This came up as a suggested video for me in YouTube today. If this is how obstetricians are learning about birth, we are in more trouble than we thought. This robot is currently being used at Johns Hopkins University Hospital – a leading teaching hospital in the US.
There’s so many things wrong with this I’m really not sure where to begin.
Perhaps what is most disturbing to me is the purely mechanical approach to teaching obstetricians about how a normal woman births. It shouldn’t surprise me, since that fits with the obstetric view of birth as a purely mechanical process – the process of a baby negotiating a perilous pelvis. This robot is a graphic physical representation of that mindset. Yet we women – who experience birth with our whole being – know that there is far more to it than that. Birth is not just the negotiation of a body through a pelvis. It is an emotional, spiritual and hormonal experience that prepares our babies for life, and ourselves for the role of motherhood. Where is the respect for that here?
The obstetrician begins by saying that the robot is “very realisitic – with the way “it’s” positioned on the table”. The dummy is in a lithotomy position, and yes I guess that it is realisitic for many obstetric attended births. This is a real eye opener for us about the way that obstetricians are trained. Note how the mother is passive and on her back – most likely not the position she would choose to be in if she were unmedicated and able to follow her body. And unless the mother wanted it, probably not the position she would be in if she were being attended by a midwife. This is why many women who tell their obstetricians that they want to choose their own birthing position will still end up birthing on their backs. If that’s how obstetricians are trained, that is how they will feel most in control of the birth. Midwives, on the other hand are trained to catch babies in whatever position the mother is comfortable – including all fours, standing, on a birthing stool, in a shower, or in some cases in a tub of water.
The obstetric nurse then goes on to explain that the robot is “just like a real person – she has a fetal monitor so we can monitor the baby, and and IV”. Reality check – this is not how a “real person” labours. Women move around in labour – they aren’t tethered to anything unless there is clearly an issue with them or their baby that indicates monitoring and IV’s are needed. She then goes on to describe – with a smirk – how the robot has no voice and the medical students have to pretend to talk for her. I wonder what she finds so smirk-worthy about this. So many women in their final stages of labour find themselves voiceless, vulnerable and unable to express what they and their babies need.
The narration goes on to expound the virtues of this robot, who can help OB’s train for “complications such as long labour and breech birth”. When did “long labour” become a complication? If a mother and her baby are well, long labour is not a complication. It is normal. I have attended plenty of medically supported “long labours” – and those babies have all been just fine. The length of a labour alone is no criteria for categorising it as complicated – what happened to looking at the woman and looking at her baby? What happened to looking for those signs that tell us something is changing…even if it’s not at the rate of one centimetre an hour. And as for breech birth, it was a variation of normal until obstetrics rendered the skills to assist it obselete. Now when a babe presents breech in hospital you’d be lucky if there is anyone present who knows what to do. Not because breech birth is dangerous, but because it is has become such a rarity in hospitals that we now have practicing obstetricians who have never even seen one.
This video enraged me. Birth, as depicted here is a medicalised procedure and the mother is rendered completely irrelevant, except to be a container for her baby. This is horrifying. We can’t allow this mindset to become pervasive here in Australia. We are, unfortunately already well on the way. Women – we have to take some responsibility for our choices.
What a busy month it’s been! I’ve helped welcome four new babes in the last month, and waiting for a fifth to arrive very soon. All these babies arriving have kept me away from the computer, so I’ve had minimal time to blog. But today, I have a little (OK, slightly major) announcement to share – we’ve decided to relocate our little family to Toowoomba in June.
I was born and raised in Toowoomba, so I’m really looking forward to taking my children home and showing them all the things I enjoyed there as a child. It will be wonderful to fully reconnect with my family and friends, and have them part of our day-to-day lives again instead of just on the periphery. This is a whole new chapter for me – I can’t wait to get up there and get into it!
Move over St Angelina Jolie. Salma Hayek has just flicked you from my socially conscious celebrity list (and it is a very short list).
Video has just hit the internet of Salma breastfeeding a one week old infant in Sierra Leone, after his mother told her that she had no milk left. Salma did what I hope most of us would do in the same situation – she pulled up a chair, got out her boob and she gave that baby a feed. The look on the baby’s face as it stares up at her made me cry. Hayek is breastfeeding her one year old daughter and has been outspoken about the benefits of breastfeeding since her birth.
What a woman. I love her.
2009. A new year – with new challenges, new experiences, and best of all….new babies!
Happy New Year to all who drop by here. And especially warm wishes to the mums, babes, and families who have shared their birthing journey with me in 2008. Thank you for opening up such an intimate and personal life experience to me. I am blessed to have walked the road with each of you.
May the new year be filled with love and laughter, for you and your beautiful babies.
Incidentally, one of my resolutions is to update here regularly. I have been improving over recent months, but I can do better. Lets see if I can make a post every week. Stay tuned.
Bring on 2009!
Image via WikipediaBrowsing the Brisbane Times this morning I came across this article discussing an apparent increase in the number of women requesting elective caesareans for psychological and social reasons.
It’s an interesting article for a few reasons. Everyone knows that the caesarean rate has been steadily climbing in the last 10 years – to the point that at 30% nationally, it is now almost triple the rate advised by the World Health Organisation for a developed country. Even the RANZCOG admits that our caesarean rate is too high – that is not in dispute. What has been in dispute though, is why.
Obstetricians argue that we are having babies later, we are fatter, and we are generally more unhealthy during childbearing than our mothers were. They have also been the loudest to proclaim that women are asking them to perform caesareans because they don’t want to birth vaginally. Which brings me to the article – I quote.
A National Institute of Health and Welfare report on mothers and babies reveals…a total of 1197, or 6.5 per cent, of caesareans in Queensland were for “psychosocial” or “patient choice” reasons.
So, of all the caesareans being done in Queensland every year, only 6.5% are maternally requested. Six in every hundred. Or put another way, 93.5% of women having caesareans probably got pregnant planning for a vaginal birth. Yep, it seems we are bashing down the doors of obstetricians to book elective caesareans in order to save our pelvic floors, or avoid the agonies of labour.
Our maternity system has some major obstacles to overcome if we are to lower the caesarean rate to anything near acceptable levels. It’s incredibly unhelpful to lay blame at the feet of women, and looking at the data near impossible to justify. How on earth have we gone from a caesarean rate of 17% in Queensland in the late 1990’s, to double that in only 10 years? It’s obvious that there are systemic factors involved here – we didn’t all get that old and unhealthy and incapable of birthing babies in just 10 years. Humans just don’t “devolve” that quickly. It doesn’t make sense.
Hopefully the release of this report will put to rest the claim that large numbers of women having caesareans are asking for them with no medical reason. There are certainly implications here too for the private vs public debate – maternally requested caesareans are often blamed for the massive discrepancies seen in caesarean rates between public and some private hospitals. It looks like that argument won’t really stand up any longer either – particularly for those hospitals with rates over 50% (and yes, we have some of those in Queensland).
Late last week my oldest, dearest friend gave birth to her second baby. Like many new mums, the early days of breastfeeding haven’t been without their challenges. So by way of welcoming baby Christian earthside, here are some breastfeeding resources that I’ve found especially useful, both for myself and for my mums.
1. The Australian Breastfeeding Association (ABA)
The ABA is a major source of support for breastfeeding mothers, Australia wide. Their website is a wealth of information – check out their index of articles for detailed, accurate information on literally everything to do with breastfeeding newborns, babies and toddlers. Whether it’s a supply issue, attachment problem, breastfeeding in public, or returning to work – you will find help here. The ABA also run free counselling services providing over-the-phone assistance for specific problems. Mothers can also access support groups in their area, enrol in breastfeeding classes during pregnancy, or purchase breastfeeding items via Mothers Direct.
2. Australian Lactation Consultants Association (ALCA)
While midwives, GP’s and paediatricians may be able to provide basic breastfeeding advice, it might surprise you to learn that their training only covers the fundamentals of human lactation. Lactation Consultants have specific, specialised training in all aspects of human lactation. They are the breastfeeding experts! Their knowledge and experience in breastfeeding will far exceed that of any other health professional – so if you’re having problems it is worth cutting to the chase and seeking out an LC. Many will visit you in your home, which has the added bonus of them actually seeing you feed your baby, instead giving advice in a more general context. You can locate an LC near you via the ALCA site.
This video shows infant-led attachment to the breast immediately after birth. Many of my clients are now asking to be supported in this immediately after birthing. We know that there are many benefits to the establishment of breastfeeding in not separating mother and baby in the first few hours after birth, and in keeping disturbances to a minimum. Hospital routines such as weighing and measuring baby, administering Hep B and Vit K, and physical exams can be left until at least an hour or two after birth to give you and your baby this precious time – mostly it’s just a matter of letting the hospital know that this is your preference in your birth plan, and having your partner or doula remind them of this after your baby is born.
Kellymom is one of the most comprehensive and authoritive sources of breastfeeding information and articles online. The site is maintained by Kelly Bonyata, an international board certified lactation consultant (IBCLC). Kellymom also offers an excellent collection of free handouts on breastfeeding and related issues.
The growth charts used to assess normal growth in babies are derived from data obtained from formula fed infants. Babies who are fed formula tend to gain weight differently to breastfed babies – and comparisons between the two can lead to the mothers of healthy breastfed infants being told their baby is not gaining enough weight. This often leads to weaning, or the introduction of supplementary formula. The World Health Organisation (WHO) has now released revised infant growth charts based on the normal growth of breastfed infants. These charts are slowly finding their way into use within the mainstream medical community.
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When my first child, Emily, was born four years ago I expected the first months of her life to be a haze of sleep deprivation. After all, that’s how it had been for all of my friends who’d had babies – everyone I knew with a newborn had endured that craziness for varying lengths of time. I was prepared for it, and I wasn’t going to be caught off guard!
Emily was breastfed, and at ten weeks old she “slept through the night” for the first time. I woke up at 5am, a good eight hours after her last feed and my blood ran cold. I tore into her room to find her sleeping soundly just as I had left her.
She has done this every night since, except for a few nights here and there when she was unwell. Even when teething, she continued to sleep 12 hours a night, uninterrupted.
So two years later, when my son Toby was born – I knew it all. He was also breastfed, and he would be sleeping through too by ten weeks, because hey! – I was an expert. Those of you with more than one child probably already know what’s coming. Yes, karma bit me on the backside, hard. No matter what I did, Toby had no intention of sleeping through at 10 weeks. At 10 months he was waking up almost hourly, and I was nearly beside myself coping with a toddler during the day and no sleep at night. That is when it started.
Suddenly, I was inundated with advice, most of which had a common theme: “You need to wean him”. Everyone from my husband, my mother, my friends, to our GP said that at his age, he would never stop waking up until I stopped breastfeeding him. Suddenly, this wonderful gift I was giving my son was a tool for everyone around me to use to make me feel that my suffering was somehow self-inflicted – and that unless I was prepared to “do” something about it (ie. wean him), I should just stop complaining.
I didn’t wean him because I just knew in my heart that he wasn’t ready. He continued to wake at night for a breastfeed, even beyond his first birthday. While it was never as bad as it had been at 10 months, he still woke twice a night without exception. By the time he was a year-and-a-half old, I had long lost any expectation that he would ever sleep through the night.
About month ago, we celebrated Toby’s second birthday. And two weeks ago, completely out of the blue, he slept through the night – and he has done it every night since. He’s still breastfeeding and nothing else has changed. He was just ready. I know that for him, weaning him early would have achieved nothing in the sleep department – and we would have lost not only our breastfeeding relationship, but probably even more sleep getting up to heat bottles in the middle of the night when he continued to wake up anyway.
Now that he has night weaned by himself, I’m so glad that I kept breastfeeding through the temptation to quit. Breastfeeding babes do sleep through – sometimes at 10 weeks, some not until two years – but just like every other baby, they do it when they’re ready and nothing will make them do it before that magical, blessed day arrives.
Now, if you’re listening Toby it would be lovely if you’d wean completely by Christmas. But if you aren’t ready yet, that’s OK too.
Being pregnant and birthing in a society that mostly has an ingrained and widespread fear of birth, is not an easy job.
The messages can be relentless. Birth is dangerous. Birth is degrading. Birth is messy. Birth belongs behind closed doors. Birth is a spectator sport. Birth is the domain of medicine, not of women.
This post is an antidote to all of that. Here are some of my favourite articles and videos that remind me that birth is beautiful, powerful and transforming! Enjoy.
1. Pelvises I Have Known and Loved by Gloria LeMay
This article has been around for quite some time now. If you’ve ever been told your pelvis is too small to birth a baby, or this is something that you’ve wondered or worried about – read and be amazed.
2. Georgio Padraic’s Freebirth
This video shows an unassisted (no midwife/doctor/birth attendant present) waterbirth. Even if you’d never in a million years consider a homebirth or an unassisted birth, this video is still amazing viewing. A little boy is born gently and easily into his mother’s waiting hands. I love this video because through it, we can see what is possible.
3. The Endocrinology of Ecstacy and Pain In Labour – Dr Sarah J Buckley
The first time I read these articles they blew my mind. Sarah’s work just appeals to my common sense. So often we hear generalisations about our “hormones and endorphins kicking in” or “just knowing instinctively what to do” in reference to labour. These articles explain exactly how this happens. As well as presenting a bucketload of information on the relationship between birthing hormones, breastfeeding and bonding. I challenge anyone to read these articles for the first time and not have their view of labour and birth changed forever.
4. How to Check Your Own Cervix – It’s not Rocket Science – Gloria LeMay
Cervical dilation has become shrouded in mystery since birth moved into hospitals. It’s so empowering to have the confidence to do this yourself, and really easy once you do it a few times. If you’re worried that this is dangerous, think about this – are you more likely to be injured picking your own nose – or letting someone else do it for you? Many women check their own cervix pre-pregnancy as part of natural fertility management, and this is really no different.
5. Active Birth – Janet Balaskas
If you can’t get hold of a copy of the classic book, this article is a fantastic summary and starting point. Janet Balaskas reminded women the world over of what their bodies already knew about the benefits of birthing actively, and putting the mother at the centre of birth.
A blessingway is a nurturing and life-affirming ritual for the mother-to-be. Unlike a baby shower which is centred around material gifts for the baby, a blessingway honours the mother and the journey she is about to undertake in labour.
A blessingway brings together the women in our lives whose love and support means the most to us, and whose wisdom will guide us through the uncharted path to motherhood. The blessingway is for our mothers, grandmothers, sisters, daughters, aunts, cousins, best friends and soulmates. Through symbolic ceremonies and rituals in which all take part, the mother-to-be is strengthened, supported, and nurtured in preparation for her birthing time.
Blessingways are a personal expression of the mother and her circle. Here are some ideas you can use to inspire your own.
Belly Painting: Using non toxic natural paints or henna, a design is painted onto the mother-to-be’s big baby belly.
Beads: Each person brings with them a bead, over which they say their own personal prayer/blessing/wish. The beads are threaded onto some string to make a bracelet or a necklace. The birthing mother has these beads with her in labour and draws on the strength and love of those in her circle.
Candles: Each person undertakes to light a candle for the mother when labour has begun.
Massage and Pampering: Using scented oils, soft towels and incense the mother-to-be is pampered and massaged. Hair brushing, or a facial/pedicure can also form part of this ritual.
Notes and Blessings: Handwritten notes of love, support and birthing or mothering wisdom can be pasted into a special notebook for the mother to keep.
