If only American Doctors Would Care This Much

2 New Book Recommendations

I can't seem to get enough of this stuff. I am reading two different books right now.

The first, which has quite a bit of midwife technique in it is The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. It details different stages of labor and what can possible be the cause of slow progress in that stage. This is really more for that mother that is looking for more than the normal natural birth books offer. It is not for a mother who wants a casual read with lots of stories. This doesn't have any stories in it.

The second book is Artemis Speaks: V.B.A.C. Stories & Natural Childbirth Information. This book was recommended by my midwife's partner and while it is a little out of day (written in 1983) it is full of super information about natural birth, VBACs, and tons of VBAC stories (both in the hospital and at home). She is a real feminist so there is a couple of chapters that make me uncomfortable and some wording used that I would not use but overall it is a good read.

23 Weeks

Amniotomy - Why it should be avoided.

So I know many of us have seen in the movies that the first sign of a woman in labor is her "water" will break. In reality, it happens less than 15% of the time. So that means that you are more likely to have your water break sometime during early or active labor. Now the question begs, "Should the "water" be artificially broken by your provide?"

My opinion is no, if there is not medical reason for it (i.e. if the baby is already in fetal distress). The risk of an amniotomy far out weight any benefits, according to studies. The main reason practitioners perform this procedure is to "speed things up" but in reality this is not guaranteed and if it does, not significantly.

On the other hand the risk include:

• Increased chance of cord prolapse. When the cord drops down below the baby and is squeezed between babies head and cervix.
• Increased chance of cord compression. When the cord is squeezed by the babies body with the uterus.
• Increase chance of infection.
• Increased risk of Cesarean section.
• Increased risk of fetal distressed. Caused by the cushion around the baby being gone therefore the baby takes a much harder hit during contractions.
• If the baby is not already in the "right" position, lack of fluid prohibits proper placement.

Obviously these risk can happen whether or not the rupture of the membrane is artificial or spontaneous but more likely when you have a spontaneous rupture it is happening at the appropriate time for your body and baby, not when your practitioner says is a good time.

Speeding up labor should not be seen as a necessity (unless for medical reasons) and you should trust that your body will work things out in the right time. Letting nature take its course is usually the best option.

How much is my responsibility?

How much is my responsibility? This question has been one that reoccurs in my mind from time to time during this pregnancy. During my pregnancy and birth of my first son I did not take much responsibility on myself but relied heavily on what others said and rested in their training and/or knowledge.

For instance, my midwife choice. I did no research on her other than a short interview but made the decision almost exclusively because she was recommended my my sisters friend who had delivered with her a few times. While this is great, I did not take into account what really makes a good midwife and good fit for you. She could be to blunt instead of kind, rely to heavily on test and less on intuition, hold alternative world views (especially in religion) rather than have commonality. All these things make a big impact on whether a successful relationship will take place between yourself and your practitioner. I took these things for granted the first time around. I recall even telling my husband midway through my pregnancy that "while I know my midwife is very experienced I will not use her again as we just don't mesh". I felt obligated to stay with her as I had already paid her in full up front.

Another example of this reliance was in the way of knowledge. I held no real knowledge about a plan for a successful birth or how to labor efficiently, or how to handle complications. I just assumed that I just had to have the contractions and push and the midwife would do everything else. I did not take into account that I am by far the best judge as everything is happening to me and I don't have to explain. Obviously I believe that a midwife's knowledge should be there to encourage and even correct but this should be only needed when you either are out of your depth (i.e. less common complications) or your emotions are getting the better of you and you need a stabilizing figure.

This time around I am taking more on my shoulders and it feels empowering. First, in my selection of my midwife I took my time. I researched and I let my intuition and the Lord lead me to my choice. I picked someone with far less experience but much better suited to my personality. I knew that she, like most midwifes, would give me the "right" answers to my list of questions so instead of talked more in conversation that in interview style and feel I learned a lot more this way.  In regards to knowledge, I am reading and talking with others as much as possible. I am reading the basics and the not so basic. From "Heart and Hands: A Midwife's Guide to Pregnancy and Birth" which is a basic guide to midwifery and natural birth, to "The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia" which is a much more descriptive book on labor complications. Both I highly recommend. I am reading other blogs and books that give be both knowledge and encouragement. I process this information and store it away for hopefully what turns out to be a pretty uneventful birth.

My overall point is that I want to make sure that I don't just point the finger in blame on others (midwifes and/or doctors) while realizing that we are somewhat in control. This information may make no difference at the end of the day when something just comes to steal away that ideal birth, but it more likely that not will make a difference. Of course, experience sometimes just has to happen to learn these lessons, as in my case, but if you don't want to chance it, take responsibility for yourself.