Well at least I'm not the only one saying it!

Medical interventions in childbirth adding undue risk

UPDATED: 2009-01-28 12:14:10 MST

By THE CANADIAN PRESS

TORONTO - The group representing Canadian obstetricians and gynecologists says there should be fewer medical interventions used in low-risk pregnancies.

The Society of Obstetricians and Gynaecologists of Canada says doctors should be promoting “normal childbirth” to women who seem unlikely to undergo difficulties during delivery.

A new policy statement from the group says the number of medical interventions used in healthy pregnancies is on the rise and could be subjecting mothers and babies to risks they don’t need to take.

It says health professionals are turning too quickly to interventions such as caesarean sections, induction of labour prior to 41 weeks of pregnancy, and the use of forceps or vacuum assistance during delivery.

The statement says doctors should only resort to these types of interventions when there is a valid reason, and should not use them when labour and birth are progressing normally. (But then I ask, what is normal for one my not be normal for another)

Supporters of the statement include the Association of Women’s Health, Obstetric and Neonatal Nurses of Canada, the Canadian Association of Midwives, the College of Family Physicians of Canada and the Society of Rural Physicians of Canada.

“We are seeing a significant increase of medical intervention during childbirth, but there is a real concern that unnecessary interventions introduce risks for mother and baby that could be prevented,” says Gisela Becker, president of the Canadian Association of Midwives.

“We want to be sure that women who are at low risk for complications receive adequate information and support to have a normal birth.”

So then we need to remember or rather have faith that women's bodies were designed to do this particular job. Without assistance from drugs, contraptions, monitors and what not. Women who have a team to support her, to help her feel loved, safe and supported will labour at her own pace follow her bodies own natural tendencies and birth her baby safely and easily.

Why must we send women into hospitals only to be hooked up, told they aren't labouring effectively, tell them their contractions are ineffective, basically saying you can't do it and then pump her full of drugs to force her baby into being born when perhaps they weren't ready.

My favourite saying from a renowned doctor I met was..."Nature doesn't screw up that badly. Human's screw up, but not nature." So why must we constantly believe that nature doesn't know what it's doing?

Pleasantly surprized!

I spent Valentines at the birth of a wonderful couple in Women's College Hospital. The birth was wonderful, everything went very well. So why was I pleasantly surprised? My only experiences with this hospital was one birth with midwives and several women telling me that their doctor was insisting they not have a doula.

One woman, a single mother with only her elderly mother for support asked her doctor about getting a doula and he told her it wasn't necessary, that he would be there and doulas were not worth it and would ruin their birth. She was a candidate for a volunteer doula and was the one person who really did need a doula. Thankfully she didn't listen to her doctor and had a doula and that took a lot of pressure off her and her mother to be there all on their own. Their doctor was not there for her, he wasn't even there for the birth.

My client this weekend told her doctor that that she was having a doula. He told her that their doula "had better watch her place. I'm not talking to her about you." I was worried that this doctor would ban me from the birth. He had some chip on his shoulder that a doula would encourage a client to go against their doctor. That a doula would give medical advice. That simply isn't the case. Doulas are not medical. Our role is to comfort, physically and emotionally. Our job is to educate and make sure that when a client has a big decision to make they are doing it with all the information.

So when I entered the hospital I was concerned that I would not be able to support my clients to my fullest abilities. Turns out the only problem I had was the incredibly small room. The nurses were awesome and respected my role on the team. The anesthesiologist was fabulous and let me stay for the epidural despite the size of the room. Her doctor went off shift and the new doctor was great and very pleasant.

I was very pleased with how everything went and stayed longer then I usually do. I'm actually looking forward to my next birth there.

2009 is the year of optimism

So I'm feeling particularly optimistic these days about what 2009 has to offer. Let consider 2008 as the year of trial and error. I had some awesome births, I had some that were horrible and one that was completely devestating to me and made me question my strength to continue on in the birth world. I took courses, I learned lots, not only about birth and breastfeeding but about myself. I became a stronger person. I became a better mother, a better wife, a better daughter and a better doula.

2009 will see the birth of many babies and also the birth of a new chapter in my doula life. This chapter includes new training, a new partnership and the birth of a new organization. The Toronto Doula Group will be emerging and taking on the doula world by storm.

I'm so excited about this and I know that there is only good things ahead of me in this brand new year. So watch out, I'm here and I'm not leaving.

Inductions suck! (A Very Tired Rant)

Let me start by saying that for some, inductions are necessary. Those women with high blood pressure or PIH, those with gestational diabetes and those who suffer from other illnesses that may threaten their or their baby's life. For them inductions have saved lives.

Having said that, for women who are "past date" or their water has broken or their doctor is impatient inductions SUCK!

The main reason being that they are designed to fail. Lets consider how it goes:
The pregnant mother comes into the hospital with the belief that her baby is 'overdue', 'very large', 'her water has broken 24 hrs ago', or they had thought they were in labor and the hospital was not busy and even though they were only 1 cms dilated they were kept and given a room. (Hint, go home!!!!)

She is told, for whatever reason, that she will need to be induced. The reasons given sound grave and usually the mother is so sick of being pregnant it is a straw she can't help but grab.

And thus it begins.
She is sent to a room. Forced into a hideous blue gown with her butt exposed. Propped up all comfortable in bed, (The first of the problems). Attached to fetal monitors (The second of the problems) and either her water is broken or she has an iv started and is pumped up with pitocin. (The third of the problems).

If the induction begins with breaking her water, there is usually a shred of hope in that she is able to walk around at least after a little bit of monitoring. This is good and necessary because women need to move in labour.

If she has pitocin then she is doomed. Women in labour can't remain in bed, unless their body is telling them too. Being on pitocin she must stay monitored and thus stuck in bed. Thus begins the interventions.

An epidural follows because the contractions she is getting from the pitocin are unnatural and very painful and being stuck in bed she can't move around to find a comfortable position. You can try sitting in a chair or standing or even on the birth ball, but heaven's forbid she should move because then the monitor won't pick up the baby and the nurse has to reposition it until the baby can be 'found' again and that usually involves the mother being uncomfortable and begging for pain medication.

Thus the epidural now has slowed the labour and mom isn't labouring at the rate she should. According "the text book" you should dilate at a cm per hour once you hit 4cms. Now because of this delay the pitocin is continuing to be increased. After a while the baby may not tolerate the pitocin contractions and the heart rate will dip repeatedly and the pit is stopped but the contractions do too and then the cycle starts. After a while, usually just enough hours to really drain on the mother and her partner the doctor mentions the dreaded "C" word. At this point, the dips on the monitor have scared the parents, they are exhausted and just want to see their baby and be done with it all.

Thus the end of the induction is a c-section. Failure!

So then what are you to do? First off get as much information as possible before you are induced. Ask the following questions:
"Am I or my baby in danger?" If the answer is yes then you have no choice and the induction is necessary.
"What happens if we wait a little longer?" Most of the time it will buy you some time and if the answers you get are satisfying to you then, wait!
"What happens if we do nothing?" Again, more time is bought and you get more information to make a sound decision about the care you are going to be receiving.

Don't blindly jump into an induction without all the facts.

Second, there are lots of great ways to get your body ready for labour:
Massage, accupuncture, chiropractics, sex, and more.

Try everything else first.

Well that is my rant for the day. In case it wasn't obvious I had a failed induction on the weekend and while mom and baby are doing great I'm saddend by the fact that she missed out on the birth she was hoping for.

Therefore: Inductions Suck!