As of today, I’m officially a DONA-certified birth doula. Woo hoo!
Kristina French, CD(DONA)
Monthly Archive for January, 2008
After a cesarean birth, even when one is done with real cause for concern, some (though not all) women have a hard time adjusting. Instead of feeling like they were able to give birth, they describe their experience as their bodies being cut open, their babies taken from them, they felt completely out of control. Arms strapped down, they did not get the chance to hold and comfort their crying infant. Bright lights, the hustle and bustle of the surgical team, and the focus of what is going on below the curtain (the surgery) with little emphasis on what is going on above the curtain (the mother’s experience) all contribute to the feelings of confusion and fear. Once the new family is home, sometimes the mother has a hard time bonding with her new baby – did this child really come out of me? (She did not see it.) Am I really not pregnant any longer? (She did not, in her mind, give birth.)
And cesarean is not tea and roses for the infant, either. In normal birth, babies “choose their birth day” through a beautiful dance of chemicals and hormones that flow from baby to mother and back again, but begin in the baby’s brain. During a cesarean, the baby is unaware he is being born and is quickly removed from the womb, instead of having the opportunity of vaginal birth where the hours of labor that pass tell him that something important is happening. Babies are separated from mothers longer after birth, and often have a harder time breastfeeding because of this separation.
Enter the “natural cesarean birth” – a newer idea that is being pioneered at a British hospital. Lights are dimmed for a calmer experience. There is no curtain – the mother can watch the baby emerge if she wishes. The room is quieter. The baby is born slowly, allowing the mucous to be naturally removed from the baby’s lungs (as it is with vaginal birth). The baby is placed on the mother’s tummy, skin-to-skin, within the first three minutes, and mom is able to caress her new child with her hands, which are free. Perhaps a doula was present – a calming presence in the delivery room for mother and another support person in the event mother and baby have to be separated for longer – one support person for baby (the partner) and another for mother (the doula).
Although this is far from the standard of care in the rest of the world, it may be possible to raise awareness for these ideas by writing a few of them into your birth plan then discussing them with your care provider beforehand, in the event a cesarean birth becomes necessary.
An essay about a new way to approach cesarean birth written by an obstetrician here.
The National Center for Health Statistics has released final prematurity birth data for 2005. The preterm birth rate (babies born at less than 37 weeks gestation) is continuing its rise.
2004 – 12.5%
2005 – 12.7%
2006 – (preliminary) 12.8%
These may look like small jumps, but in the health statistic world, they are big. Each .1 percent increase accounts for over 5000 more babies a year. There were 543,000 babies who were born in 2006 that were at a high risk for brain, breathing and digestive problems and death in the first days of life. (I would also add that there are added risks of breastfeeding problems and a possible mother-infant bonding issues resulting from having to be separated in the first days of life while the baby is in the NICU.) Prematurity is the leading cause of death for newborn infants.
The number of preterm babies born has climbed more than 20 percent since 1990. When we look at the numbers, that is staggering.
And the numbers aren’t just staggering in the medical sense, but financially as well. In 2005, preterm births cost the nation more than $26.2 billion in medical and educational costs and lost productivity. Average first year medical costs were about 10 times greater for preterm than for term infants.
So why is this rate climbing? It is a complicated question, and we don’t yet know all the answers. Risk factors include previous preterm birth, multiple pregnancy, IVF (even for single gestation), uterine or cervical abnormalities, low prenatal care, infections (ex: urinary, vaginal, uterine, or STD), clotting disorders, birth defects, maternal weight (under- or over-), a short time between pregnancies, smoking, alcohol, drugs, domestic violence (physical, sexual or emotional), lack of social support, stress, and long working hours with a lot of standing. There is a lot of research being done currently about environmental toxins being another possible cause of prematurity.
As most NICU nurses will tell you, this rate probably is higher because of another cause of prematurity that doesn’t make the statistics. Many babies end up in the NICU may not be officially labeled premature, but they might have been because of due date miscalculations. Many mothers take a best guess as to when their baby is due from the first day of their last period, which they may or may not get right. If a baby goes 10-14 days past her due date, there is a very real risk of complications with the viability of the placenta, and cesarean or induction of labor is indicated. I’ve noticed, though, that induction seems to be creeping into the language of many care providers early, and inductions are starting to be routine just a few days after a due date (a date which may or may not be correct). This means more babies are ending up in the NICU simply because they weren’t ready to be born yet. They may not be labeled premature, but if we would have known their dates, they would have been.
Why not give yourself the gift of celebrating your form in all its ripeness and at the same time involve yourself in a fairly new, woman-centered ritual of pregnancy? I do belly casts. My fee is $75, which covers my supplies and time.
Belly casts can preserve your shape, let you celebrate your own beauty, and serve as a keepsake of your journey to parenthood. You can decorate your belly cast with paint, feathers, photos of your baby, buttons, baby hand/footprints or any number of things. They can be made to hang on a wall if you wish or can be put away to serve as a reminder of the belly that – believe it or not – you’ll miss when it is gone.
Go on, celebrate your form! It is beautiful!