Friday, April 24, 2009

Pitocin on the brain

I've got Pitocin and induction on the brain. In large part because I'm about halfway through Pushed, by Jennifer Block, and just finished reading about the consequences of Pitocin and labor induction. Here are some sobering excerpts...
"A British midwife told a researcher that the sounds women make when they're on artificial oxytocin [Pitocin] are hauntingly different: 'It's a panic, it's a scream and it's different from the noise they make when they're working with their bodies. . . . It sounds like someone's being murdered'" (p. 135).

"And with an epidural deadening the body's natural pain threshold, staff can keep upping the dose, which can lead to contractions that fire like a machine gun or that last for minutes, during which time the fetus is oxygen-deprived. This is called hyperstimulation. It is not uncommon and would be considered a trauma--beyond what is normal" (p. 137).

"A recent ACOG survey found that in 43% of malpractice suits involving neurologically impaired babies, Pitocin was to blame" (p. 137).

"Even Williams Obstetrics offers a sobering history: 'Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions'" (p. 138).

"A 2004 study out of Australia found that autistic children were twice as likely to have been born without natural labor, either by elective cesarean or induction" (p. 139).
Pitocin use in U.S. hospitals has increased alarmingly in the past couple of decades. In 1990, only 9.5% of labors were induced. In 2006, in a study of 5500 low-risk, first-time mothers, 40% were induced and 70% received Pitocin at some point during labor (see Pushed, p. 5-6).

I can see these stats reflected all around me. I know very few women who have given birth without Pitocin dripping through their veins. If it's true that 70% of low-risk first-time mothers are given Pitocin, then it's no wonder birth horror stories and epidural use are the norm. How strange that so few women know what normal birth actually feels like. Instead they have a warped and painfully skewed misrepresentation. We are human beings, but yet so far removed from the most basic human experience.

The truth is that we really don't know how these highly-medicalized births may be influencing and possibly damaging our society. Oxytocin is the hormone of bonding and love, so some suspect that these births (virtually devoid of natural oxytocin) may be partly to blame for the increased violence, autism, and other mental and psychological disorders running rampant in our modern world. Pitocin (and cesarean sections) may also influence how we bond and how we respond to our children as parents.

I've never had Pitocin in labor, but I was given Pitocin through my IV following my first daughter's birth to help slow my bleeding. It wasn't until a couple of weeks ago that I had an epiphany about that Pitocin drip. It's almost certain that once Pitocin was introduced into my system, my body stopped or slowed its own oxytocin production. Artificial oxytocin doesn't produce the same bonding effects as the hormone produced by our own bodies. It wasn't until roughly a week after her birth that I "fell in love" with my daughter. I thought there was something wrong with me... why didn't I love her right away? I'm now quite certain that Pitocin interfered.

There are certainly plenty of women who fell in love with their babies at first sight even with Pitocin or cesareans. But not all women do. Everyone's individual body chemistry is unique. If I could struggle even having had an unmedicated, wonderful birth experience, I have to wonder what it would have been like for me if I'd had drugs or a cesarean... I shudder to think where those paths might have taken me...

Then I contrast those struggles with my most recent birth, and I'm in awe. As my births have gotten progressively more "natural," bonding has gotten progressively easier. And my parenting style has gotten progressively more responsive. I spent the first couple of weeks after my son's birth feeling blissed-out and totally and madly in love with him. In fact, I could hardly bear to be separated from him. What a change from my Pitocin-jolted postpartum experience!

Pitocin has its time and place. But there's no question that it--and the droves of women and babies receiving it needlessly--are being abused. Will we stand by and let this abuse continue?

Saturday, April 18, 2009

The slideshow (finally)

I spent hours working on this today... while my baby boy ate and slept (and I neglected the rest of my family). I should be doing relaxing things like making birth slideshows, right? ;-) This is definitely more skin than I'd show in public on a regular day, but I tried to keep it as G-rated as possible. Enjoy!

HUGE thank you to Cassie and Brooke for the photos!

To view my birth slideshow, click over to this post on my new website!

Hodgepodge

I've missed this blog. And I've had a lot of things I've wanted to post here. But my poor baby boy was somehow exposed to Staph and contracted a horrible infection (bullous impetigo), so we've been preoccupied with that. Fortunately, he appears to be nearly back to normal!


Here's a quick hodgepodge of things I've been wanting to share...

International Midwives Day Celebration


If you live in AZ, be sure to attend this awesome event. If you live elsewhere, hopefully your local birthing community is planning something. If not, maybe you could plan something yourself! Here are the details:

WHO: Midwives, Families, Doulas, Childbirth Educators, the Birth Community, and anyone interested in supporting midwives and learning more about the Midwifery Model of Care

WHAT: A Celebration of Midwives, including a potluck (bring a dish to share!), raffle with prizes, kids area, maternity and children's clothing exchange (bring your stuff!), and informational booths

WHERE: Papago Park, 625 North Galvin Parkway, Phoenix, AZ 85008, Ramadas 9 and 10 (Please park in Phoenix Zoo Parking Lot)

WHEN: Tuesday, May 5th From 10 a.m. To 2 p.m.

WHY: Midwives provide the highest level of healthcare to the pregnant women and families they serve. Let's get the word out and celebrate these amazing women!

An Award for Ina May

Ricki Lake and Abby Epstein (the creators of "The Business of Being Born") will be presenting Ina May Gaskin with their first "Best Birth" Award on May 5 in honor of the huge contribution she has made to American midwifery and maternity care. As part of the presentation of their award, they want to present Ina May with a large donation toward her Safe Motherhood Quilt Project and her efforts to raise awareness about preventable maternal deaths. Ricki and Abby will match every $5 donated. Please consider making a donation! Here's how:
Please make your $5 donation for Ina May via paypal.com to the account barrancaprod@gmail.com. If you prefer to send a check, please make it out to "Business of Birth LLC" and mail it to: Business of Birth, 15 W. 11th St. #3A NY, NY 10011. Email info@thebusinessofbeingborn.com if you have any questions.

Birth Models That Work

I really wish I had a spare $65 to order this new book!

Courtesy of my 3-year-old

In reference to her baby brother: "Mommy squished his head out. Like a big poop. And the midwives catched him. And then they washed their gloves 'cause they got all messy."
Birth Photos

My doula brought over a disc with my birth photos last week! I've selected the "appropriate" ones for public viewing and plan to make a slideshow (or something) soon. Stay tuned for those! :-)

Sunday, April 5, 2009

My first home birth

Sorry to keep you waiting, but I ended up remembering more details I needed to add. And then the editor/perfectionist in me had to revise and rework it a few times. It's still not perfect, but I knew I'd be cruel to keep you waiting any longer. (I won't have the photos from my doula for a few days, but I will throw in a few of the snapshots we took.) Here it is... unabridged and uncensored with all the gory details... :-)

Wednesday, April 1, at about 3:30, the girls and I sat on my bed with a pile of books to read. At about 3:45, my three-year-old needed to use the bathroom. As I stood to go help her, I felt a trickle of warm fluid that had “ruptured membranes” written all over it. Over the next few minutes, I could feel my heart racing. After helping my daughter, I used the bathroom myself and felt more fluid come out into the toilet. I could see that it was tinged pink and had a distinct smell that immediately took me back to my previous births.

First, I called my husband and told him. “Are you serious?” he said. He said he’d be home as soon as he could. This wasn’t what either of us had expected. We had been so sure that this birth would get started in the middle of the night (like my other two births)—it never crossed our minds that it could be in the afternoon. When my water broke before my oldest daughter’s birth, my labor had started right away, so I thought I might start feeling contractions very soon. I hadn’t bargained on my girls being awake during the birth, so I started brainstorming what we’d do with them.

Then I called my midwife, Mary. She didn’t answer, but then she called me right back. I explained what had happened, and she said to call her back in twenty minutes and let her know if I had started feeling any contractions. We kept in touch every 20-30 minutes over the next while as I waited for labor to start and monitored the baby’s movements. I also called my doula, Cassie, and Kimball and Brooke (my brother and his wife), to let them know. They all said they’d come as soon as they could.

Meanwhile, I began a restless nesting frenzy—cleaning clutter off the countertops and wiping them, emptying and loading the dishwasher, starting a loaf of bread in the bread machine, tidying up the family room, and thawing some hamburger for meatloaf, etc. I also took a few moments to update my facebook status and blogs to let friends and family know my water had broken. After my husband returned home, I had him listen to the baby’s heartbeat to reassure me. He has always been able to hear my babies’ heartbeats by sticking his ear up against my belly. The baby sounded great and put my cord prolapse fears to rest.

Kimball and Brooke arrived at about 5:30 followed by Cassie at about 6:00. My husband kept the girls entertained and Kimball watched a movie while I finished getting dinner ready. Cassie and Brooke kept asking if they could help with anything, but I was so restless I just wanted to stay busy and didn’t know what to suggest for them to do. We chatted and enjoyed each other’s company, and I shared my mixed feelings—wanting labor to get started but simultaneously willing it to wait. As the sun began going down, I groaned jokingly, ‘cause I was sure that my labor would probably kick-in once it was dark, and I had to admit I was nervous about what I was in for. I paced around a lot, and kept asking everyone, “Is it hot in here?” I turned on the air conditioning.

Sometime between 5:30 and 6:00 I felt a mild contraction or two—very far apart and brief. I kept talking to the baby, “Wait… let me eat dinner first!” And I also hoped he’d wait until we could get the girls to bed. At about 6:30 I began having regular contractions, so Brooke and Cassie started timing and keeping track of them for me. After I’d had several within 7-10 minutes of each other, I called my midwife to let her know labor had begun. She said to call her back when they were regularly 6-7 minutes apart and lasting longer. It was about this time that we sat down to eat. I was cheerful but joked with everyone about my fears—“I know what I’m in for… and that’s why I’m scared!”

After dinner, my husband hurried the girls to bed, and I called my midwife. Cassie and Brooke helped me get the bedroom and bathroom ready for the birth—putting shower curtains and a set of unloved sheets on the bed, spreading plastic drop cloths on the floor, and moving the birth pool into the bathroom. My three-year-old walked out of her room as she was getting ready for bed and saw us putting the plastic on the floor. She said, “Mom, are you going to paint your room?” We got a kick out of that. I went in to have goodnight prayers with the girls and give them hugs, shouting across the house to let Cassie and Brooke know when I had a contraction. At that point, I turned down the thermostat quite a bit, and then changed out of my regular clothes and got into my pre-designated birthing outfit—sports bra for support, white tank top to stay cool and somewhat modest, and a loose and comfy skirt for “easy access.”

Labor started to really intensify at this point. Cassie suggested getting on the birth ball for some lunges or hands and knees to facilitate the baby’s rotation for optimum fetal positioning, but I was wary of encouraging labor to progress any faster until my husband was finished getting the girls to bed and my midwives had arrived. Between 8:40 and 9:00 I had several contractions about 4 minutes apart and lasting two minutes each. I decided to call my midwives again and let them know things were really progressing. They said they were only about a block away. At this point I realized it was too quiet, so we put my birthing cd on quietly. We played it through 3 or 4 times over the course of the birth.

I spent most of this time doing what my body told me to do… which was pacing the floor of my room back and forth. I took a bathroom break and found myself blind-sided by an intense contraction that necessitated some deep breathing as I sat on the toilet. It wasn’t much longer before my husband emerged from the girls’ room. Thank goodness… I needed him!

The midwives arrived at about 9:00 and began setting up their equipment and filling out paperwork. Now that everyone was present and everything was in place, I finally consented to getting some use out of the birth ball. I draped my upper body over it and rocked with my knees on the floor while my husband and Cassie applied counter-pressure to my back. After a bit, Nedra (my other midwife) wanted to check my cervix and listen to the baby during and after a contraction. Cassie had predicted earlier that I’d be 5 cm when the midwives came, and she was right.

Reclining on the bed while she checked my cervix was extremely uncomfortable, especially during a contraction. Being upright and mobile had made labor so much more manageable. It made me think of all the countless women who spend most of their labors strapped to a bed in the very position that had been most uncomfortable for me. No wonder they need epidurals!

I spent the next while pacing the floor some more. When contractions came, I would grab my husband and lean on him in a sort of slow dance. The midwives had gone downstairs to prepare some more things or give me my space. Cassie and Brooke sat on the bed and birth ball. I think they both felt a little unsure what to do… wanting to be helpful, but also wanting to respect my space. I was grateful for their supportive presence but felt, at that point, able to cope fairly easily with the contractions, so I didn’t really need them to engage in the labor much yet. We were all still cheerful and chatty between contractions at this point. Cassie and Brooke kept saying how quiet I was. I assured them they’d get to hear me make some noise… no question about that! I told them it wouldn’t be long before I’d be zoning out and unable to answer any questions.

Around this time I drank some Gatorade and ate some of the peanut-butter cookies Cassie had brought. Then a few intense contractions finally had me moaning as I leaned on my husband, so I asked for the midwives to check me. This was probably around 10:00. I was discouraged when they said I was still only a little more than 5 cm, but they started filling the birth pool. Mary suggested that I spend a few contractions on my left side on the bed and thought that would get me far enough along to get into the pool. Then the midwives headed back downstairs. So I lay on my left side facing my husband and holding onto him. Cassie put pressure on my right hip through the contractions—it made a big difference. Those few contractions on the bed were definitely moving things along. Mary was right. And I was getting louder! I guess the midwives could tell by the noises I was making that I was ready to get into the pool, so they sent up their assistant, Hayley, to let me know.

I decided I wanted to use the toilet before I got in. As soon as I sat down, a giant double-peaked contraction rolled through me. I grabbed onto my husband, who was standing in front of me, and moaned my way through it. As soon as it was over, I stripped down to my sports bra and hopped in the warm water. My husband knelt outside the edge and Brooke and Cassie also joined us in the bathroom. Not long after I got into the water, Mary asked if I felt more strongly about avoiding a tear or giving birth in the water. I told her I really didn’t want to tear, but I didn’t have an agenda about where I gave birth. She recommended delivering on the bed so they could more easily protect my perineum. She came in periodically to listen to the baby’s heartbeat during contractions. I knelt in the water with my legs spread out, leaning on the edge of the pool and holding onto my husband. During contractions I moaned and breathed (or tried to keep breathing). Cassie put counter-pressure on my lower back. She kept telling me over and over, “You’re doing so awesome, [Busca].” I don’t think I reacted much, but her positive words really helped. Mary asked at one point if I felt like I was getting ready to push. I didn’t yet.

I could tell I was in transition when I found myself reaching my limit. It was at this point that I turned to God. I don’t think there is any other physical experience that brings a person closer to the veil between earth and heaven than childbirth—particularly the 7 cm to delivery span. I silently cried to God: “Help me!” My mind wandered back and forth between my present physical surroundings and an otherworldly distant space. Somewhere in that space I found myself pleading, “Catheryn, I need you now!” I don’t know if it was her voice or my own that whispered in my head, “It’s almost over. You’re almost finished.”

After a few long double-peaked contractions, and my loudest noises yet, one of the midwives asked me to turn onto my back in the water so they could check me during a contraction and listen to the baby. (My eyes were closed for most of this period, so I don’t recall who was doing a lot of things.) The combination of my position and the midwife’s fingers inside me made the contraction horrendous. I writhed and wailed through it. I remember feeling my husband massaging my shoulder and I grabbed the hand I found at my left (apparently it was Cassie’s). I was 8 centimeters at that point. Mary suggested having two more contractions in the water and then moving to the bed. They also said I could turn back onto my knees, but another contraction hit me almost immediately, and I was in too much pain to try to move. My husband’s soothing touch and the words “It’s almost over” playing over and over in my head are what carried me through to the end.

Mary listened to the baby again during a contraction. Then she left the room and came back in and said, “This baby’s telling us he needs to come out, so after the next contraction let’s get you into the bed. We need to get this baby out.” As soon as I was able, I lunged out of the pool, tore off my sports bra (Mary said we wouldn’t want any wet clothes to touch the baby), and crawled on hands and knees across the bed as people threw towels over me. I moaned and wailed as more contractions rolled through me. Mary firmly got my attention, had me turn onto my bottom so she could check me and listen to the baby, and reiterated calmly again, “This baby is telling us he needs to come out now. You only have a lip of cervix left, so with the next contraction I want you to push. I’m going to protect your perineum, don’t worry.” My husband sat to my left and Cassie was at my right. The midwives had her putting a tube of oxygen by my nose. I kept turning away because it was irritating me, but then my rational mind kept telling me to stop it because obviously the baby and I needed it if they were having her give it to me. Really bizarre tug of war between my animal and rational minds!

I remember Mary saying something about the umbilical cord. But she was calm and cool, so we weren’t overly alarmed. My gut told me everything would be fine as long as I followed her instructions. My visions of what the delivery would be like were definitely out the window. At this point I really didn’t care if I tore or what position I was in or waiting for the “urge to push.” She said my baby needed to come out fast, so I was willing to do whatever it took to make that happen. I was also just so glad that the process was nearly over that I was thrilled to do anything to make it end faster.

Mary squirted olive oil over my perineum and applied warm washcloths. In between pushes she tugged around the edge of the opening, stretching the skin with her finger. She told me again to really push so we could get the baby out quickly… even urging me to keep pushing between contractions. I was making lots of noise, clutching onto my husband and Cassie (my brother downstairs joked later about the “dying cat” he heard). Soon I heard everyone commenting on the baby’s hair… “Lots of hair! He’s right there, [Busca]!” Perhaps it was Mary’s oil and hot compresses, but I never really felt the “ring of fire.” I didn’t even really know the head was out until I heard someone say, “His head is out!” Then Mary said (smiling), “He’s doing great, he’s rotating now…” and I did feel his shoulders come out… wondering to myself for a moment if they were going to get stuck ‘cause they felt so big. I pushed a bit harder and they slid out just fine. Then Mary said, “Reach down and pull out your baby!” I grasped onto his warm, slippery shoulders and pulled him up onto my chest. It was 10:55 pm on April 1—an April Fool’s day baby!

At first all I could see was the top of his dark-haired head and his slippery arms and back. My husband and I touched and rubbed him—alternating between smiling at each other and staring at our baby—as the midwives draped a towel over him. I breathed quickly in and out, saying something like, “Oh my gosh!” and then, “Is he OK? Is he OK?” Mary smiled and calmly said, “He’s just fine! He’s doing great!” Everyone started talking and smiling and taking photos. My husband said he felt a wet tear roll down his cheek and watched it land on my shoulder.

(Mary later told me that the first thing he did after he came out was poop—an indication that he had been stressed—but his APGARs were good… 8 and 9. She also said she really didn’t know why his heart rate was dipping with the last few contractions, but she said it’s possible his umbilical cord was getting pinched somewhere. She said there was only a very subtle indication of distress, but after 30 years of experience she has learned how to recognize those little indicators very early on and how to take swift action to prevent major complications. Thanks to her expertise, everything went beautifully.)

After a couple of moments, my baby boy started making little noises and let out a little cry. When I flipped him over to cradle him in my arms, he peed on me! That’s when I mentally verified that he was, in fact, a boy. Around this time, Cassie commented on the music: “What a perfect song for this moment!” (or something like that). I hadn’t even been paying attention to the music, but then I listened… it was “Calling All Angels” (Jane Siberry/k.d. Lang).

Mary examined my perineum, and I was flooded with relief when she said, “No tears! What a great looking bottom!” I was so incredulous, I had to ask, “I didn’t tear?!” She said, “No! Just a tiny little scratch! Look at that beautiful bottom, Nedra!” I looked at my husband and smiled with every ounce of my being. He smiled right back, “You did it!” Woohoo! Even after pushing fast and hard for less than five minutes!

Mary and Nedra monitored the umbilical cord and helped my husband cut it when it stopped pulsating. Within a few minutes, I pushed out the placenta and Mary checked it and showed it to us. Then we began our first feeding while Mary, Nedra, and Hayley cleaned-up and emptied the pool. While I nursed, I ate a piece of warm buttered bread from the fresh loaf out of the bread machine. Yum!

After we finished nursing, Nedra did the newborn exam and weighed and measured him. He was just the size Mary had predicted at my last prenatal appointment—7 lbs, 8 oz and 19 and ¾” long. My husband put a diaper on him and held him officially for the first time with a huge smile beaming on his face. We took some more photos and thanked the midwives again and again. It had been my fastest (about 4 and a half hours) and easiest birth yet. It was the best and easiest for my husband as well. He was so proud of himself that he never once felt light-headed or queasy, even when he looked at the placenta.Hours later, after Cassie and the midwives had gone home, and we finally went to bed, my husband crashed instantly, and our baby boy slept between us, but I was wide awake and riveted. No doubt the lingering cocktail of birth hormones flooding my system were responsible—adrenaline, endorphins, oxytocin, prolactin, etc. Instead of sleeping, I spent the night watching every movement, listening to every breath, memorizing the shape of every feature on my little sleeping son’s face. With every moment that passed, I fell further and further in love with him. And the more I hold him, gaze at him, and feed him, the deeper that love grows. I don’t know if I’ve ever been so happy.

Here's the question

I stayed up way too late tonight finally writing my birth story. It took me four and a half pages in a word document. So here's the question... do you want it all? Or should I condense it? Cast your vote in a comment. :-)

And... for fun... here's a picture of my girls enjoying their favorite new toy (the birth pool)...

Friday, April 3, 2009

I should be sleeping

But I decided to check email while feeding Bubby and saw that my doula/photographer had sent a sneak peek of the photos from my birth. I haven't had the time or energy to write the birth story yet, but here's one sweet birth photo to whet you appetites... thanks, Cassie!Comfy clothes sure beat open-back hospital gowns! ;-)

Thursday, April 2, 2009

Bubby Boy!

Definitely no joke! :-)

Here he is!Born last night (April 1) at 10:55 pm, 7 lbs 8 oz, 19 3/4" long.

Fun fact: the first time I held him he peed on me. :-)

I'll post more pics and details soon!

Wednesday, April 1, 2009

Ruptured membranes

AKA My water broke at 3:45... :-)

I'll keep you posted.