Thursday, May 26, 2011

Birth Pool Accessibility Now in Question

If you are a birth professional, you will know how quickly the news about the FDA making accessibility to birth pools in the U.S. harder went viral today (5/26/11) .   The following is  information from long time expert and waterbirth advocate Barbara Harper: 

"In my personal conversations with a woman(Patricia Jahnes) in the "Office of Compliance- Center for Devices and Radiological Health" (that's where they put us) I was told in no uncertain terms that pregnancy is classified as an "illness" and "birth is a medical event" and therefore ANYTHING that is used during this time is considered a "device" and therefore needs approval by the FDA". ! BH

There is a flaw here in their (the Office of Compliance) reasoning.  A huge flaw.  So if one arm of the U.S. government believes that pregnancy is an illness and birth is a medical event and anything that is used during this time is considered a device that needs to be approved by the FDA, then what about Foley catheters used for Foley Inductions rather than for urinary flow?  What about Cytotec that is used frequently but not approved for use during pregnancy and birth?  And what about the inconvenient truth that both the electronic fetal monitors and the Apgar scoring system were never intended to be used in the manner that they are today?

I realize that these may be the difficult and unpopular questions.  However, I also realize that many of a woman's options and choices in pregnancy and childbirth are under attack.  

And therefore since one arm of the U.S. government believes that pregnancy is an illness and birth is a medical event and anything that is used during this time is considered a device that needs to be approved by the FDA, what is the next option/choice to go? 

Tuesday, May 24, 2011

10 Simple Truths About Childbirth ~ #4

"Men fear most what they cannot see" ~ perhaps that is why they fear childbirth? But all they really have to do is....look.

Fear is by far one of the driving forces behind the increase in medical intervention in childbirth.  "Men" meaning humankind, fear what they cannot see.  And since a good visual is not available for what is happening in the uterus and in the most dangerous 4 inches in an infant's life - the journey through the birth canal - then fear takes over.

Yet as much as we intervene in childbirth in the U.S., research continues to show with the rise in intervention rates, the rate of maternal morbidity and mortality/infant morbidity and mortality is still extremely poor.  In fact, 40 other countries have better statistics than the US in spite of the fact that the US spends more money on maternity health care.

But as the quotation says,  perhaps all one has to do is to look and they can "read" a laboring women.

I am not talking about EFMs or vaginal exams.  

I am talking about physical presence, verbal cues and emotional signals from women in labor.  

Study how she moves - left alone, a labor woman moves in perfect syncrony with her body to promote the cardinal movements of the baby: those miraculous movements that the baby initiates as the journey of birth begins.  Not signaled by the mother or caregiver, the baby instinctually knows how to move, bend and extend in order to fit through the tight spaces of the pelvis.  The mother will also move, bend and extend, crouch, squat, stand, sit, kneel, sway, lean and walk as if listening to a birth song...dancing to this song to bring her baby into the world.

Likewise, she may also "sing" along with this birth song...verbalizing as best as she can the effort going into this work.  It may be in the form of talking, moaning, singing, yelling, groaning, or talking in soft, loud or angry tones.  With each phase/stage of labor, her verbalizing changes, signalling the change from one phase to another.  Her verbalizing tries to match the intensity of the contractions and the work her body does.

As her verbalizing changes in intensity, so do her emotions.  From calm and expecting, to intense and working, to fierce and with effort, a laboring woman's emotions also change to match the work she does.  As the contractions become stronger in an effort to push the baby from the uterus to the loving arms on the outside, the emotions (and endorphins) match this strength.  With the protective fierceness that exists down deep in all mothers, a laboring woman expresses her emotions verbally, on her face, in the tone of her words and in her physical actions.

If we as caregivers take the time (albeit precious) to be fully present at a birth and watch with careful eyes the emotions, movement and verbal cues given by laboring mothers, then as we learn what is normal (and what isn't), birth will no longer be a fearful experience.  But we absolutely must know the normal before we can truly deal with the abnormal.  Then our morbidity and mortality statistics will be more reflective of the maternity care we all want to achieve.

While this has spoken more about the fear that caregivers have of birth, I will soon write Simple Truth #4a - about the fear that pregnant women have surrounding birth.  That also must be addressed.

Friday, May 06, 2011

The New Birthsource Lamaze Childbirth Educator Program!

In the spring of 1979, my husband and I sat in a Lamaze Childbirth Education Class in Lompoc, California.  While I was a nurse, normal and natural childbirth was something new to me.  We were taught about crisis intervention and all of the modern technology of the day, but this was totally new.  I was incredibly inspired by our educator, Linda Richardson (I believe that was her last name).  The spark of childbirth education had been ignited.

During the birth of our first daughter in April of '79, I experienced the Lamaze techniques and some of the same feelings we saw in the birth film (reel to reel ~ LOL) "Nan's Class".  As I held my beautiful daughter in my arms, counted her fingers and toes like all new parents, I knew my destiny.  I wanted to be an educator!

Several month later, I called Linda only to find that ALL of the Lamaze Educators in the local area were leaving, as their husbands were all military and it was time for new assignments.  They all helped me complete the educator program, including my own Seminar taught by Harriet Palmer in Fresno.  In August of 1980, I taught my first Lamaze childbirth education class, under the observation of one of the other educators.  I was hooked!  I soon became an LCCE and then a charter FACCE.

When our second daughter arrived in 1986 at Cape Canaveral Hospital in Florida, I had been teaching for seven years and really got an opportunity to "practice what I preached".  Her amazing birth reinforced that normal, natural childbirth was possible, even in a hospital setting; that there were care providers who believed in the power of women and the normalcy of birth!  Her birth strengthened my focus and further dedicated me to education.

During the 31 years since certification, I have taught in many states (as my husband was also in the Air Force), locations (adult schools, colleges, military hospitals, civilian hospitals, churches, and privately).  As I checked the mail yesterday, that same thrill came to me as I opened the envelope from Lamaze International containing the welcome letter and certificate for the new Birthsource Lamaze Childbirth Education Program!

While to many it may just be a natural progression - the sage femme becomes the educators' educator - to me it is an honor and privilege to be an active part of such a respected and prestigious organization that has stood for education, advocacy and maternity reform for so many years.

I guess now I too can say.....Thank you Dr. Lamaze.
And thank you to my daughters, who unknowingly played such an important part of my career!
And to my husband, who stood by me, cheering all the way.