I made a mistake; I was wrong

December 24th, 2010 § 0 comments § permalink

Such immensely difficult words to say at times, but why? Because we want to be right, we don’t want to make errors, and, in the case of laboring mothers, we don’t want to give them false information or false hope.

Today, I read a midwife’s account (on her blog) of her making a mistake when checking dilation. I found it encouraging to read about how she handled it, and how well the situation turned out.

This is her story:

A VBAC BIRTH THAT FOOLED ME

One of my VBAC clients called me to say she was having regular sensations. She seemed to be in the early stages of birth so I settled in to just wait it out. About 10 p.m. at night, things picked up dramatically so I decided to do a dilation check (this was 20 years ago). To my surprise and delight, she was 7 cms dilated. (that should have been a clue that I was making a mistake. When the external world doesn’t match the internal exam, check more carefully). I held her and massaged her all night long while the others slept. By morning, everything had petered out and I couldn’t figure out why she wasn’t actively pushing by that time. She had been snoozing between her sensations through the night but I’d had her on the toilet, walking around, in the shower, etc. I did another exam only to realize, at that point, that I had completely blown it, she was only 2 cms dilated and wasn’t even in the birth process yet. That was one of those awful moments when you have to say BOTH of the top two difficult things at once. I said “Theresa, I’m sorry I’ve made a mistake. Last night when I checked you it wasn’t accurate. Right now, you are 2 cms dilated and you’re not in the birth process yet. I shouldn’t have been encouraging you all night that you’d be having the baby soon. Right now, the only way that this will work is if you’re willing to begin anew. Cancel everything we’ve done so far and get back to the very beginning. You need to eat, get some sleep, downplay this early stuff, relax. Everything is normal and healthy but I have made a huge blunder and I’m sorry.” The worst thing I could have done in this situation is to lie to this woman and tell her that she had gone backwards in her dilation—yes, many practitioners do this. It’s so unfair to a woman who already thinks her body might fail her. Not only that, but I think somewhere in the woman’s own “knowing” place, she realizes that she has not really been in the birth process.

This amazing woman did begin anew. She and her husband forgave me for my mistake, rested, ate, relaxed, summoned their patience and had a home VBAC for their baby. I will be grateful to them forever.

~Gloria LeMay

The Fruits of the Womb

December 24th, 2010 § 0 comments § permalink

No, I’m not talking about babies this time…I’m talking about the womb itself!

I was reading a midwife’s blog today and discovered this short instructive video on the various sizes and shapes of the womb as it grows and changes from the pre-pregnancy shape and size, to the 20 week size, to the term size, to the postpartum shape and size—all with fruits!

I thought it was a great way to give expecting moms and dads—and student midwives—a visual aid.

I believe…

November 25th, 2010 § 0 comments § permalink

Each new life is a precious gift from God.

Having a baby is a normal function of a healthy woman.

The entire process of childbearing, from conception to postpartum is perfectly and elegantly designed by God, and is inherently safe.

The vast majority of healthy women who take good care of themselves will be able to deliver vaginally.

Midwifery care and home birth are safe and wise choices for healthy women.

What do you believe about pregnancy and birth?

Exercise!

November 5th, 2010 § 0 comments § permalink

I’m on an exercise streak right now. I love it! Walking is great, stretches are great. Right now, my favorite exercise program is from Katy Bowman of katysays.com. She is a bio mechanist, and she has some great stretches/strengthening exercises that strengthen the body, but especially benefit the pelvic floor (something very interesting and important to me as a midwife). Pelvic floor strength is important all the time, but is especially helpful during pregnancy and birth. A strong pelvic floor means you will avoid incontinence and organ prolapse—which none of us wish to experience! I’m linking to some of her best blog posts that feature different exercises or helpful information on strengthening the pelvic floor. Enjoy!

Five Simple Ways to Avoid Back Pain
Natural Pregnancy, Natural Birth
Mind Your Pelvis
What a Waist!
Knee Bone Connected to the PF Bone (Five exercises that gently help you prepare to squat- especially if you can’t squat without pain)
You Don’t Know Squat (For those of you who find it very tiring to squat)

The Business of Being Born

October 14th, 2010 § 0 comments § permalink

I just borrowed a copy of “The Business of Being Born” from our local library. I can’t believe I’m just getting around to watching it; it’s been available for awhile now, after all. I realize it doesn’t come from a Christian perspective on women, birth, or life, but I’m hoping it may still have a unique and valuable perspective, and worth watching at least once. We’ll see.

I’m planning to post a review on it once I’ve watched it. Stay tuned!

Why is nutrition so important?

September 22nd, 2010 § 0 comments § permalink

“Nutrition is the relationship of food to the health of the human body.” There is not a single problem during pregnancy that cannot, in some way, be improved or helped by better nutrition. Nutrition is the foundation for good health, and the “single most important physical factor in determining the outcome of pregnancy”. Studies have demonstrated the clear (and common-sense) link between good nutrition, and good outcomes. Of course, just because someone eats a good diet does not guarantee a good outcome for them—life is not that certain. However, this premise still makes sense—you cannot grow a truly healthy baby with inferior fuel. No amount of prenatal supplements or other supplements, can make up for a poor diet.  A “good diet” or “good nutrition” implies that all the essential nutrients the body needs (including water, protein, fats, carbohydrates, vitamins, minerals, and enzymes) are being supplied in sufficient quantities, and are being properly utilized, for the body to function optimally. God’s intent was for us to get all the nutrition we needed from food. Food supplies what our body needs, complete with the so-called “passive substances” that many supplements lack because they are seen as unimportant, not having the same noticeable effect on the body as the active substances. Research has, on the whole, neglected to study the passive substances, so we know very little about their possible role in balancing and supporting the active substances. Although we may not yet understand why, when God created plants, He put the passive substances there, so there is a reason for their presence. There are clear benefits to eating things as close to their created form as possible; all forms of processing cause the loss or destruction of nutrition and enzymes.

Resource: Holistic Midwifery by Anne Frye

Medical model of care vs. Midwifery model of care

September 22nd, 2010 § 0 comments § permalink

I wrote this as a new midwifery student as part of my homework. Since I am studying for the NARM, I am going through all my homework to refresh my memory, and remind myself of things I have forgotten, and pick up on things I missed the first time through.

Explain the difference in the medical model of care and the midwifery model of care.
The midwifery model of care encourages women to trust in God’s elegant design of their bodies, and His design inherent in childbearing; it recognizes that conception, pregnancy, and birth are natural processes that God designed to function with minimal intervention. The female body is seen as unique, and normal. Midwives realize the value in good nutrition, exercise, and a wholesome lifestyle and supportive, healthy family relationships to promote good health and minimize complications. The midwifery model of care recognizes the mother as the only direct health-care provider for her unborn baby. When the mother is taking good care of herself, the baby will also be well-cared for. The midwifery model of care believes it is the client’s responsibility to make their own choices about tests and treatments, so midwives respect their clients by providing them with complete and accurate information for them to make informed health care decisions for themselves and their babies. Midwives seek to avoid practices and treatments based solely on fear, and instead seek to only carry out only those that have clear benefits for the mother and her baby. The process of pregnancy and birth is important to midwives, as well as the outcome. Midwives recognize that unnecessary interference can cause complications that would not otherwise occur, therefore they see themselves as guardians over these natural events and seasons, and intervene only as necessary for the health and well-being of the mother and baby. “One size fits all” does not apply to labor and birth; the midwife recognizes that each pregnancy, labor, and birth will be unique, and she is prepared and willing to be patient and flexible, allowing each woman’s body the time it needs to bring forth the baby, and in whatever positions are most effective. They also realize that spiritual and emotional issues can slow or stall labor, and they seek to resolve these, if at all possible. Midwives see pain in childbirth as a positive force because it brings forth a baby; they recognize that it is not a damaging pain, and therefore, it should not be feared. The midwifery model of care contends that mothers can birth just as safely, and more so, at a home or birth center, than in a hospital. The midwifery model of care sees birth as a personal, spiritual, and social event. Although in today’s world midwifery is viewed as “alternative” or “non-traditional”, until recent history, midwifery has been the traditional care—often the only care—for women worldwide.
The medical model of care sees pregnancy, labor, and birth as events that are fraught with dangers, and inherently pathological. They view the male body as the norm, and the female body as deviating from that. More often than not, the medical model offers fear-based care: in other words, they will intervene in the natural process to prevent certain complications, often causing other problems as they do so. The expectation, detection, and management of problems is foundational in the medical model of care. The expectation is that all births will need intervention. Mainstream medicine has a rather mechanical view of the body and treats symptoms rather than seeking to identify and treat the cause. They consult time charts to determine how long labor may take; they view deviations from these schedules as unsafe. If labor is slow or halting, Pitocin is used. The medical model of care values only the scientific—only that is can be measured or tested is viewed as useful information; the objective is valued, the subjective is mistrusted. In the medical model, the doctor is in charge and responsible for the outcome—as it is he who is making nearly all the decisions. The ultimate goal in mainstream medicine is to avoid death at all costs.

Resource: Holistic Midwifery by Anne Frye

The Dangers of Pitocin—used to control postpartum hemorrhage

September 8th, 2010 § 0 comments § permalink

Plenty has been written on the dangers of Pitocin for induction or augmentation of labor. As a midwife practicing out-of-hospital, I am prohibited by law from using Pitocin during labor—although I would not consider using it during labor were it permitted. I believe it should only be used during the antepartum—and very rarely, at that—in the hospital.
On the other hand, midwives are permitted—if they have doctor’s standing orders—to use Pitocin to control postpartum hemorrhage. I have given a shot of Pitocin IM under my preceptor’s supervision a couple times, and I believe it was justified.

However, someone recently asked me if I really knew the side-effects and the dangers of Pitocin, and I had to admit that though I knew the basic ones (allergic reaction, for instance, and retention of fluids), I hadn’t done an in-depth amount of research on the topic. Of course, you hear about all the dangers to the baby and the mother when Pitocin is used during labor, but postpartum use is quite different. The danger to the baby, of course, is no longer there once the baby is born. The risk of uterine rupture, likewise, is no longer a factor once the uterus is empty. So what are the risks and dangers that accompany postpartum Pitocin use?

This, my readers, is what I have yet to discover…

Stay tuned for the upcoming post.

Here is an article written by another midwife on Pitocin (the emphasis is more on Pitocin during labor) risks and the risks of the preservative in it. Take a look.