This article is from a survey taken by The Royal College of Midwives (love that name!) in the UK. I know, it's trying to be inflammatory. Most of the article ("research") is anecdotal - meaning it's based on a few experiences and not on much actual reliable research - and isn't worth much. But it raises a good question.
I don't think men should be banned from the delivery room. I think, though, that it should be up to the couple to decide, and that men should face no social (or family) stigma if they determine that the man will not attend the birth.
The only problem with my theory: it's anecdotal. It's based on two experiences. OK, maybe three.
The first is my own. My husband, after being by my side throughout twenty hours during my first labor, didn't feel the need to be present for the second one.
I objected to this idea, until I attended a birth as a doula where the husband didn't want to be there at all. It was their third child. He sat in a chair and looked green for most of the labor, and during the delivery he was detached and sickly. I realized that he was not contributing anything, and if anything his reaction detracted from the loveliness of the atmosphere. To me birth is sacred, but if anyone in the room disagrees with that premise, the entire birth team is affected. He wanted to stay at home, and he probably should have.
My husband did attend the birth of our second child, and I am glad he did. Though after that doula experience I didn't think that his presence was required, I felt more supported by him than anyone else, whereas at the first birth I wasn't able to really distinguish one person's support from another's.
But if he truly had not wanted to be there, I would not have demanded it of him.
In another birth situation I witnessed as a doula, the husband watched TV the entire time. His wife, rendered speechless by the strength of her contractions, reached for his hand but he didn't notice. This went on for a few hours.
"Birth is a fundamentally female event." It is difficult to argue with that statement.
If men are required by their women or by society to be there during labor and delivery, well, why should that be the case? What benefit does it give to women if the man is not going to be supportive? Certainly if he's going to turn green and wish the entire time that he didn't have to be there, it would be better to let him be somewhere else.
"A woman who says she prefers not having her partner in the delivery room is doing so to protect him, because she thinks he can't handle it. Why oh why do women keep on treating men like children? And why oh why do men keep on acting as if they were?"
Not all men are the same. Some can handle nearly anything, while others get nauseous by the sounds and smells of childbirth.
"Conception, reception - if you're there for one, you should be there for the other."
Not so! Bad logic! Bad! That's the "you-did-this-to-me-and-you-must-be-made-to-suffer" mindset.
"I think men should be allowed in the delivery room if they want to be - it is an experience not to be missed: very emotional. Unlike watching it on film, you don't tend to notice the blood and mess when it is actually happning before your eyes. However I do think they should stay in a corner out of the way and should not be made to feel guilty if they change their mind and want to go out. The best person to be present is a woman who has been through it.
The best place for a man is actually right outside the door within earshot. That way they don't get in the way but will still know how much the woman has gone through and will be more sympathetic afterwards.
I had my first in hospital and my husband was at home. He expected me to be up and about and cooking the meals immediately afterwards. I had my second at home and he heard everything despite not being in the room and he looked after me better."
First of all, it is a very different experience to watch someone give birth and to give birth yourself. When you are delivering a baby, you don't notice the blood and mess, but when you are watching another person, you certainly do, along with all the smells and unusual sights. That is one of the main objections that the husband of my client had: birth is gross. Sometimes it is. If the man wants to be involved, he should be, and not "put in a corner" to stay out of the way. I doubt there is ever reason to worry about giving too much support to a laboring woman.
"The best person to be present is a woman who has been through it." Amen, amen.
I didn't agree with having men hear the labor so they can understand what their women are going through, but based on her experience, it sounds like it was a good thing. Each man is different. I think that most wouldn't assume that women are exaggerating about the ordeal of birth, but maybe I'm wrong about that. It is work. Sometimes it is very painful. And women tend to want all the sympathy they can get.
And that right there is why men should not ever be banned from the delivery room.
Friday, May 05, 2006
Friday, April 28, 2006
Absence of Tens
...as in ten centimeters
This may be anecdotal, but I have witnessed and heard of a number of women who do not progress beyond nine centimeters. I'm not sure why. I have heard of first-time and experienced moms who stay dilated to 9 for hours. One client of mine was at 9 cm for 10 hours before she ended up having a c-section (there were other complications at this birth).
I have a number of theories, but I'm not sure how to find out if there truly is a common cause:
This may be anecdotal, but I have witnessed and heard of a number of women who do not progress beyond nine centimeters. I'm not sure why. I have heard of first-time and experienced moms who stay dilated to 9 for hours. One client of mine was at 9 cm for 10 hours before she ended up having a c-section (there were other complications at this birth).
I have a number of theories, but I'm not sure how to find out if there truly is a common cause:
- lack of movement/activity: too much laying in bed prostrate doesn't help the baby's head apply pressure to the cervix and aid dilation;
- posterior baby: wrong birthing position and the baby is unable to rotate because of mom's failure to be upright and moving around (see above);
- interventions (like epidurals) given too early, interrupting labor's progress, and dilation doesn't occur because of uterine exhaustion.
I don't know what the reason is, but I have heard of more and more moms who don't progress past 9 cm and never feel the urge to push.
...as in TENS unit
In many childbirth books and resources, references to TENS units abound. TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a small machine that delivers electrical currents through wires to specific places on the back, and the sensation tends to block the perception of deeper pain (like a labor contraction) and causes the body to release endorphins (natural painkillers). It does not alleviate all of the discomfort, but usually helps to significantly reduce the sensation of pain.
There is no documentation of side effects, and the machines can be small enough to carry in your palm. As far as I can tell, there is also no restriction of movement, though the unit would of course need to be removed for labor tubs or shower use. They are often used for physical therapy and to alleviate the pain of arthritis and fibromyalgia.
However, I have never heard of a US hospital employing the TENS unit for labor. I have never seen one, nor have I heard of anyone personally who has used this method.
Why not??
No side effects, freedom of movement, pain relief...why not?
Hypnobirthing might be dangerous, but we aren't sure why...
Article here.
The New York Times on Thursday examined hypnobirth, a childbirth technique that does not use drugs to control pain but instead uses a combination of relaxation, breathing and visualization techniques to control pain, according to Linette Landa, a hypnobirth teacher. According to the Times, "hypnobirthing" is meant to relax women through contractions so "that there is no screaming to tire the mother or alarm the baby, and labor is shorter." The American College of Obstetricians and Gynecologists allows physicians to decide whether they will permit hypnobirth, and, although many hospitals permit the technique, some physicians have concerns about the process, the Times reports (Olson, New York Times, 4/27).
Very strange. I wonder what the concerns are? Why not "permit" hypnobirthing? I checked out the New York Times article, and it became stranger, and scarier:
While many hospitals now permit hypnobirth, doctors are wary because they fear litigation. The American College of Obstetricians and Gynecologists leaves it up to the individual doctor's judgment.
Oh, of course. Because they might get sued for something.
Such techniques are not a surefire way to avoid pain, but rather "adjuncts and not the end-all to birth," said Dr. Jeffrey M. Segil, an obstetrician who offers the HypnoBirthing option to every patient in his practice in Dover, N.H.
"Women should not be set up to feel that they've failed if they can't follow through to a totally natural delivery," he said.
Don't even bother to set goals, pregnant ladies, if you aren't completely sure that you can reach them.
It doesn't work for everyone: Jennifer Richards, 29, said she gained self-confidence from hypnobirth methods, but had an epidural because of the intense back pain during her 30-hour labor.
I have said many times before that with back labor, all bets are off. But that might just be me.
I have so many questions about this that I don't know where to begin.
Seems like we could do more good helping the childbearing women in other countries than worrying about whether or not hypnobirthing is going to mysteriously make something go wrong.
The New York Times on Thursday examined hypnobirth, a childbirth technique that does not use drugs to control pain but instead uses a combination of relaxation, breathing and visualization techniques to control pain, according to Linette Landa, a hypnobirth teacher. According to the Times, "hypnobirthing" is meant to relax women through contractions so "that there is no screaming to tire the mother or alarm the baby, and labor is shorter." The American College of Obstetricians and Gynecologists allows physicians to decide whether they will permit hypnobirth, and, although many hospitals permit the technique, some physicians have concerns about the process, the Times reports (Olson, New York Times, 4/27).
Very strange. I wonder what the concerns are? Why not "permit" hypnobirthing? I checked out the New York Times article, and it became stranger, and scarier:
While many hospitals now permit hypnobirth, doctors are wary because they fear litigation. The American College of Obstetricians and Gynecologists leaves it up to the individual doctor's judgment.
Oh, of course. Because they might get sued for something.
Such techniques are not a surefire way to avoid pain, but rather "adjuncts and not the end-all to birth," said Dr. Jeffrey M. Segil, an obstetrician who offers the HypnoBirthing option to every patient in his practice in Dover, N.H.
"Women should not be set up to feel that they've failed if they can't follow through to a totally natural delivery," he said.
Don't even bother to set goals, pregnant ladies, if you aren't completely sure that you can reach them.
It doesn't work for everyone: Jennifer Richards, 29, said she gained self-confidence from hypnobirth methods, but had an epidural because of the intense back pain during her 30-hour labor.
I have said many times before that with back labor, all bets are off. But that might just be me.
I have so many questions about this that I don't know where to begin.
- What's wrong with learning relaxation techniques? Why does that have to be equivalent to setting oneself up for failure? What about women for whom epidurals have no effect - aren't they also in danger of relying on "adjuncts and not the end-all to birth" by planning on using methods that might not work?
- Why isn't this decision left up to the mother instead of the "individual doctor's judgment"?
- What potential litigation are the doctors really worried about?
Seems like we could do more good helping the childbearing women in other countries than worrying about whether or not hypnobirthing is going to mysteriously make something go wrong.
Tuesday, April 18, 2006
I Swear I Am Not Making This Up
Obstetricians are using a pregnant robot to practice attending births.
Named Noelle, the gestating automaton, hooks up to a laptop and can approximate breech births and failure to progress. It can be given IV fluids. The baby robot can be programmed to be born healthy and pink or blue and not breathing.
With this amazing innovation, doctors can practice cesareans, instrument delivery, suturing...
...and they never have to see the natural pattern of undisturbed birth, progressing on its own.
When I heard about this, my first thought was, Why? Is any obstetrician lacking in human births to attend? Is any OB short of practice regarding medical interventions?
We are getting farther and farther from knowing what normal birth looks like. Whatever situations our plastic-and-metal friend Noelle can imitate, undisturbed childbirth allowed to progress on its own, remains a mystery to those in medical training.
No one is asking me. But I think that obstetrical training should involve rotation through a homebirth practice. Just so they know that birth can be left alone and turn out well, so they know that women can give birth without medical assistance.
Named Noelle, the gestating automaton, hooks up to a laptop and can approximate breech births and failure to progress. It can be given IV fluids. The baby robot can be programmed to be born healthy and pink or blue and not breathing.
With this amazing innovation, doctors can practice cesareans, instrument delivery, suturing...
...and they never have to see the natural pattern of undisturbed birth, progressing on its own.
When I heard about this, my first thought was, Why? Is any obstetrician lacking in human births to attend? Is any OB short of practice regarding medical interventions?
We are getting farther and farther from knowing what normal birth looks like. Whatever situations our plastic-and-metal friend Noelle can imitate, undisturbed childbirth allowed to progress on its own, remains a mystery to those in medical training.
No one is asking me. But I think that obstetrical training should involve rotation through a homebirth practice. Just so they know that birth can be left alone and turn out well, so they know that women can give birth without medical assistance.
Monday, March 20, 2006
Reading Recommendations
General Pregnancy Information:
Pregnancy, Childbirth, and the Newborn by Penny Simkin : Not divided by month, as pregnancy books usually are. This book goes through pregnancy issues by subject. Very detailed and informative.
The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger : Anything byKitzinger is fantastic - in this thorough guide she presents childbirth as a normal, natural process. She talks at length about prenatal exercises and water birth. She also has one of the best descriptions of labor I've ever read.
Psychology of Labor:
Ina May's Guide to Childbirth by Ina May Gaskin : I consider this book necessary reading for pregnant women. The first half is empowering birth stories, and the second half addresses the psychological issues in labor. She talks at length about how your mindset can affect your labor.
Childbirth Without Fear by Dr. Grantly Dick-Read : The first book to discuss the fear-tension-pain cycle. It's a bit outdated (it was written in the 50's), but the principles are still true. It was out of print until recently and is now available on Amazon - the old editions can be found at most libraries.
Birthing From Within by Pam England : A wonderful workbook for pregnant women. This book takes women on a creative journey to deal with their fears of labor and birth and find out what birthing method would work best. It is written with the perspective that a woman is the expert of her own body and birth.
Birth Practices:
Natural Childbirth the Bradley Way by Susan McCutcheon : An excellent book about using the Bradley (husband-coached) method during labor and birth. She discusses techniques for early and active labor and pushing. As with all Bradley teachings, prenatal nutrition and non-intervention during labor and birth are emphasized.
Active Birth by Janet Balaskas : All about how listening to your body during labor can help ease pain and tension and help labor progress. She talks at length about strengthening squatting muscles during pregnancy to prepare them - and you - for delivery.
HypnoBirthing: The Mongan Method by Marie Mongan : A great overview of HypnoBirthing philosophies, including dealing with fears, visualizations and positioning, and nutrition. The new version includes a practice CD with a relaxation and imagery script.
Doulas:
The Doula Book by Marshall Klaus : Written simply and clearly, this book is an introduction to what a doula can do for laboring women. By the end of it you'll understand why we say "don't give birth without one!"
The Birth Partner by Penny Simkin : A very thorough guide on supporting women in childbirth. Though not specifically about doulas, it can give women an idea of how a dedicated support person like a doula can help them. Women also read this to find out what to expect of their own bodies and needs during birth.
More Information:
The Thinking Woman's Guide to a Better Birth by Henci Goer : A detailed investigation into each of the medical interventions imposed on laboring women, including all risks and benefits. Required reading for women who wish to be informed about what hospital staff might not tell you about the actions they routinely take to alter labor and birth.
Birth Reborn by Dr. Michel Odent : This is an introduction to Dr. Odent's understanding of birth as a natural process that works best when it's left alone. A short but wonderful book about the birth practice he created at Pithiviers in France, where midwives allowed mothers to labor with privacy and did nothing to interfere.
Breastfeeding:
The Womanly Art of Breastfeeding by Gwen Gotsch, et al : Among the most reassuring books on the subject. This flagship publication of the La Leche League is encouraging and discusses some of the most common breastfeeding difficulties. However, it is not a very complete resource about problems...
The Ultimate Breastfeeding Book of Answers by Jack Newman : Recommended because it talks more thoroughly about breastfeeding difficulties not mentioned in the LLL book. For example, this book has a section on recognizing dehydration, something not mentioned at all in The Womanly Art of Breastfeeding. However, it has been criticized for being arrogant and difficult to read. But together, these two books make an excellent addition to a breastfeeding library.
Pregnancy, Childbirth, and the Newborn by Penny Simkin : Not divided by month, as pregnancy books usually are. This book goes through pregnancy issues by subject. Very detailed and informative.
The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger : Anything byKitzinger is fantastic - in this thorough guide she presents childbirth as a normal, natural process. She talks at length about prenatal exercises and water birth. She also has one of the best descriptions of labor I've ever read.
Psychology of Labor:
Ina May's Guide to Childbirth by Ina May Gaskin : I consider this book necessary reading for pregnant women. The first half is empowering birth stories, and the second half addresses the psychological issues in labor. She talks at length about how your mindset can affect your labor.
Childbirth Without Fear by Dr. Grantly Dick-Read : The first book to discuss the fear-tension-pain cycle. It's a bit outdated (it was written in the 50's), but the principles are still true. It was out of print until recently and is now available on Amazon - the old editions can be found at most libraries.
Birthing From Within by Pam England : A wonderful workbook for pregnant women. This book takes women on a creative journey to deal with their fears of labor and birth and find out what birthing method would work best. It is written with the perspective that a woman is the expert of her own body and birth.
Birth Practices:
Natural Childbirth the Bradley Way by Susan McCutcheon : An excellent book about using the Bradley (husband-coached) method during labor and birth. She discusses techniques for early and active labor and pushing. As with all Bradley teachings, prenatal nutrition and non-intervention during labor and birth are emphasized.
Active Birth by Janet Balaskas : All about how listening to your body during labor can help ease pain and tension and help labor progress. She talks at length about strengthening squatting muscles during pregnancy to prepare them - and you - for delivery.
HypnoBirthing: The Mongan Method by Marie Mongan : A great overview of HypnoBirthing philosophies, including dealing with fears, visualizations and positioning, and nutrition. The new version includes a practice CD with a relaxation and imagery script.
Doulas:
The Doula Book by Marshall Klaus : Written simply and clearly, this book is an introduction to what a doula can do for laboring women. By the end of it you'll understand why we say "don't give birth without one!"
The Birth Partner by Penny Simkin : A very thorough guide on supporting women in childbirth. Though not specifically about doulas, it can give women an idea of how a dedicated support person like a doula can help them. Women also read this to find out what to expect of their own bodies and needs during birth.
More Information:
The Thinking Woman's Guide to a Better Birth by Henci Goer : A detailed investigation into each of the medical interventions imposed on laboring women, including all risks and benefits. Required reading for women who wish to be informed about what hospital staff might not tell you about the actions they routinely take to alter labor and birth.
Birth Reborn by Dr. Michel Odent : This is an introduction to Dr. Odent's understanding of birth as a natural process that works best when it's left alone. A short but wonderful book about the birth practice he created at Pithiviers in France, where midwives allowed mothers to labor with privacy and did nothing to interfere.
Breastfeeding:
The Womanly Art of Breastfeeding by Gwen Gotsch, et al : Among the most reassuring books on the subject. This flagship publication of the La Leche League is encouraging and discusses some of the most common breastfeeding difficulties. However, it is not a very complete resource about problems...
The Ultimate Breastfeeding Book of Answers by Jack Newman : Recommended because it talks more thoroughly about breastfeeding difficulties not mentioned in the LLL book. For example, this book has a section on recognizing dehydration, something not mentioned at all in The Womanly Art of Breastfeeding. However, it has been criticized for being arrogant and difficult to read. But together, these two books make an excellent addition to a breastfeeding library.
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