New Montessori Post-- Children & Toys

Just a note to say that I have another post up at MariaMontessori.com.  Here's an excerpt:

I’ve never been a big fan of toy boxes. They seem messy, and as if they’re designed for toys to get lost and/or broken in them. It’s hard to teach children to be careful of their toys when the way to put them away is toss them into a box with a bunch of other stuff. So when we started thinking about how to set up our son’s room and how to store/display his toys, I knew I didn’t want a toy box.

Instead, I wanted to set up his room as if it were his own private Montessori classroom. Which means, rather than toys being hidden away in a toy box somewhere, I wanted to find a low shelf to hold and display his toys so he could easily see them and where each toy would have its own specific place. 

I'd love it if you went and read it! =)

In other news, I dropped D off with the new nanny this morning.  He was SUPER excited about going back to Arjun's house all morning, especially since we were just there last night for a BBQ and he had a blast playing in the backyard with the toys.  The other parents there were amazed, D literally spent a good hour or 2 playing in the yard on his own, entertaining himself.  They asked what my secret was.  Honestly, this was the first party where I've been able to actually converse with the other adults instead of chase D around, so I was just grateful for the opportunity!

Anyway, so ever since we woke up this morning he kept talking about going to Arjun's house and was so excited.  Then we drive over, he knocks on the door, and the nanny opens it... and it's like he suddenly went, "Oh, crap!" in his head, realized what was about to happen, and turned to me with open arms and cried, "MOMMY!"

I came in, showed him his favorite truck among Arjun's toys, then gave him a hug and kiss good-bye, then walked out the door as he screamed and cried.  Ugh.  But, it's been half an hour and I haven't gotten a call, so he must have calmed down.  Hopefully the transition will go well, quickly, and the tearful good-byes will lend themselves over to happy waves out the window before long...

six word sunday: Getting ready for a tiny bundle.

six word sunday challenge

rough week

It's been a rough week over here.  Allow me to vent for a moment.

I'm thinking perhaps Vince Colt (Zach's nickname for the baby, in honor of Vince Young and Colt McCoy) is going through a growth spurt or something, because I am 1) completely zapped on energy, 2) my belly feels stretched to the max and just plain uncomfortable (this might be Braxton-Hicks contractions starting up, too), and 3) my lower back is aching more constantly.  I like the growth-spurt theory because if that's the case, it's temporary and I can hope that in another day or 2 I'll get a bit of energy back and feel better.  This cannot be third-trimester fatigue coming on early, because I don't think I can take 3 months of feeling like this.  Either way, my stores of energy, understanding, and patience are quite low.

Combine that then with D, who has also been acting out.  Mercifully, he's spent a lot of the past week playing on his own, giving me a break here and there.  He has also spent a lot of the time being your typical, textbook-difficult two-year-old.  Every other suggestion out of my mouth is met with an angry, "NO!"  Even for things I know he wants to do.  Every single mention of "Let's change your diaper" is met with that same NO!, or just a loud screech and him running away.  Usually he's happy to walk upstairs to his room on his own, but this whole week I've had to carry him, using trial-and-error to find ways to hold him so his knees won't hit my sensitive, always-in-the-way belly.  The times I do lose my cool and raise my voice, he responds with "Don't talk that way!" or "No, you don't do that, Mommy!"  Understandable, but infuriating.  Oh, and the past 2 days his naps have been a measly 30-45 minutes long.

I'm exhausted.  I just want to curl up and take a long, long nap.

The good news: through a stroke of fabulous, wonderful luck, we've been getting to know a couple who live close by and have a little boy just under 2 years of age. They use a nanny with him 2 days a week, and the mom offered to share her if I wanted.  We've been wanting D to start preschool somewhere (both for his and my benefit) but for several reasons that probably won't happen till spring at the earliest, so I jumped at this chance. Starting next week D will go to their house 2 morning a week and get to play with new toys and a new playmate.  I will get to do chores, run errands, or just laze about and enjoy the calm and quiet.... and, in a few months, get some one-on-one time with my newborn.

So, that's exciting.  It's a relief just knowing that I'll get a bit more time to myself soon.  I know I've been needing it... and D will probably benefit from spending some time with people other than his tired, grouchy mama.  ; )

I'm holding out hope for a better week next week...

give water

Last year I joined charity: water's September campaign to help raise money to provide clean drinking water to a few of the 1 billion people around the world who don't have access to it today.  This year, I'm doing it again.

Help me celebrate my 30th birthday by donating $30 to my charity: water campaign.

Here's a video explaining a bit about the project, and the people in the Central African Republic who will be helped by this year's campaign:

charity: water 2010 September Campaign: Clean Water for the Bayaka from charity: water on Vimeo.

Why water?  Because we can't live without it.  It is one of the most basic needs human beings have.  And for far too many people, it is unavailable (appropriately, PhDinParenting just published an excellent post on the uneven access to clean water around the world, please go read it!).

Click here to read more about charity: water.

On Motherhood, Breastfeeding, and Guilt

I saw this video the other day, and instantly loved it.



And yet, as I was watching it, as much as I immediately wanted to share it across every online space I could, I also kept thinking, "Oh, but this will make some moms feel guilty..."

Ah, guilt.  It goes hand-in-hand with motherhood, it seems.  I'm sure fathers feel guilty as well, but it seems moms are the ones who get hit the hardest with guilt... possibly because it is an unsaid assumption of Truth that however a kid turns out, is a direct reflection of how well his or her mother raised them.  And so not only do you have us newbie moms fretting over whether we're making the right decisions (fairly understandable, given that we have no idea what we're doing most of the time and no way to tell short-term how well it's really working out) but also mothers of full-grown adults who still feel guilt over whatever they did or did not do long ago.  I've often heard both my own mom and my mother-in-law lamenting over their past mistakes (nevermind that all their kids have turned into healthy, happy, well-adjusted, and productive adults).

But while guilt presides heavily over most parenting decisions, for some reason the act of breastfeeding vs formula feeding hits the hardest of all.  It's difficult these days to mention any benefit of breastfeeding without a public outcry of "Stop making moms feel bad!"  Which means that while many of breastfeeding's benefits are well-known, many others are just not talked about, or certainly not to the extent they would be if the benefit came from any other act.

Unfortunately, part of this reaction is the result of a few misguided but very outspoken breastfeeding activists who use shame and ridicule to try to get mothers to breastfeed.  Clearly, this is the wrong way to go.  And for any of the formula-feeding mothers who've had to face this type of activists, I don't blame them for cringing anytime anyone says anything about breastfeeding to them since it triggers all those same feelings from being berated for your choice/outcome.

But we need to figure out some way to get out of this current stalemate.  We can't keep not talking about breastfeeding for fear of angering mothers who didn't/couldn't breastfeed.  We also can't keep harassing moms for the decisions we make.

The latest numbers I've seen are that, in the US, about 70% of mothers start out trying to breastfeed in the hospital, but only about 30-40% of moms are still exclusively breastfeeding at 3-6 months.  Something is happening there, and we need to find out what.  My guess is a lot of it is due to poor support for moms who really do want to breastfeed-- support in the hospital, support from friends and family (who themselves may have formula-fed and believe there's no difference or discourage breastfeeding because "boobs are for sex"), support from the public so moms can feel confident to nurse whenever and wherever they need to.  It is for all of these reasons that we need to have open, honest conversations about breastfeeding and why it is so beneficial to both mothers and babies.

I have many friends who have breastfed their babies for 6 months and beyond. I also have several friends who tried to breastfeed, and for whatever reason had to stop.  No one deserves to be ridiculed or shamed for the way they feed their baby.  All mothers deserve understanding and support, whether our babies get breastmilk or formula.  And while this is certainly much easier said than done, I think we mothers need to learn how to feel secure in our decisions and not allow others to make us feel bad about them.

--If you choose to give your baby formula instead of breastfeeding, that's your decision.  I may not agree with it, but then again I don't have. It's your body, your baby, your decision.

--If you tried to breastfeed but had to stop before you wanted to for whatever reason, know that you did what you could and that's all anyone can ever ask of you.  You don't have to answer to anyone else about why things went the way they did, and you don't have to apologize.  If you plan to have more children you can do research to see if the obstacle(s) you faced could be avoided next time.  But ultimately, it's up to you.  Only you can know what your unique situation was.

--If you are a breastfeeding mother who is struggling, know there are so many great resources for you, so many people who will be understanding and try to help you as best as we can.  Find a certified lactation consultant, talk to other breastfeeding moms, use online breastfeeding forums.  Chances are good that you can find a solution and move past whatever roadblock you are facing.

Guilt is only useful when it motivates you to change something that is within your control.   If it's out of your control, let go of the guilt. It is not doing you, nor anyone else, any good.  Breastfeeding or giving your baby formula does not make you a good or bad, worse or better mother.  It makes you a mother who breastfed or gave her baby formula.  Hopefully if we can let go of that guilt, we can then talk about breastmilk versus formula without automatically going on the defensive or turning to attack one another.

six word sunday: That poor bird had no chance

six word sunday challenge

(No, Nev didn't catch a bird.  She can hardly catch flies inside the house. But, she has spent lots of time in the patio, and up on that fence...)

pendulum

It continues to amaze me how this job can be so fun and so awful all at the same time.  The other day D and I had such a great afternoon.  We went to Target, and since I only needed a couple of small items I let D take this small canvas bag with short straps, which is small enough for him to handle.  He was so excited to have his own bag and strutted down the aisles holding it in the crook of his elbow.  He followed me to get the few things I needed and put them in his bag, then I let him lead the way for a good 20 minutes or so.  He'd turn down random aisles saying, "Let's go this way..." and then he'd stop and look at different items on a shelf or rack and say, "Oh, look at this!"  It was adorable, so, so completely, heart-metingly adorable.  Then he helped me check out, load things back in the bag, and walked back to the car.

Then we got home, and I don't even remember what all happened after that but I believe it involved a lot of this very whiney fake-sounding cry he's taken on lately, and pretty soon I was counting down the minutes till I heard Zach's key in the lock.

And so it goes....

Yesterday we got to meet up with friends who visiting family in town.  We had a great morning at the railroad museum, aka one of D's new favorite places EVER thanks to the two tables with large sets of Thomas railroads and trains set up for kids his age to play with.  He could probably spend hours there if he could.

And now, the weekend. Not much planned.  Looking forward to that. ; )

Wordless Wednesday: gadget overload...?

(left to right: Zach's cell phone, his droid Incredible for work, his ipod touch, my cell phone, my ipod touch)

Oh right, there's a person growing in my belly....

I laugh now when I look back on my first pregnancy.  I fully realized at the time how much free time I had, and how it was all about to change... which was part of why I relished all that freedom while I still had it.  We were living overseas, and I was the pregnant expat wife who got to spend my days exploring a neat city and meeting up with girlfriends for lunch.  Or taking long naps, if I felt like it.  Or watching the entire 6 seasons of Sex and the City (I sometimes joked that D would be born thinking Sarah Jessica Parker was actually his mother, from hearing her voice so often).

This pregnancy is, well, slightly different.  Heck, a lot of the time I forget I'm even pregnant (though now that I have a decent belly and feel kicks on a regular basis it's a bit more "real").  I love feeling those kicks, the gentle (so far) reminders that there is a little person growing inside my body, but it still all feels so abstract, and I don't get much time to focus on this pregnancy, this baby, or the changes that are ahead for all of us.

The other day D and I were playing and it hit me-- we've only got a few more months of it being just the two of us, unrestricted and with all the time in the world to play and cuddle and just hang out.  We've talked about the baby, how he's going to be a big brother and we'll have a baby that he can help Mommy and Daddy take care of.  How the baby at first won't be able to play or do much, and Mommy will have to spend lots of time taking care of him.  But as much as I try to prepare him, there's no way he can really know what's going to happen.  There's no way I can really know what having a baby will mean for us as a family, just as there was no way for me to really know (no matter how much prior experience I had with children and babies) what it would be like to have D.  These are things you have to go through and experience to have any inkling.  I imagine that going from 1 to 2 kids is a less jarring life change than going from none to one, since we've already made a lot of the big life adjustments that come with having kids.  But then again that's sort of like saying, "Well, it's won't be quite as big an explosion as an atomic bomb..." I'm bracing for the swift kick in the ass life will be doling out to each of us in about 4 months' time.

I feel pretty calm about the birth.  I actually started looking forward to giving birth again long before I felt at all comfortable with the idea of having another baby, which I know seems very odd especially since after D was born I had absolutely no desire to go through that again for a looong time.  I suppose they're right about hormones making you forget. ; )  I think I was pretty calm about giving birth before D, as well, but this time I have the added bonus of experience. Of knowing that I can do it, because I already have.  I do occasionally start to question-- what if this labor is way harder than D's was?  What if the techniques that helped me deal with contractions don't work as well this time around?  Am I forgetting things that I did to prepare last time, that will then make labor harder this time?

But overall I feel fairly calm and confident.  I'm looking back over notes from the birthing class we took last time.  I'm reading books, both old and new ones (I wish I'd known about Ina May's Guide to Childbirth with my last pregnancy, so much great information!).  I'm trying to keep up some form of exercise, even if it's walks around the block with D.  And while I don't think I'll get around to taking the class, I did order a book on hypnobirthing as I think the visualization tactics could be very helpful.  I know that while my last labor was a challenge, I never reached that point of thinking "I can't do this" or "Take me to the hospital and give me the drugs already!!"  I'm preparing myself mentally for things not going the way I hope they will, but also focusing on keeping a positive outlook and confidence as I firmly believe there is a huge psychological component to giving birth.  I like reading through the birth stories in the Ina May book and on the Mothering website.

So that's where I am: trying to enjoy this pregnancy before it flies by me, and to appreciate this last window of time of us as a family of three before my baby boy becomes a big brother.  These are exciting, happy, and slightly bittersweet times.  Life, it is good.

six word sunday: Oh, kiddo. You melt my heart.

We were sitting on the front steps, him eating a snack of dried mangos, when I realized how beautiful the light was and how it lit up his eyes, and I had to run and grab the camera. I get so few shots of him like this anymore-- he doesn't sit still long enough anymore.  Am grateful for these.

horrified

As I mentioned in yesterday's post, when I come across a link that I find hold important information, I'll usually share it on twitter, and sometimes on facebook as well.  Every so often, I come across too many links in one day.  And sometimes, I have too much to say about them for either twitter or facebook.

Today is one of those days.

Today I came across the term "pit to distress."  This is, apparently, a medical term meaning that the doctor wants to use large doses of Pitocin in order to make the woman's labor progress as quickly as possible, and even to cause fetal distress so they can call for a c-section.  

My first reaction was skepticism.  This sounded too horrifying, too downright malicious, to possibly be true.  Then I read the following posts:

"Pit to Distress": Your Ticket To An "emergency" Cesarean?

"Pit to Distress": A Disturbing Reality

"Pit to Distress" Around the Birth Blogs

Each of those posts (and there are plenty others) recounts either a L&D nurse's personal experiences with doctors who practice "pit to distress," or link to nurses, doulas, and midwives who have also personally dealt with it.  I can't say how widespread this practice might be, but that it happens at all sickens me.  That it happens often enough for this many birth attendants to say, "Yep, I've seen that," is horrifying.  These posts were all written last summer.  Has this practice died down since then? Increased? I don't know.  But dear lord.  I wonder how many of those women had any idea what was being done to them as the Pitocin was increased (or as their nurses battled with their doctors to keep it from happening).  

See, I don't blame women for wanting to birth in a hospital. I may not share it, but I can understand that desire.  I do blame is the doctors and hospitals who practice this sort of "medicine," as well as the lawsuits that have made it so that we collectively believe that performing major abdominal surgery is somehow "safer" than letting labor progress on its own.  This is what drives women like me to not want to touch a Labor & Delivery unit with a 10 foot pole.

And now, the flip side-- another amazing post I came across today, except this is a positive one.  This is a midwife's description of what generally happens during prenatal care and then home birth with a midwife:

What is a Home Birth Like?

It seems a lot of the vitriol against home birth seems to come from people who have no idea what one is like, or what a midwife's role and capabilities are.  So, here's hoping that spreading posts this like last one around might help improve that just a bit.

I am not here to judge

You may have noticed that over the past several months I've become slightly obsessed with the topics of pregnancy, childbirth, and breastfeeding.  I've talked about them some here on my blog, but I've been especially vocal on facebook and twitter.  Lately I've been reminded of how easily these discussions develop a judgmental, accusatory tone, as if there's only one "right" way to do things and anything else is wrong.  So, I wanted to stop for a minute and make a clarification.

I am not here to judge, and I am not trying to tell anyone what to do.

It is not my intention, when I post information about home birth, or breastfeeding, etc, to make others feel bad for making different decisions or having different experiences/outcomes than mine.  I do not think less of anyone for choosing to birth in a hospital, having a c-section, giving their baby formula, etc.  I have no interest in making others feel guilt or shame-- that helps no one, ever.

I have friends who have breastfed and formula-fed, who gave birth via c-section, with and without an epidural, and through home birth.  Each one of these mothers has made the best decisions she can for herself and her baby, and I support them fully in what they do.  Just because I do things one way does not mean I think others should do the same.  The answers are different for everyone.

I post links and information because a lot of this info seems to be hidden and not widely known about in mainstream culture.  There is so much misinformation about childbirth, so that very few people realize that giving birth with a midwife, even at home, can be a safe and realistic option for them.  Many don't realize what it can take to breastfeed successfully, or have heard myths that can be damaging.  So, as I find out information that I think is really important and useful, I try to share it.

I also have the selfish motivation of trying to help others understand why I've chosen certain routes that may not be very popular.  We pay a lot of lip service to breastfeeding here in the US, yet only 1/3 of mothers breastfeed past the first 2-3 months.  Midwives attend about 8% of births in the US, and home births make up just 1% of births.  Birthing at home and breastfeeding for a year (or longer) are pretty radical actions these days.

My goal is not to judge or get people to make the same decisions as me.  My goal is to help others have as much of the information as possible available to them when they make a decision, so that it can be a fully informed one.  Two people can look at the same set of data and come to very different conclusions.  I look at studies on birth and know that I feel safest giving birth at home with a trained, well-experienced midwife, and a hospital close by in case I (or the baby) needs a transfer.  Someone else may look at the very same information, and think, "That's nice and all, but it's not for me."  The way I see it, there is no "right" or "wrong" option as long as that decision was made after carefully considering all the options available, weighing the risks vs benefits, and going with what makes the most sense for you.

wordless wednesday: a boy and his cat

So, how's Sacramento?

Pretty great, actually!

I remember the very first time Zach mentioned Sacramento as an option to me.  It was before he'd even left his previous job, but was looking around and had heard of an interesting opportunity here.  I'd never been to Sac other than driving through to get to Tahoe, and from what I'd heard from many others in the bay area that's about as much as you'd ever want to see of it.  So when he said he'd sent in a resume for a job here, I wrinkled my nose and said, "Sacramento? Really?"

By the time he got his current job offer our 2 options were Michigan or Sacramento, so I was a bit more open to the idea.  But, I was still apprehensive.  Then we visited and discovered the downtown area, and fell in love.

And after living here for almost 2 months, I'm happy to report that we are still loving it.  =)

Our house is adorable.  We're still finishing setting it up, eventually I'll post pictures.  But we have wood floors throughout, decent light, and enough space (upgrading from a 2/1 to a 3/2.5 has been quite lovely!).  Our kitchen is no longer a cave hidden away from the rest of the house.  We have an adorable little patio for D and the cats to play in and a semi-private driveway for riding his firetruck.

Our location is great.  There are two main neighborhoods I think of when I say "downtown Sacramento"-- Midtown, which is populated more by 20something singles, and East Sacramento which is much more family-oriented.  We're kind of between the two, which means we get to take advantage of both.  We have bars, restaurants, and shops all within easy walking distance... as well as great parks, a community center with pool and library (which I still need to check out), and even a kid-geared art studio that D has fallen head over heels for.  The neighborhood itself is beautiful-- lots of gorgeous historic Victorian homes; tall, mature trees to provide lots of shade; great sidewalks; lots of crosswalks.  It's very flat, too, so you see about as many people riding bikes as you do driving cars.  So much is within walking distance (I even found a dentist for D that's walkable) that we don't have to use the car unless we want to.



Also, the people here?  Maybe we've gotten lucky, and maybe it's the downtown crowd, but people have been super friendly.  We've already made all sorts of connections, from the playgroup I joined right after moving that's taken me right in and been incredibly warm and welcoming, to people we just happen to strike up a conversation with while out at a park somewhere.

It kinda feels like this is Sacramento's well-kept secret.  The best part? We could actually afford to buy here.  Cost of living is a good bit cheaper, meaning we might actually be able to buy the kind of house we want in this neighborhood.  As much as we loved the bay area, that has yet to be true there, at least in the kinds of neighborhoods that would be equivalent to this.  So that feels good (knowing we have a decent chance at home ownership).  We even considered buying soon after moving, but figured we probably should wait to see how Zach's job pans out.  Being a start-up and all doesn't exactly make it the most stable of employments (the company does have funding for another 2-3 years, but I'd rather wait till we know we'll be somewhere semi-permanently before buying).



And that's another benefit of being out here-- if Zach were working at a start-up in Silicon Valley, I would probably never see him.  Here, he's working about as heavy a load as usual, and most nights is home in time to help give D dinner and put him to bed.  It's nice to be away from the workaholic mentality.

So, yeah, Sac's been good to us so far.  Here's hoping that continues.  =)

PS- To clarify, none of the houses pictured here is our house, they're just other gorgeous homes in our neighborhood.

six word sunday: a sweet souvenir for the road

six word sunday challenge

We drove to San Jose yesterday for an overnight visit, to see friends and go to Sophia's 2nd birthday party.  It was really fun, though a bit surreal to be taking all those same roads we used to drive on a daily basis, that are not Home anymore.  We stayed overnight at our friends John and Carolyn's house, where we made the mutually-beneficial trade of using Donovan and their welsh corgi, Penny, to entertain each other.  It worked out quite well. ; )

Before we left Carolyn cut these flowers from her garden to take home with us.  They survived the 2hr drive, and are stunningly gorgeous.  I took the opportunity to play with the FxCamera app on the HTC Incredible Zach just got for work.  The good news: he now has a smartphone that I can steal borrow and use when we're out and about together! The bad news: Zach is now tethered to work by this virtual (but oh so real) leash.

(I shouldn't complain, actually, considering that he's working at a start-up his work schedule hasn't been very hectic at all. It's shocking to realize how different the expectations become when you leave the work-all-the-time-no-time-for-life Silicon Valley mentality...)

21wks

Today I went to what will likely be my last prenatal appointment with Kaiser Permanente.  I wanted to do this appointment to get to talk about the results from our ultrasound (and because the nurse practitioner I saw last time pretty much forced me into making the next routine prenatal with them), but after this there doesn't seem to be much of a point to continuing double coverage.  I can bring D with me to midwife appointments which is awesome, but to go to KP I have to find a baby-sitter and pay her along with the co-pay for the actual appointment, and since I'm already getting quality care from the midwives it seems unnecessary to spend that money and time.  So I'll take the glucose test at their lab when I'm around 27wks, then that will be it.

I am happy to report that today's appointment went much better than the last one. This time I saw one of the KP midwives-- Marcy Ronnenberg, CNM.  She burst into the room and was bubbly and sweet and so lovely, it almost made me sad that I won't be going back to see her again!  She was 100% supportive of me wanting a home birth (she used to work with a home birth practice) and said she and the KP midwife group were more than happy to be my back-up.  She also mentioned that the KP hospitals here in Sacramento are getting labor tubs!  I'm still sold on doing this at home, but it's very exciting to know that they're making these changes and making things like labor tubs and water available to women.

Oh, and she also gave me her business card with her voicemail phone number, so I can call her directly if I do decide to come back for another appointment at any time.  Love. That.

By the way, she said everything looked perfectly fine and healthy on the ultrasound.  Pee test, blood pressure, and baby's heartbeat all came out great, too.  I've been feeling pretty ok lately, fatigue comes and goes and as of yesterday all of a sudden I'm feeling indigestion and heartburn.  But, no other complaints.  So, so far so good. =)

Car Show

Saturday evening the California Automobile Museum held their 2nd annual car cruise and show in downtown Sacramento.  We're not really car people, but D certainly is, and the events were taking place just a few blocks away so we figured we'd go check it out.

We walked over to Thai Basil for dinner, where we watched the classic, modern, and vintage cars make their way down J Street from our table on the terrace.  Donovan was, of course, entranced, pointing at all the cars and saying, "Look at that car! Look at that blue car! Whoa, look at that red car! Hey look at that funny-looking car!"

After their initial drive through downtown, the cars all lined up and parked along several downtown streets, which were then blocked off to regular traffic so the crowds could mill around and check out the different cars.  Donovan loved this, too, going from car to car, his eyes nearly bulging out of his head the entire time.  All in all, it was a pretty neat way to spend a couple hours.  =)

No, home births are *not* irresponsible

The other night I got an email from an online friend with a link to an article about a UK medical journal piece that has stated that pregnant women should perhaps not be allowed to opt for a home birth.  This opinion is based on a recent research meta-analysis published by the American Journal of Obstetrics and Gynecology that concluded that babies born at home might have higher death rates than those born in hospitals.  Basically, they (the UK journal) have decided that home birth is riskier than a hospital birth, and that women "do not have the right to put their baby at risk."

Many thoughts swirled through my head after reading that article.  For example, the many analyses of the AJOG study that suggest that it might be deeply flawed.  Or all the previous research that's found home birth to be just as safe as hospital birth (including, interestingly enough, many of the studies used in the AJOG meta-analysis).  And let's not even go down the slippery slope of the implications this type of statements holds, as it easily could be applied not just to a mother's decisions regarding childbirth but to every moment from conception all the way through infancy and childhood.  Are we going to start policing women for deciding to have a glass of wine during pregnancy or, say, doing something as high-risk as driving with their kid in the car?

Then there's this aspect of women not being "allowed" to decide.  This makes me angry on a few levels.  I immediately thought of our sky-high c-section rate, how clearly many, if not most, of those c-sections are unnecessary, and how c-sections are indeed riskier for both mother and baby than vaginal birth (especially so if the mother wants to go on to have more children in the future, in which case that previous c-section also increases the risk of all sorts of complications for each future pregnancy).

But I guess those are risks doctors are willing to take-- are willing to decide for us.  We moms, however, shouldn't have the "right" to make our own risk/benefit analysis and decide what we think might be better for us and our babies.

And that's the other thing that gets me-- behind every one of these articles about the "risk" and "danger" of home birth or of using midwives instead of OBs, lies the belief that those of us who choose this route are being careless and irresponsible.  That we aren't looking at the risks and have instead made our decisions based on our own selfish desires, on whim, rather than on evidence and what's best for our babies.

This assumption makes my blood boil.  It should go without saying how ridiculous it is, how erroneous.  The truth is most of us have spent hours pouring over websites and online studies, weighing very carefully the risks, and deciding, yes this is what's best for us -- "us" meaning both ourselves and our babies.  We look at the hospital model for birth, with the high rate of interventions (which you can in theory opt out of, but often not without a fight and labor is the one time you should not have to fight with anyone); the 30% chance (or higher, depending on the hospital) of ending up with a scar on your belly; the alarming increases in maternal mortality and morbidity in hospitals over the recent decades (which are quite likely linked to those higher interventions and c-section rates), and we say "No, thank you."  We realize there is some risk involved-- there always is, no matter how you give birth-- and we accept it, and we prepare as best we can to reduce that risk as much as possible.  We love our babies just as much as any other mother, we care about them and their well-being just as much, and we should be trusted to know how to make decisions that make the most sense for all of us.

There is one aspect in which the journal article gets it right-- that in high-risk, complicated pregnancies, it's best to give birth in a hospital.  Which is exactly what most midwives will tell you.  Part of a midwife's job is to help a woman determine whether or not she is a good candidate for home delivery, and if there are risk factors such a placenta previa, preeclampsia, or certain breech presentations, any decent midwife will urge that woman to give birth in a hospital.  One problem that can arise, however, is that of determining who should or should not be classified as "high risk."  As this post at Fertile Feminism points out, in the UK (not sure if US has this, either) there is no conclusive criteria for what it means for a pregnancy to be high risk.  Doctors get to decide what conditions or factors push a woman over into the high risk category-- these can be legitimate risk factors like the ones I mentioned above, or can be things like "advanced maternal age" (aka over 35) or just being overweight.  Until there are objective guidelines outlining what factors make a pregnancy high risk (and even with that in place) it should be up to the future parents and their medical provider (OB or midwife) to discuss the risks and benefits of different birth options, and up to the parents to make an informed decision about what they want to do.

Somehow our ability to assess risk has gotten completely skewed.  If a mother or baby dies after a home birth, you'll see headlines splashed all over declaring home birth unsafe and irresponsible (even if the death had nothing to do with the location or access to medical services).  If a mother or baby dies after a vaginal birth, the doctor gets sued for not "doing enough." If a mother or baby dies after a c-section... well, um, nothing.  No accountability, no wondering why, or what could have been done differently.  We blow certain risks out of proportion (home birth, vaginal birth, VBAC), while completely ignoring others (non-medically-necessary inductions or c-sections-- and yes, I have read doctors claim there are no risks to c-sections, even that they're safer than vaginal birth).

And that right there is the bottom line for me.  Let's talk openly about what are the pros and cons, the risks and benefits, but let's look at ALL the risks.  Let's not go on and on about how "dangerous" home births are while claiming that epidurals, inductions, and c-sections are "perfectly safe."  There are risks to consider no matter which way you go in the many decisions involved in childbirth (and child-rearing, for that matter) and women deserve to know about them all and make informed choices for ourselves.

PS- Here's a wonderful post on complications during home births, and how midwives deal with them.

six word sunday: Possum thoughts consumed her doggy brain.

six word sunday challenge

Joey, my mom's dog (well, technically, Jenny's dog who is in foster care with Mom and Philip while Jen's in SF and unable to have a dog with her).  Adorable daschund, vicious possum killer.  As in, I caught her playing with her latest kill one evening while in Texas...