Belly Tales

Four pharmacists were suspended in Illinois for refusing to fill prescriptions for emergency contraceptive (Plan B). ABC has the full article here.

Just a few thoughts, to counter all of the doubts and questions I was asking a few posts ago. I saw a beautiful birth this morning. The woman had high blood pressures (150s/80s - 160s/110s), but her pre-eclamptic labs had come back negative, and she didn’t have any of the toxic signs or symptoms that often indicate preeclampsia (blurry vision, headache, epigastric pain, nausea, vomiting, protein in her urine, etc etc.), although her doctor had decided to treat her as if she did, just to be on the safe side. She was 37 weeks and 1 day, just barely term, and her body really wasn’t ready to go into labor at all, so naturally, she had every intervention under the sun. Instead of using cytotec or cervidil (prostaglandin gels that help ripen the cervix), her doctor decided to use a balloon catheter to manually stretch her cervix to three centimeters, and then she got more pitocin after that. Epidural, foley catheter to drain her bladder, oxygen mask on her face because the baby started having variable decels (surprise surprise, the cord was wrapped once around the neck, loosely), magnesium for the high blood pressure, epidural top-off because she was in transition, a small median epsiotomy to crown it all, and you know what? It was still a beautiful birth. The love in the room was overwhelming, and an absolute joy to watch. The husband was the woman’s rock, she clung to him through every contraction, and he was constantly whispering words of encouragement in her ears—we both were, in fact, and she pushed with such strength and determination that the baby was out within fifteen minutes from the start of the 2nd stage of labor (the pushing part). Both the mother and father were crying as the baby was born. The head crowned, and then slowly emerged, and the little one started screaming immediately. She was tiny and pink and adoreable, waving her arms around in outrage, Apgars 9/9, sweet little peanut of a baby, only 5 lbs 5 ounces. So, hospitals…yeah, we do a lot of things that don’t need to be done, and it’s infuriating, and disappointing, and frustrating and sad, but amazingly (miraculously, even) the beauty of birth is still there, shining through all of the unnecessary interventions. Modern technocracy hasn’t yet found a way to dim the miracle of it, and in so many ways, the manner of the birth is so much less important than the fact that the baby is being born, period (although, of course I still think that the woman’s satisfaction with the experience, and trying to make the birth as high touch, low-intervetion as possible will always be important and worthy goals). But birth is birth is birth. I can’t imagine ever seeing a healthy birth (no matter what the circumstances) and not thinking that it was beautiful, although some births you’re just swimming in love, like the onen I saw this morning, and that certainly makes the beauty glow all the more obviously. Ahhh. *contented smile* It was a long, gorgeous night. I’m off to bed.

Another birth story! Goodness, it’s raining babies. yay! Thank you, Heather and Gabe, for sharing your awesome (and action packed!) story.

When it came time for my first yearly exam after moving to New Jersey, I went looking for a new obstetrician. My husband and I were hoping to have a second child in the near future. I picked a doctor based on location and some advice from my mom. She said, “Go with a male gynecologist, and you’ll never be kept waiting in the office.” I liked him instantly. He said, “I don’t like to tell women what to do. And I especially don’t tell women what to do when it is their second pregnancy.” (Read on …)

One exam down. Two to go. One massive paper to finish. And a final discussion question to answer for Research.

I have one week left to accomplish all of this. The paper and discussion point are due next monday. The two exams are next Tuesday. My hope is to finish the paper today or tomorrow, and then I can start focusing on studying for the exams.

I can’t wait to have all of this DONE. I’m very ready for the semester to end.

I’ve been feeling very frustrated lately about a lot of the choices I’ve made (not all of them school or work related, but certainly a few of them are). I feel like I will never be a midwife. Yes, I know I’m in midwifery school, and that the eventual outcome will be me as a midwife, but everything we’ve done this semester has been so medical: primary care, health assessment of women. I’ve learned more about hyperthyroidism and breast disease and urinary tract infections than about pregnancy and birth. Next semester I’ll be taking antepartum and well-woman gynecology, so at least in antepartum we’ll be dealing with pregnant women, as opposed to non-pregnant, but even so…labor and birth is still a long way off. Sometimes I wonder if I went about this the right way. My heart lies so clearly with homebirth, and being a homebirth midwife someday, but the path I chose is going to teach me a lot about hospital birth, and the two are completely different species. I’ve seen hundreds and hundreds of hospital births in my work as a nurse. After a certain point, they’re all the same. The women get epidurals, they watch TV, they polish their nails, their water is broken, they get pit, they push on their backs, the doctor cuts an episiotomy, the baby is born, usually everything is fine, and sometimes, if you’re lucky, you have time to help the mother nurse before she is whisked away to postpartum. Sometimes I am able to make a huge difference in a woman’s birth, but a lot of the time, she doesn’t want anything different. She wants to be treated with care and respect, certainly (and sometimes it is a real fight for her to get even that from her caretakers), but she wants exactly what she thinks her friends have had—she wants that hospital experience. She wants the ritual of birth in a hospital, the rite of passage we’ve developed: the hospital gown, the epidural, the painful stitches and ice packs afterwards, the grandparents and husband looking so cute as they peer at the baby through the glass of the nursery wall. 90% of women in this country give birth in a hospital, and most of them are perfectly content to have thier babies while numb up to their waists; a healthy baby and minimal pain is all they desire from the experience.

Birth can be so much more than that, though! I’ve seen the rare natural childbirth in the hospital, and I’ve seen several births at a local birthcenter. I’ve seen the woman in transition, unmedicated, her face glistening with sweat, her body glowing, working harder than she’s ever worked before, her eyes with a dreamy, far away look. I’ve seen women overcome the pain and the relentlessness of the contractions. I’ve seen them rise above, and do something they dind’t think they were capable of. I’ve seen births where I am so obviously in the presence of Deity. I’ve watched babies crown, and sometimes it’s like staring at the unmasked face of the Goddess. Having birth while medicated is like having meaningless sex your entire life, with someone you don’t care about and aren’t in love with, and thinking that that’s what sex is, without ever once dipping into the Mystery of it, into the incredible beauty of two souls entwined, without ever once making love. It’s the same kind of energy. Birth is making love in a different way—and who would want to make love while numb up to their waists? True, this may not be the best metaphor in the world, and true, birth is not always (or even often) a pleasurable experience, but it’s still one that I think you should feel.

When I started my work in the hospital, I was excited about being able to reach so many women. I knew that the majority of women give birth in the hospital, and I felt like that’s where my presence would make the most difference, but now I am starting to wonder. By the time a woman gets to the hospital, she’s already taken steps down a road that’s very difficult to get off of once you’ve started down it. If I want to reach out to women and help them have better births, I should probably be reaching out to them before they even get to the hospital. Meeting them at the doorstep and telling them I’ll be their nurse is probably not the best way to affect change. Educating them before they’re pregnant…teaching them about other roads before they’ve made their choice…would probably much more effective. So many women don’t even know that there ARE other options, let alone that they would want them. How do you open women’s eyes?

And of course, there are those women who don’t want their eyes open. Which is fine. That is their choice, and if you are committed to caring and respecting women, that includes respecting their choices. When I have patients like this, it’s so easy to be their nurse, and give them exactly what they’re looking for: make the usual banter, ask them what they’re naming the baby, explain what the epidural will feel like—and that’s all it takes to make them so satisfied with the experience! If my path is truly to become a midwife, and not a childbirth educator, then maybe what I really need is to apprentice myself to a homebirth midwife. Maybe I shouldn’t be pursuing a CNM certification after all, but a CPM instead. If my calling is to assist women through the long, exhausting hours of labor—to wipe their brows and support them while they contract, and tell them over and over that YES, they can do this, and YES, they’re doing great, to be the silent gaurdian at the doorway—then maybe I shouldn’t be working at a hospital.

It’s late. I am just now sitting down to start a marathon writing session on Chapter Two of my research proposal, which, disappointingly, has not decided to write itself in the past three days while I was working. Naturally, such a dismal use of one’s friday night (not to mention the mountains of work I’ve got to get done in the next few weeks) calls for inspirational poetry! Tally ho!

The last of the birth stories sent to me via Miriam Axel-Lute, intrepid reporter for Metroland, and another beautiful one, at that. This one reads a bit more like an interview, and offers a really neat perspective on homebirth and homebirth midwifery. Wendy and Sean, thank you so much for sharing your stories with us!! (Read on …)