A lesser of two evils…. is still evil May 27, 2008
I could have just linked you to the “Why McCain?” post, but I just HAD to have this on my blog..
Gestational Diabetes testing … May 27, 2008
The ICAN email list not only offers support and advice, but it’s a great source of information and education. This was emailed out today:
The US Preventative Health Task Force has issued new guidelines ( 2008 ) for GD testing. Below is their conclusion:
“Current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes mellitus, either before or after 24 weeks’ gestation,” the statement concludes. “Until there is better evidence, clinicians should discuss screening for GDM with their patients and make case-by-case decisions. The discussion should include information about the uncertain benefits and harms as well as the
frequency and uncertain meaning of a positive screening test result.”
(summary found on Medscape)
Thanks, Linda J.!
The Rest of the Story — Daddy’s version May 23, 2008
As promised, here’s my husband’s version of Bella’s birth:
12 inches of snow fell March 13th and 14th. Erin began having contractions, and with the roads completely covered and beyond traveling condition we felt certain that it was the beginning of something real. Well…maybe it was.
But, for the subsequent ten days Erin and I watched as contractions and cramping would begin around 6:00 pm get nearly regular and fade away. We got to the point that we would have to keep ourselves quite unexcited lest our dreams of Bella coming soon would be dashed by the clock’s strike of 9. So Erin would eat her chocolate ice cream with strawberry preserves and I would rub her feet. Night after night, sleep getting harder, they’d pass as they always had.
Tuesday the 25th we woke up…7:45. Erin rolled over and said she had been having contractions and they were “different” than they had been. Unimpressed, and having mastered being unexcited, I asked her to time them while I took a shower and got ready for work.
Out of the shower and ready for work…8:15. With excitement, well-tamed Erin sat up, “They’re seven minutes apart.” We debated whether I should go to work or whether this was the real thing. Still unimpressed by their regularity, I left for work. Only to call her every half hour, “How are they? Are they longer, stronger, and closer together?” (I had listened in my Bradley Class). Sure enough they stayed. I went home at 2:00 to give her a nap and did a little spot cleaning just in case the midwife might be dropping by.
They regularized at about 5 minutes apart when we called. Erin’s parents had been watching Emmy so Erin and I could concentrate on what she was feeling. I said, “If you all want to bring Emmy on over, we’ll put her to bed. And if you want…we’ll play Uno.” And play Uno we did! Of course, every five minutes or so we’d pause for a moment of silence. No one won, but the game was competitive.
11:00 rolled around, our company left, and Erin and I settled in for the night that never happened. Her contractions began to space out again, and her untamed excitement had gotten the better of her. “Why are they spacing out?” she said to me half asleep, “they have been regular all day.” And as I began my sleep-intoxicated comfort blurb she gave a yelp.
“That one was really bad,” she said after it passed.
3 minutes
“Woh!”
3 minutes
“Why are they so bad all the sudden!”
3 minutes
“Have you called Susan and Jennifer?”
And so I did. It was about 2:00 in the morning when I called our Doula, Susan, who was as chipper as a chipmunk…woken up in the middle of sleep. But, I told her what I knew i.e. that they were 3 minutes apart and lasting one minute and that Erin really needed her to come by. After one hour of these regular and fierce contractions soaked up by our trusty birth-ball, I called Jennifer our midwife. Things were in full swing. She wanted to talk to Erin, and while Erin had a bit of a difficult time talking, what with the crazy contractions and all, Jennifer was able to gather that she should get on her way
Susan showed up about the time I called Jennifer, and Jennifer showed up about an hour after I made the phone call. At this point Erin couldn’t get a word out, she didn’t want to talk, and she did…did not…did…did not want me to touch her. As these progressed, and we filled the birth tub with the warm water of our kitchen faucet via a fish tank cleaner, the doula assistant and the midwife’s assistant showed up in due course. The more people showed up, the more Erin snapped out of it, and snapped into her role as Donna Reed. If it had not been for those contractions she probably would have thrown a dinner party for everyone. She offered food, apologized about the microwave having not been wiped down yet that week, and even discussed how everyone was doing so very early in the morning. The con…tract…ions spaced out as you could imagine…or further than you might imagine.
At about six o’clock, our midwife vocalized exactly what I was thinking, “Let’s let everyone go home.” It was obvious things were slowing due to Erin’s preoccupation with every one else’s comfort. I wasn’t going to say it, but no need, Jennifer did. I sat down with them as they packed up, “As soon as you all walk out that door they are going to pick up. I know her well enough to know that.” Bags packed, doors closed, Erin ’s crying, on come the most fierce contractions yet. She nearly threw up. She was progressing.
This was the only part of the labor that surprised me looking back on it. She screamed, she tightened, she did everything that every book told her not to do, but she was disappointed that she had stalled and embarrassed she woke everyone from their night. It was understandable. All those hours, all that work, only to have everyone bail, she felt.
One hour of fighting contractions, she walked from the bed to the dresser, from the dresser to the doorway, from the doorway to the toilet and the reverse. Another hour came and went. Another came and went. The same pattern. She stopped talking, refused my touch, and went interior. I called Susan.
She arrived as I remember it, at about two o’ clock. In all her doula-ity she knew just what Erin needed, birth ball time, honey straws, and support, and that’s just what we did. As Erin ate the honey straws she began to come back around, she began to talk to Susan more, and then she got a bit chatty again. The con…tract…ions.
“You are tired, you need to rest,” said Susan firmly, “but you cannot go around these contractions. The only way you are going to do this is go right through them.” Erin shortly thereafter fell asleep. Every five minutes, she awoke, got to her knees in the tub, moaned, rocked, eased, sat, and fell asleep again. It was much needed. It was what Susan told her to do.
Erin went three hours in this routine, and at about five o’clock something happened. We actually still don’t know what, but she said, “I think my water might of broke.” Maybe, we’re not really sure, but it was about this time that we called Jennifer and the point of no return was certainly passed.
By the time Jennifer showed up Erin was getting pretty comfortable with her routine which she had been doing for some four hours. Feeling pretty good. Said our midwife, “You’re going to need to get out of that tub.”
The water was slowing the contractions, and against her will Erin made her way to the bed. She HATED the bed. Her contractions would almost immediately pick up and the pain was excruciating in that position. We tried the ball. Nothing. We tried the toilet. Something, but not enough. Eventually we pulled the gliding chair in from the living room and there she plopped, and eased into transition.
Silence. That’s how I remember it, oh except for the snoring. A contraction would come on and with it came the heat of pain and she wanted her blanket off, it would pass and the blanket was gently draped on again. She said nothing, I lightly touched her. She eased in and snored away. Contraction, remove blanket, rub…ease, reapply blanket, snooorrrrre. It was so cute, it was so wonderful, and it was simply one of the most beautiful things I have ever seen. My wife was doing what God created her to do. Pain meant nothing, heat, cold, all of it, just a part. She was comfortable. Well, you know, every three minutes or so.
Finally she let out quite a moan. She had been moaning for some time, but this was noticeably lower than the previous. Our midwife peered in from the hallway, she wouldn’t come in because every time she did Erin ’s contractions slowed,
“When did she change to that position?” she whispered to Susan.
“Just now.”
“We need to move her, she has a cervical lip.”
Okay, now there is some prophetic gift or something these birth junkies have access to, because Jennifer had never, I mean never, done an internal exam on Erin. She had checked heart tones frequently throughout, but had never examined Erin internally. But, she knew. Somehow she knew. We helped Erin up in relative silence and brought her to the toilet where she sat facing the lid and tank.
All of a sudden, a change: “Cody, when am I going to go through transition?” She hadn’t talked in a good hour or more.
I smiled, “Don’t worry about that Mabe, just go through this one. Just like the others.”
“I don’t remember the others.”
“That’s okay, that’s good.”
“I still have to got through transition, though.”
“Honey, your in it,” says Susan from the bedroom.
“Oh, I think I pushed. Is it okay to push?”
It was so funny, but the part of labor she feared the most was upon her and she became as sweet as she could be. Susan asked if she wanted something to eat, maybe an apple with peanut putter or something. Erin replied, “Oh that sounds good… but that’s going to be a lot of trouble. Don’t worry about that.”
“ Erin if you want to get in the water, now would be a good time, you’re getting ready to push.”
“I don’t to get in the pool it will slow down my contractions.”
“You’re long passed that!”
And we helped her waddle her way down the hall, lift her legs to get in the tub, and on all fours she went and the contractions did their work. No one said a word. The only voice was the occasional note taking of Justina our midwife’s assistant and the whispers, “get her a cold rag,” “let’s warm this water up; its too cold for the baby,” “wooooooooo—eeeeeee—-ooooooo,” (that was the doppler that had gotten wet and had become conversant in whale).
The contractions would come. Erin did great. Another. Another great one. Then, “Bella, come out!” Momma said and her pushing became more intense. Momma was working with the contractions pushing, pushing, pushing. The pain was gone. Push. Push. Push. No sound, just silence, occasional whispers and candle light flickering. No one would dare say, “Push,” no need for that.
“Tell me what to do.” Pleaded Momma
Susan Replied softly, “You’re doing it!”
Push, the head… the pain came back. Push. Water broke. Almost. Push! And out came Bella, the most beautiful smile Erin had ever shone (and I mean that it shone), and “I did it! We did it!” Bella sucked her little hand, Daddy patted Momma’s arm, and said, “you hold her, you didn’t get to hold Emmy.”
The rest is just after Bella moments. Third stage labor, nothing to speak of. The placenta sitting in a chuck’s pad in our bed for the following hour or so, unforgettable. It was amazing. It was over and it was totally amazing.
My first “A Commitment To Loveliness” May 19, 2008
From one of my new favorite blogs to read, Charming the Birds From the Trees
“It’s time for another Commitment to Loveliness! This is a fun way to increase femininity and beauty in our lives each week without even trying! All you have to do is choose five things that you would like to work on or do during the week that will increase the loveliness in your life!”
1. Clean and re-organize the computer room/office
2. Sort through Emmy’s toys; store some away to cycle in and out
3. Finish sewing gifts for my pregnant and new-mom friends
4. Make a new recipe book and grocery list
5. Get new flowers for our new prayer corner
FREE “Business of Being Born” screening in Louisville May 9, 2008
Ray’s Monkey House has a weekly Monday night film screening series. Films are Free and start at 7:30pm. 1578 Bardstown Rd, 459-4373 for more info.
On Monday, May 19 at 7:30 pm, check out “The Business of Being Born“
“As part of Pregnancy Awareness Month, Ray’s is pleased to screen the acclaimed documentary from Executive Producer Ricki Lake and Director Abby Epstein. You will never look at giving birth the same way again.
Description:
Birth is a miracle, a rite of passage, a natural part of life. But birth is also big business.
Compelled to explore the subject after the delivery of her first child, actress Ricki Lake recruits filmmaker Abby Epstein to question the way American women have babies.
The film interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system. When director Epstein discovers she is pregnant during the making of the film, the journey becomes even more personal.
Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?”
Just wondering how it went… May 7, 2008
The 2008 ACOG Clinical Meeting is going on right now, and I’m wondering how some of the talks are panning out. I’m particularly interested in Monday’s Presentation:
“Resource Use in Delivery After Cesarean
Allowing VBACs is not associated with a greater need for additional hospital resources compared with planned cesarean deliveries.”
Other topics seem like a big ‘ol “duh” to me, but I guess things have to be researched and presented in the name of Science:
“Effect of Perineal Lubrication on Laceration Severity and Episiotomy Rate
Applying lubrication to the perineum during labor reduces the rate of episiotomies among women who have given birth previously and decreases the severity of perineal lacerations among women having their first birth.”
“Dietary Counseling Prevents Excessive Weight Gain During Pregnancy: A Randomized Controlled Trial”
And I wish I had been consulted on this topic:
“What Women Want-Factors Most Important to Pregnant Women in Choosing an Obstetric Practice
When choosing an obstetrician, women’s top five criteria included: reputation of the practice, acceptance of their insurance plan, continuity of care, phone access to physician, and convenience of office hours. Gender and ethnicity of the physician were most often viewed as of minor importance.”
While those are good factors, I can think of a few more that would bump those from my ‘top five:’ like-mindedness of associate OBs, preference for and belief in natural birth, low intervention and cesarean rates, to start…
But nobody asked me…
‘TIME’ Readers respond to “Choosy Mothers” article May 6, 2008
I am a former labor Doula and am currently leading the national effort to reverse hospital bans on vaginal birth after caesareans [April 28]. Mothers never tell me that they chose a medically unnecessary caesarean. Rather, their caesareans were ordered, coerced or bullied by their doctors because labor was too early or too late, mom was too small or too big, baby was too small or too big, mom had too much or too little amniotic fluid or for myriad other reasons sometimes verging on the bizarre. Plus, let’s not forget that many hospitals in our country forbid women who have had caesareans from choosing vaginal births in later pregnancies. As for the woman featured in the article, I’m glad she is happy with her caesarean because chances are she won’t be allowed to opt out of one the next time. Barbara Stratton, BALTIMORE
Nowhere in your rosy article about elective caesareans do you discuss the risks of the operation: anesthesia side effects, infection, mistakes made during the operation, longer recovery, time lost from work for family members needed to support a mother who can’t pick up or carry her new baby, etc. You discuss the cost of lawsuits to doctors who don’t perform the operation but neglect to mention the cost to insurance companies or public funds when a caesarean is done–a cost significantly higher than for a vaginal birth with or without medication. I would expect a higher level of reporting from TIME. Morgan K. Henderson, WELLESLEY, MASS.
After giving birth vaginally, by caesarean and then vaginally again, I nearly lost consciousness reading “Womb Service.” The line “Pretty tidy way to conduct the often messy business of childbirth,” about Euna Chung’s elective caesarean, was most disturbing. Trust me: suffering the effects of major invasive surgery is not a tidy way to do anything. Vaginal birth has been proven to be safest for moms and babies. It is irresponsible for TIME to suggest otherwise. Alana Brown, AVON, N.Y.
