I finally got the video of my chicks hatching uploaded! It is in segments and there is kind of a long blurp of Asher running around our backyard digging in the dirt, showing off his new underpants, and saying cute things like "Cookie Mauker" and "Scripture Powder" (ie. Cookie Monster and Scripture Power). Oh... and please... ignore the brief martial skiff... we aren't perfect by any means.
Also I wrote a guest post at the Gift of Giving Life about what I learned about birth from watching my chickens hatch... and a really great story about cows.
8 comments:
Heather,
We disagree about birth. You have given birth. I have not, nor will I ever. You have had outstanding outcomes with lovely children. Some other people do not. You are a doula and have had several dozens of hours of training, and have participated in maybe several dozen births (I'm being optimistic). I have had markedly more training and experience with births than you, even though you likely will discount my experiences as somehow less than the rich and fulfilling examples you cite.
You likely understand the rich, full, intense experience of birthing in a way I never can. However, I doubt you could carry on a conversation about the physiologic changes that occur in the parturient. Does the hemoglobin level increase or decrease during pregnancy? How much? Does any of this matter? How does the cardiac output change during various trimesters? Does that matter? Why does the blood pressure of a pregnant lady drop during pregnancy? Does this affect uterine blood flow? Could this be important in saving a fetus life?
I will never pretend to imagine that I understand as much as you do on a spiritual and personal level about your pregnancies (though I've also had two children and had pretty intense spiritual experiences while they were in utero). However, don't pretend to be able to discuss maternal safety.
The anecdote you retell is misleading, and in my opinion, irresponsible. It uses all sorts of pastoral, show-d'em-city-slickers-how-it-is stories and likens them to farm animals. It also implies that you feel that all women would be better off delivering babies at home. The evidence actually shows that, largely due to modern healthcare, maternal mortality has dropped from about 1 in 100 births in 1900 to 11 in 100,000 births in 2005. This is a 100 fold decrease in maternal mortality, not to even discuss fetal mortality.
Do we have problems? Yes. Are there probably better ways to deliver babies? Assuredly. Do we do too many c-sections. Absolutely. Is the better way to return to the 1900s or the experience of Central/Southeast Asia and South America? If we really value life, then no.
If you really want to make a difference in the lives of these mothers, continue being a doula. However, take some college level and graduate level physiology classes. Study about the process. Learn why these clinical outcomes take place before you condemn them. It is really frustrating to be second-guessed by a whole group of people who have never had to make a judgement based on a clinical situation and don't even understand why it is made.
Here are a few of several hundreds of citations about the improvements in maternal mortality.
Costello, A; Azad K, Barnett S (2006). "An alternative study to reduce maternal mortality". The Lancet 368: 1477–1479
Van Leberghe De Brouwere V. Of blind alleys and things that have worked: history's lessons on reducing maternal mortality. Stud Health Serv Organ Policy 2001;17: 7–34.
Loudon I. Maternal mortality in the past and its relevance to developing countries today. Am J Clin Nutr 2000;72(Suppl 1):241S–246S
Levine R. Millions saved: proven successes in global health. Center for Global Development Brief 2004;3(3)
Maternal Mortality in Central Asia, Central Asia Health Review (CAHR), 2 June 2008.
Nathan,
I realize that our perceptions and philosophies of birth are very different and that we will probably always disagree about birth. But you know… I think that is just fine. You, as an anesthesiologist, have great expertise and passion about what you do. You do a wonderful job and fill a much needed role in the birth community. We need people on both ends of the spectrum… those who are passionate about natural birth and women’s rights and those who are passionate about advancing medical care to save lives. We both share the same goal… a healthy mother and a healthy baby. There is really a need for medical professionals, birth advocates, and mothers to have productive and serious dialogues about birth and how to make it the best possible experience… medically, emotionally and spiritually.
So I’m glad we can have this conversation.
I realize you have much more medical training than I do and have attended many more births. Yet please don’t discount my experience and knowledge. I don’t know if you remember but I spent three years studying nursing at BYU before I switched my major. I’ve taken several advanced anatomy and physiology courses in college and would feel comfortable talking with you any day about how the cardiac output changes during various trimesters.
I fully agree with you that modern medicine has done SO much good for women and has made childbirth so much safer. I’m glad there are people like you who go through so much work to get well trained to handle emergency situations. You save a lot of women’s and baby’s lives. I am in NO way saying that we should go back to the 1900’s, nor am I saying that all women should give birth at home. Some women are too high risk and other women wouldn’t feel safe outside of a hospital, which would make her experience traumatic instead of transformative. I’m sorry that if in my post I made it seem like I was saying the only way to have a beautiful birth experience was at home. That is not what I meant. What I intended to covey was that women have a great inner power and knowledge about how to give birth and that when that is trusted, nurtured and encouraged they do much better.
Yet I will say that I do feel very strongly that birth has become too medicalized and in some cases does more harm then good. Perhaps you’ve heard the recent numbers by the CDC that show there has been an increase in the maternal mortality rate in the US over the last several years. One article reported that, “ In the United States, there was an increase of 42% from 12 maternal deaths per 100,000 live births in 1990 to 17 in 2008, which is more than double the rate in the United Kingdom, 3-fold the rate in Australia, and 4-fold the rate in Italy.” . It has been speculated that this increase is due to increased reporting and new guidelines or that it is related to the increase in c-sections and interventions and that it may be even higher than currently reported. The jury is still out on this one. Granted this is a much smaller number than in the 1900’s and in other places in the world but I still think it is a crisis that women in the world’s richest country are dying in childbirth at an increasing rate… and its not because they are having their babies at home.
It is getting imperative that we find some sort of good balance between letting things unfold naturally and medically controlling them. This is why I am grateful for your comment. We really need to find a way for the doctors, the researchers, midwives, doulas, birth advocates, mothers and fathers to find a way in which women’s needs can be met but that honors and respects all aspects of the birth process and lets it unfold like God intended it too.
Also, I don’t think I ever have, or ever would, discount yours or any other person who experiences birth in a clinical setting as having a less rich and fulfilling experience than a non-clinical birth. I realize that wonderful and beautiful births happen every day in hospitals and that home birth IS NOT the best thing for everyone. Yet, once you’ve experienced a home birth, a natural hospital birth, an epidural hospital birth and a c-section—which I imagine I’ve seen more of the first two and you more of the last two—it is really amazing how INCREDIBLY different they are and how each one offers a woman and baby something different. I don’t think there is any right way to birth, but I do feel strongly that women should have a choice in how they give birth. Every woman and baby will need a different birth experience and they deserve to be respected and supported in whatever way they choose to come to this earth.
I’m sorry that you’ve felt like you have been “… second-guessed by a whole group of people who have never had to make a judgment based on a clinical situation and don't even understand why it is made.” I think there is a lot of peacemaking work that needs to go on between the two birth “sides” and I think it will be made by realizing that there is not one right way for a baby to be born… and that in an ideal world every woman would be able to make a prayerful and faith filled, instead of fear filled, choice about where and how her baby is born.
Thanks for your thoughts Nathan and at least we can still be good friends even if we don’t see eye to eye on this one.
Here is the link to the summary of the article about increasing maternal mortality
http://www.medscape.com/viewarticle/720152
and here is another one that may or may not be as reliable in its data but which is interesting
http://www.amnestyusa.org/demand-dignity/maternal-health-is-a-human-right/the-united-states/page.do?id=1351091
Heather,
Thanks for your reply. Those are fascinating articles. In fact, the Amnesty International Article is especially important. The link to the Amnesty International article and its full text is here:
http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf
These are the 10 recommendations from the article:
1 The US government should ensure that health care services, including sexual and
reproductive health care services, are available, accessible, acceptable and of good
quality throughout an individual’s lifetime.
2 The US government must ensure that all women have equal access to timely and
quality maternal health care services, including family planning services, and that no
one is denied access to health care services by policies or practices that have the
purpose or effect of discriminating on grounds such as gender, race, ethnicity, age,
Indigenous status, immigration status or ability to pay.
3 The Office of Civil Rights, within the Department of Health and Human Services,
should undertake investigations into laws, policies and practices that may impact on
equal access to quality health care services, including maternal health care services.
4 State governments should ensure that pregnant women have temporary access to
Medicaid while their permanent application for coverage is pending (presumptive
eligibility) and that Medicaid provides timely access to prenatal care. In cases where
a woman receives prenatal care before eligibility is confirmed, states should ensure
that Medicaid reimburses retroactively for services provided.
5 Federal, state and local governments should ensure that an adequate number of
health service facilities and health professionals, including, nurses, midwives and
physicians, are available in all areas. Particular emphasis should be given to medically
under-served areas, including by expanding community health care center programs,
such as the Federally Qualified Health Center (FQHC) program.
6 The Department of Health and Human Services should, in collaboration with
affected communities and the medical community, develop and implement
comprehensive, standardized, evidence-based guidelines and protocols for maternal
health care services.
7 Health care providers should ensure that sufficient, accessible information is
available to all women so that they can make informed decisions about their health
care.
8 The US Congress should direct and fund the Department of Health and Human
Services to establish an Office of Maternal Health with a mandate to improve maternal
health care and outcomes, and eliminate disparities.
9 Washington, DC, and each of the 29 states that do not currently have a maternal
mortality review committee should establish one. Committees should receive ongoing
funding to collect, analyze and review data on all pregnancy-related deaths and
address disparities. Efforts at state level should be coordinated nationally by the CDC
in order to identify and implement best practice.
10 State and federal authorities should devise and implement programs to improve
data collection and analysis in order to better identify and develop responses to issues
contributing to maternal deaths and complications. This may include requiring all
states to report maternal deaths and morbidity to federal agencies, including the CDC,
on an annual basis and standardizing data collection tools.
While some of the family planning issues are problematic to catholics and some mormons, otherwise all the recommendations in this article (and the other article to which you linked) that you cite are to promote MORE access to medical services ('having the cows in the barn" so to speak) rather than less. I guess that is why the story you wrote so bothered me. If your story was to argue that women should have more access to prenatal medical care, more nurse midwifes and doctors and insurance then I misread your intent and I agree wholeheartedly.
Nathan
I am glad that we understand each other. I agree and would support all the recommendations made by Amnesty in regards to increasing the care that pregnant and postpartum women get. I think that the only place that we disagree, and perhaps always will disagree, is that I feel that women should have a choice if they want to be "in the barn" or "out of the barn" but that in both situations their decision should be respected and supported. I'd like to see women have MORE choices about how they have their babies and be supported to give birth where they feel safe, supported, and in-tune with God, their bodies, and their babies.
Thanks for your thoughts. Actually I don't think we really are different in our opinions as it seems. I think we can both learn a lot from each other.
By the way, Jon and I are coming up to Oregon this summer for my family reunion-- it would be fun if we got a chance to see you and your beautiful family! We'll keep you posted.
Hi Heather!
I stumbled across your blog and was fascinated by your homemade diaper wipes and tips for cloth diapers. I am hosting a "Baby Week" on my blog, Oopsey Daisy, http://oopsey-daisy.blogspot.com/, in June. I was hoping I could convince you to be a guest author to share the recipe for the wipes as well as some cloth diaper advice. Is this something you would be interested in? If so, will you e-mail me at oopsey.daisy@yahoo.com (I couldn't find a way to contact you on your blog!). Thanks SO much. You seem to be an expert on all things baby!! Hope to hear from you!!
Alison
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