Wow! Thanks to all the amazing women at The Rebecca Project, New York State has become one of six states in the U.S. to ban the practice of restraining female prisoners to the bed during childbirth.
Now hopefully we can get the other 44 states to recognize that women just quite aren’t up for ripping their IV’s out and sprinting down the hallway in their flimsy hospital gown while pushing seven pounds of baby out of their body.
For those of you who were told you were not allowed to get out of bed during childbirth or were required to have continuous monitoring (despite ACOG recommendations against) during a normal birth, we’ll work on your figurative chains next.
You would think that by the time of your third pregnancy, you'd be immune to all the idiotic things folks say when you are pregnant. After raising kids for 15 years and working with pregnant moms for almost as long, I should be indifferent to the shameless crossing of boundaries that the general public has with pregnant women. Instead, now that I'm expecting my third child, I find myself more irritated than ever with the bizarre patronizing advice, comments and innuendo one gets walking around as a large tired swollen pregnant woman.
At first, I thought I could be patient. When the chipper twenty something at the 'national upper middle class coffee chain we all hate ourselves for buying at' said to me “can I ask you a question,” I braced myself knowing it was pregnancy related. However, as I’m ordering my small coffee, my belly practically resting on the counter in front of her, she asks "I thought pregnant women weren’t supposed to have caffeine?"
Bless her really, the poor thing doesn’t quite have the courage to point blank say “coffee” but I smile and reassure her that the occasional cup of tea or coffee during a pregnancy isn’t going to hurt my baby - and in fact could quite possibly do a lot in preventing a complete meltdown on the pregnant mothers part. After all, a little bit of flexibility from the ridiculously rigid food recommendations of pseudo nutrition that we have here in the US has got to be a good thing - but that's a subject for another blog.
Of course it doesn’t stop there. The bigger you get, the more folks feel allowed to open their mouths and have some drivel fall out of it. On another occasion when it was about 103 degrees out in a nasty humid August, I decided to get a milkshake. So I walk in to the same upper middle class shop and order "the strawberry and cream milkshake please." The boy at the counter repeats my order.
"You want the banana strawberry smoothie?"
“No, I want the strawberry and cream milkshake thing.”
“But we have a banana strawberry smoothie - it's much healthier.”
What I want to do here is grab his shirt collar and with gritted teeth say "Give me the damn milkshake, and f*%! the healthy smoothie,” but instead I just clarify that I would like the strawberry milkshake as I requested. I wonder who in the world he would suggest the healthy smoothie to besides pregnant women. To be fair, he did at least have the good grace to then ask if I wanted whipped cream...
What I find SO annoying about this is that I don’t see him ask the very overweight person if they want the healthier version, or the growing kid. Or really that they make comment on any ones else’s order except pregnant women. That my gestation is somehow public domain for every food, behavior, and action judgment to anyone around me, I take issue with.
And then of course, there are just the idiots that cant keep their mouth shut:
"Wow you are BIG!” I hear, as I’m standing on the subway platform. As I turn away from the leering man, he asks me how much longer until I give birth. Stupidly I answer that I'm due in about six weeks.
"Wow-you are going to POP! That is going to HURT!”
It's hard to believe, but I am directly quoting, I swear. Who are these people in my city who think they can butt into my business?!
My advice: please keep your mouth shut when you see a pregnant woman and just offer her your subway seat.
There was a good article on the BBC website yesterday about pain in childbirth. For those who don’t want to read it all, here is a summation: A doctor says that it turns out that the pain in childbirth has a biochemical reason and helps us produce chemicals that support labor’s progress and bonding with the baby. It would be a good idea if women were aware of this phenomena and had access to many coping options for labor such as hydrotherapy, relaxation techniques etc. Another doctor said in response: while that may be true women should have access to epidurals.
Pretty straightforward stuff, right? One doctor says pain has a purpose and there are many ways to cope, and another says yes there are many ways to cope but its always a nice idea to have the epidural in your back pocket. I have to agree with all of that. Oh, but let me add another fact from the article, which in this modern era one would think is irrelevant given these are both medical professionals speaking. It was a MALE doctor that said women should have access to a broad range of coping tools and that the biochemical reason for the pain is to support the positive hormones. Wow. Is he a feminist encouraging us to know about our bodies? Is he a pioneer in informing women? Oh wait not today, the reaction pendulum went the other way this time - he is but a man, not a doctor, not an educator, not a professional… just a man.
I must inform you that the doctor is being crucified in the UK blogs for …well, just for being male while making a simple factual statement about the biochemical process of labor. I can’t help but think this is missing the point. He didn’t say all women should have natural childbirth, or avoid the epidural, or that we couldn’t bond with our babies if we use medication. All he did was state that it would be a good idea if women were informed about how their body works and why it does what it does and that it would be a good idea if we learned a variety of coping tools - not just the epidural.
The over-the-top emotional reaction this has received makes us look like a bunch of hysterical women - not the logical people we want the world to know we are. If a male doctor stepped forward and said “not smoking decreases the chance of breast and cervical cancer” would we shout “how dare he say that! He doesn’t have breasts or a cervix!”? If a mother said, “I do/don’t think I want my son to be circumcised” would we scream at her “how dare you, you don’t have a penis!”?
Often, when it comes to birthing we mix up a factual statement with our own fear of being judged, or we see it solely through the lens of our own personal experience. If I say the epidural has a 1% chance of giving you a spinal headache, it doesn’t mean I’m anti-epidural. If I say that I am teaching women how to use the epidural it doesn’t mean I’m anti-natural childbirth. Yet I find many will REACT as if the factual statement is a judgement. This is our own baggage. I would suggest we stop bleating among ourselves about whether or not a woman gets the epidural and what HE said about it, and start supporting each other in getting the facts about all of our choices.
Stillbirth is a sad subject, and not a popular front page topic. One thing I appreciate about the British paper The Guardian, and also the BBC, is that they routinely address women and baby wellbeing in their journalism; articles on pregnancy, birth, postpartum, working mother benefits and child welfare statistics show up with much more frequency than in American papers and media.
While I recognize that a system of national health such as they have in England has its problems, one thing that Americans do not seem to realise is that mother-baby outcomes are predominantly determined by access to care. Duly, in America your economic or educational status determines your likelihood of a serious problem when it comes to pregnancy, birth, postpartum and your baby’s well being. Because there is already a cultural and economic system in a place in the UK that acknowledges a basic right to heath care, it seems the press covers these topics with much more gusto, thoroughness, more factual basis and quality than we get in American papers.
So when the BBC reports on the need to improve baby outcomes what gets called for is: (shocking I know) but more prenatal care access for all women, longer visits so pregnant women get the attention they need, more nurses and midwives and consultant doctors, and one-to-one care for sick and premature babies. These are all things that in the United States would be buried by fear of the cost, accusations of socialism, the insurmountable liability premiums, and the time suck that we do not consider valuable.
But ultimately, when you have a government with limited budget not designed to profit off its health care, rather than a profit-oriented private industry, accountable for health care cost, it seems that evidence-based medicine which achieves good outcomes at effective costs, wins. For example, the UK has gone from 1% to 2% homebirth rate in the last few years due to a specific education and practitioner push to make homebirth more accessible. For women having low risk pregnancies (i.e. normal pregnancies) the Royal College of Obstetrics agrees it’s a cost effective safe way to give birth as compared to crowded, busy hospitals where infection rates are climbing.
Yet the primary difference in the article is the call to action, the request for more support for medical care, the numerous possibilities suggested that could change outcomes for the better - not finger pointing, victimization, lawsuits or an ‘it’s just too big of a problem’ attitude. It allows one to read the article with compassion and hope that - even while it’s a sad and devastating topic - we can make a change.
In reading the recommendations from the BBC for more staffing and longer prenatal visits, I am reminded of the hundreds of times in my fourteen years of teaching I have heard students complain about their cursory abrupt visits with their practitioners. Most women sigh and resign themselves, believing that this is the standard in our current system for prenatal visits. What is important for families to know is that there are many doctors and midwives who take time with each visit to answer questions, and update the woman as to what she should be looking for at this point in her pregnancy. Practitioners that say "we will talk about that later" or "let me worry about that" are the practitioners that are not encouraging women to educate themselves and really understand the variables in pregnancy and birth.
What practitioners who patronize women in this way fail to understand is that this is less likely to create an environment of trust. And trust is vital in this area. It’s important if something out of everyone’s control happens that the client actually does trust that the doctor or midwife did everything they could to help because the women and practitioner together understand how the process works.
If you want info on the range of care and how to know if you are getting great prenatal care than check out our Real Baby, Real Body Talk and find out why raising your expectations in the short term creates better health in the long term!
There’s a great article on VBACs (or Vaginal Birth After Cesarean) in last week’s Time Magazine. You can read it here.
Pamela Paul does a good job laying out the lines of thought from practitioners who are wisely concerned about overuse of surgery and loss of skill, to those who have put aside medical pragmatism for fear of increasing liability premiums. The liability insurance industry is basically, at this point, determining access to and quality of obstetrical care in this country. By raising premiums to an unfathomable level, doctors and midwives who take time with their patients-which is documented to improve outcomes-are being put out of business. When will medicine and healthcare get some balls and become ‘by the people for the people’?
Luckily, for our cesarean “veterans” as the article calls them, we know many experienced midwives and dedicated doctors who are achieving great success at supporting women in their VBAC’s. The largest body of evidence shows that if possible, it is wise to decrease the woman’s risk of additional surgery both for her and her baby’s well-being. If you have questions about VBAC, birthing options in NYC or need a VBAC class call us for more information and resources!
A few days ago, I was contacted by a student who had questions about absentee ballots. It seems that a woman who has a due date near or on Election Day is eligible for an absentee ballot but according to the NYC Board of Elections her partner is not! Rather odd that at a moment where the future of the country is more personally relevant than ever, a partner may have to make a last minute choice to witness their child coming into the world or participate in our great democracy. Here’s my advice partners, dads and husbands - LIE and get an absentee ballot for travel. It’s time to get your votes in there, parents!
And of course, don’t forget to get an absentee ballot yourself if you’re due soon!
Abc.com recently published an interesting article entitled "Trying to Take Back Natural Childbirth," written by Susan Donaldson James. The article takes a look at both sides of the childbirth debate - the mom who is planning a natural childbirth, and another mom who is planning to have an epidural.
Although the article was sparked by a staff member at ABC who was surprised at how hard it was to find a doctor in New York City who would be supportive of the couple trying for natural childbirth, the piece does well not to show bias and instead explains the different perspectives regarding what a woman needs or wants from her birth environment in order to cope.
What I find funny about conversations about "the woman who wants to do natural childbirth" and "the woman who wants an epidural" is the defensiveness. Saying that women are trying to take back childbirth, and yet implying that the way to take it back is through advocating natural childbirth is still missing the point. 'Taking back childbirth' isn't about how we decide as individual women to cope. Instead, it's about understanding what happens to our bodies and being respected enough in a moment of vulnerability that the professionals around us will have what we need - whether that's medications or jacuzzi's and massage. The article does a good job explaining the frustration women are having at finding practitioners and facilities that understand that individuality and provide a range of coping choices.
The more critical aspect of 'taking back childbirth' is about curbing our race to excessive surgery. A woman now has a one in three chance of a surgical delivery, according to the recently released 2006 NYC Department of Health statistics. Don't get me wrong, surgery has a time and place, but not 31% of the time – and this is a surgical shift that has occurred in just one generation. If we're going to take back birth, we need to start understanding why it's a good idea to have a baby come out of our vagina - both for our body and for the baby. Our vaginas are multi-use works of evolutionary perfection, and women need to have equal access to doctors and midwives who are skilled and trained to birth babies out of them.
When women understand how their body works, how their baby works, how reproduction works, how evolution worked and how medicine can support them but not play god, they no longer live in fear of the myths and the pain, but rather see it as a process that is doable in one way or another. That's taking it back.
One thing I’ve noticed recently is that since Ricki Lake and Abby Epstein’s docu-movie 'The Business of Being Born' came out, about 20-30 percent of our students are changing providers. Not necessarily to a homebirth which the movie advocates (although some are), but rather they're raising their expectations about the quality and treatment they feel they should receive from a doctor or midwife. Classes that used to begin with get-to-know everyone introductions are now a hotbed of questions, concerns, confusion and adamant opinion that didn’t used to surface until later in the series.
As an educator for almost fourteen years now I’ve never seen a piece of media have the impact that this movie is having.
The fact that parents have been slow to realize that they deserve a certain level of care is because most people are only passionate about it for an extremely short window in the last trimester of pregnancy - and then they are through it and on to the all-consuming task of parenting!
Since any area that is primarily a woman’s health or social issue has often required steady organization and commitment over a long period of time to affect change, pregnancy, birth and postpartum have often been left off the major political map. But ‘The Business of Being Born’ is having an impact on parents in a wide spectrum - especially in terms of raising the bar on the level of attention they get from visit to visit.
For many years I have heard women justify the rushed or cursory clinical care they get by saying “but he/she is a good doctor”. I find this double standard we apply to ourselves as pregnant women so odd. We would never tolerate our child’s pediatrician being rushed or cursory simply because they were thought to be a good clinician. I know so many great doctors and midwives who are great clinicians as well as being patient and nice. Why settle for just half of the equation when we are already vulnerable in pregnancy and birth?
Well after I gave a little bit of a hint in my last entry, I can now tell you that our sibling preparation class for second time around parents was filmed by NBC’s Today show this past Saturday! It will be airing TOMORROW (Tuesday March 27th) in the 9am hour of the show.
The filming went really well, with Giada De Laurentiis being an incredibly gracious hostess/anchor! She even hung around a few minutes extra at the end so that my daughter could get her picture taken with her, since my daughter loves the Food Network and just happened to be at a cooking class at the Natural Gourmet Institute around the corner.
I also have to say it was the most well-behaved group of three year olds I've seen in a long time - really great kids and caring parents. The sound lady, a very cool person named Helen (as she clipped the mic to me before the shoot she said, "Are you ready for your fifteen minutes? Well don’t blink your eyes!" which made me laugh) said afterwards that I had the patience of a saint. I doubt my kids would say the same thing. Nothing like a camera to instill patience!
If we can we will figure out a way to link the segment with the blog so you can see it but tune in to NBC tomorrow morning and check it out!!!
Just found out that the book was reviewed in the New York Post this weekend. William Georgiades describes the book as "EVERYTHING you ever wanted to know about birth, but were afraid to ask". And even better, he says that he only wishes that "this reassuring, humane and endlessly useful handbook had been in print when my daughter was born".
It's a great review, and it's rewarding that people are reacting so positively to the book. If you missed it in the paper, you can read it online here.
It's been a few days since I posted on here - as you can probably imagine, it's been hectic with the release of the book and the construction to expand into an additional space. Thanks for all your support with the book so far, the positive feedback has been amazing and is deeply appreciated. And thanks to everybody who has read the blog to date, or passed on the link to friends and family!
A couple of you have left comments, including Lori Ungemah who wanted to know when we're going to be opening a Realbirth in Brooklyn.
What a great idea! We are actually looking for the right space and have been for quite some time. However, we do actually already run some of our childbirth education, breastfeeding and newborn care classes in Brooklyn, at Ola Baby on Court Street in the Cobble Hill/Carroll Gardens area. Take a look at the Realbirth website for details of the classes and the schedule.
A conveniently located Brooklyn space of our own is the long-term goal! However, it's a huge challenge to find affordable space in New York City (as we all know!!), since running parent education classes and postpartum support groups isn't exactly Wall Street! We will keep you posted though, I agree there is a need!
I'm sure that lots of you have read the Ask Moxie blog, a great online resource in which Magda helps people troubleshoot their parenting problems. She took the newborn care class at Realbirth before the birth of her older son, and then our sibling preparation class before the birth of her younger son, so she knows plenty about the way we operate!
Well one of her latest posts on her blog is a glowing review of The Big Book Of Birth, which you can take a look at here. I'm really grateful for the support, and it's nice to know that people like the book and think that it can be a valuable resource. The feedback to the book since it came out last week has been so good, and it's great to hear how people are reacting. Feel free to leave a comment here on the blog letting me know what you think.
And as ever, please do let your friends and colleagues know about the book. You (and they) can buy it online from Barnes & Noble by clicking here, or at Amazon by using this link. Or just visit your local book store and buy or order it there!
Realbirth continues to grow, you'll be pleased to know. We are opening a second location in April, at 49th St and 9th Avenue. We will contine to expand our great programs, and we are adding a “green” parenting and baby store called “Bump to Baby”.
We'll still be functioning as normal at 22nd St, so make sure you pop in to see us very soon.
When I go places with my kids, they assume I know every pregnant woman they see or just about any one with a baby. I taught in my neighborhood hospital for years, and they grew up with me answering breastfeeding questions in the frozen food aisle of the grocery store, or sleep questions on the way to the park.
My daughter is already phenomenal with kids and is going to be the most in demand babysitter ever. My son just rolls his eyes at our high estrogen household and finds refuge in his pet turtles, frogs and computer.
And 2007 brings tremendous personal change as well as professional. I am getting married in October and while I’ve been a single mom for seven years, this woman has got to say that she’s a fish who likes to ride her bicycle…