Wednesday, September 28, 2011

The Power of the Mind..

One of the aspects of Natural Childbirth that I strongly agree with, is the belief in the connection between mind and body. Advocates of Natural Childbirth believe that our thoughts and our state of mind during pregnancy and labor can have a remarkable affect on it and it's outcome.

When I discovered I was pregnant I had an immediate interest in hypnotherapy for labor. As someone who has suffered from anxiety and panic attacks, I am well aware of the power the mind has over the body. Fear is an incredible thing, and will make any experience unbearable.So, I was really thrilled to try Hypnobabies and I had a strong faith that it would work because I truly believe in it.

Unfortunately, some people see no connection between the body and the mind and actually use this belief as a source of sarcasm and ridicule. Their belief is that if your labor was short or lacking in pain, it was purely luck. I'm sure that is true in some cases, but certainly not all. If you attempt to explain all the preparation you took to ensure a positive birth experience, they accuse of you wanting to pat yourself on the back and take credit for "good luck". They say that there is no scientific evidence to prove that the mind has any effect on labor and birth.
Perhaps no formal studies have been done on a woman's state of mind and the outcome of her labor, but I do know this.... fear, anxiety and negative thinking, will make you perceive that your experience is much worse than it actually is. If you had a choice between preparing and taking ownership of your birth experience, over not preparing, wouldn't you want take whatever steps possible to try to make your experience as positive as possible? I know I did.

The interesting thing is, there IS a lot of scientific evidence that proves there is a mind-body connection. There is plenty of evidence to support how powerful the mind can be and that by harnessing that power, we can truly do extraordinary things with our bodies.

A few years ago, I read a book called, "The Intention Experiment". It's a fascinating book about the study of intention and thoughts. One specific chapter of the book talks about a study that was done by a Harvard Medical Professor on a group of Tibetan Monks in India...

In a monastery in northern India, thinly clad Tibetan monks sat quietly in a room where the temperature was a chilly 40 degrees Fahrenheit. Using a yoga technique known as g Tum-mo, they entered a state of deep meditation. Other monks soaked 3-by-6-foot sheets in cold water (49 degrees) and placed them over the meditators' shoulders. For untrained people, such frigid wrappings would produce uncontrolled shivering. 

If body temperatures continue to drop under these conditions, death can result. But it was not long before steam began rising from the sheets. As a result of body heat produced by the monks during meditation, the sheets dried in about an hour. 

Attendants removed the sheets, then covered the meditators with a second chilled, wet wrapping. Each monk was required to dry three sheets over a period of several hours. 

Benson is an associate professor of medicine at the Harvard Medical School and president of the Mind/Body Medical Institute at Beth Israel Deaconess Medical Center in Boston. He firmly believes that studying advanced forms of meditation "can uncover capacities that will help us to better treat stress-related illnesses." 

Benson decided that he needed to locate a religious setting, where advanced mediation is traditionally practiced. His opportunity came in 1979 when the Dalai Lama, spiritual leader of Tibet, visited Harvard University. "His Holiness agreed to help me," recalls Benson. That visit was the beginning of a long friendship and several expeditions to northern India where many Tibetan monks live in exile. 

During visits to remote monasteries in the 1980s, Benson and his team studied monks living in the Himalayan Mountains who could, by g Tum-mo meditation, raise the temperatures of their fingers and toes by as much as 17 degrees. It has yet to be determined how the monks are able to generate such heat. 

The researchers also made measurements on practitioners of other forms of advanced meditation in Sikkim, India. They were astonished to find that these monks could lower their metabolism by 64 percent. "It was an astounding, breathtaking [no pun intended] result," Benson exclaims. 

To put that decrease in perspective, metabolism, or oxygen consumption, drops only 10-15 percent in sleep and about 17 percent during simple meditation. Benson believes that such a capability could be useful for space travel. Travelers might use meditation to ease stress and oxygen consumption on long flights to other planets. 

In 1985, the meditation team made a video of monks drying cold, wet sheets with body heat. They also documented monks spending a winter night on a rocky ledge 15,000 feet high in the Himalayas. The sleep-out took place in February on the night of the winter full moon when temperatures reached zero degrees F. Wearing only woolen or cotton shawls, the monks promptly fell asleep on the rocky ledge, They did not huddle together and the video shows no evidence of shivering. They slept until dawn then walked back to their monastery. 

The next time someone tells you that mentally preparing for birth and releasing fears has no significance on your labor you might want to tell them about this study. Yes, this study is about meditation and not labor, however it does prove the powerful effect our minds can have on our bodies, when we focus and prepare and practice.

Due to using Hypnobabies and giving birth at home in an environment where I felt safe and protected, I ended up with a labor under 6 hours, with mild pain comparable to period cramps. I found pushing to be painful but still bearable. I wonder what would have happened if I had not prepared.....  It's interesting to me how many women have such completely different experiences giving birth after they have prepared mentally opposed to not preparing at all.

Keep in mind, though, that we don't have control. We can do all the preparation in the world and still might not end up with what we hoped for. Relinquishing control, actually gives us more control. So, have faith that events will unfold the way they are supposed to and be prepared for the unknown. But never forget the power you hold.

All that we are is the result of what we have thought. The mind is everything. What we think we become.” Buddha

Monday, September 26, 2011

The Truth about Midwives.. Part I

There is a lot of misinformation out there about midwives. Generalizations about their character, why they choose midwifery and how much money they make, have all been misrepresented.  I think we deserve to know the truth about midwives and all the different areas of concern. There's a lot of ground to cover and there is a lot I have to learn, so I am beginning this post as Part I and will continue with Part II in time. I want to discuss where there is room for improvement, as well as the best aspects of midwifery care. I am also interested in interviewing a CPM, so if anyone reading is interested, please let me know. In this post I'd like to look into a misconception I've been seeing a lot lately..  the salary of the CPM.

For awhile now, I have watched silently as people discuss the very large amounts of money CPMs must make. The theory, is that they make 4k a birth, do 4 births a month and therefore make 16k a month, which would almost be 200 thousand dollars a year. I'm assuming that the people who claim this about midwives must not know any. It's a nice thought but entirely unrealistic. When I had my homebirth I had two midwives attending. These women usually spent at least two hours with me at every appointment. Looking back, they were very kind to let me ramble on with my questions and concerns, well past my time slot with them, every time. I never felt rushed, I never felt they had somewhere more important to be. They both have three children each and are part of a large, busy practice, yet I always felt like I was their only patient. They each made $1500 from my homebirth. Probably less because a third midwife also helped with my prenatal care and I know some of that money went to her. That is $1500 for the six and a half months of  pregnancy care, the 5 hours they stayed with me during labor and giving birth and the 5 hours afterwards where they cleaned everything up- which included doing our laundry. That included the 6 weeks postpartum care and the time when I called at nine at night, crying  because I couldn't get my baby to latch and my midwife rushed over to help me. I could go on and on about everything they did, all the time and effort they put in to giving me the best care possible, and I still don't think I could do an accurate job of displaying how amazing and dedicated these women were.  In all honesty, I actually think they were underpaid for all the time and effort they put into me and my family.

Now compare that with the 2 or 3 months I saw an OB, had 15 minute appointments each time and still had to pay him $1000 after insurance. I understand this is not everyone's experience with midwives or with OBs but it was mine and I thought I'd share it. I do think OBs are getting a bad rap and I don't think that's fair, considering there are many compassionate and caring ones out there. I think part of the problem is that OBs are very busy and if someone is wanting more one on one time, they might be disappointed with their OB experience. I am also well aware that there are some really negligent midwives out there. I have heard horror stories that absolutely no woman should ever have to encounter. But I'll get more into that later.

However, I think it is really inaccurate to tell people that midwives, in general are in it for the money or that they make more than OBs. Yes, I have even heard that one being claimed!
According to this link, OBs make around 200 thousand a year.

It's more difficult to know exactly how much midwives, CPMs specifically, are making a year because there can be a pretty distinct difference in what each midwife charges. Also,  there isn't always a guarantee a midwife will be paid in full or even paid at all. 
Here is a discussion between those who think midwives are making a killing and a woman who is in her early trainings to become a midwife. 

I thought it was interesting to read first hand knowledge of how much midwives are making and what that money goes to.  My feeling is, if most midwives were in it for the money, if they only saw their clients rarely or always showed up late for births, homebirth would die out. Word spreads pretty quickly and I don't think we'd be seeing such an increase in homebirths if the majority of midwives, as it has been suggested, are just in it to make a buck.
To be continued...

Friday, September 23, 2011

Let's look at the source..

It is my belief that when someone is trying to convince me of something, one way of knowing if they are legitimate or not, is by looking at their actions. How ethical is this person? How consistent is this person? The actions of somebody can tell a lot about them. Now, nobody is perfect obviously. Everyone makes mistakes sometimes. People have their moments of frustration and might display some immature behavior. But to me, the person or persons who continually show hypocritical behavior, immature behavior and downright rude behavior over and over again, are not people I would personally take seriously.
I have often seen this type of behavior coming from the group that is adamantly against homebirth.
They want to convince you not to give birth in your home, no matter what the reason may be, and if you decide not to listen to them, then you really just don't care about your baby's life. Example:

This is a response to someone who said their homebirth went well and the midwife was knowledgable enough to pick up on some breathing problems so the baby was taken to the hospital. There was no mention that the birth itself caused breathing problems, as we all know sometimes babies need some time in the NICU even when born with all the best technology around them. But this is the kind of judgment that people get for choosing homebirth.
The problem is, are the people who are judging us worthy of judging us? What kind of people are they that they can act so holier than thou? What do their actions reveal about them?
Well, here are just a few examples of their behavior.. Are these sensible, compassionate women? You be the judge....

And this is what they said about me for simply disagreeing that there is enough evidence to claim homebrth is dangerous... They got really angry at me for exposing the truth and even began to say I was lying and then banned me from their page..

But then they just want people to stop judging them..

Because they don't judge people, they just judge ideas..

And the kicker...

In all honesty, this just makes me sad. We are all mothers and women and we  probably have a lot in common when you take how we birthed our babies out of it. Remember, these are THEIR words and they need to own them. Are these the actions of women wanting to keeping mothers and babies safe?

*Update: Yes, these words were taken out of context and my response is, so what? I can't think of a single situation where I said things like this- no matter how horrible the people were. If you disagree with someone's actions, you attack the *actions* not the person. Any mature, reasonable adult would do that. Resorting to name calling and threats are signs of immaturity and cruelty. The majority of these words were taken from two separate posts. If I had spent the time going through numerous posts and taking screen shots of the *many* instances of ugly behavior, the results would be much worse than this. This is a only small example of what I have seen.
The screenshots were found here and here

Thursday, September 22, 2011

The Anecdote and what it proves..

What is the point of an anecdote? Sometimes, an anecdote is used as a way to convince others of something or to prove a point. Unfortunately, we cannot use anecdotes as scientific evidence. I have often seen opponents of homebirth/natural birth, use anecdotes to prove homebirth is dangerous. One famous way the opponents prove  homebirth is dangerous, is by using the, "a baby died at a homebirth" anecdote. Considering they don't have much else to rely on, these anecdotes are used as though they are scientific data.

Unfortunately, this tactic often comes at the expense of others; homebirth loss mothers and their families. First of all, the way these anecdotes are found is by scouring blogs and mothering boards, looking for grieving mothers who have literally just posted their birth stories.  No one has spoken to the doctor that attended the mother when she went to the hospital. No one has seen an autopsy. No one has spoken to the staff at the hospital. Nope. No one has looked at the mother's medical background and knows her history. Yet, despite all this, an assumption is always made about how the baby died and it usually goes something like this... " If this negligent, baby killing midwife had known what she was doing, the baby would still be alive today. If this mother wasn't so selfish and ignorant, this baby would be alive today." I personally know for a fact, that one mother who was attacked and her story used, did not lose her baby due to negligence on the midwife's part or her choice to homebirth. This one specific mother, who had just lost a baby and was grieving terribly, told me she had the autopsy done and it concurred with what the doctor had told her- her baby was simply a stillborn baby. It was nobody's fault. Although stillbirths are actually quite common, opponents still exploited this mother and child and used her story as an indictment on homebirth. The most disturbing result of this, was that her story was presented in a such way that made it appear that it was FACT her baby died because of negligence and ignorance and selfishness on the mothers part. And as a result of that, this women was harassed... even though she had to plan a funeral for her baby... even though she had just lost a child she carried in her belly for more than 9 months.

No, anecdotes don't prove anything. Actually, the only thing they do prove is that some people lose their babies. Some people lose their babies due to a doctor's negligence, a midwife's negligence, because the baby was at home and because the baby was at the hospital.
I am going to prove to you right now that anecdotes do not prove homebirth is dangerous. For all of those anecdotes about negligent midwives and homebirth horror stories, you can easily find another story with a negligent doctor that took place in the hospital. If I took the time, I could fill this page with preventable hospital death stories.

So, once again, how do we prove homebirth is dangerous?  The only way to prove homebirth is dangerous is by using peer reviewed studies. If you don't have that, you don't have anything.

The Truth about Homebirth

I have recently discovered an outspoken group of people who are strongly opposed to homebirth, natural birth and other choices that women in the natural childbirth community make. Their argument is that homebirth is "dangerous" and therefore, if you choose it you are a selfish mother and you don't care about your baby's life.  They also believe that CPMs ( Certified Professional Midwives) are so incompetent and uneducated, that the entire profession should be abolished.
It's quite obvious that they are biased and their extreme views on these matters make them all the more unbelievable. The generalization that all CPMs are one way is another example of their rigidity in thinking. What I take offense with, is that there is simply not enough true scientific evidence in our country to make either of these claims about homebirth safety or homebirth midwifery care.

Let me explain...
Here, in the United States, only a few studies have been done on the safety of homebirth. Unfortunately, the two most well known studies, the Johnson and Davis and the Wax study, are controversial, for they both have been criticized for being flawed. I think it would be fair to say that neither of these studies should be used to prove the dangers or safety of homebirth.
The Wax Study, for instance, concluded that the neonatal death rate is 3x higher for homebirth babies. The neonatal death rate is the numbers of babies who die between day 7 and 28. However, the perinatal death rate, which includes stillbirths and babies up until seven days old and is considered the best measure of obstetric care, was equal for both home and hospital in this study. Another significant point, is that the perinatal death rate in the Wax Study was based on close to 500 babies, whereas the neonatal death rate was only based on 37 babies. Clearly, the perinatal numbers are more robust and therefore should be more significant. This is just one example of the study's flaws, for a deeper understanding of why it has been criticized you can look here:

The one thing I do think should be more closely examined, is the fact that all the studies done on homebirth, in this country and others, shows many, many benefits to baby and mom. Benefits such as a significantly lowered chance of interventions and c-sections as well as a lowered chance of tearing, laceration, PPH and infection. There is less birth injury in the babies and less need for oxygen within 24 hours after birth. Those findings alone should make people stop saying that homebirth is only about the mother's experience. The experience is often very good but that doesn't mean it's the only reason mothers choose homebirth.

So, you may ask- if this is our only source of data about homebirth, how is it possible that people can claim it is dangerous as if they know it as a fact? Well, there are two other points people make about homebirth to "prove" it is dangerous. One thing that is often brought up, is the CDC dataset. The CDC numbers are based on raw data and have not been peer reviewed. A dataset that has not been peer reviewed is not scientific evidence, I think we can all agree on that. The numbers are also based on only a few years and they lump all non-nurse midwives into the same category. Meaning, the most inexperienced, lay midwife is put in the same category as licensed CPMs. Even women who aren't midwives can be put into this category, such as a doula, friend or childbirth educator. There is also no sure way to exclude all the high risk women who gave birth at home because birth certificates give us only minimal information. Obviously, it is more dangerous for someone to give birth to a footling breech with a doula posing as a midwife,  over a low risk woman with a licensed CPM.
Even Amy Tuteur has claimed that birth certificates are inaccurate when it comes to the mother's pregnancy complications and risk factors.

Nevertheless, opponents of homebirth still like to use this data, because it shows that the homebirth neonatal death rates are higher at home than at the hospital. When they analyzed it, they found that the neonatal deathrate for homebirth babies is 1.15/1000 and .61/1000 for hospital babies.
Now, please take into consideration what was posted above. The homebirth neonatal death rates include low risk women and high risk women, women attended by licensed midwives, lay midwives, inexperienced midwives, and people who are not even considered midwives. The homebirth numbers also include highly religious people who will refuse transfer to a hospital, no matter how dire the situation and the Amish, who live in rural areas and have many children, becoming more high risk after having the fifth child.
It's clear to me, that if the CDC data proves anything, it proves that homebirth is actually quite safe!

The bottom line is that those who harshly judge women who choose homebirth in our country need to realize that they don't have sufficient evidence to do so. They also don't have sufficient evidence to claim that all American homebirth midwives are dangerous, greedy or unnecessarily killing babies. Until the day comes where we have a well done, unflawed American study, I really don't think anyone has the right to be pointing fingers at homebirth mothers or midwives.

Now, the second point opponents of homebirth like to make, is that emergencies happen and the best place to be is the hospital if those emergencies happen. Yes, that is true but ultimately, we can't look at specific cases to prove anything is dangerous. Someone's personal story is nothing but an anecdote. Saying, "If I hadn't been in the hospital, my baby would have died", does not prove homebirth is dangerous nor does finding homebirth loss stories on the internet. No, you have to look at the whole picture and the only way to do that is with peer reviewed studies done here, in this country.
Using anecdotes to make a point, proves nothing. But I will delve further into that on the next post......