Letter to a Baby Not Yet Conceived - Anonymous Post

The following piece was submitted anonymously as my family and friends do not know that my husband and I would like to try for another child. More controversially, they do not know that we intend to deliver said baby in our home with a midwife. I’m not sure how this will go over with my family and do not want to find out just yet. 

Dear Baby #4:

Last night, Daddy and I watched “The Business of Being Born” and our minds were blown away. We had heard of people having homebirths or water births or using midwives instead of OBs but honestly, it all seemed like hippy stuff to us.

I’m almost ashamed to admit it but I often looked at women who did these things as crazy for risking their baby’s life. For all I could tell it was just for a power trip. But last night it clicked. The realization of just how broken our maternity system is was shocking to me. I sat nearly in tears as I thought over my births in a new light. Our experiences would have been exponentially different if we would have been one of these freaks.

#4, I never thought we’d have you. With three big sisters, (and really only planning on two of them) you’d think we were done. And we thought we were. We really did. But you are in our hearts so deeply right now, no matter how crazy it would be. You are the hope we still hang on to. We have to make sure life works out to fit you into it. Finances and space are two big factors. Your sisters are still too young for us to even think of expanding yet. But this gives us time; important time to research everything we want for you.

I’m sorry I didn’t know more when I was pregnant with #1. I took a few basic classes. I wanted to try delivering naturally but it wasn't an overwhelming passion. I had no idea what the body was capable of and I didn't give mine a chance. I made it to 7 cm (which was further than I really thought I’d make on my own but I progressed quickly and reached this point after only a couple hours of labor.) For whatever reason, I gave up; thinking I still had hours to go. The epidural was placed but within minutes your sister was ready to come out. The nurse insisted I hold her in as the doctor wasn’t near. I hadn’t even seen a doctor yet. Heck, I was just getting settled. A few minutes later, an on-call doctor rushed into the room and out came your sister. She was delivered by the hands of a stranger. I tore even though there was no real reason for it. Looking back, I see it was resisting pushing that caused the extra strain.

I had an epiphany this morning as I dreamed of you becoming a real part of our lives. The doctors treated #1 as preterm. I had an early ultrasound with your sister that dated her as being younger than we thought. I had regular cycles and knew when the exact date of conception. The due date shouldn’t have really been negotiable by that much. But for whatever reason, the ultrasound tech moved the due date back by five days. It was no surprise that I measured ahead the entire pregnancy. And when your sister arrived late in the 36th week, she was treated as a preemie even though she very much came on her own time.

She was healthy but the doctors were scared. I should have stuck up for her but I didn't know I could. I didn't know that as a mom, her rights were up to me before she was even born. I wasn't given the chance to nurse her right away nor do kangaroo care. Her apgars were in healthy range. She had good color though and was breathing just fine. But that’s not how they treated us. With no nourishment, they stripped her down and took her from me for several hours. It was no wonder that she then showed low glucose levels and colder than average temps. Without even giving me a chance to help her, she was whisked away to the NICU.

The experience wasn't what we planned but we got home a few days later and settled into a very comfortable routine. I was lucky that after the separation, she still learned to nurse like a champ. I wore her often. The natural side of me came through and I soon forgot about the emotional pain and what if’s from her delivery. The time came a few years later that we decided to try again. The second time around, I knew I wanted things differently. I had it all planned out. 

And then the egg split.

I know now that this shouldn't have ruined my plans. I had more options but I didn't take them. I didn't know then that I even could take them. Instead I laid in a hospital bed for months on bedrest, was cut open without so much as a try for a vaginal birth. I was ripped away from my family and faced with a threat of endangering my babies at my weakest moment. I was limited in my interactions with my tiny newborns born too early.

In those moments I failed your sisters. Yes, they were born early and I am grateful to the NICU for giving them the extra assistance they needed. Yes, I needed to be off my feet and resting to keep my uterus calm but the constant monitoring just lead to more scares, more internal checks, more irritability, more contractions; it was a vicious and stressful cycle. The c-section was possibly preventable. I know this now. Sister #2 was head down and ready to go. My body could have done it. My doctor didn't trust my body. Since Sister #3 was breech, there’s no way to know what would have happened. I’d like to think she would have happily changed positions and come out head first like nature intended but I know maybe that wouldn't have been the case. 

I wish I would have thought ahead and consulted a doctor who was willing to do a breech extraction. Mine was not. I think I have a good doctor but she likes to play it safe. And while I always leaned towards safe equaling better now I realize there’s a wide variety of “safe.” I was afraid of the idea of having a split delivery with my twins but I never considered the emotional aspect of what would happen after the c-section and after not getting a chance to try.

So baby #4, if there is a you at all, I’m going to do it right this time. I want to know all my options and face all my fears. It won’t be easy. Daddy supports me as well as a wide community of online supporters but the ones closest to us don’t seem to understand. They see you as a risk they don’t think I should take. They think the things I want are kooky. I wish they could read my mind, feel my pain and my emotions, and understand the excitement that you bring to Daddy and I even as just a plan or a thought and not even as a conceived baby yet. 

I often think of you as a rainbow baby. Rainbow babies are created after a loss and most often referred to as a baby after an infant is loss, a stillborn or a late miscarriage of a little one. I didn't lose your sisters. I don’t intend for my pain to take away from that type of pain because I do not know it but I lost part of me during their births, part of me that I’ll physically heal from but emotionally will always be with me. So even though we never thought of having another baby, you were put in our minds and hearts as our rainbow baby.
Midwives like to say that homebirths are 90% excitement and 10% fear. So this is me facing that 10%, going outside of the normal.

Love,

Mommy 

Mommy is an upper twenty something freelance writer and parenting blogger that stays home with her girls in their Midwest home. Her passions are breastfeeding, babywearing, cloth diapering and holistic medicine. She has three beautiful daughters age 4 years and 18 months x 2.

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Welcome to the Olive Garden...

In case you missed it, the American Association of Birth Centers released The National Birth Study II this week.  You can read the article here.  The findings are HUGE!  I want to give you the condensed highlights and then we'll chat....

The study included 15,574 women at 79 birth centers across the U.S. between the years of 2007 and 2010.  This is a respectable sized study.  About 80% of the women were married and about 3/4 of them had at least some college education.  Half of them were having their first baby, while the other 50% had given birth previously.

Here's the awesome part of the study - 94% of the women planning a birth center birth had a vaginal birth!  This means that only 6% of these women had a cesarean section.  It's true, they were all low-risk.  But in the hospital, the rate of cesarean section for low-risk women is 27%!  Read this paragraph again.  I'll give you a minute...

There were no maternal deaths ("I would have died if I would have had my baby out of a hospital!") and the stillborn/newborn death rate was very consistent with other birth places.  In other words, these babies likely would have died regardless of where they were born.

Interestingly, the rate of cesarean birth in the hospitals has dramatically increased over the decades, while it has remained stable - and low - in the birth centers between 4.4%-6%.  The women in this study saved more than $30 million simply by birthing in a birth center instead of a hospital.

According to Rebecca Dekker, "The National Birth Center Study II shows that when women receive midwifery-led care in birth centers, preventable C-sections are prevented...  Legislation is needed to align payment methods and regulations so that we can better promote the proliferation of birth centers."  In other words, if you are low-risk, hire a midwife, birth out of hospital, and demand that insurance cover midwifery care at a birth center!

For years I have said that birthing in the hospital is like eating at the Olive Garden.  Before I go any further, let me just say that I worked for Darden Restaurants at the Olive Garden for nearly 4 years.  They are a fabulous company to work for.  Seriously.  I got vacation, insurance, incentives.  Sometimes I still miss it.  It's also still one of my favorite places to eat.  With that being said....

When you walk in, you are welcomed by the hostess.  Hopefully you don't have to wait too long for a table.  You have a lovely meal, but if you camp out, your server starts getting nervous.  Because of all the refillable items, the server's section only consists of 3 tables in order to give great service.  If he/she is going to make any money, they've got to turn those tables.  When one table hangs out, it hurts the profits of both the server and the restaurant, and the lobby starts filling and backing up, especially if several tables are "camping out."

When you are birthing at the hospital, you simply cannot labor in a room for hours upon hours, or sometimes days.  The lobby (triage) is filling up and your table (room) is needed.  Even the best care providers working in the hospital will tell you to "come in pushing" because they know that women are much more likely to have things done to them to speed things along once they are in the hospital - things that interfere with and interrupt the natural process.

One of the most significant points worth repeating from the study is that low-risk women have a 6% c-section rate at a birth center, but in the hospital, they are more than 4 times as likely to have a c-section, at 27%!  Some of the reasons for higher c-section rates when mom plans a hospital birth include:

* We need your table - i.e. Failure to Progress - Mom has "failed" to progress within her time limit imposed by the hospital.

*  High rate of induction and not allowing labor to start on its own - A first-time mom is twice as likely to have a c-section when her labor is induced.

*  The use of epidurals and IV drugs do affect the course of a woman's labor.  These are not options in a birth center.

*  Baby is more likely to have heart decelerations with pitocin and other drugs in mom's system, causing care providers to worry more - not just about the baby but also about lawsuits.  The what-if factor is huge and a lot of cesareans are performed as a direct result.

*  We cannot ignore the money factor.  C-sections make more money.

*  We cannot ignore the time factor.  The more time the OB is in the hospital, often, his lobby is full over at his office.  Ever wonder why you wait for 3 hours at your OB appointment?  He/she is aware they are getting further behind the longer you are taking to have your baby.  They don't have time to wait around.  (I actually get this one.  I am super selfish with my time.  I can't stand to wait - on anything - and know I'm getting behind with other things.  I would make a terrible midwife for this reason.)

Personally, I believe at the root of choosing hospital birth is the desire for an epidural.  I believe that if women (and men) weren't so afraid, they wouldn't ignore this evidence about the safety of out-of-hospital birth.  Education takes the fear away.

 "You CAN have an amazing birth!"  -  Birth Boot Camp

Now, go enjoy a delicious meal at the Olive Garden and tell them Banned From Baby Showers sent you!

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The Mother-Friendly Cesarean - A Ceci Jane video debut

I have mixed feelings about writing this post.  I don't want to glorify the cesarean or make it look desirable.  It's become so common to elect for a cesarean section instead of experiencing childbirth.  I honestly believe fear is at the root of this epidemic.  I've been there with my first baby - I get it. But that is not the purpose of this post.

This post is about those women who want and have planned for an unmedicated birth.  They dream of the water birth in the quiet, dimly-lit room, where their baby is baby is placed immediately on their chest.  They want to experience the oxytocin and bonding that is held so precious in natural birth circles.  They want to be empowered through their natural birth.

Every now and then a cesarean birth becomes the only option.  I'm not talking about the mom who didn't do any classes and has placed all her trust in her OB who tells her it's dangerous to go past 40 weeks and her baby is too big anyway.  I'm talking about the mom who truly has no other options.  My graphic designer for Birth Boot Camp, who had a bicornuate, or heart-shaped, uterus.  She tried everything possible to get the baby to turn before finding out why her baby couldn't get head-down, or even butt-down.  It broke her heart to have a cesarean.

Sometimes a cesarean is actually even a better option than a vaginal birth.  I bet that surprises many of my readers to hear me say that.  I've been talking with a mom, who, at 18, gave her baby up for adoption.  She had an episiotomy which led to a 4th degree tear, or into the rectum.  For many years, she has lived with a poorly stitched perineum and has had many issues. She had a reconstructive surgery, but is still dealing with problems and pain. Now, at 9 months pregnant, she's been advised to have a cesarean.  She's getting a second opinion, of course, but she is devastated.  She's been preparing for and looking forward to a homebirth.  The doctor explained that the skin and muscles between the vagina and rectum are paper thin and she has a significantly shorter perineum.  He is convinced that the baby will tear things open as he/she passes through.  He said she is certain to be looking at another surgery with probable lifetime incontinence and even leaking fecal matter through the vagina.  Of course, there is no guarantee that is how things are going to go down, but at some point, you are left deciding which surgery do you want to recover from?  Which possible life-long effects from which surgery are you more "willing" to deal with? I am grateful I was never forced to make a decision like that.  I honestly am not sure what I would choose and it's not my place to tell her what I think she should do.  She is informed and she will make the right decision for her family.

The moms that have been in this position are left mourning the loss of what they didn't have - their natural birth.  All the "at least you have a healthy baby" comments often make them feel guilty for being sad about their birth. It's OK to be sad or disappointed.  If the sadness is interfering with bonding or parenting, seek help.  Talking about it with people who understand will help.

If you are in this situation of having an unwanted cesarean, it doesn't have to look so different from the immediate postpartum vaginal birth.  Many women want their baby immediately and they don't want to delay breastfeeding.  My good friend, Ceci Jane, recently filmed a birth video for a family desiring a Mother-Friendly cesarean.  She called me immediately after this birth, so excited!  She said it was amazing, that it "felt" very much like a vaginal birth. I've worked with Ceci on a number of projects, including Birth Boot Camp (read about her version of recording/editing the documentary-style classes), and I knew she had been asked to film this video a few months ago.  I am honored she allowed this debut to take place here on Banned From Baby Showers. The mother and father were treated with such respect and their wishes were honored.  Rather than spoiling this special video, I'll let it speak for itself.  Grab your tissues.


Uriah Nehemiah from Ceci Jane on Vimeo.

So, you've seen the video, but the question inevitably comes up - What makes this a Mother-Friendly Cesarean?  You are always hearing me talk about the Mother-Friendly Childbirth Initiative written by CIMS.  Many of those steps can be applied to cesarean birth as well.  A Mother-Friendly cesarean is a gentle cesarean, for one.  The baby - and the mother - is not handled so aggressively.  The cord is not immediately clamped, but rather the baby receives all of its cord blood.  Mother has the baby handed to her in a matter of seconds.  In this birth video, baby stayed on his mama's chest for a solid 2 hours.  Baby breastfeeds soon after birth, like a vaginally born baby would.  Newborn procedures, including weighing the baby, were delayed until parents were ready.  Like anything else, if the consumer demands things be done a certain way, eventually, we will see change.  If you find yourself in this situation, where a cesarean is the last - or best - option for you and your baby, request a Mother-Friendly cesarean.

Ultimately, no matter how your baby enters the world, you are becoming his or her parents.  We wish a gentle birth for all babies, but so much of that is about the first minutes and hours of his/her life.  We talk so often about natural birth being empowering, but empowerment also comes from knowledge and making informed decisions and having those wishes and decisions respected. Some of the best mothers I know had cesarean births.  You can still breastfeed, co-sleep, and wear your baby. Ultimately, it doesn't make you a better mother just because your baby came out of your vagina.

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Combating Gestational Diabetes

Jenni Rongey, a co-Chapter Leader for the Tarrant County Birth Network, wrote this post for the Banned From Baby Showers readers.  I've known Jenni for a few years - she was Jillian in the BOLD Fort Worth production of  "Birth" two years in a row.  She had a VBA2C almost 2 years ago and you can read her birth stories here. She also works as a birth assistant at a local birth center.  She is a wealth of knowledge and I hope you walk away with a new perspective on dealing with gestational diabetes after reading Jenni's comments.  Thank you, Jenni, for sharing your expertise and story with us here.

"Diabetes has affected every part of my life but none quite so deeply as pregnancy. I have personally experienced many of the complications and risks associated with Type II diabetes in pregnant mothers. Multiple miscarriages, strict diets full of counting carbohydrate to protein ratio, insulin injections, pre-eclampsia , c-section, induction leading to an emergency c-section, babies with under-developed lungs that were separated from me for hours or days after birth.

Funny thing is I’ve also seen a diabetic pregnancy where none of those complications reared their ugly head. That was my pregnancy too. So what changed you might ask? I stopped listening to my doctors list off all the reasons why I was high risk and I couldn’t have a normal, uncomplicated birth. I realized that the only thing that separated me from my friends that had normal, low risk, out of hospital births was that I had blood sugar
levels that fluctuated from high to low and they did not. I just needed to figure out how to control my blood sugar levels without medication. Figure it out I did and like so many of our modern day diseases it was all about diet and lifestyle.

What I want to discuss are the measures a woman that has been diagnosed with gestational diabetes mellitus (GDM for short) can take to help boost her chances of having the birth she wants. Merely getting a birth without all the interventions is an uphill battle for someone with gestational diabetes. It’s even harder if you desire a natural birth or one out of the hospital. The best thing you can do is to educate yourself and keep your blood sugar tightly controlled and educate yourself. Did I mention that you need to educate yourself?

First you should know that gestational diabetes can be readily controlled without medication. It takes some planning and determination to stick with your plan but aren’t the things that are most important in life worth a little work? Let’s get to work.

10 Things You Need to Know to Keep GDM under Control

1. Understand Gestational Diabetes – 
Gestational diabetes is a condition where a woman that has never been diagnosed with diabetes suddenly has high glucose levels in the third trimester of pregnancy. Insulin is an important hormone in the body. Its two main jobs are storing fat for future use and escorting glucose (sugar) into the body’s cells where it can be used for energy. When a woman becomes pregnant her body naturally becomes insulin resistant to a degree. This means that some of her cells start refusing to let insulin do its job. Extra glucose is left circulating in her bloodstream where it ends up being metabolized by the fetus. This is the body’s way to secure a steady stream of energy for the fetus as it grows. By the third trimester the mother’s insulin resistance is higher so that extra glucose can be secured for baby’s fat stores before birth. In most women, the insulin resistance isn’t noticed because their pancreas puts out ever increasing amounts of insulin to keep blood sugar levels normal. However in some women, the pancreas just can’t keep up and despite high levels of insulin in the blood stream, blood sugar levels remain elevated. Being diagnosed with GDM does not mean you are diabetic. It can mean however, that you have a greater chance of developing type II diabetes in the future. Learn to take care of it now and you greatly reduce that risk.

2. Understand the Actual Risks of GDM
• Big Baby Syndrome - Insulin works in the body by taking glucose out of the blood and putting it in cells for energy. It drives glucose first to muscles, then to the liver, and finally to store in fat. If your blood sugar
remains elevated the baby’s pancreas is left to deal with the excess. It will produce extra insulin which will help store glucose as excess body fat. That is how an uncontrolled diabetic mother can have a baby that is
too large. If your blood sugar is tightly controlled this is not an issue. By the way, if you do have a large baby there are several squatting style birth positions that open the pelvis by an extra 30%. This is a lot of wiggle
room. A large baby alone is not a reason for an automatic c-section.

• Low blood sugar in the newborn – If your blood sugar has been chronically high or is high during labor then your baby may be born with low blood sugar. Remember that your baby’s pancreas puts out extra insulin to help get rid of the excess glucose in its blood. When the supply of excess glucose is shut off by birth, the pancreas still takes a while to slow down production of insulin. This can result in low blood sugars. Symptoms of low blood sugar in the newborn can be hard to see but they include irritability, lethargy, excessive hunger, and rapid pulse. For a baby exhibiting signs of low blood sugar the best cure is to put the baby to the breast early and often. Usually no other treatment is needed to help stabilize blood sugar as long as it is not dangerously low.

• Significant increase in interventions – The most dangerous risk of being diagnosed with GDM is merely being labeled as a gestational diabetic.  A woman diagnosed with GDM has up to a 50% increased chance
of induction or c-section just by being diagnosed. She may also be subjected to frequent sonograms, non-stress tests, and other invasive and unnecessary procedures. Many doctors want to induce around 38 weeks to “make sure the baby isn’t too big.” If you keep your blood sugars tightly controlled and within normal range your risk of having an overly large baby is no greater than a woman without GDM. Educate yourself so you can defend your choices if it comes to that. If a natural or low intervention birth is what you are wanting, you will need to be ready to fight for it. The best thing you can do is keep your blood sugar in the normal range. Ready for the how-to?

3. Eat a Diet That Does Not Raise Your Blood Sugar and Insulin Levels.
If a food raises your blood sugar it will also raise your insulin. The pancreas will fight hard to put out extra insulin to take care of any extra glucose in the bloodstream. The damage inflicted by excess insulin circulating in the body is enormous but for the purpose of GDM I will distill it down to one important complication, pregnancy induced hypertension. Insulin raises blood pressure and this is part of the reason that women with uncontrolled blood sugar in pregnancy are at a higher risk of developing pre-eclampsia. So exactly what foods will raise your blood sugar and insulin levels? Glad you asked!

4. Go Grain Free
Grains are the number one culprit in high blood sugar with sugar close behind. Are you surprised that sugar isn’t in first place? Unless you are drinking gallons of corn syrup laden soda and eating Snickers for snack
everyday (and if you are, quit that!) most people consume more wheat, corn, rice, and oats than sweets in any given day. This makes them the number one food to control. Do you really need to cut out all grains, even whole grains?  The answer I’m afraid is yes, at least until you have had a week or two of absolutely normal blood sugar readings. Then add in whole grains, if you must, one serving at a time. Pay careful attention to how you respond to any particular grain. I personally can’t even look at rice without my blood sugar hitting the ceiling but small amounts of corn or corn tortillas can usually be tolerated. If you monitor your blood sugar carefully you will know when you have reached the upper limit of your grain intake whether that is one serving a day or four. Along with grains you have to watch your intake of starchy vegetables, mainly potatoes and peas. White potatoes are the vegetable world equivalent of white bread. Sweet potatoes offer great nutrition with a much lower impact on blood sugar. What about sugar? Obviously sugar needs to be severely limited in your diet (even if you aren’t dealing with GDM.) Have you noticed that most of our favorite desserts and treats pair grains with sugar? Talk about a double whammy. So what’s a pregnant girl to do? Eat fruit…..just kidding! Check out recipes for grain free treats that are sweetened with honey, maple syrup, or other unrefined sugars. There are thousands of tasty recipes on the web waiting for you. If you are the experimental type in the kitchen you can start trying out wheat flour alternatives like almond or coconut flour.

5. Eat Whole, Real Food from Good Sources
Grass-fed meats, wild caught fish and seafood, and pastured chickens and eggs should make up the bulk of your protein. Local, seasonal, and hopefully organic vegetables will give you your best source of vitamins and minerals.  Organic fruit should be eaten in small quantities. I can hear the rumble of, “Sheesh! I’m not made of money,” out there. I know. I’m not either. Figure out your priorities. If you eat a lot of eggs but rarely touch red meat then spend your money on pastured eggs, and go ahead and buy standard grocery store meat. That small amount won’t be your undoing. You get the idea.  Dairy is questionable for some people struggling with blood sugar issues.  Usually cheese has very little impact on blood sugar but milk is actually quite high in sugar (lactose.) It will just take a little experimentation to decide whether or not milk will be an option for you. For those of you that are Weston A. Price devotees, and you know who you are, raw milk generally has less of an impact on blood sugar than pasteurized. Always eat dairy in the full fat form. It will slow the impact on your blood sugar plus the vitamins and calcium in dairy foods require fat for your body to absorb them.

6. Don’t Worry About Fat in Your Diet
If it’s good fat that is. Fats are necessary to human health. Fats feed our brain,  give our cells structure, and keep our skin glowing and wrinkle free. Fats help us metabolize vitamins A, K, and D. Good quality fats are necessary to  properly nourish mom and baby. The problem is figuring out which fats are  good and which are not.  Saturated animal fats from pastured and grass fed  animals are great! Grass fed beef is high in omega 3 fatty acids. Pastured lard  is full of heart healthy monounsaturated fats. If you eat pastured bacon save the grease and cook your eggs in it just like Grandma used to. Butter, cold pressed coconut and olive oil are all good choices that are easy to find as well.  Steer clear of processed vegetable oils, even canola oil. These oils become oxidized and rancid during processing. To hide the awful smell they are chemically bleached and deodorized. Sounds yummy right?

7. Check Your Blood Sugar Often
How can you know if you are successfully keeping your blood sugars level if you don’t check? Get a glucometer and check your blood sugar several times a day. Yes I know it’s tedious but trust me, it’s better than having to inject insulin twice a day. Your care provider should go over the values that you are looking for but just in case, your fasting blood sugar should be below 100mg/dl and under 140mg/dl two hours after a meal. Consider your glucometer your most important tool to helping you stay on track.

8. Exercise! For Real, Do It!
Consistent exercise is a major key to blood sugar control. When you do any exercise you move large muscle groups. To fuel those large muscle groups your body will direct glucose out of your bloodstream and into the cells of the muscles. Exercise can have a large and immediate blood sugar lowering effect.  If you exercise consistently it will boost your metabolism and make you more sensitive to insulin. Over time regular exercise will help to keep your blood sugars lower. I’m not talking about hours every week at the gym. Moderate walking several times a week for as little as 30 minutes has a huge impact on your insulin sensitivity.  Consistency is what’s important here. The more consistent you are the more benefit you will see. If you find that following all of these recommendations isn’t quite getting the job done there are a few more tricks up my sleeve.

9. Great Supplements
Choose quality whole food supplements that support metabolism and lower blood sugar levels. A whole food prenatal may be in your best interest. It is generally believed that people with metabolic disorders, and GDM is one, have a harder time absorbing nutrients. A whole food prenatal vitamin is more readily available to your body. A whole food chromium supplement is a must.  Chromium is a necessary mineral that helps regulate blood sugar. With depleted soils it is impossible to get all you need from food. Cinnamon is another valuable supplement for lowering blood sugar. While you can buy cinnamon capsules, just sprinkling some on your food everyday is a tastier way to get it. Certain brands carry Chromium blends specifically for blood sugar control that contain cinnamon as well.

10. Coconut Oil 
I know I went over fats earlier but coconut oil is a special one. Coconut oil when taken as a supplement supports your adrenal system, boosts metabolism, and lowers blood sugar. You can take up to 3 tablespoons a day if needed. If you have been on a low fat diet then start small. Begin with 1 teaspoon before each meal and work your way up. You may find benefits at a low dosage or you may need to go all the way up to 1 tablespoon before each meal. You can stir the oil into herbal tea or take it straight from the spoon.

As with anything regarding your birth, the better educated you are the better chances you have of getting the birth you desire. Gestational diabetes is not a one-way ticket to a c-section or induction. With some planning and dedication you can have the birth you envision. Happy healthy birthing to you!

*I am not a doctor or licensed medical professional. I have done my research and these are the steps I took to control my blood sugar during pregnancy. If you have been diagnosed with GDM and are currently controlling it with medication you need to start this diet under supervision of your care provider. You will need to very carefully monitor your blood sugars as you wean off of medication."


For more information, I wrote a post about testing for gestational  diabetes earlier this year, including the criteria set by the American Diabetes Association.

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How to Have a Natural Birth

Recently, I had a conversation with someone about wanting a natural birth and how hard it is to get that without a fight on your hands.  She asked the question, "Why can't you just say 'I don't want the drugs.'?"  It was an interesting question, really.  Why is it so difficult in American obstetrics to have a natural birth?

I think there are many factors here.  Fear is at the top of the list.  Fear of pain, fear of lawsuits, fear of the time commitment.  I think loss of control is also a factor.  We like to control everything.

And as much as we glorify the "superhero," we hate her when it comes to birth.  We want her to fail.  Her natural birth makes me feel bad about my medicated birth.  It's easier to believe that no one can do it than it is to believe I couldn't do it. 

The media is at fault here too, but it's largely because they feed the fear.  I have a mom right now doing Birth Boot Camp online classes that was thinking about transferring to a natural-birth-friendly hospital but it's an hour away.  We get this idea from all the sitcoms that the minute labor begins - or water breaks - the baby is going to fall out.  Women and men are fearful of a birth place that is more than a few minutes away. In reality, they could probably cross state lines with plenty of time to kill!

And then there's the noise factor that I've been talking about for years - the majority of the people at the hospital want you to have the drugs because of the noises you might be making, be it moaning, grunting, or even screaming.  Those noises make people uncomfortable when they are not used to hearing them. Personally, I like to hear the noises a woman is making in labor because you can tell how well she is handling things. Those noises let her support team know what she needs. Who needs a vaginal exam?!  Just listen to her!

In addition to making the laboring woman be quiet, the control is now shifted to the medical staff.  They do not have to wait for your labor to progress.  Like magic, they can force your uterus to contract whenever they want it to with pitocin.  What power!  The laboring woman is powerless at this point.

Frankly, people just don't understand why someone would want an unmedicated birth.  I was that way with my first baby.  I couldn't believe it when people would ask me if I was having the drugs.  Of course I'm having the drugs!  I get it.  I've heard a million different reasons for wanting a drug-free birth over the years, but in the end, a couple has to be willing to do what it takes.

HOW TO INCREASE YOUR CHANCES OF GETTING A NATURAL BIRTH

1.  Believe that your body and baby will work together.

2.  Choose a care provider very carefully.  They may make or break this experience.  If you have chosen wisely and you do have a cesarean or are encouraged to induce, you will not second guess them EVER.

3.  Take a thorough childbirth class.  As the founder of Birth Boot Camp®, I believe our 10-week curriculum is the best program out there, preparing both partners for an empowering birth experience. If there is not an instructor in your area, take the online course. After you have an amazing birth, become an instructor!

4.  Communicate with your partner.  This is an opportunity to grow closer together.  It's not every day you bring a baby into this world.

5.  Hire a doula.  She will help you achieve a drug-free birth.

6.  Know your options.  If your chosen birth place is not natural-birth-friendly, RUN.  If you take the attitude of  "I'll stay with my OB this time and switch to a midwife next time," they may set you on a path of cesareans that will make it harder next time around.

7.  Practice relaxation on a regular basis.  Eat well.  Stay fit.  If you become high-risk because you eat junk food and have a sedentary lifestyle, your plans for an intervention-free birth may go out the window.

8.  Surround yourself with people that believe in YOU!

9.  Don't be afraid to ask the hard questions and read between the lines with your care provider.  If you feel like you are jumping over red flags, you probably are.  As long as the baby is still inside of you, you have options.  Regardless of what you may have heard, it's never too late to switch care providers.

10. Read positive birth stories.  Read - and believe - affirmations that you can do this.  You are strong and capable.  Embrace this experience.  It is yours and yours alone.

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Jessica Simpson's Fear-Based Elective C-Section

Another celebrity -- this time Jessica Simpson -- chooses a c-section and it makes the headlines.  Unfortunately, women are choosing to have surgery in order to avoid the "pain" of labor and childbirth every day in America.  I can't help but think that the media and the "horror stories" from friends and family about how hard and awful the experience is contributes to this elective e-section phenomenon. 

Some of the highlights, in case you missed it, are that Ms. Simpson is "terrified of pain" and "too scared to push."  ''The thought of going into labor scared the bejeezus out of her. She was so anxious, she was even breaking into cold sweats at night.  Jessica has no tolerance for pain. She even turned to hypnotherapy to calm her fears about it, but nothing was working.  She desperately wanted to experience the joy of a natural birth, but decided to go with what made the most sense for her.''

She obviously has her choice to elect to have surgery, and I don't really care about taking that choice away from her.  I am more concerned with where the fear comes from, and how do we conquer this fear that is so prevalent in our modern society?

I was scared to death when I was pregnant with my first baby.  I've written his birth story here, but in case you missed it, here it is again.  I was, like Jessica, terrified of the pain. Everything I knew about birth came from the movies and TV sitcoms.  Elective cesareans had not taken off (I wouldn't have chosen that option anyway) so I had to face my fear -- which I bravely did by demanding "my epidural"!

The two things that helped me overcome the fear of natural childbirth were:   
1)  Knowing someone who had actually done it
2)  Education

So, while I am sad that so many women are missing out on the amazing -- and even hard -- experience of natural childbirth, I understand the fear.  If you have had a natural childbirth, talk about it!  Encourage the women around you.  They are strong and capable.  I always believed I was strong.  Now I know I am strong because I faced my fear.  That knowledge is powerful as a woman becomes a mother.  It's powerful in other areas of your life too.  The more you know, the less you fear.  Get educated! 

Conquer your fears!  Each time you do, you become a stronger woman.  I spent my entire life being terrified of bees.  One year I planted a garden, and in doing so, learned how necessary the bees were to the survival of my 20 tomato plants. Without pollination, there would be no fruit.  You've seen The Bee Movie, I'm sure. As the summer went on, I welcomed the bees and simply worked around them.  I overcame my fear because the desire to have my garden flourish was stronger.

Birth is no different.  Get educated, surround yourself with people who believe in you, make informed decisions and conquer your fear!  You are stronger than any fear you currently have.  Put that in your pocket, Jessica Simpson!

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VBAC vs. Repeat C-Section -- by Abbey Robinson

I hope you enjoyed Allison's HBA3C story from last week.  I asked another friend, Abbey, who has also had a VBA3C to write a post about the safety of VBAC versus Repeat C-Section (RCS). Abbey is a doula who writes a blog dealing with vaginal births after multiple cesareans and other interesting topics.  She recently started a Facebook page as well.  She's pretty opinionated too, but VBACs are her passion. 

I've always considered myself an advocate of all things 'natural'.  A bit of a hippie in high heels, well, wedges to be exact.  I've never wanted my children to be exposed to anything artificial or harmful and have always wanted to give them a gentle start to life.  Of course, all of that starts at pregnancy and birth, so naturally I expected and planned natural births and to breastfeed my babies. 

The benefits of natural birth are far to strong to ignore...including but not limited to:

* Baby coming when ready (lower NICU rates, longer gestation means better brain development (ref 01)

* Immediate skin to skin contact (better bonding)

* Delayed cord clamping (increased levels of iron, lower risk of anemia, fewer transfusions, and fewer incidences of intraventricular hemorrhage) (ref 02)

* Immediate ability to breastfeed (ref 03)

* Faster, easier recovery

* No scarring on uterus, so no increased risk of uterine rupture or other effects on future pregnancies

For many of us, the desire to birth naturally is based largely on the emotional aspect of birth.  It's what WE as women want to be able to do.  There are FAR too many emotional benefits to natural birth to list.  The glorious hormones received after an uninterrupted birth have been talked about by advocates of natural birth for many years.  The famous French Obstetrician, Michel Odent says, "Oxytocin is the hormone of love, and to give birth without releasing this complex cocktail of love chemicals disturbs the first contact between the mother and the baby."  He says that any interruption of that process is damaging to the mother/baby bond including any induction or augmentation of labor.  Artificial oxytocin does not have the same effects as natural oxytocin.

Unfortunately my journey to birth took a very medical twist, despite having good information and support.  Fourteen years after my first pregnancy, my natural birth score card read 3 to 1.  That's right, 3 c-sections and 1 natural VBAC (Vaginal Birth After Cesarean -- I had a VBA3C).  Despite the odds, my bond with my babies was strong and I learned to advocate for my own health.  I have always thirsted for knowledge and continued researching risks/benefits of both VBAC and RCS (repeat cesarean section) since the birth of my first child in 1996.  I'm a bit of a sponge with statistics and numbers and love to share that information with others.  I want women to make truly informed decisions about the kind of birth they want, but they can only do that if they are given ALL the information.  I'm sorry if the numbers below make your head spin, but they are SO important...especially in these days where c-sections are treated like lollipops and being handed out to every woman who (thinks she) wants one.  Here's a little of what I've learned over the years.

The risks of VBAC carry the same risks as vaginal birth, but also the same benefits.  The major difference is the increased risk in uterine rupture.  Did you know that women who have never had a scarred uterus can have a uterine rupture?  According to a 12 years study in 1983, the uterine rupture rate in an unscarred uterus is 1 in 16,840 or about 0.006%.   (ref 1)  7 of the 10 cases of rupture were reported in women who either had used oxytocin or prostaglandins to augment or induce labor.

Finding the rupture rate for a scarred uterus is a little more complicated because there are so many variables that have to be considered that can increase risk of uterine rupture.

But let's keep it as simple as we can for now.  In an Australian study of over 29,000 women, the risk of uterine rupture in spontaneous labor without augmentation after one prior incision was 0.15%.  (ref 2)  Once you introduce labor augmenting and induction drugs, the risk of uterine rupture increases from 3-14 fold and jumps to 1.91%.

The conclusion of this study was NOT that women shouldn't VBAC, it was that "careful consideration should be given to the use of oxytocin for augmentation of labour or induction by any method for women with a previous caesarean" Because that's where the true risk lies.

In the summer of 2010, ACOG revised it's VBAC guidelines to say "VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars. ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor." (ref 3)

I read a story the other day of a mother who was attempting a VBA2C.  Her OB seemed supportive up to 38 weeks and then he informed her that she would be having a RCS.  The mother printed the ACOG guidelines and when presented to her OB, he said he had never seen it.  The c-section appointment was cancelled and that mother was given more time.  I suspect there are MANY OBs, nurses, and other medical professionals who don't know about the ACOG statement... sad but true. We often hear about the risks of c-sections, and not many people I know really want to have a primary c-section but after they've had that first one, there is a belief in this area that a repeat c-section is safer than attempting a VBAC.  How true is this?

After you've had your first c-section, you have a choice to have a RCS or to VBAC.  If you are only going to have ONE more child, your risks during your second surgery still skyrocket, but after 2 c-sections, the risks are downright scary. 

Some of the risks of RCS include but are not limited to:

* Hysterectomy

* Blood transfusion

* Placenta accreta

* uterine rupture 

* additional surgery due to hemorrhage

* injury to the bladder or bowel

* thromboembolism

* excessive blood loss

* cystotomy

* bowel injury

* ureteral injury

* and ileus (bowel obstruction)

* the need for postoperative ventilation

* intensive care unit admission

* duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries (ref 5)

* lower breastfeeding rates

* immediate skin to skin more difficult

* delayed cord clamping much harder

* harder/longer recovery

* scheduled delivery means baby could be premature (higher incidences of NICU stays)

Some long term risks are:
* Scar tissue/adhesions (can cause any number of issues, pain, fertility problems, etc.)

* Endometriosis and Adenomyosis can be caused from scarring on the uterus resulting in surgery and hysterectomy years after c-section

The charts below are from ICAN.

1st C-section Risk of hysterectomy: 0.65%
Risk of blood transfusion: 4.05%
Risk of placenta accreta: 0.24%

2nd C-section	1st VBAC
Risk of major complications: 4.3%	Chance of successful VBAC: 63.3%
Risk of placenta accreta: 0.31%	Risk of uterine rupture: 0.87%
Risk of hysterectomy: 0.42%	Risk of hysterectomy: 0.23%
Risk of blood transfusion: 1.53%	Risk of blood transfusion: 1.89%
Risk of dense adhesions: 21.6%

3rd C-section	2nd VBAC
Risk of major complications: 7.5%	Chance of successful VBAC: 87.6%
Risk of placenta accreta: 0.57%	Risk of uterine rupture: 0.45%
Risk of hysterectomy: 0.9%	Risk of hysterectomy: 0.17%
Risk of blood transfusion: 2.26%	Risk of blood transfusion: 1.24%
Risk of dense adhesion's: 32.2%

4th C-section	3rd VBAC
Risk of major complications: 12.5%	Chance of successful VBAC: 90.9%
Risk of placenta accreta: 2.13%	Risk of uterine rupture: 0.38%
Risk of hysterectomy: 2.41%	Risk of hysterectomy: 0.06%
Risk of blood transfusion: 3.65%	Risk of blood transfusion: 0.99%
Risk of dense adhesion's: 42.2%

5th C-section: placenta accreta: 2.33%
hysterectomy 3.49%
in the women with previa, the risk for accreta was 61% (ref 5)

6th (or more) C-section:  placenta accreta: 6.74%,
hysterectomy 8.99%,
in the women with previa, the risk for accreta was 67% (ref 5)

Additionally, the risk of accreta for women who had previa was 3%, 11%, 40% for 1st, 2nd, and 3rd c/sections.  (ref 5)

NOTE: "Major complications" include one or more of the following: uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss. (ref 4)

There was a study done with over 30,000 women having their 1st c/section up to their 6th (or more) c-section over a 4-year period that concluded, "Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery." (ref 5)  This study alone should deter ANYONE from wanting to have multiple c-sections.

If you want more info on the risks and benefits of VBAC and RCS, www.ICAN-online.org is a fantastic place to start.  www.VBACfacts.com is good, factual information.  www.specialscars.org is for women who have had 'different' types of uterine scars, including classical, T, inverted T, J, myomectomy or other uterine scarring. 

http://www.ncbi.nlm.nih.gov/pubmed/21713130  (ref 01)
http://www.bellybelly.com.au/birth/cord-clamping-delaying-cord-clamping (ref 02)

http://www.llli.org/llleaderweb/lv/lvaprmay05p40.html (ref 03)

http://www.ncbi.nlm.nih.gov/pubmed/9166298  (ref 1)

http://www.ncbi.nlm.nih.gov/pubmed/20716251  (ref 2)

http://blog.ican-online.org/2010/07/21/ican-responds-to-new-acog-guidelines-on-vbac/ (ref 3)

http://icanofomaha.webs.com/vbacorrepeatcesarean.htm (ref 4)

http://journals.lww.com/greenjournal/Abstract/2006/06000/Maternal_Morbidity_Associated_With_Multiple_Repeat.4.aspx (ref 5)

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POOP

That's right, you read the title right. Let's talk about poop for a few minutes. Did you know that you might poop when you push your baby out? Most people never think about this, and others are completely obsessed with the possibility of this happening. I've even had one of my couples have a c-section over this topic. She made it to a 7, everything was going great, and she opted for a c-section. She just could never let go of the fear.

Approximately 30% of women poop when they push their baby out. There is a trend I'm starting to see pop up of offering/pushing enemas to women when they are in labor. I got an email from a friend this week and here is a portion of it: "They gave her an enema before starting pitocin because the doctor didn't want to be pooped on. Yes, he personally told the mom this."  Gotta love the OB that does things for his comfort and not the mom's. 

At any rate, the body, typically at the beginning of labor, will naturally get rid of waste.  She'll usually have loose bowels, sometimes even diarrhea.  She should eat and drink throughout her labor though, which means more waste.  And that's ok!  So, along with all the questions I've given you over the years to ask your care provider, here's another one:

"How do you feel about poop?"

If you are super concerned with pooping when you are pushing your baby out, do the enema.  If it makes you feel more confident, by all means.  Know that I am not advocating the enema whatsoever!  In fact, I'd really just like to see women comfortable with their bodies and not afraid to eat and possibly poop in labor.  But, like all interventions, I believe there is a time and place. 

Let's go back to the mom who just can't let it go, no matter how much her husband and care provider tells her it's ok, it's normal.  They don't care if she poops.  There are some other issues associated with this fear.  At the top of this list is sexual abuse.  Pooping during pushing is not about vanity.  I strongly suggest counseling in this situation.  To most, this topic is funny and only slightly embarrassing.  To others, it's completely paralyzing.  

Last I read, approximately 1 in 4 women have been sexually abused or molested.  Poop has the potential to be a big issue for many women -- even one million per year -- about to give birth.  I can't help but wonder about the women who elect to have a c-section and never experience any labor.  It's a question that simply cannot be asked, and yet, I can't help but wonder.  Is sexual abuse a part of their history?  Labor and birth is an extremely vulnerable time in a woman's life.  She is exposed in every way possible.  It's a lot for a woman who has not been abused or molested to come to grips with.  But for a woman who has endured abuse or molestation, vaginal birth  may be much too overwhelming.  

If you have seen Orgasmic Birth, they address sexual abuse and birth in a very tender story.  The woman is terrified to surrender to the power of her birth.  When she does, she comes out stronger on the other side.  If you have not seen the movie, check it out.  It's about much more than just "orgasmic" birth!

What started out as a funny post, took a very serious turn.  You know me, I can't end like this.  So, in class, the mamas planning a water birth always want to know about pooping in the water.  (My water birth is the only birth I didn't poop!)  I tell them that if they are really worried about it, if the dad will just throw a bunch of tootsie rolls in the water at the time of birth, she'll never know if she pooped or not.  (I've never had anyone actually do it, but it would be a very funny trick to play on a midwife.)

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Hospital Policies that Encourage these Outrageous C-Section Rates

Over the years, I have narrowed down the hospital policies that are the biggest problem for moms who want to have an unmedicated birth.  Short and sweet!  Here are your red flags:

1)  The use of continuous Electronic Fetal Monitoring (EFM).  I wrote about this one last week.  This chains mom to the bed.  She's not moving around, helping her baby figure his/her way out.  This policy is applied in nearly all hospital births.  It's very convenient for the nurses, but not for the mom.  Evidence indicates that it is not safer for the baby and the c-section rates rise when EFM is used.  Check with your hospital and your care provider.  If your care provider "approves" intermittent monitoring, make sure that gets written in your chart.  (Just a heads up -- while this improves your chances of not having EFM, it is not a guarantee.)

2)  If your water breaks, you are in bed for the duration of your labor.  They claim this is for your benefit, saving you from a c-section, as the umbilical cord could suddenly slip out, endangering the baby, making a c-section necessary.  The chances of this actually occurring are about .3% of all births.  How can you prevent this from occurring?  Don't let anyone break your water!  This is more likely to happen if the baby is high in the pelvis.  If your baby is low, this is not really a risk.  Also, if this is going to occur, it usually happens when the water breaks. 

A couple other things worth noting that may or may not seem obvious:  You will be on a time clock once your water breaks (find out what that means at your place of birth - usually 12-24 hours), so you really want to do things that encourage the baby to come.  Laying in bed on a monitor doesn't really do that!  Pitocin is usually started after water breaks.  Evidence just doesn't make a lot of sense with this policy.  They say that they are trying to prevent you from having a c-section, but by keeping you in bed, that is exactly where you are headed!

3)  Vaginal Exams every two hours.  The reason women are given vaginal exams are because they have epidurals and can't feel when they are ready to push.  A woman who isn't numb doesn't need to be told how dilated she is or when to push.  Failure to Progress is the 2nd most common reason women have c-sections (2nd to already having had a previous c-section).  So let's add this up:  She's in bed, on a fetal monitor, having vaginal exams every two hours.  She's not moving or using gravity. I know of a hospital midwifery group that hardly ever does vaginal exams, unless there is a medical reason to do so.  This is how it should be.  Many women will stay at a certain number of dilation for many hours and then suddenly dilate in a short amount of time.  Labor is not all about the dilation of the cervix!  Vaginal exams are directly related to the dreaded time clock. 

4)  Does your hospital employ midwives?  This is a big deal.  If there are not midwives at your hospital, only the medical model of care is practiced.  This is the only model the OBs use and the only model the nurses see.  The midwifery model of care views labor and birth as a normal process.  The medical model views childbirth as a medical emergency waiting to happen. They believe that medicine and technology improve the safety and process of birth.  

5)  Does your hospital have a no-VBAC policy?  Then they don't trust birth and they don't read the evidence.

Finally, don't ignore the red flags.   I could go on and on about policies that the majority of hospitals have that are problems for a natural birth mama.  Follow your gut.  There are great places to have your baby.  Seek them out.  Hopefully this list will be helpful on your journey.  Don't be a victim!  Like I always say, as long as your baby is still inside, you have options.  This is your birth.  Choose a birth place that respects your wishes and shows reverence towards your special day.

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Electronic Fetal Monitoring -- Is it really saving babies?

 As Tim McGraw's biggest fan, I subscribe to a number of Country news emails and Facebook groups.  I skip over most of it, but sometimes I'll see something that catches my eye that is not even related to Tim.  As you can imagine, it usually has to do with someone having a baby.

A couple of weeks ago it came across my News Feed that Jewel was showing off her new baby.  She lives in this area of Texas, about an hour from me, and because we have about a 50% c-section rate, I was very curious how things turned out for her.  (I had heard that she had desired a "natural birth.") 

The story goes that she was doing Hypnobirthing -- no details available.  Could have been self-study or CDs, maybe a class.  So I assume that desiring a "natural birth" really did mean an unmedicated birth, not just a vaginal birth.

The article went on to describe how violent the Braxton-Hicks contractions were and put the baby at risk.  Yadda, yadda, yadda... she had an emergency c-section that miraculously saved her baby.


The singer, who studies hypnobirthing, was eager to have a natural birth, but things didn’t work out as planned. When Jewel started having early Braxton Hicks contractions, Kase’s heart rate dropped. She admits, “I feel lucky to be pregnant in the modern age where they could actually tell he wasn’t well during those contractions.”  

In the end, Jewel says her scheduled birth plan wasn’t what was important to the young family. “We felt thankful that we had good doctors and a good hospital nearby, and that everything was OK,” she says. “I’m so lucky that we have a healthy baby boy. That’s all I cared about.”

I can't help but think this poor reporter got his terms mixed up about the contractions, and there's little information to go on from there.

Regardless, how many women have had c-sections that truly believe they were necessary -- that their baby would have died without the surgery?  Countless.  The year the Electronic Fetal Monitor was introduced, we went from a 5% c-section rate to 23%.  Studies have shown time and again that a baby who is truly in distress will be picked up with intermittent monitoring.  (Side note:  "intermittent" means different things to different care providers.  It may mean during and between a couple of contractions per hour, or 20 minutes per hour.  Find out what intermittent means at your place of birth.)

One of the problems with the continuous monitoring is the lack of communication between the birth team and the parents.  Mom is monitored from down the hall, and when a nurse does walk in, she tends to look at the monitor and not the laboring woman.  Another problem is obvious:  mom can't move around and help her baby out.  The baby is left to figure it out on his/her own. 

Problem number 3:  Any time a mom receives drugs of any kind, she'll be put on a monitor to be sure the baby is handling it OK.  This can mean hours and hours of a baby being exposed to ultrasound.  That's what Electronic Fetal Monitoring is -- ultrasound.  I've written posts on the risks of ultrasound in the past.  Click here and here and here.  You need to decide how comfortable you are with this intervention.

Problem number 4:  The biggest problem of all is simply that they have to do something with the results of the readout.  Take a baby that has a cord around the neck, for example.  This baby will have decels of the heart rate on the printout.  They aren't sure why the baby's heart rate is dropping, but better safe than sorry, right?  Lawsuit alarms start going off and a c-section is performed.  The baby is fine (Jewel's baby looked great!), but there is this perception -- or defense mechanism -- that thank goodness the c-section was performed and saved the baby. 

Was the baby ever in trouble?

We'll never know.  But now, because it's so hard to find a VBAC-friendly doctor, we've put this mom on a c-section path for all her children -- unless of course she becomes informed of her VBAC options.  As an OB, this is exactly where I want her.  Easier for me and twice as much money.  Few women will question the c-section because it makes her look like a bad mom.  She trusts her doctor.   It's easier to believe that the surgery saved the baby.

Another side note:  The cord around the baby's neck occurs in about one in three births.  When a c-section is performed where the cord is around the neck, the OB often makes a big deal about it, making the parents feel like this was very dangerous.  It's not.  The OB or midwife, after the head is out, will simply lift it over the baby's head.  It could be wrapped around the neck several times!  The most I've seen from one of my student's was 4 times!  Had she stayed with her original hospital and OB -- who required continuous monitoring -- she assuredly would have had a c-section.  Instead, she had a fabulous water birth with CNMs at a different hospital.

So, I feel bad for Jewel.  Maybe her baby really was in distress, but I suspect that the doctor didn't want such a public birth taking a chance at going sour.  Given the high c-section rate in our area, perhaps he was less comfortable with (unmedicated) vaginal birth than cesarean birth.  He knew he could perform a mean c-section and spin it like he saved the baby.  Again, just me speculating.  I do believe that she was likely another victim of our broken maternity system and doesn't even realize it.  While I always advocate for women being informed of their choices in childbirth, sometimes ignorance is probably quite blissful.

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