Saturday, November 8, 2008

My attention was brought to this Article by Heather Cushman Dowdee

Industrial Childbirth

“Revisiting my son’s birth has made me angry.”

* Shonagh Strachan
* | 15 Oct 2008

* mother
* childbirth

Industrial Childbirth

My experience of childbirth was not an unusually traumatic one. In medical parlance I had an NVD: a Normal Vaginal Delivery. The midwives were pleasant. I was given an epidural. I was admitted to hospital at 2pm and delivered a healthy baby boy ( 8lb 7oz ) eleven hours later. This is the essential information, is it not? This is the only kind of information that we ever really hear about other women’s experiences with childbirth.

But there is more to it than that. It took me a while to sort out my feelings after the birth – the elation you feel at the presence of a new life combined with your physical exhaustion leave room for little else. And I never really experienced the hopeless grief of the flippantly named “baby blues” in the weeks or months that followed. What I felt – when I was finally able to identify the reasons for my confusion – was anger.

Is anger only blame and self-pity? Or can it be illuminating? For me it can – anger has traveled beyond blame, beyond the individuals involved and my personal experience, and shocked me into changing my whole outlook on life.

I wasn’t angry during my pregnancy at the lack of options for childbirth. I never knew what else I could expect. I wasn’t angry during any stage of my labor. As soon as I was admitted, I was told that I was two centimeters dilated and my waters were to be broken with something resembling a crochet hook. “Okay.” After that I wandered the halls and breathed through contractions for a few hours. When I was re-examined, I hadn’t “progressed” enough. I was told this was dangerous for the baby, and I needed an Oxytocin drip to speed up and strengthen the contractions. “Okay.” Now, these heightened contractions would be very painful so I’d probably be requiring pain-relief. “Okay.” The epidural is probably the most effective “Okay.”

I gritted my teeth but I wasn’t angry as the drip was repeatedly and painfully inserted incorrectly into my hand, or as the epidural took 20 minutes to stick into my spine. I wasn’t angry that I wasn’t allowed to eat anything even though I was very hungry. And I wasn’t angry that my parents weren’t allowed to see me in the delivery ward after driving for hours to be there.

As I watched the clock pass midnight into Halloween, fireworks cracked and flared outside the hospital. I smiled knowing that my baby would have great birthday parties to come. And for this next hour, I shivered in freezing shock, immobilized on the delivery table, uncaring and unangered as the drugs wore off so I could finally push. I wasn’t angry because the hospital staff was just doing their jobs and it seemed so normal for them. I was moving towards having my baby and this is what every mother went through.

The point at which I started to feel a twinge of anger was when, after the delivery, I wasn’t allowed to feed my baby. It was only then that my instinct was strong enough to say, “No. This is really wrong.” There is a period of about an hour after the birth where the newborn is alert and breastfeeding can be established. However, after a brief hold, he was taken away as I was given a Syntometrine injection and his placenta was delivered (by tugging on the cord). He remained away as I was stitched and examined and had to wait for a doctor to examine me.

By the time I was given the all clear (in tears at this point asking, “Can I feed him now?”), I had to be moved from the delivery ward and down to the post-natal ward. It was now 2 am, so friends and family in the waiting room were told to go home without ever having seen the baby or me. The baby’s dad had been present at the birth but was also sent home. Yet again I asked, “Please, can I try to feed my baby?” but he had to be taken away again – this time for a Vitamin K injection and for the nurse to bathe him and put his first vest and Baby Gro on.

When she brought him back he was tired and wanted to sleep. The nurse asked if I still wanted to feed and gave a little perfunctory hold of him up to one breast and then the other and said, incredibly, “No. He’s not a boob man is he?” She then put him down to sleep in the cot beside me, told me to sleep too and that I could try again when he woke up. I spent that first night wide awake, watching every twitch my new son made, desperate to hold him, horrified that I hadn’t managed to take him to my breast after he was born.

When he finally did wake up, I remember ringing for the nurse – looking for her permission to pick him up! This same nurse was the one who would throw back the curtains from around the beds at night if anyone dared to wish for some privacy.

Thankfully, my baby started to feed hungrily the next day. The rest of my stay in hospital was a blur of no sleep, noise, crying babies, feeding times, masses of visitors for two hours and then being left completely on my own. On the second day I remember being allowed to meet my teary mom at the end of the corridor as she passed me some supplies. Later that day I finally managed to have the baby fed and sleepy at a time when there was a lull in hospital activity. I was just dropping off – for the first time in about 70 hours – when I was woken up to bring the baby in for a BCG injection. I did so in floods of exhausted tears.

I gave birth to my son at the Holles Street National Maternity Hospital, in Dublin. Obstetricians at Holles Street have pioneered a policy of “active management” – an obstetrician-led intervention process that speeds up hospital labor. It begins with ARM – artificial rupture of the membrane of the amniotic sac or “breaking the waters” – though this may leave the fetus unprotected and vulnerable to pressure and infection. It continues with monitoring the birthing women and administering to them if they aren’t progressing “correctly.” In Holles Street, for example, the decided-upon correct rate of cervical dilation is 1cm/hour. If the mother “fails to progress” at this rate, she is hooked up to an Oxytocin drip which causes the onset of sudden intense contractions. In 2004 (the year I gave birth), 55 percent of first-time mothers at Holles Street were told they had “failed to progress” and needed to be sped up in this way (unsurprisingly, a slightly larger percentage opted for an epidural to ease the pain). Active management is currently used widely throughout the world.

The most oft-stated defense for the prevalence of today’s medicalized births is that in pre-hospital years gone by, childbirth could be a death sentence. The reality, though, is that most complications during pregnancy and childbirth occurred due to poor maternal nutrition and infections that are now easily treatable or preventable with better hygiene. The high-tech medical interventions available today certainly save some lives but in many cases – especially where active management is practiced – these interventions are often used unnecessarily.

There is also an often noted “cascade of intervention” where once one medical procedure has been carried out, another follows, and then another – leading to more invasive and traumatic interventions and often culminating in a caesarean section. In Ireland, the average rate of C-section is one of the highest in Europe at 25 percent. The midwife-endorsed alternative to this policy of aggressive intervention is “wait and see.” Strangely enough, this usually works out just fine.

In theory, a woman has the right to refuse any of the interventions offered to her. In practice, the normality of intervention and the culture of risk minimization (read: liability minimization) mean that women do not feel empowered to say “no.” I certainly never thought about saying “no” or asking what the alternatives were. I blame myself for this – that I was not more informed and proactive. But I am also angry at the bullying system in place. It is hurried and overwhelming so there is never time or space to question the “professional” medical opinion as to what is really right for you and your baby. So we become numbers, subject to routine interventions.

At Holles Street membrane rupture is carried out routinely. A “managed” third stage of labor is also routinely administered – with hormone injections and cord tugging to deliver the placenta. This is justified by saying that it reduces the risk of postpartum hemorrhage – a fact disputed by many midwives who argue that the early cord clamping involved is potentially injurious for the newborn and that the third stage of a normal birth should never be managed.

Until recently, episiotomy (cutting the perineum to allow more room for the baby) was routine. It is now being shown to be usually unnecessary and at worst a mutilation. Until recently, if a woman had one caesarean section, she could not expect to be allowed to try for a vaginal delivery in subsequent births (this is now slowly changing). At Our Lady of Lourdes hospital in Drogheda, Dr. Michael Neary carried out unnecessary routine hysterectomies, post-caesarean-section, over the course of 25 years before it was brought to light in 1998. At the same hospital (and at Holles Street, the Coombe and others around the country) between the 1950s and the 1980s, hundreds of women underwent a procedure known as a symphysiotomy. Here, a woman’s pelvis was literally sawn apart during childbirth, as an alternative to a cesarean-section. The justification seemed to be a good catholic one – the pelvis would heal widened and the woman would be able to bear more children – even though most were never even told what procedure had been carried out on them and many suffered life-long pain, incontinence, problems walking and arthritis. This is the history of routine interventions by those who know what’s best for us.

Our collective idea of childbirth is pretty nasty – blood and fluid, panting and screaming, stretched anatomy, the emergent gooey greyish-purple alien… horrible! Remember when you first heard about sex? Remember how horrible that seemed? But sex isn’t horrible, is it? What’s missing – and indescribable to a virgin child – is the emotional element. Sex is a natural and beautiful process, all entangled with love and passion. So too, and a million times more, is birth. In essence, our modern patriarchal institutionalized world has a childish view of childbirth. It can’t imagine that something that looks so gruesome could be anything but a horrendous experience and one that should be shortened and medicated. But childbirth is not a medical procedure any more than sex is.

Now, I’m not saying that every woman should have a pain-free, blissful, complication-free birth. I am saying that fear has no place in the process. Fear causes adrenaline production. This initiates the “flight or fight” response where blood drains from the uterus to the limbs, slowing the process of labor until the primeval woman escapes to a safe place to give birth. Meditation and relaxation techniques during childbirth – which are often described to women as methods for coping with pain – can in fact be methods of preventing pain by preventing fear. As with sexual intercourse, if a woman does not feel safe, relaxed and preferably loved, she will experience tension and pain during childbirth.

Without ever taking a single deep breath or doing a second’s meditation, what woman wouldn’t feel more relaxed anywhere but on a table in a hospital delivery “suite”? Looking back on it, it seems like the most ridiculous place to try to give birth. As with sex, your body wants a darkened, intimate, safe and private place to give itself over to its natural urges and processes. Instead, we retain bizarre postures under the bright lights and the ready interference and stares of strangers. Could you orgasm under the same conditions? Are you surprised then that our labors “fail to progress,” with fear and adrenaline coursing through every vein in our bodies? Overcome it with drugs. Pull, drag and cut those children out of us. Then tell us to be thankful. Mothers, partners, sisters and doctors tell us we are endangering lives, we are taking risks. Fill us with fear. No woman wants to endanger her child’s life so almost every woman does what she’s told and gets hospitalized.

Is it shocking to hear that many women liken the experience of “normal” hospital childbirth to being sexually assaulted? Aside from the obvious – the exposure of your most intimate areas to complete strangers – there is an utter lack of control over what is being done to your body. Your consent may never be sought for certain procedures – or it may be sought in the coercive manner of institutions that count on your fear for your cooperation. The feelings that may be experienced afterwards are those of shame and guilt that you weren’t able to give birth naturally, that you didn’t ask the right questions, that you gave up control and weren’t strong enough to resist certain things being done. These feelings can be particularly strong if the mother is separated from her newborn – for example, after an emergency C-section or if a baby is incubated. In some of these cases, mothers can experience bonding problems with the infant. Even once bonding is achieved, the guilt that accompanies this can be life-long.

But surely many mothers experience hospital births without mental trauma? Surely the fact that there is a healthy infant in your arms makes up for anything you went through? Aren’t you safe? Shouldn’t you be grateful to the hospital for delivering your baby? (Do women ever get to feel grateful to themselves, to feel the power and ability of their own bodies?) Won’t questioning the event just cause unnecessary pain and distress for women – shouldn’t they just forget about it and move on with their lives? Like survivors of sexual assault, survivors may live years, or their whole lives, unconscious of feeling anguish or anger about their experiences. But this doesn’t mean they are unaffected by them.

It is my belief that at some deep level, we all feel that we have been robbed. We pass through our childbirth initiation to become disempowered, disconnected, long-suffering, patriarchal mothers. We tell our horror stories as just that, or we say nothing at all. But it doesn’t have to be this way. If I ever have another child, it will not be in the same way. And it doesn’t stop there. I will never again blindly place my trust in authoritarian professionals and institutions. I will recognize all capitalist patriarchy for what it is and I will do my best to speak out against it.

Every day, in every way, my son is a wonderful gift. I would go through ten more hospital births just to keep him. I am sorry for his shabby entrance into this world but I am thankful to this little person for helping me to see something: the bald, blatant, oppressive, damaging, misogynistic forces at play in the most vital aspects of women’s lives. Revisiting his birth has made me angry, but that has made so much else clear: how blinded we can be by the guise of protection, how crippled we can be made by fear.

I wish that we talked about it. That we could stop reveling in horror stories and better place our fingers on the reason for our traumatic births – not the curse of Eve medicated to by our benevolent system – but the systematic violence that delivers our babies for fear that we might give birth to them ourselves. For in the process we might begin to understand our own strength and find words for our anger. We might begin to disobey.
Read more articles from Issue #80 - The Freedom From Want

Saturday, October 25, 2008

From Dr. Mercola's Website

Prominent Scientist Warns of HPV Vaccine Dangers

one less, gardasil, cervarix, HPV, human papilloma virus, virus, vaccine, STD, fertility, infertility, sterility, sterilization, population control, abortion, reproductive problems, pregnancy, WHO, world health organizationIndependent health researcher Grace Filby, who won a Churchill Fellowship for her research into phage therapy, is calling on the government for more research into the possible side-effects of the HPV vaccine that is currently being given to teenage girls.

Filby believes that not enough is known about the effects of the vaccine on children with pre-existing medical conditions and weakened immune systems. She says, "We simply do not know whether the vaccine interacts with other medication or medical conditions, and the manufacturers have not studied it yet. This could be a very valid reason why some families and schools might hesitate or opt out."

She has this week written to UK education ministers and health officials calling for urgent small-scale independent studies that would highlight any health problems stemming from vaccinations already carried out.

* Medical News Today October 1, 2008

Here at Last — New Krill for Women
Find Out More

Dr. Mercola Dr. Mercola's Comments:

According to the CDC, the human papilloma virus (HPV) is the most common sexually transmitted disease in America. More than 6 million women contract it annually, yet cervical cancer claims less than 3,900 women – most of which are due to not getting regular Pap smears. In the U.K., cervical cancer claims a mere 400 lives per year.

Why is your risk of dying from cervical cancer so low?

Because your immune system is usually strong enough to clear up this kind of infection on its own, and does so in more than 90 percent of all cases. The CDC even admits to this fact on their website.

And, as long as you’re getting regular PAP smears, cervical cancer can be caught in its early, and easily treatable, stages.

So, the question begs to be asked: WHY is the HPV vaccine being pushed so vigorously when:

1. it prevents a type of cancer that is very rare to begin with
2. it protects against a virus that, 98 percent of the time, is not the cause of cervical cancer
3. it prevents a type of cancer that can be easily caught and treated by promoting regular gynecological exams
4. it offers less protection than what promotion of safe sex practices could accomplish
5. it is promoted to girls years before becoming sexually active, even though the vaccine may only offer about three years worth of protection
6. it prevents just 4 out of more than 100 strains of HPV; all of which your body can clear up on its own in 90 percent of all cases anyway
7. it has NOT been proven safe. No one knows if it can cause cancer or infertility, for example

And why would the feds go so far as to add Gardasil to the list of vaccinations that all female immigrants ages 11 to 26 MUST get before they can obtain a green card? We’re not dealing with potential import of bubonic plague here…

According to a New England Journal of Medicine study, the use of condoms reduces the incidence of HPV by 70 percent, offering FAR better protection than Gardasil, for example.

The HPV vaccine is a total head-scratcher of a mystery as far as what its ultimate purpose is, because “curing the rampant health disaster of cervical cancer” is certainly NOT it.

And since when do we have to be vaccinated against cancer in order to be let into a country?

Does the HPV Vaccine LITERALLY Mean “One Less”?

Marketing geniuses are known to play on words and create slogans with quirky double meanings, and if you’ve been tracking the concerns raised about the potential hazards of Gardasil and Cervarix, the potential for these HPV vaccines to cause infertility – whether purposely or inadvertently – is being heard with ever increasing frequency.

The federal government's Vaccine Adverse Events Reporting System (VAERS) has received over 9,000 reports of problems since the vaccine's introduction in 2006, which include at least 28 spontaneous abortions, and 27 deaths.

Is it possible that Gardasil’s cry to fame, ‘One Less’, is turning out to be nothing but a sick, ironic play on words?

Anti-Fertility Vaccines

The World Health Organization (WHO) and its subsidiaries have been actively researching and funding the development of contraceptive / anti-fertility vaccines that prevent full-term pregnancies to take place, for over 20 years. There’s even a Task Force on Birth Control Vaccines of the WHO!

However, no anti-fertility vaccine has ever been placed on the market and promoted as such as of yet.

Instead, as described in a 1993 journal paper published in The British Medical Bulletin, anti-fertility vaccines were being engineered “incorporating tetanus or diphtheria toxoid linked to a variety of hCG-based peptides.”

The authors of this article state,

"The fundamental principle behind this approach to contraceptive vaccine development is to prevent the maternal recognition of pregnancy by inducing a state of immunity against hGC, the hormone that signals the presence of the embryo to the maternal endocrine system.”

Free tetanus vaccines that were offered to young women of childbearing age for years in countries such as Tanzania, Nigeria, Mexico, and the Philippines, were found to contain human Chorionic Gonadotrophin (hCG), which causes spontaneous abortions if the woman becomes pregnant.

While the woman is not technically sterilized, once injected with hCG, she may never be able to carry a child full term thereafter.

HCG-containing anti-fertility vaccines have also been pursued for more than two decades by the Indian National Institute of Immunology, and The Population Council of the Rockefeller University, among others.

In fact, there are no less than 50 research papers detailing research on “contraceptive vaccines” in the PubMed database.

One disturbing paper published in the FASEB Journal in 1993 states:

“… we initiated studies relating to possible mechanisms of action and potential side effects of this vaccine, which should be relevant to world-wide regulation of population growth.”

So again, why the frantic push for the HPV vaccine, created for young, fertile women, when there’s NO solid, rational basis for its use?

Massive Brazilian Vaccination Program Raises Suspicions of Covert Sterilization Plans

A much more recent case of illogical mass vaccinations against a minor health problem is that of the massive, mandatory vaccination program in Brazil, which has raised suspicions among international pro-life activists, who note that the program is similar to other vaccination programs in recent years that have included a hidden sterilizing agent in the vaccines.

The campaign to “annihilate rubella” began in early August this year, mandating rubella vaccinations for all women ages 12 to 49, and 12 to 39 for men; a total of 70 million people, despite the fact that only 17 Brazilian children per year suffer birth defects from the disease.

Adolfo Castañeda of Human Life International notes that just two years ago, researchers found that the rubella vaccine used in a similar campaign in Argentina was laced with human Chorionic Gonadotropin (hCG).

“The suspicion that brought about the investigation [into the rubella vaccine] was caused by the fact that there were very few cases of the disease in Argentina, which didn’t merit a large-scale campaign,” Castañeda said, adding, “The ages for women are the same as those who received the vaccines in Nicaragua, where they included a hormone that sterilizes the woman who receives it, and similar to the age of those who received another sterilizing hormone in the Philippines.”

Polysorbate-80 – One Less Mouse, Researchers Found

Now, let me state clearly that there’s no proof of hCG being present in any of the current HPV vaccines.

I am merely playing devil’s advocate as I examine the similarities between these other irrational vaccination programs in other countries for relatively minor public health concerns -- that turn out to have far more sinister agendas than mere greed – compared to the fervent, irrational push behind the HPV vaccine here in the U.S.

However, Gardasil does contain Polysorbate-80 – a surfactant used in pharmacology to deliver certain drugs or chemical agents across the blood-brain barrier -- which has been linked to infertility in mice.

Researchers Gajdova found that administration of Polysorbate-80 decreased the weight of the uterus and ovaries, and caused chronic estrogenic stimulation. The ovaries of the mice were also without corpora lutea (a mass of progesterone-secreting endocrine tissue that forms immediately after ovulation) and had degenerative follicles.

So what might the estrogenic effects of Polysorbate-80 be on pre-adolescent girls and pregnant women?

Anti-Fertility Vaccine Ingredient Also Has Clinical Application in Cancer Vaccines…

A potential coincidence I find most disturbing is some of the more recent research detailing the use of hCG, and other molecules, in vaccines against hCG-producing cancers, such as – certain cervical cancers.

One 2005 paper titled, Recent advances in contraceptive vaccine development: a mini-review published in the journal Human Reproduction concludes:

“At the present time, studies are focused on increasing the immunogenicity and efficacy of the birth control vaccine, and examining its clinical applications in various HCG-producing cancers.”

But research published just a few months ago in the journal Molecular Cancer states that the free β-subunit of hCG (hCGβ) – which was originally considered biologically non-functional -- has recently been shown to stimulate tumor growth, and lead to more aggressive tumors that are more resistant to therapy.

Again, I’m mentioning all of this because it just goes to show that pharmaceutical companies have little or no clue of the extent of harm these vaccines might cause, especially long-term. Something believed to be completely non-functional or harmless can turn out to be a MAJOR cause for concern after more thorough investigation.

For example, Gardasil also contains L-histadine, and histamines have been found to increase clot production five-fold when combined with, guess what? Surfactants! (L-histidine can also pass through your placental wall to your fetus.)

Granted, this laboratory investigative report titled Surfactants Attenuate Gas Embolism-induced Thrombin Production used surfactants like Perftoran, not Polysorbate-80, in their trials, but could Polysorbate-80 have a similar effect?

Could this explain why death from blood clots within hours or days is the MOST COMMON form of death after receiving Gardasil?

The HPV vaccine clearly has a lot of questions left to be answered. And those questions should be answered BEFORE pushing Gardasil on an unsuspecting public at the rate that it’s being done.

Be One Less to Get Gardasil

I think this would be a more appropriate message to send out to young women: There is absolutely no reason to risk the serious side effects of this vaccine to prevent an infection that goes away on its own 90 percent of the time. And there’s no guarantee that you’ll be protected anyway, since you can still get HPV once you’ve had the vaccine. It’s really a no-win situation for those who receive it.

Of course, you can radically reduce your risk of getting HPV in the first place if you follow safe-sex practices, or wait to have sex until you’re in a committed relationship. Then, keep your immune system in tip-top shape, and it will be more than able to shake any HPV virus that comes its way.

Wednesday, September 3, 2008

On Going Green

Being Green has become one of the most trendy things a person can do. It's exploded into a status symbol. Any famous person worth their salt is either planting trees in Africa or flying huge jet-planes around, preaching about being green, promoting eco-friendly habits or posing for organic clothing ads. However, I've noticed that the more trendy something is, the more expensive it tends to be.
Some time ago, I was a member of a naturally minded parenting group that met at each other's homes once a month for play-dates. My experiences with these women were my first hard-core introduction to doing things “green”. These women were all upper-middle class white women (for the most part). They all lived in nice houses, had two cars, manicured lawns, big back-yards, children that wore organic clothes and they all wore Birkenstock's. Ok, not ALL of them wore Birkenstock's but you get the picture. . They all did the same things I did (breastfeeding, cloth-diapering/ec, baby-wearing, etc) our approaches were about as different as they could get. They cloth diapered because it was “natural” and ec'd for the same reason. I did these things because I couldn't afford to do it any other way. These women's children sported the fanciest, prettiest most adorable $15-30 butt-covers I'd ever seen. It goes without saying that breastfeeding is the very best choice for my children's health, but I would be lying if didn't admit that the fact it's 100% FREE played into that choice, as well. For them, it was natural for well educated, progressive women to do the natural thing and nurse their babies. The natural lifestyles these women led came in sharp contrast to their SUV-driving status. My point is that at first glance, it appears that “going green” is something for the rich and famous (or at least the moderately wealthy). If my readers are anything like I was, going green is downright intimidating and may even feel impossibly cost prohibitive.
Thankfully, it doesn't have to be that way and without realizing it, we got greener and greener over the last couple of years, almost by default. “Natural” living is a slippery slope and even though it's not necessarily recognized, its' hard to go natural without going green, too. Surprisingly, in many ways it's actually cheaper than doing things conventionally, too (providing you don't buy into the consumerist gimmicks that have followed the green movement almost since it's inception). For us, it actually started with breastfeeding. Nursing our babies is the simplest, cheapest way to nourish our children. It never occurred to me to do anything else so being a “lactivist” was never part of my motivation for nursing my first child. I did a lot of research on the topic, however, because I wanted to be successful and what I learned caused me to become a rather outspoken breastfeeding supporter. Breastfeeding our babies actually has a significant impact on the the earth and therefore the people around us, not to mention those roly-poly little people that deserve nothing but the best. All health benefits aside, there are no big, pollution spewing factories involved in the manufacture of the bottles that aren't needed, the cans for formula that aren't used or, of course, the unnecessary formula. Some breastfeeding mothers will need some of those things (bottles, for example, or breast-pumps) but not necessarily. For those that do, they are saving so much money by not buying formula, that they can probably afford the extra expense for eco-friendly bottles/nipples/pumps.
From there we came upon the issue of diapering. I remember when I was pregnant with my first, I was absolutely adamant that I would NOT be cloth-diapering. Too much work! I still chuckle at myself, looking back. As it happened, disposable diapers turned out to be a much bigger money-drain than I initially realized so I began the hunt for affordable cloth diapers. It was during an Internet search for these that I came across a post by a woman who was talking about the success she was having with her 5mo old on the potty. I could not believe my eyes. EC (or elimination communication, also known as Infant Potty Training, Early Potty Learning, Natural Infant Hygiene, Trickle Treat and Un-diapering) is a practice as old as humanity. Growing up in the US, though, I had never even heard of it, except when wondering how African women carrying their babes in slings on their backs managed not to get peed on. So, of course, I scoffed at this woman's post and wondered where I could get some of whatever she was on. At the same time, though, she was so enthusiastic that I just had to look it up and figure out what on earth she was talking about. It was not at all what I thought it was and it made so much sense that I couldn't resist giving it a try with my 4mo old daughter. Our successful venture with EC is a story for a different day but it's worth mentioning here because within two months, we were done with disposables, I had a small stash of used cloth diapers and my 5mo old was reliably using the potty. How does this pertain to going green? Paper diapers take up an unbelievable amount of resources. The average baby goes through about 5,000 diapers between birth and toilet training. Diapers made up 3.4 million tons of waste, or 2.1 percent of U.S. garbage, in landfills in 1998 -- the last year this information was collected, according to the Environmental Protection Agency. An interesting excerpt from the following website says this:

“In 1988, over 18 billion diapers were sold and consumed in the United States that year.4  Based on our calculations ...we estimate that 27.4 billion disposable diapers are consumed every year in the U.S.13

No one knows how long it takes for a disposable diaper to decompose, but it is estimated to be about 250-500 years, long after your children, grandchildren and great, great, great grandchildren will be gone.5

Disposable diapers are the third largest single consumer item in landfills, and represent about 4% of solid waste.  In a house with a child in diapers, disposables make up 50% of household waste.5
The manufacture and use of disposable diapers amounts to 2.3 times more water wasted than cloth.3

Over 300 pounds of wood, 50 pounds of petroleum feedstocks and 20 pounds of chlorine are used to produce disposable diapers for one baby EACH YEAR.6”

All of the above plus, they are expensive. They don't seem so at first, but the bigger your baby gets, the prices on the packages go up and you get LESS diapers per package. Some people truly feel that cloth diapers start-up cost is rather high (and it certainly can be) but in the long run, it saved us a lot of money. Un-diapering saved us even more money and you can't get much more environmentally friendly than skipping diapers altogether.
Along with diapering comes the question of wipes. Wipes certainly aren't the most expensive item on the “must have” list for parenting but the reality is that every penny counts. I like to sew and I tend to have scrap bits of fabric laying around so, after being inspired by seeing someone else do it, I made a bunch of cloth wipes. I'm so glad I did, too. Not only were they practically free (they can be made out of anything from old towels to old t-shirts) they were so soft and had no chemicals in them. I was a happy “wanna be green” Mama! Four years later, I'm still a fan and I use my home-made wipes for everything from dusting the furniture to washing my face, to say nothing of the stack JUST for my baby's bottom. I'm not saying I never use conventional wipes or that I never buy paper towels. Sometimes I do. But usually, I use my home-made wipes. That reduces my personal use of the world's resources to water and some natural gas-powered washing machine usage. Oh! and laundry detergent (I've heard that you can make your own and I have a recipe but haven't tried it yet).
When we had our first baby, everybody and their brother gave us clothes. At that time, most of them were brand-new clothes as well wishers from seemingly every area of our lives showered us with gifts. When we had our second baby, though, we didn't need all that stuff because we had hand-me downs! We were blessed with another girl, so that made it even easier. I think this is one area of being eco-conscious that people often overlook. The clothing industry is a HUGE one. The clothes do not make themselves, they are usually manufactured in sweatshops (unfortunately) and are often made from non-natural fibers and even when they are not, textile mills are notorious for pollution. Our family is not wealthy enough to feasibly afford organic, fair-trade, entirely natural fiber clothes BUT we can afford hand-me downs! And we do so, without any shame. Good-will, Salvation Army, friends closets, etc, are doing more to help our earth than people realize. And of course, when those clothes are finally beyond wearable, we make wipes! Recently I began turning some baby clothes that weren't in good enough condition to pass to anyone into a patchwork quilt. Someday it would really be nice to be able to afford the aforementioned “super-green” clothes but in the meantime, we do what we can. It saves us a tremendous amount of money and it feels good to know that in some small way, we are doing our part for the environment, too.
It is my opinion that going green goes hand in hand with “waste not, want not”. We live in a disposable society. We want everything now, we want it to require little or no effort on our part to cook, clean up, put together, etc. We love our microwaves, our gadgets, our plastic throw-away containers and our dishwashers. The question is, though, “Do we NEED any of that stuff?” My husband and I have discovered that no, we do not. Having these things is not necessarily wrong, however, if every person was to take a hard look at all their “stuff”, I'm betting we could each pare down some things. This would positively impact the earth, removing one person less of various industrial wastes. Reducing how much we consume is a fantastic way to better our world. The fact is that things sell because there is a demand for them. If there is less of a demand, there is less production and less waste and ultimately, less garbage. Perhaps if, as a society, we moved away from needing to have every gadget and newfangled thing on the market, we'd do better as a planet.
One of the ways my family strives to do this is by paring down stuff in our home we don't actually need. Do I really need another bottle of shampoo to join the collection on the bathtub? Are 25 towels actually a necessity? Do I really need an entire closet-full of sheets for one bed? And what about those towels and sheets? They look ratty and worn? What could they be used for instead of running out and buying something else I don't need? Wouldn't it be better to use them than add another 2 or three bags of garbage to the dumpster? I have a friend that takes old bed-sheets and turns them into diapers for her kid. I know another woman who was very good at making summer play-clothes and pajamas out of things like that. I've seen baby pants made from Dad's old sweatshirts and beautiful diaper covers converted from a sweater that had a hole in it. I made a sling recently out of a sarong that had a hole in it. We ditched our microwave (it broke and we decided not to replace it) and we've never missed it.
There are many other little things that we do in our day-to day lives that I believe makes a difference. They don't have to be expensive or come with trendy labels on them. Most of the changes we have made that are better for our family and our environment were simple, inexpensive things that happened without our even realizing they were “green”. It is just simple, smart, frugal living.

Friday, August 22, 2008

My Work

I have the greatest work in the world;
The job of rocking a baby to sleep,
That of guiding his tottering feet,
A baby's clothes to launder and fold,
A precious life to shape and mold,
A drink to give from a little cup,
At night his toys to gather up,
Hurts to heal and fears to quell,
A baby to keep clean and well,
A stack of diapers to put,
Oh, what a happy worthwhile day!
I am a "Mother."

I have the greatest work in the world;
A husband to encourge when things go wrong,
When he comes from work to greet with a song,
Denims and shirts to wash and mend,
A helping hand, when needed, to lend,
Three times a day is meals to cook,
To strive to be my best to look,
His back to rub at the close of the day,
For his faithfulness to God I pray,
When hubby's in the field I take lemonade,
for all these tasks his love has Paid.
I am a " Wife."

I have the greatest work in the world;
A home to keep happy, clean and bright,
Make things go smooth and strive for the right,
Jams to cook and jellies to make,
Cookies and pies and bread to bake,
Washing, ironing, and sewing to do,
So many tasks, will I ever get though?
Lettuce to wash and peas to pick,
floors to scrub, lost items to seek,
Dishes to wash and windows to shine,
These and many more tasks are mine.
I am a "Homemaker."

Help me, Father, to faithfully work,
Forgive if I unconsciously shirk,
give me the patience and love I pray,
To keep myself in duties way;
With all the hustle that each day brings
May I not neglect the needful things;
Each day to spend time alone with Thee
That Jesus Christ be seen in me.
Thank you for husband, our home, our boys;
Thank you for love which brings me much joy.
Thank you , Lord.

----Mary Lou Burkholder

Wednesday, July 30, 2008

My UC Birth Story (the names have been changed except for mine and the baby that's being born)

Unassisted birth of my daughter, Abigail

April 11th, 2007: I started noticing some "difficult" contractions. I am a very braxton hicks happy woman, I've been getting them all day long since the very beginning of this pregnancy. I noticed them for the first time probably around 8 or 9 weeks. I don't mind, them I even kind of like them. They are reassuring to me, like a way of my body telling me that everything is working like it should be. Well, these weren't them. These were...well they felt like a warning. So many things were going on at the time that I chalked it up to stress and mentioned it to my husband in that context and didn't think much of it until the next day. The next morning I woke up and waddled my way into the bathroom to relieve myself. I discovered bloody show. I cannot even describe the barrage of feelings that flooded me when I saw that. I was 35wks pregnant. My first thoughts were dismissal. After all, bloody show by itself doesn't necessarily mean anything and really, it was probably just coincidence anyway. Unfortunately for me, that feeling of dismissal went right out the window as I had a painful contraction while sitting on the toilet. Then, I just freaked out in my head. I can't be in labor, dammit, I'm only 35wks pregnant! So I sat there and waited for another one. Nothing. Ok, fine, nothing, good. I got up and went about my morning routine, got dressed, dressed my daughter and had another one 20 min later. It didn't hurt as badly as the first one and was shorter. But there was this odd pulling sensation in my cervix that I recognized from being in labor with my first that meant that something was happening, albeit slowly. I knew I wasn't in active labor but I was certain this wasn't bh contractions, too. So I IM'd Paul and told him what was going on. He asked me if I thought I was in labor and I told him that no, I didn't think so but that I was really concerned as this was definitely prodomal at least and bloody show indicated to me a cervical change of some sort. I wouldn't have been concerned about that in and of itself but the painful pressure with each contraction was sort of freaking me out. I timed them at that time and they were coming sporadically but no farther apart then 20min and sometimes as close together as 5min. Their duration that day tended around 1min30sec with some variation. This went on all day and didn't let up until the late afternoon. Quieted down for dinner and came back with a vengeance when I went to bed. This was to be the pattern for the next seven days.

As I said before at first I freaked out. Paul and I had previously agreed that our safety-zone was 36weeks. We debated our options and in the meantime put me on bed rest. OH HOW I HATED THAT. It was hard for me not to have a bad attitude about it, particularly because I hate feeling like a useless couch potato and since I wasn't in active labor and wasn't sick, I just felt lazy. I knew in my heart that it was the right thing to do but you know, I couldn't help feeling like a giant bump on a pickle, making everyone's life harder. I had already spent the last month letting things go and taking it easy because of my pelvis and NOW I had to just sit down and dictate like some fat monarch on a bench. Yes, frustrating.

I spent a lot of time in prayer, tuning into my baby and into my Mama instincts. Every time I prayed and every time I "tuned in" to my baby I had this sense of peace. When I thought of transferring to the hospital, though, I felt this rising sense of fear. Now really, I have birthed in a hospital before, and while I do not believe it's the safest place (by far) for a healthy pregnant woman and her healthy baby, I am not terrified of the hospital and in some ways, being there again may have been a comfort as it's the only place I've birthed before so at least it wouldn't be uncharted territory. Nevertheless, I couldn't shake the feeling that going there would be wrong. I just knew we didn't need to go, that we shouldn't go and that I should do everything in my power to keep that baby in until at least Tuesday. We felt Tuesday was close enough to 36wks to be ok. So I quit freaking out. I assured everyone that things were fine, I probably just miscalculated my EDD and that we were going to be ok. It was so hard for me to admit that I may have just made a mistake in my dates. SO hard. Pride, anyone? We kept the my calculated due date, though, because it was the latest possible one and we felt it would be foolish to do anything else.

That week was the longest one of my life. Every morning the contractions would space out to infrequent and they'd get stronger as the day went on and taper off in the early afternoon and come back after dinner and keep me up all night long. I was emotionally strung out, exhausted. My head was in labor-land all day long, all I could focus on was the baby, keeping it in, wanting it out, etc. I went to bed early Wednesday night, telling my husband I'd probably have the baby on the 30th of May (my due date had been the 19th of May) and that maybe she just needed to be in a better position for birth and that's what the crazy week was all about. I truly just didn't believe I was going to have a baby this week after all. Part of me was disappointed but part of me was relieved and I think I had finally reached a point where I was willing to let go and let God, completely. I just realized that there was no way He'd lead me in this direction and with the complete support and peace of my my husband without taking care of us through it. Truly, and I'm sure I'll need to say this again by the end of this telling, my faith has never been tested harder nor strengthened as much as it was having this baby. It is difficult for me to convey the amount of prayer spent over this baby. Even before, during the pregnancy, Paul would pray over me and the baby, ever single night. Both of us just felt secure that God was with us, that this was His will for this birth and that we needed to trust Him. So...we did.

Thursday morning, April 19th, 2007: I was startled out of the deepest sleep I'd had in a week at 3:30 am with a contraction I was already on my hands and knees moaning through before really waking up. "Oooooooohhh, baby, baby, baby, baby" So much pressure down below it was phenomenal. When it was over, I just laid back down and went to sleep. I never really even opened my eyes. I remember thinking that it wasn't fair to do this to me while I was sleeping when it wasn't going to happen for another month, anyway. Sometime later I came awake to another contraction that had me up and moving around the bed, panting and moaning. Went right back to sleep. My attitude at this point was "whatever, body, call wolf as much as you like, I don't even care, I'm sleeping, thankyouverymuch!" I didn't watch the clock per se, didn't time contractions, but occasionally I'd look to see what time it was because I REFUSED to get out of bed until it was closer to time to get up. I'd really spent enough nights getting NO SLEEP so i was going to sleep between contractions for as long as I could stand it. But around 6:30 they were making it impossible to do so. I decided to get in the shower because I figured they would let up around 7:30 anyway and I really, really wanted to sleep. So hot shower would probably just facilitated the "drop back" of contractions and then maybe I'd get another hour to SLEEP.

The shower did nothing, if anything I just felt pukey in the hot water so I got out and went potty. Oh wow, look at that, bloody show. I mean, I hadn't had any for two days and now it was bright, red and copious. Before it was bloody mucous now it was mucousy blood. The contraction I had on the toilet was hard and I believe I was moaning through that one, too. I went downstairs to do my morning thing, still telling myself it was going to go away. I figured I'd update my livejournal and lay down on the couch so as not to disturb my husband and then they'd let up they had every other morning this week. I didn't want to believe I was in active labor, I just wanted to sleep. By 8am, though, I knew that I didn't CARE if I was in active labor or not, I could not possibly cope with those contractions all day, again, by myself with my daughter. No way, Jose! I went upstairs to find out if Paul would stay home with me. The thought of having to care for my daughter with contractions that were so hard I couldn't talk through them was just overwhelming and had me in tears. I asked Paul what it would take to get him to stay home today. He asked me why I wanted him to do that (he wasn't really awake yet) and of course, I started to have a contraction right then so I sort of gritted out, between my teeth "Why do you THINK!?!??!" He said "you think you're in labor?" and I said "I honestly don't know but I DO know that I cannot do this by myself today, I just can't."

Now see, we could only afford one day off for this birth. Honestly, any more than that and we'd be screwed. He was torn, obviously, because he wanted very much to stay home, he'd wanted to that whole week and he just couldn't and it made him feel awful. But he didn't give me an answer right away, he just told me that he'd wait a bit and see. I suggested to him that if he would just go in a little late, I'd feel better because the contractions would probably ease off for a while soon and I could cope with Elizabeth better.

They didn't go away and by nine am, my husband told me he was staying home. I contacted Rachel and told her I might be in labor and please have the girls stand by. They told me later she just told them I was in labor. I can't really remember my conversation with her but I do know that I was still thinking it might peter out and that I'd be pretty upset if it did because these contractions HURT. I mean, there was pre-labor ouchies and then there was OMG THE PRESSURE THE PRESSURE GIVE ME COUNTER PRESSURE NOW ouchies. See the difference?

This part of labor was so sweet. First of all, my daughter, Elizabeth, was still there. I had wanted her to be part of the birth, too, and wanted her to be there if she was ok with it. My final letting go for this birth was leaving that choice up to my husband as he really wasn't comfortable with her there. I think the stress of needing to be sure she really was handling it ok was just more than he felt comfortable dealing with; he wanted to focus on me. He called his mom and told her I was in labor and she said she'd come over but admitted later that she didn't believe him. She had just been out with me the day before and saw I was having contractions but also that they weren't active labor. Meanwhile, I was crawling around the living room on my hands and knees, leaning over the couch, pacing, bracing myself against the walls, etc, through contractions. I'd been showing my daughter birth videos my entire pregnancy and any of them where laboring mother yelled or cried I'd reassure her, telling her that the baby was going to come out and that Mama had to work very hard and sometimes it hurt so that's why she was yelling. The first time her Daddy gave me counter pressure I was moaning through the contraction and Elizabeth had freaked out and told him to stop it because she thought he was hurting me. So I explained to her that the baby was going to come out that day and reminded her that it was very hard work and that Daddy was helping me to do it. I tried taking a bath. While I was in there, Elizabeth came in (Paul was trying to fix her breakfast) and came over to the tub and gently started scooping water over me. She's TWO by the way. She says "It's ok, Mama, Daddy will be here to help you, soon" in this hushed, sweet little voice. Every time I had a contraction she'd reach out and touch me and tell me that it was ok, Daddy was coming. OMG just thinking about that makes me get tears every time!

I couldn't stand the tub (Fat woman + uncomfortable bathtub + intense back labor= crap.) I got out. I put my pj's back on and went downstairs and continued for a while, laboring on my knees, my chest draped onto the couch. I'd start making noise through a contraction and Paul would rush into the living room, from the kitchen, and give me counter pressure and rub my back and talk to me through them, Elizabeth watching the whole time. Sometimes she'd stroke my hair, or talk to Daddy or ask questions (I still chuckle at the mental picture of my husband rushing through the house with a towel over one shoulder and a spatula in one hand, to give me counter-pressure). When he left the room, at one point, she climbed up on my back (like she was going to "ride the horsey" and just her sitting in the exact right spot helped immensely. She then leaned forward and draped herself across my whole back and said "Daddy's coming, Mama, Daddy's coming, it's all right." I laughed a lot between contractions while she was with me. Oh I'm so blessed.

Ruth, my mother in law, showed up around this time and came into the living room and rubbed my back and asked me how I was feeling. I told her I felt good, that I was finally going to have a baby...hopefully. A contraction came and she suddenly believed that I was in labor!!! She had been present for Elizabeth's birth and I think she recognized the bellows. She had been trying to talk me out of a UC the entire pregnancy so in a half joking way, she asked me if I wanted to "go somewheres". I said "No, Mom, I'm in my jammies and I LIKE it here!" She laughed, I laughed, and she said "Can't blame me for trying!" She wished us the best, kissed me, kissed my husband and took Elizabeth and left. Elizabeth gave me hugs first and said that Daddy was going to help me, again, and "See you later, have fun!" She's so sweet.

Now my timing gets a bit fuzzy because with Ruth come and gone, I could really relax. I don't know what time Rachel got here though I think Ruth had come and gone by then. She cooked something for herself to eat and at some point in there Elise arrived. It was so cool to have them bustling around in my kitchen like any other time while I was wandering around dealing with contractions. I don't even know what they were doing most of the time although I remember thinking "Gee, this place gets cleaner every time I open my eyes". I know they cleaned the living room up (I said something like "it's too crowded in here" or something like that and the next time I opened my eyes it was like magic; suddenly it was all gone, clean, nothing on the floor!). In between contractions I pulled out some chux pads and the plastic sheet I had bought for the bed. I wanted it on the living room floor. Duct tape, incidentally, is a great way of securing a huge piece of plastic to a carpet! It just felt very homey, having my friends bustling about but not making a big deal. I heard laughter in my kitchen and the sounds of a very happy little one year old girl walking around (Rachel had brought her little girl). NO BEEPING. Oh how I hated that sound in the hospital for Elizabeth's birth.

The contractions got closer and closer together. They didn't seem to have any real pattern to them, really, at first, except I would get them in clusters. One, two, three a two three, etc. I had this intense pressure in my vagina with every contraction and it would wrap up the bottom of my uterus and into the small of my back with this incredible pressure. The pain was all down below, too, just in the bottom half. The pain in back was just immense and oftentimes it was the only thing I could think of. I was afraid of the pain!! I was, I was terrified of it and that in and of itself was a shock because I had not previously been afraid of labor pain. In retrospect, I believe there are three reasons for this: One was simply that I was just plain tired! I'd been laboring for a week! The second was that I subconsciously feared that they would get even worse because my only point of reference was the pitocen induced labor I experienced while birthing Elizabeth. The third reason is that the shock of having a baby much earlier than I anticipated left me rigid. I was just blind-sided by the reality that I really WAS having this baby a month early. I was so incredibly tense that Paul noticed and he started to talk me down. He would rock with me, walk with me, stand with me sit with me, whatever I needed and I never had to ask him once. I never told him what to do, either. It was like he just knew the right place to stand, the right thing to say, the right place to touch. "You can do this, you're doing an incredible job, babe, you need to relax, don't fight it, you can do it" just a litany with every contraction. He told me he loved me, that he was proud of me, that I was amazing and that he had faith in me. I can't even type this without crying! I just love him so much. When we had our first, he was there, he was supportive, but he wasn't free to really connect with me on an intimate level. The difference between that birth and this one in that regard was simply night and day. His talking worked, before I hit transition I was able to do something I couldn't do at all with Elizabeth's labor. I stopped shouting through contractions and instead breathed through them. When I look back on this labor, I remember this time as being the most peaceful. Paul was sitting on the couch, I was on my knees in front of him, leaning into his lap and I had my arms wrapped around his waist. He had his hands on my back and his head by my ear and with every contraction he just talked to me softly and I concentrated on expanding my belly around the immense sensations there. I cannot say I felt no pain, because I can't perceive of that feeling any other way, really. But I felt so much more than the pain. It was a fight, it really was, to stay on top of that pain and experience the rest of it but it was BLISS. I can't explain it. It hurt like a BEOTCH, no doubt about it, but it was SO MUCH MORE. I would feel a contraction building and would expand my belly around it, like we were in competition with each other, my outer layers with my inner. Or maybe more like we were dancing. It was like: my baby, covered by my womb, covered by my belly, covered by my my husband, covered by Yahweh. In my mind, womb would pull and clamp and my belly would expand and expand over it like I was trying to draw that painful feeling OUTWARD instead of loosing myself IN it. I would take these huge, slow breaths and fallow myself to open wider and wider and to not clench anything but my hands on Paul's arms or his shirt. That part was awesome.

I don't know how long that lasted but at some point Hadassah arrived. By the time she got there I was really very, very tired. I kept thinking that all I wanted to do was lie down and sleep. I even tried lying on the floor for a minute but that was awful and so not going to work. I know I draped myself over Hadassah's exercise ball for a while and she gave me some homeopathic arnica and something else to help me relax. Looking back, I know this is around where transition started because I just started to get angry with every contraction. I felt like labor was progressing too fast and not quickly enough. This wasn't supposed to be happening right now, I was supposed to have another few weeks to prepare. Contractions were supposed to stop again, like before so I could sleep and just WHO WAS IT that declared I should get a week of minimal sleep before doing this? Oh I was angry, I was exhausted, I was afraid. Every feeling of let-down, of anger, built up tension and every feeling of sorrow from the last several months just came pouring out of me. I don't remember all of what I said. Mostly a barrage of "I don't want to do this anymore" and " I can't" and " I NEED A BREAK!!!" I could not have articulated anything else coherently if I tried. I started sobbing. I've never cried so hard in my life. So much intense energy was flowing through me and I just could not contain it all. I couldn't integrate the pain *and the energy *and the intense emotions. Nope. Mouth gets free reign, my heart is open and my mind was just bubbling over.

Transition ended as suddenly as it started. I had a contraction that was very different. Pain in my back took a back burner to the DOWNWARD feeling contraction (I was standing through most of transition and I had my arms around Paul's neck). I really just like, squatted down into this contraction and just "OH MY GOD" through it. My whole body shook with the force of it. I felt like it was pushy except it felt very strange. The third one of these ended with me giving a test push and my water breaking on the feet of everyone standing around me. So many loving hands encouraging me and not a single pair of those hands ever touched me in any place I don't normally share :P. Heavenly. At this point, Paul said "Oh thank you so much for not puking on my feet, which is what I thought you were doing just now!" Laughter, all around. That sound will stay with me forever, I think.

I realized that the contractions had just stopped and suddenly, I was ok. No more whirlwind of thoughts, emotions, and feelings flooding me. I said "Oh good, a break!" and sat down on the couch. Paul took a break and went outside to smoke. I was ok, I was in this little place of waiting in my head and felt like everything was on hold for a minute. I know there was conversation and I know I participated in in it but I really am not sure what was said. All of the sudden, I just needed to stand back up. So I did. And then I had another contraction or two and then another one that was HUGE. Then, like in a dream I had at the beginning of this pregnancy, I felt the whole baby come down in one huge, sliding motion and slam into my perenium. I wanted to push but something told me to wait and see what was presenting. I gave a test push and then said "What IS that?" WHAT IS IT???? Paul came back in and got down and took a peak, while Hadassah was trying to help support me from behind. It crossed my mind that I am an awfully big woman for her to be holding up like that but wow, she did it anyway!!! Paul said: "It's a head OH WAIT, that's a foot and a butt!!" Then, I felt a squirm and two feet kicked their way out of me and into the air, of their own volition! This baby wanted to come OUT. A contraction and a biiiig puuush. Oh that felt good, it was the best push EVER. Baby out to her umbilicus. I heard someone say "Oh it's so small!" Mixed feelings with that announcement. A brief brush of fear which I shoved out of my mind as quickly as it entered with a fierce determination that everything would be fine. As I was doing that, the baby kicked her daddy's hands. I remembered another dream from over a year ago of me having a baby breech and I just laughed out loud. I couldn't believe it!! I mean, I had been fascinated with breech stories my whole pregnancy and spent some time studying breech presentation during my preparation but for some reason I was convinced the baby was vertex. I believe the Spirit tried to tell me but that I just wasn't willing to believe it for some reason. I honestly think that a part of me knew all along she was breech but I cannot explain my reluctance to admit it to anyone. I certainly thought about it a few times during the week before her birth but I refused to give those thoughts any real attention and instead kept insisting to myself that I was wrong, that the baby was vertex. *shrug* I don't know why I did that, but there you have it.

Well I wasn't having contractions again. So I pushed without one just to see what would happen. Nothing, nothing happened at all. She didn't budge. So I tried again, this time squatting into it a bit. That felt wrong. So I turned around and leaned over the couch again and tried again. Nothing, not so much as a smidgent of a budge. I prayed out loud, "Abbah, I know this is you, I know this is ok, what am I missing? I trust you, tell me!" She punched my in the birth canal and like a light bulb, duh, her arms!!! "Hey, where are her arms?" Several voices at once "they are still inside". "Ok, honey, reach up in there and bring her arms down" He started to poke around like he was afraid he'd hurt me. "Don't worry about hurting me JUST DO IT!" He said "Ok, babe" and poked two fingers in there and hooked and arm and brought it down. He told me her other arm came down on it's own. THEN I had a contraction and pushed the rest of her out in one push. My legs were shaking so badly at this point that all I could do for a second was breathe deeply with my face in the couch cushion, . Everyone was so quiet I realized that I needed to turn around and tend to the baby.

I could tell from the hush in the room that everyone was worried. I just smiled to myself. I knew everything was ok, despite that nagging little snarky voice in the back of my head that said "what if..what if...what if..." I thrust it away and turned around and sat down on the edge of the couch, on a Chux pad and Paul handed me our daughter. She was seemingly quite limp and that purplish color that baby's who are pinking up turn. It was hard to see through all the vernix. Paul looked right into my eyes in that moment and I couldn't read his expression, it was just too full of too many things. I took my daughter in my arms and put her face down over my left arm and started talking to her. "Abigail, come on baby, I love you!" I started to rub and gently pat her back, making sure her head was at a slight incline towards the floor. She moved her foot and I noticed she was getting pinker by the second. I could feel the cord pulsing between us. I had a fleeting thought to call an ambulance but brushed it aside gently, to be considered later if it was needed. I kept talking, kept rubbing and she squeaked, coughed, and squeaked again. I turned her over without really thinking about it and sucked her mouth out, spat, sucked her nose out, spat, nose twice more and by the time I was finished with that she was hollering about it to the whole world. Eyes open, lungs going, lip trembling. "I'm HERE already, goodness, just don't do THAT again!!" We wrapped her up with a blanket, a hat came from somewhere an everyone was smiling. Welcome, Abigail!!

We waited about an hour to cut the cord. It was totally limp and we clamped it on baby-side and didn't bother with my side as I'd delivered it maybe fifteen minutes after Abby was born. She was TINY (she weighed 4lbs 10ozlbs and was 17 3/4” long). I could tell she was good, by the time she'd stopped crying, there was no gurgle left to her breathing and she was just looking around with her little hands folded like she was surveying her surroundings sort of grumpily. No retractions, no cyanosis. She was perfect. She looked like a wizened old lady, , and that made me laugh. I tried to nurse her but she wasn't at all interested in that so skin to skin for a while and then I passed her off to Paul so I could get cleaned up. I went up, took a bath and carefully checked around for tears or lacerations. Nothing. Not so much as a skid mark (that I could feel). I came back downstairs after getting dressed to discover the entire mess was cleaned up. Paul said it took about five minutes (he just rolled it all up in the aforementioned plastic mat and threw it in the trash). I settled onto the couch with my new baby girl and offered her a chance to nurse. This time she was ready and opened right up and we began that "eyeball talk" that all mothers have with their babies. I was just enthralled. I couldn't believe how tiny she was, how perfect every little detail was. I still feel that way, , looking at her is like looking at a tiny little miracle.

I cannot express enough my relief we stayed home. I'm so glad I kept her in a week, too. How to express my gratitude for Yahweh's provision? I can't. There just aren't words. Footling breech baby,. 4weeks early in a hospital (we determined that my dates were spot on based on her weight, vernix, etc)? The chances of her receiving such a warm, gentle welcome are pretty slim. To date, she has never been touched by anyone that doesn't love her. No one has jabbed at her, or messed with her at all. She has had warm days of nursing, riding and sleeping since the moment she got here. Nobody tried to take her away from me. Nobody squeezed crap in her eyes, stabbed her in the feet or stuck needles into her. I shudder to think what would have happened in the hospital had she been slow to start like she was here. She has not yet developed any yellowness so I don't believe she's jaundiced. Would that be true if she had her cord cut immediately and been suctioned in a plastic box under a heat lamp? Would they have even let me take her home, weighing in at under five lbs ? I don't know, I can't answer these questions with anything more than educated speculation. But I know what answers are likely and I am grateful yet again that we stayed home. God truly blessed us with this tiny little person, .

Tuesday, July 29, 2008


New law aims to distance the FDA from the drug industry

Jeanne Lenzer

New York

Legislation aimed at ending the close relationship between the US Food and Drug Administration and the drug industry was introduced last week in the House of Representatives by Congressman Maurice Hinchey (Democrat) of New York.

The Food and Drug Administration Improvement Act 2005 has been endorsed by the Center for Science in the Public Interest in Washington, DC, a non-profit education and advocacy organisation. Merrill Goozner, director of the centre's integrity in science project, said it was "exactly what is needed to restore public confidence in the FDA."

The bill includes several provisions aimed at ending financial conflicts of interest. Drug companies would still be expected to pay fees but they would be paid to a general fund of the US Treasury. The bill prohibits the FDA from negotiating with drug companies about how it uses funds and it "terminates all previous agreements between FDA and such companies."

The bill would also prohibit scientists with financial conflicts of interest from sitting on FDA advisory panels.

Furthermore, it would establish a separate centre for post-market drug safety and effectiveness, so that "different doctors and scientists than the ones who approve a drug will monitor its safety once it hits the market."

If passed, the bill would overturn provisions of the Prescription Drug Users Fee Act (PDUFA), first passed in 1992, which established a schedule of payments by the drug industry to the FDA.

Mr Hinchey said, "[PDUFA] was initiated during the first Bush administration, allegedly to speed up the approval of drugs, but what it did—and what I think they knew it would do—was to establish a close relationship between the regulatory agency and the industry it is supposed to regulate. Right now, almost 50% of the FDA drug budget is funded by the drug industry.

"And the ridiculous part is that the FDA has to negotiate with drug companies about how they use this money. It creates a relationship that is contrary to the whole idea of what the FDA is supposed to be."

The bill would redirect drug company fees to a general fund of the US Treasury and would create mandatory funding levels to support the FDA. It would also prohibit the FDA from negotiating with drug companies and "terminates all previous agreements reached between FDA and such companies."

Other provisions of the bill would empower the FDA to mandate post-marketing studies, demand label changes, and impose penalties of up to $50m (£27m; {euro}39m) against companies that violate FDA drug regulations.

A controversial legal stance at the FDA known as "pre-emption" (; 8 Jan 2005, News Extra) that was introduced by the former chief counsel to the FDA, Daniel Troy, would also be reversed under the bill. Mr Troy argued that manufacturers of drugs that were approved by the FDA could not be held liable for adverse outcomes unless the company committed outright fraud.

The FDA does not comment on legislation. The Pharmaceutical Manufacturers and Research Association had not responded to requests for interviews at the time the BMJ went to press.

Sunday, July 27, 2008

Abortion: Feminist Right?

Feminism has promoted abortion as a woman's rights issue. It's touted by society that having that having the option to go to a doctor and have an abortion is empowering. I would like to examine that and present another perspective.

First of all, we don't need abortion clinics to eliminate a pregnancy. Women have been safely doing that for thousands of years. I'm not promoting it, I don't agree with it, but I think the highly dangerous methods of surgically ending a pregnancy that is touted as "safe" and desperately needed as legal so that women don't go for coat hangers is a grossly misleading idea. Emmenagogues are much safer than surgery and have a much lower chance of damaging future fertility. Women have been jumping on the "keep abortion legal" bandwagon largely because they truly believe that it's empowering, even for those who would never choose abortion themselves. They see it as protecting their autonomy on a broader level than just the right to end a pregnancy. They don't' seem to understand that they have been spoon-fed this lie that they NEED a clinic, a doctor and a $400-600 procedure to have this "freedom".

Feminists need to wake up. The right to murder our unborn children is not empowering nor is it protecting us. It's just one more drop in the bucket of how we've been suckered into giving up and handing over our power to someone else. One more aspect of this ridiculous system 95% of us don't' need.

In our society we promote birth control, sex education and abortion as a woman's empowerment. This is how she maintains control over her body and her life. Everything neatly in it's place, including your money in some clinician or pharmacists pocket. Where is the empowerment in depending on someone else to control your body?

I disagree with abortion on a moral level, as well, of course, but for right now I prefer to focus on the ludicrous notion of assuming it's a "right" we must protect. There is a better way, fellow sisters.

For starters, how about teaching our young women the truth of the true control they can have over their own bodies. Instead of teaching our women to take drugs to physically alter their body chemistry, having untold negative consequences on their health as a whole, why not teach them fertility awareness? There is nothing wrong with them choosing to take hormonal birth control or teaching them how to properly use barrier methods. This is all information they should have access to. But they should *also* understand that they don't' *need* any of that, that the power to control their bodies and protect that autonomy that is rightfully theirs exists within them. The fertility awareness method, if practiced correctly, has been proven to be as effective as the pill over and over again. It's something that is simple, easy and becomes second nature to anyone practicing it. Not only does it have the ability to help prevent or more accurately assist in conceiving, it also has the benefit of keeping the woman closely in tune with her body, allowing her to pinpoint telling changes and issues very early on. It's a method that promotes confidence and pride the woman's body, rather than mistrust and mystery. Why should any young girl feel that someone else should be relied upon to control her body? I think that idea subtly undermines her trust in her body and how it works. We are constantly inundated with the pervasive notion that our bodies are defective or will become defective from the time we are very young until we die.

Then there is the issue of personal responsibility. Our society promotes the idea of abortion as being a responsible choice for women who find themselves with an unwanted pregnancy. That seems the exact opposite of responsibility to me. I will be teaching my daughters that being responsible happens way before conception. The reality is that sex has a physical purpose beyond emotional/spiritual/physical gratification. That purpose is procreation. Sex is a good, beautiful and healthy thing but it serves a purpose beyond pleasure. No matter which method(s) one chooses to prevent conception, pregnancy is still a very real possibility! A responsible person doesn't take that risk without being willing to be *responsible* for the consequences. When it comes to sex, the consequences are not like possibly being grounded. The consequence is a new life, a new *person* being created. Life is precious and as women, we have been granted the privilege and responsibility of standing at the gates and guarding it with our bodies. Rather than looking at this as some sort of burden that must be collared and controlled, why not accept it as the beautiful mystery that it is? Why not embrace it? Take it seriously and be proud of this honor. I'm not saying we should all breed like rabbits but there is no reason why our options should be limited to societies excepted notions on how to deal with the growing number of unwanted pregnancies. Why not teach our daughters deep respect for themselves, their partners and the potential lives they may create? Why not teach our daughters to respect all life? Instead, our society teaches us to disrespect and mistrust our bodies, even to the point of viewing pregnancy as something that will ruin their lives.

In fact, we disempower our own young women by telling them they can not possibly care for a child, that they are incapable of being good mothers. And it's BUNK. That is only true if we as their parents raise them in such a way that they have no concept of what it takes to be responsible. I once worked with a teenage girl who was about to become a mother. Shortly after the birth of her son (whom she had been pressured to abort from conception right up until he was born by her mother) she told me, with wonder in her eyes, that NOBODY told her how fantastic being a mother was. She said that everyone she knew told her that having a baby at 16 would ruin her life and not one mother she spoke to mentioned the sheer joy of giving life to another person. Not. one. person. She was flabbergasted at the amazing transformation within herself when assuming the full responsibility for another life. How sad is that? I've known so many women to say the same thing. In the city we used to live in, there were billboards all over the place that basically said to the teenagers: "Getting pregnant is more than you can handle". In many cases, that is true but only because our society promotes a lifestyle that is fraught with irresponsibility until suddenly the people magically become adults somewhere around 30 years old. What a shame. I'm not suggesting that all teenagers should just be promiscuous and not worry about conceiving a child. I am suggesting, though, that teaching them abstinence or birth control because having a baby will ruin their life sets them up for negative attitudes about having a baby later, and encourages them to view their bodies as something that will hold them back in life. I suggest approaching the subject of teen pregnancy from a different angle altogether. Babies are precious. Sex is precious. Life is precious. So lets respect it, guard and hold it sacred. Why not raise our children with an ingrained sense of actual responsibility? Why not teach them that risking creating a new life they don't want to be responsible for IS irresponsible? Why allow them to foster the belief that it's ok, they can just terminate any new life that's inconvenient to them?

It is my belief that we would see a lot less unwanted pregnancies and subsequently a lot less abortions if we stopped crippling our women's ability to control their own bodies by convincing them they need “the institution's” help doing it. Maybe my ideas seem radical but again, where is the empowerment in depending on drugs and doctors to control your body? Where is the empowerment in teaching our young women that they are going to be failures before they even start?

I would say something similar to the pro-life movement. Picket lines, shouting obscene insults at women going into Planned Parenthood and trying to make it illegal may be coming from a noble place within the pro-life movement, but far too often it's just useless. It's approaching the problem from the wrong direction. You want to see less abortions (no abortions?) start from the ground up. Deal with the issue at it's source. The fact abortion is legal is a symptom of a much, much deeper problem. Our society has major issues and I honestly don't see abortion ever “going away” or at least lessening until those problems are addressed. Spreading hate and coldness is not going to have a positive effect. Better to educate. Better to listen and hear the voices and their reasoning behind defending it in the first place. Not every woman that has an abortion actually wants one. In fact, many upon many of them do NOT want one...but they see no other way out. THAT is a serious problem in this society as well. How many teenage girls get abortions because they fear their parents would kick them out or be completely unsupported? This is especially true in the groups that are also pro-life, ironically! What about grown women that are out on their own? How many women get abortions because they are afraid if they don't they will loose the man that supposedly loves them? Or maybe because they don't see any financial way out? Another issue that goes right back to empowerment and trust in one's own self and that is compounded by our societies lack of communal mindset.

I hope I have shared some of my ideas in a coherent fashion. I've not touched too much on the moral issues that I have with abortion as a rule. Maybe for a different day. I close with this: Society takes advantage of our desire to be “liberated women”. It feeds us lies constantly about how to do so. And yet, when we take a few steps back, we see that we are still enslaved, mostly without our recognition, in a system coerces us into their pockets. That's not liberation. It's almost as if we've traded our right to true autonomy over our bodies (with regards to birth and conception and conception control, especially) for the right to vote and be paid a fair wage. In the name of feminism, we've given up our unique powers as WOMEN. Doesn't make sense to me.

Friday, July 18, 2008

Fantastic Article by Henci Goer

Gestational Diabetes: The Emperor Has No Clothes
by Henci Goer

Good medicine demands that diagnosis and treatment of any disease fulfill four criteria:

  • The condition has to pose a health risk;
  • Diagnosis must accurately distinguish between those who have the disease and those who don't;
  • Treatment should be effective; and
  • The benefits of diagnosis and treatment should outweigh the risks.
An entire medical industry has grown up around diagnosing and treating gestational diabetes (GD) in the belief that doing so prevents perinatal deaths, congenital anomalies, neonatal complications, macrosomic babies, and because of fetal macrosomia, birth injuries and excessive cesarean rates. However, diagnosis and treatment of gestational diabetes don't fulfill any of the above criteria.

To begin with, GD doesn't fit the definition of a disease. GD as a concept began in 1964 when O'Sullivan and Mahan performed a 100g 3- hour oral glucose tolerance test (OGTT) on 752 pregnant women and tracked all women with at least two values above two standard deviations beyond the mean to see if hyperglycemic women were predisposed to develop diabetes down the road (O'Sullivan 1964). They were, leading the two researchers to conclude that the metabolic stress of pregnancy revealed a woman's "pre-diabetic status." This should not surprise anyone since overweight women are more likely to have hyperglycemia in pregnancy and to develop diabetes later in life.

Since insulin-dependent diabetes was known to threaten the fetus, researchers extrapolated that sub-diabetic glucose elevations might also do harm. This leap in logic was faulty on its face because GD does not share the risk factors of either type of true diabetes. In Type I diabetes, extremes of low and high blood glucose early in pregnancy can cause congenital anomalies or kill the forming embryo. Gestationally diabetic women make normal or above-normal amounts of insulin and have normal blood sugar metabolism in the first trimester. With either Types I or II, diabetes of long standing may damage maternal blood vessels and kidneys, causing hypertension or kidney complications. These may in turn jeopardize the fetus. Gestational diabetics do not have long- standing diabetes. The one problem GD shares with both types is that chronic hyperglycemia can overfeed the fetus, resulting in macrosomia (generally defined as birth weight greater than 4000 g) or large-for- gestational-age (LGA) (greater than the 90th percentile) babies.

Logic notwithstanding, these concerns launched a series of studies into the risks of mild glucose elevations. Unfortunately, they were badly flawed.

  • Studies selected women for glucose testing based on such factors as prior still birth or hypertension in the current pregnancy and then compared outcomes with the general population. Hunter and Keirse observe that according to Sutherland and Stowers' 1975 edition of CARBOHYDRATE METABOLISM IN PREGNANCY AND THE NEWBORN, the rate of fetal loss increases eightfold as the number of indications for glucose tolerance testing increasing from one to four. Glucose intolerance does not add to this risk (Hunter and Keirse 1989).
  • Studies included women who were known diabetics prior to pregnancy.
  • Studies failed to account for confounding factors such as that glucose intolerance associates with increasing maternal weight and age, which themselves are strong independent predictors of macrosomia and maternal hypertension.
  • Studies used management protocols that increased risks such as starvation diets, early elective induction, and withholding nourishment from the newborn.
In addition, glucose level turned out to be a poor predictor of macrosomia. Other factors such as race, age, parity, sex, and especially maternal weight, far outweighed glucose intolerance in determining birth weight. Hunter and Keirse observed that GD mothers had a 3-fold risk of giving birth to a baby weighing over 4500 g compared with normoglycemic women. However, a woman weighing over 90 kg had a 26-fold risk of having a baby this heavy compared with normal weight women (Hunter and Keirse 1989). Oats and colleagues could not find a significant association between glucose levels and birth weight until birth weight exceeded the 90th percentile. Even then, 77 percent of women had normal glucose tolerance (Oats et al. 1980).

Nonetheless, researchers concluded that mildly deviant glucose values in pregnancy constituted a new form of diabetes that required diagnosis, surveillance, and treatment. Researchers have gone on adding rooms and stories to the GD edifice, never noticing that they have built a house on sand.

Secondly, the OGTT, the standard diagnostic test, has many problems. A diagnostic test should be reproducible, its thresholds should be values at which morbidity either first appears or incidence greatly increases, and normal ranges should apply to the population undergoing testing. The OGTT is none of the above.

Obstetricians adopted O'Sullivan and Mahan's curve as the normative curve for all pregnant women, but it is not representative. For one thing, O'Sullivan and Mahan tested women without regard to length of gestation, whereas today, women are typically tested at the beginning of the third trimester. Glucose values rise linearly throughout pregnancy, but no corrections have been made for this. For another thing, O'Sullivan and Mahan studied a population that was 60 percent white and 40 percent black. Hispanics, Native Americans, and Asian women average higher blood sugars than black or white women. Since diagnostic thresholds are set at two standard deviations beyond the mean, values for O'Sullivan and Mahan's population have arbitrarily been established as the norms for all women. This means that some women are being identified as diseased simply because of race.

Worse yet, studies show that when pregnant women undergo two OGTTs a week or so apart, test results disagree 22 percent to 24 percent of the time (Catalano et al. 1993) (Harlass et al. 1991). An individual's blood sugar values after ingesting glucose (or food) vary widely depending on many factors. For this reason, the OGTT has been abandoned as a diagnostic test for true diabetes in favor of excessive fasting glucose values, which show much greater consistency, or postprandial values of 200 mg.dl or more, which are rare. Moreover, pregnancy compounds problems with reproducibility. Because glucose levels rise linearly throughout pregnancy, a woman could "pass" a test in gestational week 24 and "fail" it in week 28. These same problems hold true for the glucose screening test that precedes the OGTT (Sacks et al. 1989) (Watson 1989).

More importantly, no threshold has ever been demonstrated for onset or marked increase in fetal complications below levels diagnostic of true diabetes. O'Sullivan and Mahan chose their cutoffs for convenience in follow-up, but all studies since then have used their criteria or some modification thereof as a threshold for pathology in the current pregnancy. Numerous studies since have documented that birth weights and other outcomes fail to correlate with O'Sullivan's or anybody else's thresholds.

A test with arbitrary diagnostic thresholds is akin to claiming that all people over six feet tall have a growth abnormality or all people with a cough and a fever have pneumonia. The authors of A GUIDE TO EFFECTIVE CARE IN PREGNANCY AND CHILDBIRTH relegate "screening for gestational diabetes" to "Forms of Care Unlikely to be Beneficial" (Enkin 1995).

The original intent of treating GD was preventing excess perinatal mortality and congenital anomalies. Whatever the cause of increased deaths, it wasn't hyperglycemia. O'Sullivan and colleagues randomly assigned gestational diabetics to treatment with diet and insulin and compared outcomes among treated diabetics, untreated diabetics, and a normoglycemic control population. They found more perinatal deaths in the GD population, treated or not (O'Sullivan et al. 1966). Perinatal mortality statistics among non-insulin dependent diabetics remained unchanged between 1946 and 1972 in a Copenhagen study despite aggressive treatment throughout the timespan (Pedersen, JL et al. 1974) (Pedersen J 1977). Conversely, a Swedish study showed a marked reduction in perinatal mortality rates between 1961 and 1971, also while treating vigorously (Karlsson et al. 1972).

As for congenital anomalies, GD cannot cause congenital anomalies because glucose metabolism is normal in the first trimester. Even if it did, testing isn't done until the third trimester.

The main rationale for current GD management is to reduce the incidence of birth injuries and cesarean section by reducing the incidence of macrosomia. The goal of reducing birth weight raises philosophical problems. As with glucose values, doctors are defining deviation beyond an arbitrary point as inherently pathological. Moreover, can we justify manipulating the growth mechanism of a group of babies roughly 75 percent to 80 percent of whom will fall below the 90th percentile for weight if left alone?

Philosophical considerations aside, we have little evidence that GD management succeeds. As mentioned above, macrosomia associates with maternal weight, age, race, parity, and male fetus. Maternal overweight cannot be rectified during pregnancy; the rest cannot be altered at all. According to M.J. Stephenson, there have been only four randomized trials of diet or diet and insulin. All were flawed and taken together achieved a reduction in birth weight of 87 g, a benefit "of questionable clinical significance" (Stephenson 1993). A GUIDE TO EFFECTIVE CARE IN PREGNANCY AND CHILDBIRTH also lists insulin and diet therapy for GD under "Forms of Care Unlikely to be Beneficial."

Santini and Ales report results from a national trial that occurred in the early 1980's when some doctors at Cornell University Medical Center screened women for GD routinely and others did not. No differences in perinatal mortality, morbidity, LGA or macrosomia rates were found between screened and unscreened populations, but women in the screened population were more likely to have primary cesarean sections (19 percent versus 12 percent), more clinic visits, more fetal surveillance tests, and more prenatal hospitalization (Santini et al. 1990).

Non-randomized trials show that diet modification rarely works without severely limiting calories or the liberal or universal use of insulin. Even where it does work, only two studies of GD management reduced operative delivery or cesarean rates to reasonable levels, the main point of preventing macrosomia (Langer et al. 1994) (Coustan et al. 1984). In both studies, doctors knew which women were treated and which were controls. If they believed their therapy prevented macrosomia, which other work shows they did, this belief could well have influenced management decisions. A third study also reported similar cesarean rates in GD women and the total hospital population, but these were 27 percent and 25 percent respectively (Thompson et al. 1994).

As Santini and Ales' study suggests, not only does GD management offer little benefit, it confers risks, the gravest being a marked increase in cesarean section. The cesarean rate in a population of gestational diabetics cared for by midwives was 9 percent to 11 percent including women transferred to obstetric management, or about half the primary cesarean rate reported in populations managed by obstetricians in the same or an earlier time period (O'Brien et al. 1987). Goldman and colleagues reported that gestational diabetics had one-third more cesareans compared with a matched population with normal glucose tolerance, although birth weights were similar (Goldman et al. 1991). In another study, gestational diabetics were randomly assigned to insulin or standard treatment in the third trimester in an effort to minimize macrosomia. Insulin reduced LGA rates to 13 percent compared with LGA rates of 45 percent in the diet group and 38 percent in the group that refused randomization. Despite this, cesarean rates were 14 percent and 21 percent in the diet-treated groups versus 43 percent in the insulin-treated group, a difference attributed to transferring women on insulin to the high-risk service (Buchanan 1994).

Many doctors view high cesarean rates as a reasonable trade-off for preventing shoulder dystocia. This ignores that many shoulder dystocias occur in non-macrosomic infants (Keller 1991) and that the increase in cesarean rate for infants weighing over 4000 g has not improved outcomes (Boyd et al. 1983); not to mention the role typical obstetric management plays in causing shoulder dystocia.

Increased likelihood of cesarean is not the only risk of GD management. Insulin increases the risk of small-for-gestational-age babies and causes symptomatic hypoglycemic episodes (Langer et al. 1994) (Buchanan et al. 1994). Reducing calories by more than one-third in overweight gestational diabetics causes ketosis (Knopp et al. 1991). Finally, the poor predictability of the fetal weight estimates and surveillance tests doctors feel obliged to order, even the belief that GD is a high-risk condition, undoubtedly lead to countless unnecessary inductions and operative deliveries.

Few have noticed that the diagnosis and treatment of GD is a spectacular failure. A review article analyzes the OGTT, finds it worthless, and recommends continuing to use it to diagnose GD (Nelson 1988). After showing that current cutoffs fail to discriminate a group of women at high risk for macrosomia, obstetricians conclude in defiance of logic that they should lower the values or that insulin should be given to more women or that cutoffs should be chosen by fiat (Sacks et al. 1995) (Neiger et al. 1991) (Weiner 1988) (Tallarigo et al. 1986). Researchers take note that sonography to estimate fetal weight did no better than a coin toss at predicting macrosomia and recommended it anyway (Combs et al. 1993). Doctors find that rigid glycemic control did not improve infant outcomes and assume that means they should try harder (Hod et al. 1980). Goldman and colleagues, with similar birth weights but one-third more cesareans in the GD group, congratulated themselves on the success of their management (Goldman et al. 1991). The gestational diabetes literature reads more like ALICE IN WONDERLAND than science.

Still, midwives can winnow some grain from the chaff. Maternal weight has the strongest correlation with macrosomia rate; it makes sense to advise heavily overweight women to lose weight before becoming pregnant. Pregnancy makes extra demands on insulin production; to minimize the pressure, pregnant women should eat a diet low in simple sugars, high in complex carbohydrates and fiber, and moderate in fat. Moderate, regular exercise also improves glucose tolerance. Within the GD population lurk a few women who were either undiagnosed pregestational diabetics or who were tipped into true diabetes by the metabolic stress of pregnancy; a fasting glucose to screen for them might be prudent. And, of course, midwives already use strategies that help women minimize the likelihood of operative delivery or birth injury. Finally, to reduce the chance of neonatal hypoglycemia, the baby should be put to breast soon after the birth, especially if the baby is big, small, or the labor has been difficult.

Henci [sic] Goer is an ASPO-educator and doula. Over the past ten years , she has written numerous pamphlets and articles for childbirth professionals and expectant couples. In 1993 she received the National Association of Childbearing Centers Media Award, and in 1995 ASPO/Lamaze presented her with its President's Award in recognition of her book, OBSTETRIC MYTHS VERSUS RESEARCH REALITIES: A GUIDE TO THE MEDICAL LITERATURE. She also serves on CHILDBIRTH INSTRUCTOR MAGAZINE's Advisory Board.


  • "Gestational diabetes," INTERNATIONAL JOURNAL OF CHILDBIRTH EDUCATION. 1991;6(4):1991.
  • "Gestational diabetes: It's Not What It Seems," CHILDBIRTH INSTRUCTOR. In press
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