Independent Research Topic: “When to Cut the Umbilical Cord”
Advocacy flyer
Cover: Picture of Stewie from “Family Guy” with a speech bubble that says, “Just a
Freakin’ Fetal Minute, mother!”
Urgent Message for Mothers-to-Be: When it’s time to cut the umbilical cord, tell your doctor to wait at least a minute
Inside left page;
Why is the umbilical cord cut immediately after birth?
There are three primary reasons:
o Anesthesia
Formerly, most mothers were knocked out completely with anesthesia, and the cord was clamped immediately to keep the anesthesia from getting into the baby’s bloodstream
o Convenience
“Time is money.” Cutting the cord right away is yet another way of speeding up the institutional birthing process so that everyone can go home more quickly
o Technology
Since the clamping devices and warming trays exist now, there is a need to use them. In the not-so-old days it was normal to leave the baby attached to the umbilical cord resting on its mother for a while
Benefits of Waiting to Clamp and Cut the Umbilical Cord After Birth
o Blood from the placenta that has carried oxygen and nutrients through the umbilical cord to the fetus can continue to do so to strengthen the baby
o Waiting even one minute before clamping and cutting the umbilical cord means that 50% of the blood volume of the placenta will go the baby bringing iron that prevents iron deficiency anemia that can lead to learning delays and impairment. Waiting up to three minutes means that most of the blood volume of the placenta will go to the baby
• Waiting even one minute before clamping and cutting the umbilical cord also means the oxygen coming from the blood through the umbilical cord can help support the baby’s effort to breathe from the air for the first time. Aerating the lungs the first time requires a huge increase blood flow to the lungs. If there is not enough blood coming from the placenta, blood must come from the baby’s organs, which could be damaging to them
o Allowing the blood from the placenta to flow through the umbilical cord to the baby once it is born helps shrink the size of the placenta making it easier to come out and removing the risk of bleeding from the mother
o Stem cells in the umbilical cord’s blood stream can “differentiate” into every other kind of cell in the baby and be of enormous help to the baby’s future health
o T cells in the umbilical cord’s blood stream can help prevent cancer later in the baby’s life
o The additional blood from the placenta provides essential and even life-saving nourishment in many parts of the world where good nutrition is hard to come by including areas in the United States
o The one to three minutes of leaving the baby on its mother attached to the umbilical cord is a moment of peace for the mother, father, and baby and a
time to enjoy the wonder of what has just happened
Inside left page
Risks of Waiting to Clamp and Cut the Umbilical Cord After Birth
o Some medical practitioners have thought that cutting the umbilical cord would prevent an excessive amount of blood from overwhelming the baby’s system. The World Health Organization says that this effect does not happen. “In fact, there is probably a self-regulatory mechanism in the infant which limits the extent of placental transfusion. Moreover, there is evidence that the circulatory system of the newborn is capable of rapid adjustment to an increase in blood volume”
o There can be a mild form of jaundice caused because immature liver cannot process all the bilirubin, a yellow byproduct of breakdown or red blood cells that gets pushed out to tissues and causes baby to look a little yellow. Generally, sunlight gets rid of it, but sometimes there is a need for phototherapy, requiring technology that is not always available in some parts of the world.
Conclusion
So there we have it: Seven huge benefits to delaying the cutting of the umbilical cord and only one risk that is not serious. What will you choose to do?
Back cover:
Picture of a placenta when cut immediately after birth and a picture of a placenta after one to three minutes
Reaction #1 from Meghan who just give birth for the first time three months ago:
I wish I had known about this. My unbilical cord was cut right away even though I had a doula with me in the hospital. I signed a paper to donate the blood in my umbilical cord to a bank possibly to help others one day but was told there was not much blood and that it probably wouldn’t be that helpful. That was all.
Reaction #2 from Isabel who will give birth for the first time in sixth months:
I will definitely tell my doctor that I do not want the umbilical cord cut for three minutes. This is fascinating. I’ve read several pregnancy books and did not know about this option.
Wednesday, April 6, 2011
Monday, April 4, 2011
HW # 41 - Independent Research
When to Cut the Umbilical Cord
I find this to be an appropriate “Normal is Weird” subject because
as part of a normal birth process the umbilical cord is cut right away
in spite of the fact that all the acquired knowledge to date and research
trials recommend waiting even as short a time as three minutes
for the good of the baby.
“Health risks, benefits come with delayed umbilical cord clamping.” Center for Advancing Health. 15 April 2008
This article reports on a review of 11 studies evaluating the benefits of delaying the clamping of the umbilical cord. Results showed that “in most cases the time difference between early and late cord clamping is just one or two minutes, but the delay allows for an additional infusion of blood from mother to child.” Benefit: additional blood going to baby provides more iron and counters risk of anemia. Risk: mild form of jaundice caused because immature liver cannot process all the bilirubin, a yellow byproduct of breakdown or red blood cells that gets pushed out to tissues and causes baby to look a little yellow. Generally, sunlight gets rid of it, but sometimes there is a need for phototherapy, requiring technology that is not always available in some parts of the world.
“Effect of Timing of Umbilical Cord Clamping of Term Infants on Maternal and Neonatal Outcomes.” RHL commentary (last revised: 2 March 2009). The WHO Reproductive Health Library; Geneva: World Health Organization
This article studies that have demonstrated that “there is a transfer from the placenta of about 80 ml of blood at 1 minute after birth, reaching about 100 ml at 3 minutes after birth.” It makes the case that late clamping is especially important in poor areas where there is not “access to good nuturition.”
“Care of the Umbilical Cord: A Review of the Evidence.” World Health Organization, 1999
This article talks about traditional beliefs about the cutting of the umbilical cord in other cultures. “In many cultures, people believe that all life from the placenta must be transferred to the newborn for otherwise they baby may die. Therefore the cord is usually cut after cord pulsations stop or after the delivery of the placenta.” The article also describes the umbilical cord as “a unique tissue, consisting of two arteries and one vein covered by a mucoid connective tissue called Wharton’s jelly and a thin mucous membrane. Blood flowing through the cord brings nutrients and oxygen to the fetus and carries away carbon dioxide and metabolic wastes.”
“Early or Late Cord Clamping?” Midwifery Today E-News 23 July 1999
This article states that clamping the umbilical cord too early is dangerous because when a baby takes its first breath the aeration of the lungs causes “a massive increase in pulmonary blood flow,” which is supposed to come from the placenta. If the cord is cut right away, blood has to come from the baby’s other organs and for some babies this could be fatal.
Forro, Chinmayo. “The Unbilical Cord Blood Controversy.” 2009
This article begins with some history – first person to say that the cord must be cut immediately after birth was a 17th century French obstetrician Francois Mauriceau. Even though there was no evidence at the time, most obstetricians today follow Dr. Mauriceau’s recommendation. The article quotes Doctors Barclay and Murata from an article they published in Pediatrics in 2006 that said cutting the cord right away “might deprive the newborn of some benefits such as an increase in iron storate…Iron deficiency early in life may have pronounced central nervous system effects such as cognitive impairment,” and that delaying cord cutting is also good because “the increase of hematopoietic stem cells transfused to the newborn might play a role on different blood disorders and immune conditions.”
“Scientist says Umbilical Cords Should Be Cut Later.” 25 May 2010
This article quotes Professor Paul Sanberg, the lead researcher in a study described in the Journal of Cellular and Molecular Medicine. It says, “Delayed cord clamping may have a host of positive consequences, including reduced risks for developing conditions such as respiratory distress, chronic lung disease, brain hemorrhages, anemia, sepsis and eye disease.”
“Benefits of delayed cord clamping.” Write About Birth. 9 July 2010
This article says that it is not true that delaying the cutting of the umbilical cord could bring too much blood to the baby’s system and overload it. It says that there is evidence that the newborn’s circulatory system “is capable of rapid adjustment to an increase in blood volume and viscosity by increased fluid extravasation and dilation of blood vessels.” It also says that midwives like to wait until the pulsing action stops in the cord because they they know that the blood has all gone into the baby.
Hughes, Pattie. “Should You Bank Baby’s Cord Blood?” Families .com 2001
This article talks about some parents who spend $1500 to put their baby’s umbilical cord blood in a bank with a storage fee of $100 each year in case their child ever develops a disease the stem cells in this blood could cure. This “blood banking” is not regulated so no one knows how long the blood would be effective. Also with some forms of cancer like leukemia and genetic disorders the blood stem cells might have the disease and not be helpful. Also the amount of blood might help a small child but not be enough for a grownup.
“Benefits of Delayed Cord Clamping.” Doula and Birth Services: Butterfly Birth. 12 July 2009
This article by a doula recommends waiting as long as an hour or an hour and a half for the placenta to come out and then cutting the cord. She says it is important for the baby to be lower that the placenta before it comes out so there can be effective blood flow.
The article also explains that the reason hospitals cut the cord immediately is out of habit from a time when most women were unconscious when they were giving birth and that doctors did not want the anesthetic to get into the baby through the cord. It also talks about the fact that when the cutting is delayed the blood in the placenta (up to 40% of the baby’s blood) will go into the baby and shrink the size of the placenta making it easier for it to come out faster and prevent more bleeding from the mother.
I find this to be an appropriate “Normal is Weird” subject because
as part of a normal birth process the umbilical cord is cut right away
in spite of the fact that all the acquired knowledge to date and research
trials recommend waiting even as short a time as three minutes
for the good of the baby.
“Health risks, benefits come with delayed umbilical cord clamping.” Center for Advancing Health. 15 April 2008
This article reports on a review of 11 studies evaluating the benefits of delaying the clamping of the umbilical cord. Results showed that “in most cases the time difference between early and late cord clamping is just one or two minutes, but the delay allows for an additional infusion of blood from mother to child.” Benefit: additional blood going to baby provides more iron and counters risk of anemia. Risk: mild form of jaundice caused because immature liver cannot process all the bilirubin, a yellow byproduct of breakdown or red blood cells that gets pushed out to tissues and causes baby to look a little yellow. Generally, sunlight gets rid of it, but sometimes there is a need for phototherapy, requiring technology that is not always available in some parts of the world.
“Effect of Timing of Umbilical Cord Clamping of Term Infants on Maternal and Neonatal Outcomes.” RHL commentary (last revised: 2 March 2009). The WHO Reproductive Health Library; Geneva: World Health Organization
This article studies that have demonstrated that “there is a transfer from the placenta of about 80 ml of blood at 1 minute after birth, reaching about 100 ml at 3 minutes after birth.” It makes the case that late clamping is especially important in poor areas where there is not “access to good nuturition.”
“Care of the Umbilical Cord: A Review of the Evidence.” World Health Organization, 1999
This article talks about traditional beliefs about the cutting of the umbilical cord in other cultures. “In many cultures, people believe that all life from the placenta must be transferred to the newborn for otherwise they baby may die. Therefore the cord is usually cut after cord pulsations stop or after the delivery of the placenta.” The article also describes the umbilical cord as “a unique tissue, consisting of two arteries and one vein covered by a mucoid connective tissue called Wharton’s jelly and a thin mucous membrane. Blood flowing through the cord brings nutrients and oxygen to the fetus and carries away carbon dioxide and metabolic wastes.”
“Early or Late Cord Clamping?” Midwifery Today E-News 23 July 1999
This article states that clamping the umbilical cord too early is dangerous because when a baby takes its first breath the aeration of the lungs causes “a massive increase in pulmonary blood flow,” which is supposed to come from the placenta. If the cord is cut right away, blood has to come from the baby’s other organs and for some babies this could be fatal.
Forro, Chinmayo. “The Unbilical Cord Blood Controversy.” 2009
This article begins with some history – first person to say that the cord must be cut immediately after birth was a 17th century French obstetrician Francois Mauriceau. Even though there was no evidence at the time, most obstetricians today follow Dr. Mauriceau’s recommendation. The article quotes Doctors Barclay and Murata from an article they published in Pediatrics in 2006 that said cutting the cord right away “might deprive the newborn of some benefits such as an increase in iron storate…Iron deficiency early in life may have pronounced central nervous system effects such as cognitive impairment,” and that delaying cord cutting is also good because “the increase of hematopoietic stem cells transfused to the newborn might play a role on different blood disorders and immune conditions.”
“Scientist says Umbilical Cords Should Be Cut Later.” 25 May 2010
This article quotes Professor Paul Sanberg, the lead researcher in a study described in the Journal of Cellular and Molecular Medicine. It says, “Delayed cord clamping may have a host of positive consequences, including reduced risks for developing conditions such as respiratory distress, chronic lung disease, brain hemorrhages, anemia, sepsis and eye disease.”
“Benefits of delayed cord clamping.” Write About Birth. 9 July 2010
This article says that it is not true that delaying the cutting of the umbilical cord could bring too much blood to the baby’s system and overload it. It says that there is evidence that the newborn’s circulatory system “is capable of rapid adjustment to an increase in blood volume and viscosity by increased fluid extravasation and dilation of blood vessels.” It also says that midwives like to wait until the pulsing action stops in the cord because they they know that the blood has all gone into the baby.
Hughes, Pattie. “Should You Bank Baby’s Cord Blood?” Families .com 2001
This article talks about some parents who spend $1500 to put their baby’s umbilical cord blood in a bank with a storage fee of $100 each year in case their child ever develops a disease the stem cells in this blood could cure. This “blood banking” is not regulated so no one knows how long the blood would be effective. Also with some forms of cancer like leukemia and genetic disorders the blood stem cells might have the disease and not be helpful. Also the amount of blood might help a small child but not be enough for a grownup.
“Benefits of Delayed Cord Clamping.” Doula and Birth Services: Butterfly Birth. 12 July 2009
This article by a doula recommends waiting as long as an hour or an hour and a half for the placenta to come out and then cutting the cord. She says it is important for the baby to be lower that the placenta before it comes out so there can be effective blood flow.
The article also explains that the reason hospitals cut the cord immediately is out of habit from a time when most women were unconscious when they were giving birth and that doctors did not want the anesthetic to get into the baby through the cord. It also talks about the fact that when the cutting is delayed the blood in the placenta (up to 40% of the baby’s blood) will go into the baby and shrink the size of the placenta making it easier for it to come out faster and prevent more bleeding from the mother.
Wednesday, March 30, 2011
HW # 40 - Insights from Book - Part 3
- Hey – Thanks for writing Pushed. Your argument that women do not have enough say
about what happens to them when they are giving birth did make me think about how
our society seems often to be corrupting what is supposed to be a natural event for the convenience and legal protection of health professionals.
- Really! You think so? I’m impressed that someone as young as you and who, if you pardon me for saying so, probably won’t have the experience of birth yourself would
be that interested. What parts stood out for you?
- Well, if I’m honest, it was an assigned reading project as part of a course I’m taking at School of the Future. I remember the last part the best, which is all about your advocacy for midwives and home births.
You make the point that midwives went out of favor in the U.S. in the 1930s because of medical reports that seemed to blame them unfairly for deaths in childbirth. Obstetricians had campaigns against midwives even in the 80s with bumper stickers that said “Home Deliveries Are for Pizza.” So the new generation of midwives had to start from scratch you say because there weren’t any around to learn from. Then you tell the story of Cynthia Caillagh who is the hero, who gets falsely accused of causing a woman's death in childbirth, and then gets her reputation back at the end. It’s interesting that she had a Cherokee grandfather who told her that she was fated to be a midwife even though she was really smart and was studying pre-med when she was 16.
Cynthia trains with a “traditional Cherokee midwife" for two years. Caillagh says on page 219: “She learned her skills from another midwife, who learned her skills from a midwife.. Knowledge was handed down, midwife to midwife.” This leads to your saying that over 33 years she “attended 2500 births.” This woman is a pro with special skills who is called in by other midwives because she can successfully treat even serious conditions with special diets and with herbs.
Then Cynthia is called by Julia Peters to help with her birth. We already know that Julia is going to die and that Cynthia is going to be accused of causing her death, but there is still suspense to find out what actually happened. Then we find out there is a villain in the story, Marcella Ferro, the state of Virginia's chief medical examiner, who is part of a coverup of the facts of the case and the campaign to blame the midwife. Then on page 245 you say, “On May 5, 2000, Caillagh pleaded guilty to practice of midwifery without a license, to practice of medicine without a license, and to 'abuse and neglect of an incapacitated adult.'” Now I am even more into this story and pretty angry. The idea that Cynthia abused or neglected Julia is a very bad joke.
Even though Cynthia gets off and Virginia declares “Midwives’ Day” the day after she is let go, the reader is still mad about her treatment. What Cynthia says to you on page 248 after her whole experience of having been arrested and accused as a criminal seems to be the main point of the whole book: "To truly give birth you have to surrender to the process of birth, which is to suspend a conscious awareness. You must trust the instinctive internal self. And I think we’ve come upon a generation of women who don’t know what that internal trust looks like. I think there will come a time when we will remember or will rediscover… the intrinsic value of birth under one’s own steam.”
Of course I’m a guy so what do I know about all this?
- I’m glad you got so much out of my book. How could it have been better?
- Again, if I’m honest, I found a lot of it hard to read. The Cynthia story was the one that I read without being bored at all. Not to say that all your facts and figures and histories of policies aren’t important. They are just hard to read about unless you are a health professional or pregnant with your second child and don’t want to have another cesarean section. But if I become a dad one day, you’ve definitely made me understand more about what a mother has to go through and hopefully I would be more helpful.
about what happens to them when they are giving birth did make me think about how
our society seems often to be corrupting what is supposed to be a natural event for the convenience and legal protection of health professionals.
- Really! You think so? I’m impressed that someone as young as you and who, if you pardon me for saying so, probably won’t have the experience of birth yourself would
be that interested. What parts stood out for you?
- Well, if I’m honest, it was an assigned reading project as part of a course I’m taking at School of the Future. I remember the last part the best, which is all about your advocacy for midwives and home births.
You make the point that midwives went out of favor in the U.S. in the 1930s because of medical reports that seemed to blame them unfairly for deaths in childbirth. Obstetricians had campaigns against midwives even in the 80s with bumper stickers that said “Home Deliveries Are for Pizza.” So the new generation of midwives had to start from scratch you say because there weren’t any around to learn from. Then you tell the story of Cynthia Caillagh who is the hero, who gets falsely accused of causing a woman's death in childbirth, and then gets her reputation back at the end. It’s interesting that she had a Cherokee grandfather who told her that she was fated to be a midwife even though she was really smart and was studying pre-med when she was 16.
Cynthia trains with a “traditional Cherokee midwife" for two years. Caillagh says on page 219: “She learned her skills from another midwife, who learned her skills from a midwife.. Knowledge was handed down, midwife to midwife.” This leads to your saying that over 33 years she “attended 2500 births.” This woman is a pro with special skills who is called in by other midwives because she can successfully treat even serious conditions with special diets and with herbs.
Then Cynthia is called by Julia Peters to help with her birth. We already know that Julia is going to die and that Cynthia is going to be accused of causing her death, but there is still suspense to find out what actually happened. Then we find out there is a villain in the story, Marcella Ferro, the state of Virginia's chief medical examiner, who is part of a coverup of the facts of the case and the campaign to blame the midwife. Then on page 245 you say, “On May 5, 2000, Caillagh pleaded guilty to practice of midwifery without a license, to practice of medicine without a license, and to 'abuse and neglect of an incapacitated adult.'” Now I am even more into this story and pretty angry. The idea that Cynthia abused or neglected Julia is a very bad joke.
Even though Cynthia gets off and Virginia declares “Midwives’ Day” the day after she is let go, the reader is still mad about her treatment. What Cynthia says to you on page 248 after her whole experience of having been arrested and accused as a criminal seems to be the main point of the whole book: "To truly give birth you have to surrender to the process of birth, which is to suspend a conscious awareness. You must trust the instinctive internal self. And I think we’ve come upon a generation of women who don’t know what that internal trust looks like. I think there will come a time when we will remember or will rediscover… the intrinsic value of birth under one’s own steam.”
Of course I’m a guy so what do I know about all this?
- I’m glad you got so much out of my book. How could it have been better?
- Again, if I’m honest, I found a lot of it hard to read. The Cynthia story was the one that I read without being bored at all. Not to say that all your facts and figures and histories of policies aren’t important. They are just hard to read about unless you are a health professional or pregnant with your second child and don’t want to have another cesarean section. But if I become a dad one day, you’ve definitely made me understand more about what a mother has to go through and hopefully I would be more helpful.
Wednesday, March 23, 2011
HW # 39 - Insights from Book - Part 2
1. “Much of the risk of cesarean emerges in the next pregnancy, 91% of which today will be delivered by repeat surgery” (Block 116).
“The uterine scar can of course rupture in a future pregnancy” (Block 116).
Description of cesarean scar being the cause of the placenta ripping open the uterus and even the bladder right after birth causing severe hemorrhaging and
major surgeries.
“Michel Odent …put a database online, where one can search studies that have connected narcotics at birth with addiction in adulthood; induction of labor with autism; and cesarean section with immune disorders. The research is far from conclusive, but it points to the large, unknown territory of the impact of medicalized childbirth” (Block 134).
“A British midwife told a researcher that the sounds women make when they’re on artificial oxytocin 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.” (Block 135).
2. Cesarean births are performed much too often and can be dangerous to the mother and the baby at the time of the birth and in later years. In general, when a woman enters a hospital, even if she is healthy and nothing is wrong, she is hooked up to all these monitors and given Pitosin too quickly to speed up contractions, which causes pain and makes her need drugs, and then if the baby still doesn’t come soon enough, she will get a cesarean section. Nature is not given enough time to act, and women aren’t given ways to handle the pain without drugs.
3. “If we put women in hospitals with restrictive policies – they’re hooked up to everything, they’re expected to be in bed – of course they’re going to go for the epidural, because they’re unable to work through their pain,” (Block 174).
Use of epidural anesthesia in childbirth at large hospitals increased from 22% in 1981 to 66% in 1997 and is estimated to be 80% today” (Block 170)
“’Americans trust doctors and they trust hospitals, and they equate the two with health. What they don’t understand is that obstetricians are surgeions, and they know pathology, but they really suck at wellness.’ They are trained to sew up a tear, but not to prevent one” (Block 176)
“As doulas ‘reframe’ the birth experience for their clients, they are also shielding the hospital and its care providers from criticism and complaint. Hedley did her job so well that even though she felt her client was ‘abused,’ her client will go right back to the sambe obstetrician and hospital for her next pregnancy” (Block 160)
“Caillagh (superstar midwife) was known widely for successfully treating even serious prenatal conditions with diet and herbs, for stopping postpartum hemorrhages, and for resolving complications that would otherwise be dealt with surgically. She could turn babies who were entering the pelvis askew; ‘prolonged labbbor’ was language she never employed” (Block 223)
3. “Necrotizing fasciitis, the flesh-eating bacteria, afflicts 1.8 per 1000 surgical patients and is profoundly disfiguring or fatal” (Block 117)
OBJECTIVE: To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong.
DATA SOURCES AND STUDY SELECTION: Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'.
DATA EXTRACTION: All articles involving necrotising fasciitis in Hong Kong were included in the review.
DATA SYNTHESIS: The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis.
CONCLUSION: Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival.
“The uterine scar can of course rupture in a future pregnancy” (Block 116).
Description of cesarean scar being the cause of the placenta ripping open the uterus and even the bladder right after birth causing severe hemorrhaging and
major surgeries.
“Michel Odent …put a database online, where one can search studies that have connected narcotics at birth with addiction in adulthood; induction of labor with autism; and cesarean section with immune disorders. The research is far from conclusive, but it points to the large, unknown territory of the impact of medicalized childbirth” (Block 134).
“A British midwife told a researcher that the sounds women make when they’re on artificial oxytocin 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.” (Block 135).
2. Cesarean births are performed much too often and can be dangerous to the mother and the baby at the time of the birth and in later years. In general, when a woman enters a hospital, even if she is healthy and nothing is wrong, she is hooked up to all these monitors and given Pitosin too quickly to speed up contractions, which causes pain and makes her need drugs, and then if the baby still doesn’t come soon enough, she will get a cesarean section. Nature is not given enough time to act, and women aren’t given ways to handle the pain without drugs.
3. “If we put women in hospitals with restrictive policies – they’re hooked up to everything, they’re expected to be in bed – of course they’re going to go for the epidural, because they’re unable to work through their pain,” (Block 174).
Use of epidural anesthesia in childbirth at large hospitals increased from 22% in 1981 to 66% in 1997 and is estimated to be 80% today” (Block 170)
“’Americans trust doctors and they trust hospitals, and they equate the two with health. What they don’t understand is that obstetricians are surgeions, and they know pathology, but they really suck at wellness.’ They are trained to sew up a tear, but not to prevent one” (Block 176)
“As doulas ‘reframe’ the birth experience for their clients, they are also shielding the hospital and its care providers from criticism and complaint. Hedley did her job so well that even though she felt her client was ‘abused,’ her client will go right back to the sambe obstetrician and hospital for her next pregnancy” (Block 160)
“Caillagh (superstar midwife) was known widely for successfully treating even serious prenatal conditions with diet and herbs, for stopping postpartum hemorrhages, and for resolving complications that would otherwise be dealt with surgically. She could turn babies who were entering the pelvis askew; ‘prolonged labbbor’ was language she never employed” (Block 223)
3. “Necrotizing fasciitis, the flesh-eating bacteria, afflicts 1.8 per 1000 surgical patients and is profoundly disfiguring or fatal” (Block 117)
OBJECTIVE: To review currently available evidence on the epidemiology and methods of management for necrotising fasciitis, with particular reference to Hong Kong.
DATA SOURCES AND STUDY SELECTION: Medline, PubMed, and Cochrane Library searches of local and internationally published English language journals, from 1990 to July 2008 using the terms 'necrotising fasciitis', 'Hong Kong', 'diagnosis', 'epidemiology', 'vibrio', 'streptococci', 'clostridia', and 'management'.
DATA EXTRACTION: All articles involving necrotising fasciitis in Hong Kong were included in the review.
DATA SYNTHESIS: The incidence of necrotising fasciitis in Hong Kong and around the world has been increasing. This rapidly progressive infection is a major cause of concern, due to its high morbidity and mortality. Up to 93% of affected patients at our hospital were admitted to the Intensive Care Unit and many still died from septic complications, such as pneumonia and multi-organ failure. Radical debridements in the form of amputations and disarticulations were considered vital in 46% of the patients. Early recognition and treatment remain the most important factors influencing survival. Yet, early diagnosis of the condition is difficult due to its similarities with many other soft tissue disorders such as cellulitis. Repeated surgical debridement or incisional drainage continues to be essential for the survival of sufferers from necrotising fasciitis. Many authorities have reported that carrying out the first fasciotomy and radical debridement within 24 hours of symptom onset was associated with significantly improved survival, which also emphasises the importance of early diagnosis.
CONCLUSION: Clinicians must adopt a high index of suspicion for necrotising fasciitis. Empirical antibiotics must be started early and repeated physical examinations should be performed, while maintaining a low threshold for tissue biopsy and surgery. The timing of the first fasciotomy and radical debridement within a window of 24 hours from symptom onset is associated with significantly improved survival.
Tuesday, March 15, 2011
HW # 38 - Insights from pregnancy & birth book - part 1
Pushed by Jennifer Block
1. The first chapter - Arranged Birth - talks about the speeding up the birth process by doctors and hospitals using artificial hormones and painkillers and gadgets instead of waiting for spontaneous labor. The second chapter – The Short Cut – is about cesarean births and how common they are even when they aren’t emergency births. The third chapter – Denied Birth – is about babies in the breach position (feet down instead of head) and how they are almost all born by C sections and about VBAC (vaginal births after cesarean births) which are mostly discouraged.
2. “Why (the American birth experience) is far from optimal, how it came to be this way, and what it means for women, families, and society at large.”
3. “We are in the midst of an epidemic of patently unnatural birth: most labors are started or propelled by artificial hormones, and nearly one-third of American women are giving birth by major abdominal surgery. The norm is moving very far away from what’s normal.” “ We know if we take our otherwise healthy patient…release her cuffs, and bands, unplug the probes and sensors, and turn off the Pitocin and morphine, 9 times out of 10 her body will birth a baby with minimal interference or injury, especially if she has the one-on-one support of a skilled caregiver.”
4. Having breach babies born the natural way with legs hanging out sounds more dangerous than having them by C-section. Giving women in labor Pitocin sounds as though it is getting way out of hand. The idea that the pain that the Pitocin causes is the reason a lot of women want drugs to kill the pain makes sense. Are fetal heart monitors really not that useful? (I think one saved my life.)
Unassisted births sound too dangerous. (I would hate to be there.)
5. The author uses all kinds of evidence to back up her thesis that there is too much invasiveness with births. There is a very long “Notes” section in the back documenting all the points made in the chapters. The evidence of practices not based on the statistics is the most interesting, for example, the fact that women have to sign a consent form to have VBAC (vaginal birth after cesarian), but not a double cesarean, which can be more dangerous.
1. The first chapter - Arranged Birth - talks about the speeding up the birth process by doctors and hospitals using artificial hormones and painkillers and gadgets instead of waiting for spontaneous labor. The second chapter – The Short Cut – is about cesarean births and how common they are even when they aren’t emergency births. The third chapter – Denied Birth – is about babies in the breach position (feet down instead of head) and how they are almost all born by C sections and about VBAC (vaginal births after cesarean births) which are mostly discouraged.
2. “Why (the American birth experience) is far from optimal, how it came to be this way, and what it means for women, families, and society at large.”
3. “We are in the midst of an epidemic of patently unnatural birth: most labors are started or propelled by artificial hormones, and nearly one-third of American women are giving birth by major abdominal surgery. The norm is moving very far away from what’s normal.” “ We know if we take our otherwise healthy patient…release her cuffs, and bands, unplug the probes and sensors, and turn off the Pitocin and morphine, 9 times out of 10 her body will birth a baby with minimal interference or injury, especially if she has the one-on-one support of a skilled caregiver.”
4. Having breach babies born the natural way with legs hanging out sounds more dangerous than having them by C-section. Giving women in labor Pitocin sounds as though it is getting way out of hand. The idea that the pain that the Pitocin causes is the reason a lot of women want drugs to kill the pain makes sense. Are fetal heart monitors really not that useful? (I think one saved my life.)
Unassisted births sound too dangerous. (I would hate to be there.)
5. The author uses all kinds of evidence to back up her thesis that there is too much invasiveness with births. There is a very long “Notes” section in the back documenting all the points made in the chapters. The evidence of practices not based on the statistics is the most interesting, for example, the fact that women have to sign a consent form to have VBAC (vaginal birth after cesarian), but not a double cesarean, which can be more dangerous.
Tuesday, March 1, 2011
HW 37 - Comments
To Eloise
You wrote three highly detailed birthing posts. I found them all interesting but the first one was the zinger! Bill Hill is not your run of the mill midwife. I think your best line(and there were several of these)was, "When Bill speaks about the birthing of his wife he said,'she just pushed it out, but I did most of the work', when previously he had stated that if there aren't complications all there is to do is catch it. I believe such contradiction and prejudice towards the strength of his wife comes from the fact that she left 3 weeks after the birth of their second daughter." Its as though his wife said to him, "You did all the work so you keep them." It seems really tragic that she left him and her two babies. I'm sure has a point about hospitalsbeing a sometimes negative part of the "birthing industry." On the other hand, if there are complications, it's obviously better to be in a hospital. Even in this country, when a lot of poor people had babies at home, a lot of the mothers and babies died. The section about your own birth in France was really interesting too. My mother wishes she could have had my brother and me in France. The services are so good. She was lucky that she worked for the French American Foundation here when my brother was born and had a year of paid maternity leave. I think you wrote the way you talk, and this makes the writing lively. You just need to edit it more and I think you meant "relevant" when you said of "prevalent."
To Naima
You intervieweed three different young women, and it's interesting that they all have different views about having a baby. I think the most powerful line is this one from Beinda:"I want to have kids because I feel like it’s a struggle that I have to face that will make me stronger. Every woman in my family has been an independent mother, and I feel like I will too. Its not what I want, its just a pattern I've noticed." This response sounds so depressing to me. You said that using the term "independent" parent instead of "single" parent might indicate a "more empowered sense of the possiblities of single parenthood." I think that raising a child is a two - person job and that having two parents usually makes life easier. The fact that Belinda calls having kids a struggle she has to face and that she thinks she will probably have to do alone because that seems to be the way it happens in her family is too bad. It sounds fatalistic, and I hope she'll be the one to break the one - parent cycle. You said yourself that you wished you had prepared some different questions. I think it might have been interesting if you had asked them about what they wanted to do with their lives before having children.
-------------------------------------------------------------------------------------
From Mom
I'm glad that hearing about your birth and your brother's birth has made you think about "what a very big deal having a baby is." I think that perhaps I emphasized to you how terrifying the experience was and not enough how wondrous it was. The fact is that there is much to be scared about. Modern moms and moms-to-be read so much that they can't help but be concerned about all that they do while pregnant and all the things that can go wrong even if the odds are against them happening. There will always be someone who says to you when pregnant that we make too big a deal of having babies today. "Just think about all the women who used to have babies in the fields and then go right on working." The truth is that the fatality rate was a lot higher then for mothers and babies. Also many modern day women go to college and work and have careers. They don't consider themselves primarily baby makers. When the time seems right or when the situation is a stable one, having a baby is the most
joyful experience imaginable. Nothing is more rewarding or entertaining than one's own (or adopted) baby. The love is so strong though that when anything goes wrong, even minor things, the emotional pain is terrible. Most of us know people who have had big things go wrong. As you know, your former coach and his wife had a baby with a rare disease called Angelman Syndrome. Her brain will never fully develop, and she will never talk. Even with completely normal children the responsibility is just so great that most parents hope that their children will have their own full lives before deciding to have children themselves -- for their sakes and their children's.
From Dmitry
The bad luck of your mother's doctor was amazing. Not only did she take him away from his family on Easter but also Christmas. I guess watching football games with your dad wasn't so bad. The part about "Maple Syrup Urine Disease" really "stuck" with me. It is part comical due to the name, and part sad due to the seriousness of the disease. The way you structured the stories really kept my attention and intrigued me the further I read along. One experiment that I would like somebody to conduct would be to test if the "motherly connection" is different at all with a baby born naturally and a baby born via caesarean section.
From Eloise
Devin I think you made a very valid point, parents should really take into consideration the huge amounts of work that entail child care. I even neglected these thoughts with all my interviews. I like how you tied all your interviews back to the focal point that you grasped from your inquries. I want to know why you think women should have children when they are 30, their bodies can have them with more facility at a younger age. I think your strongest line was "Then she was told she had something called Maple Syrup Urine Disease (you can’t make this stuff up), which if not treated could cause coma and death for the baby.". I think that this line had great character and I could really hear your voice. I belive to make this part stronger you could have illustrated the point with more fluidity rather than just stating and then this happened and then this. I thought over all this was an interesting piece, you should just read over your work before publishing ! :D
From Naima
You wrote three highly detailed birthing posts. I found them all interesting but the first one was the zinger! Bill Hill is not your run of the mill midwife. I think your best line(and there were several of these)was, "When Bill speaks about the birthing of his wife he said,'she just pushed it out, but I did most of the work', when previously he had stated that if there aren't complications all there is to do is catch it. I believe such contradiction and prejudice towards the strength of his wife comes from the fact that she left 3 weeks after the birth of their second daughter." Its as though his wife said to him, "You did all the work so you keep them." It seems really tragic that she left him and her two babies. I'm sure has a point about hospitalsbeing a sometimes negative part of the "birthing industry." On the other hand, if there are complications, it's obviously better to be in a hospital. Even in this country, when a lot of poor people had babies at home, a lot of the mothers and babies died. The section about your own birth in France was really interesting too. My mother wishes she could have had my brother and me in France. The services are so good. She was lucky that she worked for the French American Foundation here when my brother was born and had a year of paid maternity leave. I think you wrote the way you talk, and this makes the writing lively. You just need to edit it more and I think you meant "relevant" when you said of "prevalent."
To Naima
You intervieweed three different young women, and it's interesting that they all have different views about having a baby. I think the most powerful line is this one from Beinda:"I want to have kids because I feel like it’s a struggle that I have to face that will make me stronger. Every woman in my family has been an independent mother, and I feel like I will too. Its not what I want, its just a pattern I've noticed." This response sounds so depressing to me. You said that using the term "independent" parent instead of "single" parent might indicate a "more empowered sense of the possiblities of single parenthood." I think that raising a child is a two - person job and that having two parents usually makes life easier. The fact that Belinda calls having kids a struggle she has to face and that she thinks she will probably have to do alone because that seems to be the way it happens in her family is too bad. It sounds fatalistic, and I hope she'll be the one to break the one - parent cycle. You said yourself that you wished you had prepared some different questions. I think it might have been interesting if you had asked them about what they wanted to do with their lives before having children.
-------------------------------------------------------------------------------------
From Mom
I'm glad that hearing about your birth and your brother's birth has made you think about "what a very big deal having a baby is." I think that perhaps I emphasized to you how terrifying the experience was and not enough how wondrous it was. The fact is that there is much to be scared about. Modern moms and moms-to-be read so much that they can't help but be concerned about all that they do while pregnant and all the things that can go wrong even if the odds are against them happening. There will always be someone who says to you when pregnant that we make too big a deal of having babies today. "Just think about all the women who used to have babies in the fields and then go right on working." The truth is that the fatality rate was a lot higher then for mothers and babies. Also many modern day women go to college and work and have careers. They don't consider themselves primarily baby makers. When the time seems right or when the situation is a stable one, having a baby is the most
joyful experience imaginable. Nothing is more rewarding or entertaining than one's own (or adopted) baby. The love is so strong though that when anything goes wrong, even minor things, the emotional pain is terrible. Most of us know people who have had big things go wrong. As you know, your former coach and his wife had a baby with a rare disease called Angelman Syndrome. Her brain will never fully develop, and she will never talk. Even with completely normal children the responsibility is just so great that most parents hope that their children will have their own full lives before deciding to have children themselves -- for their sakes and their children's.
From Dmitry
The bad luck of your mother's doctor was amazing. Not only did she take him away from his family on Easter but also Christmas. I guess watching football games with your dad wasn't so bad. The part about "Maple Syrup Urine Disease" really "stuck" with me. It is part comical due to the name, and part sad due to the seriousness of the disease. The way you structured the stories really kept my attention and intrigued me the further I read along. One experiment that I would like somebody to conduct would be to test if the "motherly connection" is different at all with a baby born naturally and a baby born via caesarean section.
From Eloise
Devin I think you made a very valid point, parents should really take into consideration the huge amounts of work that entail child care. I even neglected these thoughts with all my interviews. I like how you tied all your interviews back to the focal point that you grasped from your inquries. I want to know why you think women should have children when they are 30, their bodies can have them with more facility at a younger age. I think your strongest line was "Then she was told she had something called Maple Syrup Urine Disease (you can’t make this stuff up), which if not treated could cause coma and death for the baby.". I think that this line had great character and I could really hear your voice. I belive to make this part stronger you could have illustrated the point with more fluidity rather than just stating and then this happened and then this. I thought over all this was an interesting piece, you should just read over your work before publishing ! :D
From Naima
Sunday, February 27, 2011
HW 36 - Pregnancy & Birth Stories
Interview with my mother:
My mother said that she was extremely happy and excited about being pregnant with my older brother. She and my dad were in a new parents group that met with a “birthing instructor” once a week after work. She said the class started after dinner and ended so late that when the lights came back on after the weekly film the
future dads were all out cold – sound asleep. Meanwhile, the future moms were pretty nervous about the actual births shown in the films. She said it was an international group all giving birth at St. Vincent’s Hospital in Greenwich Village. One woman was Vietnamese. She brought in some special sticks to put between the toes of another woman whose baby was in the breach position, meaning
its feet were down instead of its head so that she would have to have surgery for a Cesarean birth instead of a natural one. The Vietnamese woman lit the sticks so that they burned without hurting the other woman’s toes. My mother said the baby turned around and did not turn back again into the wrong position. The baby was born naturally, and the parents gave all the credit to the Vietnamese woman. The future parents all got along well and met at one of the parents’ apartment after everyone had given birth. There is a really funny picture of all the babies.
One of the dads was a guitarist in a rock band called The Talking Heads and madea video with all the babies sitting up at a bar. The mothers were all told to
leave the room for the actual filming, and they refused because the babies
kept slipping off the bar seats.
My mother said my brother was born seven weeks early. She said there are some contractions that are not the real thing called Braxton Hicks contractions and she thought they were them. The contractions kept coming so my dad took her to the hospital at 6:00 in the morning. It was Easter and even though the doctor, Fernando Moreno, was not all that religious, his family was. He missed his kids’ Easter egg hunt. The nurse said that she could tell my mother was not ready to be admitted yet because she was smiling. “When the time comes, no one smiles.” They were told to walk around outside for an hour or two. My mom remembers the contractions hurting so much that she would have to sit down on the steps of houses near the hospital. When they went back inside, my dad said she wasn’t smiling. My brother was born at 11:30 at night so it was a long day. She did not want pain killers because they make the baby drowsy but she had to be given a drug to make the contractions work better. This drug makes the contractions go to a whole new level of pain, and my mom said the music from the movie Jaws kept going through her head. I guess the contractions felt like a shark coming with its mouth wide open. All the special breathing techniques were useless she said. What helped was digging her not very long fingernails into the palms of her hands. The moment the baby was born, the pain magically disappeared and she remembers the doctor saying, “What was the boy’s name you chose?” Even though my brother came early and weighed barely five pounds, he was healthy. My mother stayed in the hospital for a week with him and the day after they came home the telephone rang, and they were told to bring him back to the hospital. He had to be tested for sickle cell anemia, a disease that has no cure. Luckily, he only has the trait for it and not the disease. My mother said she was terrified and then relieved except for being told that children with the trait often have respiratory problems. Reed has not had them. That fear was just replaced by others. My mother says she watched Reed almost all night long for the first month she was so scared he might die from Sudden Infant Death Syndrome, which she had read a lot about.
When I was born six years later, my mother said she was probably more nervous than
the first time. This was because she had had five miscarriages in between. My parents were thinking about adopting a baby when my mom got pregnant again. She had to have a lot of genetic testing to find out what was going wrong. She says the problem with genetic testing is that after you’ve learned all that can go wrong with chromosomes you can’t even imagine everything going right. She still remembers the phone call at her office from the doctor telling her that I was going to be a healthy baby. She said she ate as healthily as she did for the first pregnancy but did crazy things the second time like crossing the street if someone was smoking a cigarette near her and not even having one cup of decaffeinated coffee. She went into labor on Christmas Eve and Dad and my brother had to go to the hospital early on Christmas morning. She had the same great doctor as the first time and felt really badly that he had to leave his kids on Christmas day after prying them away on Easter six years earlier. She remembers that my dad and the doctor watched football games all day long, and Reed played baseball and soccer in the hall with nurses. When it was nearly midnight, the doctor said it might have to be a Cesarian birth. She went into an operating room for surgery, but the doctor said he would like to avoid surgery by using forceps. My dad says forceps are huge and look like some kind of medieval torture instrument and that my mom was scared that they would hurt the baby’s head. A nurse said that her doctor was an artist with forceps and that the baby’s head would be perfect. I was born almost at midnight, and my brother was so happy I was a boy. He wanted to call me Bullwinkle, Wink for short.
Hearing about what it was like for my mom to have my brother and me reinforces my thinking about what a very big deal having a baby is. Nothing is ever the same for parents again so they better be prepared for it. Maybe I believe this because my parents do (although I do not follow what they think blindly), but I think that the Republicans who are trying to reverse the Roe vs. Wade Supreme Court decision so that abortion can be illegal again are crazy. Some even think women who get pregnant from being raped should have to have their babies. My dad thinks that in general men shouldn’t be allowed to have an opinion on the subject, and I agree with him. A baby needs to come into the world being wanted.
Interview with Meghan, a family friend who had her first baby in October
Meghan said that unlike my mother she was sick everyday for the first three or four months of her pregnancy. Then she was told she had something called Maple Syrup Urine Disease (you can’t make this stuff up), which if not treated could cause coma and death for the baby. A week later she was told that she did not have this condition. Later she was told she had gestational diabetes. She did have it, but fortunately it goes away after birth. After going through all the childbirth classes she found out the baby was in the breach position. She was told to swim everyday and do exercises that were hard to do in the last month. The baby did not turn around. Her feet stayed down, and Meghan had to have a Cesarean section. She said she made an appointment to have the baby the way you make an appointment to go to the dentist and never had one labor pain. She was very disappointed.
After the baby was born, she felt extremely depressed even though she loved her baby
tremendously. She was angry with herself for feeling that way and had to have some
medication. She did not tell anyone except her husband about the way she felt, and she pretended to everyone else that everything was fine. Finally, after about three months she felt normal again, and now finally she is really having a good time with her baby. Meghan’s experience just is more evidence that having a baby is not something that you do lightly. Not only does it change your life forever, but a lot can go wrong that you can’t anticipate. It’s a huge responsibility and right now I can’t imagine being ready for it.
Interview with our neighbor
Our neighbor had a girl at the same time my mother had me. She is Brazilian and has
always had asthma. For some reason her asthma is worse in New York than it was in
Brazil. When she was pregnant, she had several bad attacks and ended up in the hospital. She also had to stay home to lie down at the end of her pregnancy because the doctor wasafraid that she would have a miscarriage. After taking birthing classes, she ended up having a Cesarean birth because of the umbilical cord being wrapped around the baby’s neck. Like Meghan, she was extremely disappointed. She also ended up with an infection in the incision and had to go back to the hospital
The baby had something for the next three months called colic, which meant that she cried for hours without stopping every night. She and her husband almost went crazy and had no sleep. On top of that it was the terrible winter of 1994. There was so much snow and ice that it was hard for her to go out during the day. She and my mother would take turns lunch with one another, and even though they live next door it was hard to get past all the piles of snow and ice. She felt like a prisoner especially knowing that it was summer in Brazil.
This is another experience to confirm my thinking that if you are going to have a baby you had better be ready for anything, and you probably shouldn’t be under 30. I think you should have a lot of experiences to get you ready for the anything that can and probably will happen and also so that you don’t resent your loss of sleep and freedom.
I would be interested in finding out more about Caesarean section births vs natural births.
My mother said that she was extremely happy and excited about being pregnant with my older brother. She and my dad were in a new parents group that met with a “birthing instructor” once a week after work. She said the class started after dinner and ended so late that when the lights came back on after the weekly film the
future dads were all out cold – sound asleep. Meanwhile, the future moms were pretty nervous about the actual births shown in the films. She said it was an international group all giving birth at St. Vincent’s Hospital in Greenwich Village. One woman was Vietnamese. She brought in some special sticks to put between the toes of another woman whose baby was in the breach position, meaning
its feet were down instead of its head so that she would have to have surgery for a Cesarean birth instead of a natural one. The Vietnamese woman lit the sticks so that they burned without hurting the other woman’s toes. My mother said the baby turned around and did not turn back again into the wrong position. The baby was born naturally, and the parents gave all the credit to the Vietnamese woman. The future parents all got along well and met at one of the parents’ apartment after everyone had given birth. There is a really funny picture of all the babies.
One of the dads was a guitarist in a rock band called The Talking Heads and madea video with all the babies sitting up at a bar. The mothers were all told to
leave the room for the actual filming, and they refused because the babies
kept slipping off the bar seats.
My mother said my brother was born seven weeks early. She said there are some contractions that are not the real thing called Braxton Hicks contractions and she thought they were them. The contractions kept coming so my dad took her to the hospital at 6:00 in the morning. It was Easter and even though the doctor, Fernando Moreno, was not all that religious, his family was. He missed his kids’ Easter egg hunt. The nurse said that she could tell my mother was not ready to be admitted yet because she was smiling. “When the time comes, no one smiles.” They were told to walk around outside for an hour or two. My mom remembers the contractions hurting so much that she would have to sit down on the steps of houses near the hospital. When they went back inside, my dad said she wasn’t smiling. My brother was born at 11:30 at night so it was a long day. She did not want pain killers because they make the baby drowsy but she had to be given a drug to make the contractions work better. This drug makes the contractions go to a whole new level of pain, and my mom said the music from the movie Jaws kept going through her head. I guess the contractions felt like a shark coming with its mouth wide open. All the special breathing techniques were useless she said. What helped was digging her not very long fingernails into the palms of her hands. The moment the baby was born, the pain magically disappeared and she remembers the doctor saying, “What was the boy’s name you chose?” Even though my brother came early and weighed barely five pounds, he was healthy. My mother stayed in the hospital for a week with him and the day after they came home the telephone rang, and they were told to bring him back to the hospital. He had to be tested for sickle cell anemia, a disease that has no cure. Luckily, he only has the trait for it and not the disease. My mother said she was terrified and then relieved except for being told that children with the trait often have respiratory problems. Reed has not had them. That fear was just replaced by others. My mother says she watched Reed almost all night long for the first month she was so scared he might die from Sudden Infant Death Syndrome, which she had read a lot about.
When I was born six years later, my mother said she was probably more nervous than
the first time. This was because she had had five miscarriages in between. My parents were thinking about adopting a baby when my mom got pregnant again. She had to have a lot of genetic testing to find out what was going wrong. She says the problem with genetic testing is that after you’ve learned all that can go wrong with chromosomes you can’t even imagine everything going right. She still remembers the phone call at her office from the doctor telling her that I was going to be a healthy baby. She said she ate as healthily as she did for the first pregnancy but did crazy things the second time like crossing the street if someone was smoking a cigarette near her and not even having one cup of decaffeinated coffee. She went into labor on Christmas Eve and Dad and my brother had to go to the hospital early on Christmas morning. She had the same great doctor as the first time and felt really badly that he had to leave his kids on Christmas day after prying them away on Easter six years earlier. She remembers that my dad and the doctor watched football games all day long, and Reed played baseball and soccer in the hall with nurses. When it was nearly midnight, the doctor said it might have to be a Cesarian birth. She went into an operating room for surgery, but the doctor said he would like to avoid surgery by using forceps. My dad says forceps are huge and look like some kind of medieval torture instrument and that my mom was scared that they would hurt the baby’s head. A nurse said that her doctor was an artist with forceps and that the baby’s head would be perfect. I was born almost at midnight, and my brother was so happy I was a boy. He wanted to call me Bullwinkle, Wink for short.
Hearing about what it was like for my mom to have my brother and me reinforces my thinking about what a very big deal having a baby is. Nothing is ever the same for parents again so they better be prepared for it. Maybe I believe this because my parents do (although I do not follow what they think blindly), but I think that the Republicans who are trying to reverse the Roe vs. Wade Supreme Court decision so that abortion can be illegal again are crazy. Some even think women who get pregnant from being raped should have to have their babies. My dad thinks that in general men shouldn’t be allowed to have an opinion on the subject, and I agree with him. A baby needs to come into the world being wanted.
Interview with Meghan, a family friend who had her first baby in October
Meghan said that unlike my mother she was sick everyday for the first three or four months of her pregnancy. Then she was told she had something called Maple Syrup Urine Disease (you can’t make this stuff up), which if not treated could cause coma and death for the baby. A week later she was told that she did not have this condition. Later she was told she had gestational diabetes. She did have it, but fortunately it goes away after birth. After going through all the childbirth classes she found out the baby was in the breach position. She was told to swim everyday and do exercises that were hard to do in the last month. The baby did not turn around. Her feet stayed down, and Meghan had to have a Cesarean section. She said she made an appointment to have the baby the way you make an appointment to go to the dentist and never had one labor pain. She was very disappointed.
After the baby was born, she felt extremely depressed even though she loved her baby
tremendously. She was angry with herself for feeling that way and had to have some
medication. She did not tell anyone except her husband about the way she felt, and she pretended to everyone else that everything was fine. Finally, after about three months she felt normal again, and now finally she is really having a good time with her baby. Meghan’s experience just is more evidence that having a baby is not something that you do lightly. Not only does it change your life forever, but a lot can go wrong that you can’t anticipate. It’s a huge responsibility and right now I can’t imagine being ready for it.
Interview with our neighbor
Our neighbor had a girl at the same time my mother had me. She is Brazilian and has
always had asthma. For some reason her asthma is worse in New York than it was in
Brazil. When she was pregnant, she had several bad attacks and ended up in the hospital. She also had to stay home to lie down at the end of her pregnancy because the doctor wasafraid that she would have a miscarriage. After taking birthing classes, she ended up having a Cesarean birth because of the umbilical cord being wrapped around the baby’s neck. Like Meghan, she was extremely disappointed. She also ended up with an infection in the incision and had to go back to the hospital
The baby had something for the next three months called colic, which meant that she cried for hours without stopping every night. She and her husband almost went crazy and had no sleep. On top of that it was the terrible winter of 1994. There was so much snow and ice that it was hard for her to go out during the day. She and my mother would take turns lunch with one another, and even though they live next door it was hard to get past all the piles of snow and ice. She felt like a prisoner especially knowing that it was summer in Brazil.
This is another experience to confirm my thinking that if you are going to have a baby you had better be ready for anything, and you probably shouldn’t be under 30. I think you should have a lot of experiences to get you ready for the anything that can and probably will happen and also so that you don’t resent your loss of sleep and freedom.
I would be interested in finding out more about Caesarean section births vs natural births.
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