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VBAC: Going the Way of the Dodo Bird?

May 5th, 2011 by admin

© Natalia Klenova | Dreamstime.com

 

I’ve supported many women who are attempting a VBAC (Vaginal Birth After Cesarean). I love supporting these women. I’m not sure quite why, but I think it’s because I get to see women at their finest. Women who will stand-up for what they believe in, and who trust their instinct and intuition, which we don’t do nearly enough.

Whether the first caesarean was an emergency one or planned one, it’s not uncommon for women to want to experience vaginal birth. For some, it’s practical reasons such as having other children at home and being worried about recovering from another operation. For others, it’s about a goal to “fix” what went wrong last time. What many care providers fail to consider is the emotional impact of a caesarean on a woman. But of course, they don’t go home with mother. We do as doulas, so I have seen first hand how much some women struggle after their caesareans: physically, emotionally, spiritually, and/or some combination of those. Many women however don’t even attempt a VBAC for a variety of reasons, but one of the biggest ones is the ‘risk of uterine rupture’.

It is important – in fact imperative – to understand that there are risks and benefits to both VBAC and cesarean section. Unless the benefits and risks to both sides are understood, a truly informed decision cannot be made.

Here are some of the lastest statistics and studies related to what we know on VBAC. Hopefully this can help you consider your options and make the decision that’s right for you.

Risks related to primary and repeat cesarean birth:

  • Haemorrhage and anaesthetic complications may occur
  • Accidental surgical injury to the: bowel, bladder, uterus, uterine blood vessels
  • These incidences occur in 10 percent of cases (according to a ten year review at one hospital).

Post-surgical complications:

  • Post caesarean infection occurs 8 to 27 percent of the time.
  • 1 percent of women experience a paralyzed bowel
  • 6 to 18 per 1000 experience blood clots in their legs
  • 1 to 2 per 1000 experience pulmonary embolism
  • The ten year review reported 4.5 percent incidence of major complications

Cesareans cause more maternal deaths than vaginal births (depending on the study, the odds are anywhere from 3 to 7 times greater).

Effects on baby:

  • Cesarean delivered babies are more likely to be in poor condition at birth
  • Increases likelihood of breathing difficulties
  • 5 times more likely to need assistance with breathing
  • Increased rate of jaundice
  • Babies born by cesarean were over 3 times as likely to be admitted to intermediate NICU.
  • Baby can be cut during surgery

Women who have cesareans start motherhood behind the psychological eight ball. They face recovery from a major surgery while trying to care for a newborn.

Risks Related to VBAC

Uterine rupture or scar separation. This is the most common worry and is commonly stated at 1 in about 200 (or sometimes 4 in 1,000 births). Uterine rupture is very different from wound dehisence, which is when the scar comes a little bit open. Both of these things affect mother and baby very differently, but are both included in the 1 in 200 statistic.

Wound dehisence isn’t usually an emergency and women can often continue to labour ‘normally’. If the uterus does in fact rupture it requires an immediate cesarean and does pose significant risk to both mother and baby. If a uterine rupture occurs in a hospital with 24/7 anesthesia (more than) 9 out of 10 babies will be fine (so risk of baby not surviving is 1/2000). The rate of death is actually the same for a vaginal birth from a mother who has never had a cesarean. Hmmm…

The SOGC, ACOG and RCOG state that the routine policy for women with prior caesarean should be VBAC. This has become the norm in other Countries but not North America.

While risks always sound very scary, it’s important to weigh both sides so we can make a decision that feels right to us. We want to weight many considerations including:

• What’s important to me for my birth experience?

• Can I achieve that with the choices I’m making?

• How will I feel after?

• Is someone pressuring into making a decision I’m uncomfortable with?

• What does my ‘gut’ say?

• What are my plans for future pregnancies and children? (The more caesareans you have, the riskier it gets with each one)

• Is my careprovider really supportive of both options, so I can feel confident in his/her unbiased approach?

• If I’m considering VBAC, is my hospital supportive of VBAC?

• How often does my careprovider attend VBACs?

The chances of having a successful VBAC, according to the AAFP (2005 report), range from 60-82% or 49%-87% in the AHRQ study (2010 report), with the higher numbers happening outside the United States and Canada.
A few closing thoughts:

The World Health Organization (WHO) states that no industrialized nation is justified in having a cesarean rate greater than 10 to 15 percent. Our current rate in Canadian is nearly 1 in 3 women. Some are emergency, and many are repeat caesareans. The Society of Obstetricians and Gynecologists of Canada has gone on record to encourage a reduction in caesarean and a ‘return to normal birth’ (see links below). The current trend is of increasing caesareans and decreasing VBACs. It’s important for us to reverse both trends. In the last Niday report (2008) only 25% of women attempted a VBAC. I have spoken with many women who would like to have a VBAC but whose care providers or families haven’t been supportive. Ultimately, the decision, like all in healthcare, should reside with the patient. After all, they’re the only ones who have to go home and live with their decisions. For some women, having a repeat caesarean is of course, just the right thing.

If you are interested in weighing your options with regards to VBAC, consider a VBAC consult, which can help you sift through the massive amount of information on the subject.

If you’ve decided you want to have a VBAC, consider hiring a doula who has experience. Having the right emotional support, information, and the right comfort measures in labour can really make all the difference.

Presenting you all of birth’s choices…

The Options Expert

Birth doula, postpartum doula, birth doula trainer, Lamaze Certified Childbirth Educator

 

Interested in some “light” reading on VBAC? Here are a few websites and tools you might like. Some are more dated than others, so it is possible that newer information exists on the subject, but it might still be interesting.

Newest big study on VBAC by the Agency for Healthcare Research and Quality (2010): http://www2.cfpc.ca/local/user/files/%7B0B2FDE5F-2441-4807-99DC-F9EEAB52076A%7D/vbacup.pdf

January 2009 – SOGC press release supporting normal childbirth in Canada: http://www.sogc.org/media/advisories-20090128_e.asp

June 2008 – SOGC press release on cesarean overuse in Canada: http://www.sogc.org/media/advisories-20080625_e.asp

 

Tool to use with your doctor to assess your odds and options: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/patient_ed/tolac-color.Par.0001.File.tmp/TOLAC-color.pdf

 

American Academy of Family Physicians – 2005 Review of VBAC research: http://www.aafp.org/online/etc/medialib/aafp_org/documents/clinical/clin_recs/tolacpolicy.Par.0001.File.dat/clinicalrec_tolac.pdf

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From “Me” to “Mom”

Mar 18th, 2011 by admin

© Paul Prescott | Dreamstime.com

 

Becoming a mother has to be one of the biggest transitions in our lifetime. Really, I’d say it IS the biggest. When I found myself pregnant with my first son almost 13 years ago, it was pretty life altering. I guess it’s important to point out that I was in the middle of university, and though married, wasn’t in the least bit planning or ready for a baby.

 

I was such a keener that I read everything I could get my hands on, but nothing could really prepare me for what was going to be in store. At my high school prom, I was voted “least likely to have children” so you can imagine the worry from the part of my friends. I think to say that I was an A-type personality is an understatement. I was head-strong (aka pig headed) and pretty determined to be successful….whatever that meant.

 

Life sure took its own path from the moment my son entered the world. My friends were shocked to see me doing the “goo goo, ga ga’s” at my new bundle of joy. I think what they hadn’t considered was how much of an ‘overachiever’ I was. I really wanted to be a great Mom.

 

The hardest part for me was to accept that I was doomed for failure if I thought I could do everything right. There were absolutely moments I failed, where I didn’t make the choice I should have, and times I wish I could take back, or get a ‘do over’.

 

But one thing I definitely did right was to keep my sense of identity. To me becoming a mother has been about defining a new role in my life, not the ONLY role in my life. I see so many mothers who make excuses for why they can’t go out, see their friends, go on a date with their husband. That is not me! I believe the best gift we can give our children is a well adjusted parent. This means taking into account all of our needs and not identifying ourselves by our roles. There are many ways I’d describe myself: caring, philanthropic, stubborn, determined, successful, a mother, a wife, a friend, a daughter, a doula, a childbirth educator. These are just characteristics and roles. I am me. Period.

 

Each of us will have different needs. I know I need pedicures. Regularly. I know if my marriage is to be successful, we need time to ourselves. Regularly. I have often taken weekends away with my husband. In our early days together, sometimes they were very frugal. It’s amazing how inexpensively you can travel when you put a little effort into it. And many of those had regular pumping breaks, since I breastfed long-term. Guess what, my breastfeeding relationship and kids survived. I know I also need to work. I love my work. It’s part of what makes me feel great. So I never did take a whole year of maternity leave. I did find ways to make sure my work allowed me to be the mother I wanted to be. At home as much as I felt would be needed for my family. And I used babysitters. Gasp. The horror! That’s what I needed.

 

So as I sit here on this beautiful, (nearly) spring morning, working as a postpartum doula for today, holding an infant in my Monkeywear wrap while her mama works a job she loves (just down the hall), I don’t judge her for a second. What we’ll all need to keep our identity is as individual as there are mothers in the world. I think we should all give each other just a bit of slack. We’ll all be better mothers if we can keep our own identities and refer to ourselves by name instead of by our role of Mom. We are so much more complex than that.

 

So here’s to the mothers of the world. Go get a massage, a pedicure, your hair done, your work done, your emails answered….Whatever makes you feel good. You’ll be a better Mom for it!

 

The Options Expert

 

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Consumer Demand vs. Ignorance

Mar 9th, 2011 by admin

I was recently thinking to myself “gosh, it seems like the media spoke of plastic baby bottles being bad and within a matter of months, BPAs were banned in baby bottles in Canada”. Although I’ve known about BPAs since long before the media blitz and had already gotten rid of many in my home, it astounded me how quickly it came about.

I almost felt somewhat defeated that so much has been done to bring awareness to safe birth practices and we continue to do harm in what is such a special and vulnerable time in a woman’s (and baby’s) life. So what gives? How come we can get rid of BPAs and not affect real change in maternity care? We could literally save our country millions upon millions by implementing some really needed changes in maternity care. (I’ll list which ones in an upcoming blog post.)

So why does it take so long to change things?

I decided to research some social change theories and see what I came up with. Turns out many of the social change theories are concerned with the behaviour of people trying to meet their needs. So basically if people don’t see a problem, they’re not going to rally to fix it. The big problem here is that most people come away from birth with a healthy baby, or mostly healthy. The fact that Mom and baby could be healthier is never known by most people. Enter ignorance.

As they say “if it ain’t broke, don’t fix it”. But what if it is broken, and people just don’t know it’s broken? What if the way it looks broken is what people think ‘fixed’ looks like? And how many people do we need who know it’s “broken” to actually ‘fix’ it?

At the root of social change are individuals, who together form social movements. So, in order to understand social change, one must also understand what motivates the behaviour of individuals. “The purpose of all human behaviour is to meet needs” (Hultman, 1979, 4).

The way a person behaves is conditioned by her/his beliefs. Beliefs are a product of a person’s experiences, which includes the lessons s/he is taught about how to perceive the world. From experience, a person forms their beliefs about the world, how it works, what is right and wrong, good and bad (Hultman, 1979, 9).

It seems to me that we have been raised to trust in our medical professionals and let them do what they think is necessary. So, if this is our belief system, then no social change will ever come! I commonly here pregnant clients say things like “if I’m allowed”, “if they’ll let me”, “I had to do x”. “However, because beliefs are based on fragmentary knowledge, they may not correctly reflect the way the world truly is, in all its complexity. When an individual places so much confidence in her beliefs that she forgets the degree to which they have been abstracted from reality, she succumbs to the fallacy of misplaced concreteness” (Daly and Cobb, 1989, 25). This translates to national cesarean rates of over 25-30%, induction rates in excess of 30% and unnaturally high pre-term rates in industrialized nations, because our reality is skewed.

We live in a society that encourages status quo. We know most humans prefer to avoid a lot of change. But thankfully there are some individuals who manage to behave differently. These are the people who create social changes. In his book Order Out of Chaos, Ilya Prigogine explains that at the bifurcation point, i.e. in the moment of change, the system is highly sensitive to what’s going on. There is a “delicate interplay between chance and necessity,” and it’s at this time that ANYTHING can happen.
During a bifurcation point however, we will not like what we see.

 

This a time when one person can literally change the world. According to Strasser and Randall (1981) it’s the charismatic leaders who have provided the ‘mainspring’ for change throughout history”, and if you think back to all the great moments in history, there is a central player (charismatic leader) in almost every instance.

So what next? When will society work to improve our current maternity system? Well, I guess it will come when enough people’s minds are awoken to our ‘brokenness’.

Until then, many doulas and childbirth educators work tirelessly to help people understand what’s really going on and what’s good/bad. We work to provide evidence-based information so that people can make the decisions that are right for them. Yep, it’s not always super popular because sometimes we’re telling them things they don’t want to hear. They are comfortable in their ignorance. And that’s ok too. It’s also not always what care providers want people to learn, because it often makes their job more complicated. (I’ll give a big shout out here to all the doctors and midwives who respect their client’s choices even when it’s not what they want them to choose.)

Education and awareness will take time. But if you want to learn more about what could be best for you and your baby, talk to a doula or childbirth educator today. It’s gonna take many more millions of you to learn before real change takes place, so we’d better start today.

 

 

The Options Expert

Birth Doula, Postpartum Doula, Childbirth Educator, Doula Trainer

 

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Warrior Mamma

Nov 4th, 2010 by admin

I’ve realized lately that what I love most about being a doula is being able to witness the strength of a woman. I’m not talking about physical strength necessarily (although clearly some of that helps in labour too), I’m talking about the “no bull” strength that I see when a woman allows her body to labour naturally and normally. There’s really nothing like it.

This strength is within us all. Some of us can call upon it whenever we need, and some of us struggle with finding that inner diva….but she’s in there…I promise. Society has clearly impacted the way women see themselves. If more women could only see this seldom-witnessed strength I get to see regularly. Media, magazines, and Hollywood have impacted what we think we should look like, how we should dress, how we should speak, what we should believe about ourselves. Every woman I know seems to constantly obsess about all of these issues. Everyone jokes about the plastic surgery they’re going to get. It’s truly only a joke because they can’t afford it. If they could, it would quickly become their reality. It saddens me. Not really because of the plastic surgery idea, because of what it stands for. When I hear it, what I hear is a statement of “I’m not good enough”. For my doula clients, they often feel they’re not strong enough to labour without medication, that their breasts won’t operate well enough to produce enough milk to breastfeed their baby. Then of course their baby isn’t sleeping well enough, pooping well enough, rolling over soon enough, and on, and on…

This sense of ‘not enough’ is way too pervasive. I like the old saying “trying is having the intention to fail”. Don’t we all say that way too much? I hear it all the time: “I’ll try to go without medication”, “I’ll try to breastfeed”. I know for sure, almost all women can accomplish those two tasks, but they go into it feeling like they won’t be able to. Why? Because dozens of women around them have told them about their failures. Women doubting themselves and not accomplishing their goals leads to other women hearing their stories and taking on that failure before it’s their own. Society has failed them.

But, for the women who do decide they will accomplish their goals (despite the lack of support around them), there is an energy in their eyes that goes deep to their soul. Right after birth, the woman exclaiming “I did it!” is like nothing you can ever imagine. It brings me to tears every time. It is a rare glimpse into that power that women intuitively know is within them, that they have tapped into for a brief instant with all the confidence in their soul. It’s the warrior mamma.

The warrior mamma will transition into motherhood feeling empowered and strong. Feeling ready to take-on the world…and yes…even breastfeeding.

 

The Options Expert

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The Loudest Sound

Jul 29th, 2010 by admin

A mama roar bellows out and a baby is brought into the world. A baby’s first cry is heard. A mother accepts her newborn baby into her warm and loving arms and cries for joy as she looks down for the first time into her new baby’s eyes. It is magic. As her doula, I smile. I hold back a tear for fear of it looking less professional for me to shed one.

This woman’s body has worked so hard. The last 9 months a veritable miracle has occurred. Two people have come together to create a new life. It seems so common, something that happens every day and yet there’s something mysterious about how a perfect baby is made with very little input from us. Sure, the healthy eating and exercise help to create this masterpiece, but at no time did we need to tell our body to create a placenta to feed our baby nourishment and oxygen, or tell the cells how to exquisitely divide into a new life form.

This woman has spent 9 months doting over her growing belly, loving it, sometimes longing for the day baby would come out and meet her. So many preparations are made. Rooms prepared, items purchased, showered with gifts to help get the couple or mother ready for this new addition that is sure to change her life forever.

She has likely dreamed about the moment of birth, meeting her baby for the first time. Her body began to release the right hormones to start the whole process when it knew baby and body were ready for it to begin. It may have begun quickly or perhaps this baby and body needed a slow start, a calm beginning to new life. As her body progressed through labour, more intricately timed hormones are released, many we do not yet know about, creating an environment, a perfect environment for a baby’s passage out and transition to new life outside the womb. Without interference from outside modern medications and interventions, this process is allowed to happen smoothly and perfectly. At the perfect pace, the baby makes its way out and now lies on its mother’s tummy, gazing into her eyes.

And then violently robbed from this natural habitat, the baby is whisked away so the nurse can perform random (and yet non-urgent) checks, such as weight, length measurements, giving baby a painful shot of Vitamin K as well as gooping up its eyes with an antibiotic in case mother has an undiagnosed case of STDs. Baby cries, arms flailing about, jerking up as if reaching to find his mother. Mom says “can I have my baby”, the room’s medical professionals erupt in laughter, “you’ll have baby forever after this. It’ll just be a few minutes”. Everyone laughs but me. I know this baby needs to be with its mother and mother with baby. My eyes find the clock on the wall. Only 4 minutes did baby get to stay with mother.

The second hand of the clock catches my eye and my ears. Tick, tick, tick, tick. All the sounds of the room fade for me and my heart aches. It begins to feel like it’s climbing to my throat and beats in time with each precious second lost in separation. It aches for the baby taken away from his mother. His mother who’s body had so perfectly orchestrated the exact set of hormones for her to fall in love with her baby while gazing into his eyes. Tick, tick, tick. She looks to me saddened. I whisper, “he looks marvelous, you can ask for him”. Faced with a room of professionals, a doctor still between her legs, she sheepishly asks for her new son. More laughter. My heart cries inside. Tick, tick, tick.

The sound becomes more and more unbearable to me as this moment passes by. A moment that will never again occur. A moment that has long lasting implications to this mother-baby bond and relationship. A moment that may affect a baby’s ability to bond, love, develop normally. Tick, tick, tick. I want to scream for her, and also for the baby I had so many years ago that was also whisked away, not knowing at the time the long lasting implications it would have for us. The mother says to me “I really want to breastfeed”. Tick, tick, tick. I softly encourage her to speak-up, telling her what they are doing with baby: weight, measurements. At one point she hears the nurses chatting, looking down at her baby. She says “he must be fine if they’re just chatting”. He lies there in front of them under the warmer. WHY? WHY?! My head is swimming, spinning, wondering how and why we can allow this special, once in a lifetime moment to pass by, while we idly chat about our weekend, looking over this new babe away from its mother. Tick, tick, tick. My mind wanders to my teachings, when I remind couples what happens when a mammal is separated from her baby. Most people know she comes to reject her baby. What makes us think we are so different? As logical beings we tell ourselves we’re supposed to love and care for our baby, but for so many mothers separated from their baby, medicated to the point their body ceases to produce these important hormones, they know the truth. Their heart doesn’t feel the same. Or they simply don’t know how good it can be when it happens the way it was meant to be.

Baby is finally swaddled tight and brought over to his mother, told that his breathing may not be perfect and they may take him again soon. I wonder in my head “how could his breathing be perfect when his cord was cut so quickly and he hasn’t seen his mother’s arms, breath, eyes, or heard her heartbeat?” I help her to unswaddle him so she can really meet him, really be with him, skin to skin, heart to heart. The way nature intended. My eyes drift to the clock. More than 30 minutes have passed since birth. Almost all of those minutes away from the precious place that had been perfectly designed for his first hour. And yet much of it has already passed. This moment will NEVER again be available. Will never again return. My ears still hear the deafening sound of the clock. I am so aware of the precious time lost. And yet, I grab the camera and try to act happy about mother and her new baby. Really my heart is aching. I want to put on a more real smile, but I fake through them. I am sad for her loss, a loss she is very cognizant of. I’m sad that when she tried to ask for her baby like she is hormonally driven to do, that her request is met with laughter.

My heart realizes why I continue to do the work I do. Not only in the birthing room, but outside of it where I can advocate for change in policy. My head is already swimming with the wording I will use when I write a letter on behalf of a local advocacy group I belong to, drawing the hospital’s attention to the evidence, yes, the good solid research that supports uninterrupted skin-to-skin for one hour. I wonder how the hospitals have come to thinking this is best for moms and babies? I later read through my emails and see a great comment from well-respected doctor who really seems to care about women. He says “the problem with guidelines is they’re like cookbooks that allow (and sometimes encourage) the brain to shut off”.

 

The Options Expert

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The Perfect Doula Role

May 5th, 2010 by admin

The first time I heard the word doula was when I was doing my reading to become a Lamaze® Certified Childbirth Educator 8 years ago. It sounded like an interesting “new” profession. I put the word new in quotations because really it’s one of those professions that are as old as time. See, in the history of human kind, women would have almost always been surrounded by other women in labour and birth. Some would have been self-taught midwives, but many were there for comfort and non-medical duties like fetching items, food, water, and helping the labouring woman with soothing touch. This is the role of the modern-day doula: non-medical physical comfort and emotional support in pregnancy, labour, birth and the postpartum period.

Many people confuse doulas with midwives. I kinda feel bad for the midwives on this one for two reasons: 1-it puts pressure on the midwives to act as doulas when they have a lot of other duties on their plates and 2-it really isn’t fair to compare the extensive education a midwife receives with the limited education and training a doula would receive (on the medical side of things). In Ontario, a province in which midwifery is legislated (regulated and covered by our health care system) midwives take 4-7 years to be able to care for all aspects of a woman’s pregnancy, birth, delivery, and postpartum period (for 6 weeks).

Many doulas wish they could do more things that midwives do: check the baby’s heart rate, check a mother’s cervical dilation (to help her decide if it’s time for her to go to the hospital), and other medical duties. I get it. I see where they’re coming from. I too have been a doula for a mother who felt like it was time to go to the hospital only to get there and find out she’s less than 1cm dilated. So discouraging…and then there’s often no turning back. I too have had times where being able to do those medical things could have been beneficial, but I chose not to become a midwife. I chose to be a doula. The doula role doesn’t include those duties. The most important reason why is because we haven’t had the extensive education – theory as well as practical – that midwives have had to interpret those results. Labour progress is about a lot more than a number of cms. A baby’s well-being is about more than a heart rate between 120 and 160. What more is there? Well, I wouldn’t know because I’m a doula, not a midwife.

The doula role is really so perfect: supporting a woman without judgment of her choices in a non-medical way. That is so wonderful all on its own. I feel sorry for the doulas who can’t seem to find that enough. It IS enough ladies. It’s perfectly enough.

When doulas overstep their role, they hurt everyone. They think they’re “saving” the woman they’re supporting, but they’re really doing irreparable harm to the next woman who won’t be able to have a doula because the hospital she wants to birth in has banned them. She won’t help one bit to advance people’s trust in ‘normal birth’ because she will have turned the other professionals against us.

I am an activist and a feminist at heart, but I leave those hats at the door when I enter a birth room. There I am a doula. That is all I need to be in that moment. I will definitely be an activist in other moments, more appropriate times. For the woman who has hired me though for her birth, I’m a doula…because that IS enough.

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Spiritual Evolution: But What About My Little Monsters?

Apr 4th, 2010 by admin

I’ve thought a lot about my personal spiritual evolution over the past decade. For me it was as though something was stirring to gently encourage me to become a better person. Although this journey causes great turmoil, I’m so glad for it. Every few years I look back at what I knew and who I was and I’m grateful for who I’ve become. More ‘evolved’ I think.

Now, if you’re sitting there wondering what I mean by more ‘evolved’ then you’re maybe just starting your own journey. Kudos for that. I guess what I mean by that today (which may be different from what it comes to mean in a few years) is the spiritual evolution of my person; how I’ve come to consider more of life’s possibilities, how I’ve come to be more gentle to others, more compassionate, more concerned for our planet, our future, our humanity. I have come to appreciate God in a different kind of way. By God I mean that energy that HAS to exist. That energy that seems to push for the betterment of humans, that energy that wants us to succeed and gives us those ‘open windows’ when we get a ‘closed door’.

So enough of that deep stuff…I just needed to set the stage. So this morning, as I was getting ready for day’s events, I could overhear my oldest son (11years old) start to play ‘hide and seek’ with my other two children (ages 4 and 7). My first thought was pride that they were actually playing nice for once. Then 5 minutes go by and my husband goes into the living room and says “nice”. He proceeds to tell me how my son just got the other two children to hide so he could watch “Star Wars”, which he knows his two younger siblings aren’t allowed to watch. I felt absolutely distraught that he would just sit there watching his show while his two siblings wait for him patiently from their hiding spot, especially the younger one, whose innocence trusts blindly.

Then I wondered, how long will it take him to begin his spiritual journey of awakened consciousness….or will he ever begin it? It’s so interesting to me how almost barbaric children seem to be by nature. How then, do we go from that to an awakened awareness of our spirituality? I kinda wonder what Eckart Tolle’s kids would do? Does he have kids? Maybe if he was on his spiritual journey early, he realizes how friggin’ hard it is to have children and stay ‘Zen’?

Sometimes you have to wonder how we all do it. Well, now I’ll go break-up the kids fighting. It sounds like they’re beating each other up with some sort of light saber. Sigh.

 

The Options Expert

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Bullying 101: The Fight for Normal Birth

Mar 29th, 2010 by admin

Bullying 101: The Fight for Normal Birth

Our country has a cesarean birth rate of more than 1 in 4, with many hospitals at 1 in 3. While I can appreciate some of the benefits modern medicine has brought us, it’s plain ignorant to think these come without a cost.

The World Health Organization says an industrialized nation shouldn’t have a cesarean rate over 10-15 percent. Any more than this number and we are most likely using it more than necessary, hence not garnering the live saving benefits intended.

A colleague of mine was recently hired by someone to teach cesarean preparation and recovery. She said this was a HIGHLY educated individual who is having her first baby and who truly believes that an elective cesarean will be safer than a vaginal birth. There is no medical indication for it…just fear. That darn four letter word. I think it’s probably the worst one. It saddened me quite a bit to hear of a woman citing reasons why it would most likely be ‘safer’. I know my colleague wanted to support her decisions, but the words inside her just wanted to scream out: “don’t you know that’s not true?”, “don’t you know your baby is 69% more likely to die with a planned cesarean compared to mothers who ‘give it a try’ the other way, including the stats on the women who do end up with a cesarean1.

Cesareans have more risks to mother, to baby, to bonding, to breastfeeding success, to future pregnancies (both in getting pregnant, staying pregnant, and to your baby). See the new CIMS factsheet that lists all these details. http://www.motherfriendly.org/pdf/TheRisksofCesareanSectionFebruary2010.pdf

And yet, we continue to go in for repeat cesareans because we are SO afraid of the potential for a ‘uterine rupture’ (if we’ve had a cesarean before). I won’t minimize that risk, but I will tell you to do your research. You will soon see there are risks on all sides of this table.

I feel sad that as women we have given-up so much of ourselves. We allow others to tell us how to look, how to dress, how to act, how to feel, how to behave. I’m admittedly a “self-help” junkie. I find myself always wanting to learn more so I can do better. But, I’m blessed to not have an “all or nothing” personality. I can read a book and say “I like that idea, but the rest isn’t for me”. When we do this, we avoid judging ourselves for what we aren’t capable of achieving and instead feel great for what we have achieved and decided to change.

I’m so distraught that as women we have forgotten this amazing intuition we have inside ourselves that allows us to birth our babies. Did anyone ever consider what happened before all these cesareans? Would you be surprised to know that in the 70s we had a mid single-digit cesarean rate? You may be even more surprised to know that we have no fewer maternal or infant deaths now than we did then. What does that mean? In plain English: we’re doing more cesareans but not saving any more mothers and babies. In that process, we’re significantly increasing risks to mother, baby, and her future pregnancies.

I was recently able to be a good friend’s VBAC (vaginal birth after cesarean). She did struggle with the decision to do a repeat cesarean or a VBAC throughout her pregnancy until the very end, but chose to try for a VBAC. I will forever remember the look on her face when she turned to me after birthing her baby and said “I did it! I had a VBAC!”. That look will forever make me CERTAIN that women can and should trust the beauty of normal birth, the amazing power within themselves, the strength they are capable of. If you’re struggling with this issue, may you also be so certain.

 

The Options Expert



Reference

1– MacDorman, M. F., Declercq, E., Menacker, F., & Malloy, M. H. 2008.

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Making Choices: Where Has Our Decisiveness Gone?

Mar 9th, 2010 by admin

As a doula and childbirth educator I find myself part of one of the most important and private moments of someone’s life: birth. Much more than “just another day”, it’s such a key moment. It can catapult a woman into the bliss of motherhood, or sometimes the pits of despair. And so, as I work with women and couples on this journey, I often wonder and question where our decisiveness has gone? Why are women all of a sudden in pregnancy and birth allowing others to make decisions for them? Why is it that we research our next car purchase for a month and we accept whatever OB we’re ‘referred’ to without a question? Why do we go to 5 stores looking for our next big screen TV and not 5 doctors’ offices looking for the person who will (arguably) most impact our experience? And how many of us are even considering options outside of an OB? We could always consider a family doctor (if there are any ‘catching’ babies in your area) or a midwife, which have wonderful statistics on lowering rates of intervention, use of medication, cesarean, and increased satisfaction for mothers.

It often seems to me that during the most key experiences in our life, we women appear to become less able to confidently make decisions? What is the reason for this? Where is that inner ‘diva’ in those moments? My feminist self is frustrated for this reality.

I am always so excited to work with women with conviction. Those women who know exactly what they want and are willing to do what they need to in order to achieve that. It is so powerful to work alongside these women. I just wish I saw more of them!

I think I would have loved to be a 1970s feminist, burning bras and all that exciting stuff. I now find myself a modern-day feminist. It took me a long time to use that word, but realize at its core that word describes me. I love the power of women, the strength of women, and I’m completely committed to making sure women get what is due to them: respect, honour, love, compassion.

I long for the day when women feel secure, strong, empowered, confident to make decisions for themselves, to research their important life decisions, to assert themselves and their power.

If you’re a women doing this, pat yourself on the back! If not, may I take a moment to tell you that you are wonderful, strong, beautiful and that you owe it to yourself to do so. Now go decide something!

 

The Options Expert

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Welcome to My Blog

Feb 18th, 2010 by admin

My whole life I’ve always had something to say. While most parents are reading report cards suggesting their child should participate more in class, mine likely said I talked too much. I guess I’m pretty opinionated, but not in a “I know everything kind-of-way”. Turns out a blog may be just the right thing for me. So here I am, bearing all for you to share in my thoughts.

So who am I? I love that question, although, our first instinct is always to say ‘what we do’ instead of who we are. I’ll answer both for you.

I am a thirty-something woman who is passionate, giving, a great friend, a hard-working mother, an activist, a doula, an author, a speaker, a wife, a mother of 3. I spent 10 years in the corporate field in strategy and intelligence before giving it all up to focus on the area of my life that I really feel strongly about: helping women. You will hear me speak about many issues in my blogs: living your dream, health & wellness, parenting, finance, pregnancy and birth, women’s rights, the law of attraction (yeah, common, who doesn’t talk about that).

I hope you’ll join me in my rants….and who knows….maybe learn a thing or two and share a thought of your own.

 

The Options Expert

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