and I told her they mess with stuff too much. They are in too much of a hurry to get the placenta out. I remember attending births with my first preceptor and she always waited until the mother felt the cramping of the placenta detaching itself, even if the amount of time that elapsed was quite long. She told me that whenever she questions what to do she thinks about how birth would have been thousands of years ago. "Thousands of years ago, a mother would have pushed out the placenta on her own once she felt cramping. You can't mess with perfection." I couldn't agree more.

Update and Rant...

I talked with my friend S. this morning. She had her baby boy yesterday around 8:30 pm. He has been in the nursery all night because he is having a hard time breathing. I would venture to guess its because they induced her and the baby is early! It makes me so angry to think that this baby would have been able to stay with his mother and breastfeed (he has only had formula so far) if the asshole O.B. hadn't insisted on inducing my friend for no reason whatsoever! He was only 6 lb. 10 oz. and I think letting S. go until she was ready to have this baby would have made at least a pound difference in his weight and a lot more maturation of his lungs. It is just so sad, the bonding she is missing out on and the effect that may have on her breastfeeding. They didn't even have her pump throughout the night! I just feel like writing a string of profanity... Instead I will update after I go see her today.

The State of Birth Today...

Where to begin with this topic... I guess I am surrounded by pretty progressive people for the most part, but I do still have a few "mainstream" friends. A friend of mine from high school is due to have a baby August 9th. Even though I love this friend, S., she doesn't ever question the status quo. She chose an O.B. at a community hospital and basically goes to her appointments and that's the extent of her involvement. She eats O.K., definitely not stellar, and drinks too much soda (with caffeine I might add). This is really not much different than many others. She has had a completely uneventful pregnancy, but she is being induced Tuesday.

So, my friend S. is being induced the day before her due date. I thought it was bad enough when people were induced on their due date. What is the world coming too? When she told me this, I had to really control myself. Here is just one example of the absolute cluelessness: A mutual friend of ours had a 9 lb. second baby right around her due date and I said "did you hear that Sue had her baby? It was a 9 pounder (proudly)! S. says "I can't believe they let her walk around like that!" And I said "like what? Like why didn't they induce her?" And S. said "yeah!" See, I don't even know where to begin with that. Anyway, I digress... When I spoke with S. today and she told me of the planned induction, I asked her why they were inducing her and she said she didn't know why, the O.B. didn't give her any reason. S. believes it may be because she is 3 cm. and 80% effaced (that is some messed up logic!).

I find it very interesting that people believe there are no risks to these interventions, but even more disgusting is that their doctors are not informing them of the risks versus benefits or I bet most would not agree to an induction. So, I want to list the risks for my own sanity:

• ACOG's own statement: The side effects of oxytocin use are principally dose related; uterine hyperstimulation and subsequent fetal heart rate deceleration are the most common side effects. Hyperstimulation may result in abruptio placentae or uterine rupture (a rare complication). Water intoxication can occur with high concentrations of oxytocin infused with large quantities of hypotonic solutions. The antidiuretic effect usually is observed only after prolonged administration with at least 40 mU of oxytocin per minute. A rapid intravenous injection of oxytocin may cause hypotension.
• Labor is more painful
• An IV is required
• Continuous fetal monitoring is the norm
• Uterine hyperstimulation is possible
• Baby may be born in poor condition (doubles risk)
• Increased PP blood loss
• Increased newborn jaundice
• Increase ceserean birth rate
• All of above have their own additional risks

Breasts!

Even though I'm at work right now, I had to post a comment on this news story Breast Isn't Best?

This absolutely makes me irate! Are people just fucking crazy or what?! I don't see anything offensive about this picture, you can't even see any nipple, give me a break! I can't believe someone in the article said they ripped off the cover so as to not scar their children.

I find it very sad that in our country breasts are only seen as sexual objects, even when nursing a baby. I have seen way more skin on the cover of most magazines (like Glamour, Rolling Stone, whatever) and these photos are demeaning to women! A mother should be more concerned with her daughter seeing women displayed like objects in magazines than breastfeeding!