Here's what's going on out here...

My "duh" file is getting full: Cesareans increasing, more women dying

photo by aka Quique

An increase in the number of (unnecessary) Cesareans means more women are dying, unnecessarily. Like so many other facts of modern life (don't get me started), a lot of people would like to see this information suppressed or distorted. But there it is. A striking quote from the study of maternal deaths in California: the current trend represents “the most significant spike in pregnancy-related deaths since the 1930s…it’s more dangerous to give birth in California than it is in Kuwait or Bosnia.” Don't think the problem is just California--they're just the first ones to be honest about it.

So much for the lifesaving benefits of modern medicine, so frequently touted when the safety of homebirth is questioned, as it often is in the media these days.

Kind of makes that live elective C-section on the Today show (the one the doctor characterized as "orderly, routine and scheduled for this timeframe, just the way these are supposed to go...as happens at countless hospitals all over the country,"--indeed) seem a little in poor taste. The doctor in this case notes that the Cesarean was scheduled--mind you, with no "trial of labor" first--"because in both of their families, babies run big and she was past her due date and those are two indications that a cesarean section is a lot safer than having a vaginal delivery."

I'm sorry, what?! With countless increased risks of morbidity and mortality to both mother and baby, there are VERY few situations in which a SCHEDULED ELECTIVE PRIMARY CESAREAN TO A HEALTHY WOMAN CARRYING A HEALTHY FETUS is "a lot safer than a vaginal delivery." As a matter of fact, her own professional organization notes that "the evidence does not support prophylactic [ie scheduled] Cesarean delivery for suspected macrosomia [large baby]," and studies have estimated that it would require over 1,000 such Cesareans to prevent one permanent birth injury (generally the concern over giving birth vaginally to a large baby). Even more sobering, if such a policy of rampant unnecessary Cesareans were enacted, for every 3.2 brachial plexus injuries (the most common birth injury, a kind of nerve damage to the arm) prevented, one maternal death would occur due to the complications of Cesarean. And I don't think there is a professional out there who could give you any kind of support for the statement that going past a woman's due date (or guess date, as it is sometimes known--because the 40-week mark is simply the midpoint in the normal "due month," which encompasses full-term deliveries anywhere from 38 to 42 weeks) is an indication for scheduled Cesarean.

Bad, bad medicine. And women are dying, literally, to bear it out. It makes me want to scream.

Meredith Viera (who gaily tells the woman that SHE had a Cesarean and so knows that she'll be "on her feet in no time") notes toward the end of the show, "They chose the right way to deliver, that’s sure… by c-section."

I'm sure glad I chose the WRONG way to deliver my 10-lb (2-oz) baby--one that isn't contributing to the rising toll of dying mothers.

Saturated fat: Does a body good

photo by Vicious Bits

First BPA, and now it gets even better. We'll just call this the winter of our vindication.

As evidenced by our shift to a diet heavy in cream, lard, butter, cheese, half-and-half, and whole milk, we came to disbelieve the association between saturated fat and heart disease awhile ago. Up until now, despite the fact that the science said otherwise, this mentality was considered pretty out-there and fringe-y (mainly because nobody was looking at the science, just parroting what they were paid to say by special-interest groups). Well, this morning at the gym I saw on the news that the mainstream media has finally picked up on the fact that studies have shown that there is NOT a link between saturated fat intake and heart disease. While "scientists" still rush to tell people to "increase their intake of vegetable oils," nonetheless, at least the beginnings of the truth have been sounded.

Food Renegade is one of my favorite health writers, and she explains here and here and here why the "low-fat (especially low saturated fat) = healthy" mantra is a myth. While the media hasn't yet gotten this far, the next step in all this is to understand why high cholesterol doesn't "cause" heart disease--AKA the "lipid hypothesis." You can go here to read one researcher's explanation--that cholesterol IS present in the arteries of people with heart disease, but only in the same way that firefighters tend to be present at fires. As she puts it, it would be ridiculous to blame the firefighters for starting fires simply because they always show up there! Instead, the role of cholesterol in repairing inflammation (caused largely by sugar and free radicals) explains why high levels of lipids are found in those with damaged arteries. It also explains why drugs like statins lower cholesterol, but not mortality. And, it explains why so many people's ancestors, like mine, lived to a ripe old age "despite (as doctors would have us believe) eating eggs every day, spreading lard on their toast, etc etc. In fact, it turns out that those humble, traditional foods are probably the exact reason WHY they lived to a sharp, active old age.

For me, seeing this on TV this morning was especially timely because our hospital's health fair is today and I was planning to pop by after the gym to get my cholesterol, blood pressure, and blood sugar checked. (Being part of a sea of people, with easy access to a number of exit points, is about as close as I like to get to the medical establishment.) I was practically jumping up and down with anticipation to see what the numbers would be, given my switch in the past few years from a lower-fat, vegetarian diet to a traditionally-based one that includes a lot of saturated fat.

Total cholesterol: 162
(Ideal: less than 200)

HDL ("good" cholesterol): 56
(Ideal: greater than 50)

LDL ("bad" cholesterol): 2.9
(Ideal: less than 3.5)

My random blood sugar was 86 (ideal: 70-14), reassuring given that I could be considered at high risk of diabetes based on my chunker of a baby. And finally, I was pleased to see that my blood pressure was normal because it has been elevated in the past (during nursing school, for example) and high blood pressure runs in my family. However, I was not surprised to see that it had normalized, as we have recently become believers in some of John Sarno's theories about psychosomatic links to pain, chronic illness, and hypertension, and feel that exposure to his work has helped us become healthier than ever. As was long the case for the contention that saturated fat does not lead to heart disease, Sarno's work has yet to be accepted by mainstream medicine--but to us, that's just one more reason to give it a closer look.

You mean BPA is dangerous?

We thought so. And now we know so. Too bad there's "nothing that can be done about it," huh?

Are women's bodies broken and defective? Just ask your TV.

Most people know that we don't expose ourselves to much media around here. However, we get a snippet here and there, and more often than not, we're disgusted with what we hear.

This morning at the gym, I happened to catch a glimpse (sound turned off) of this segment on Good Morning America. (GMA happens to be the show that visited my hospital, spoke with one doctor, refused to speak to nurses, and then "spoke out" on the "dangers of doulas.") What seems to have happened is that a Haitian woman went into preterm labor at 32 weeks. American doctors suspected that the baby was lying transverse and thus unable to delivery vaginally. There were also signs that her uterus was becoming infected. A flurry of text messages later, they managed to get her to a field hospital, where it was discovered that the baby was actually head down, in a fine position for delivery. She subsequently delivered her baby vaginally, and, it seems, fairly uneventfully.

Watching this clip with the sound off, I was struck by the imagery. Poor, third-world, black pregnant woman splayed out in front of the TV cameras while white men all over the world exchanged electronic missives about what to do with/to her. She's rushed off to lie flat on her back in a hospital bed in a tent, an Israeli field hospital with, of all things, electronic fetal monitors strapped to her. Where did those come from? Why would they have a machine that not only costs thousands of dollars, but doesn't improve outcomes? When periodic listening with a fetoscope--or in times of need, an ear against a pregnant woman's belly--can tell you what you need to know?

The message these pictures spoke was: women's bodies are trouble. They're defective. They're ticking time bombs. And they need men--wealthy white men, judging by these images--and their machines to save them.

Despite the fact that the birth was eventually effected with very little technology (which I couldn't tell from the clip--to me, it appeared that she underwent a Cesarean, but she must have just given birth in a room that looked like an OR), ABC News still managed to worm in a statement of how OMG SHE WOULD HAVE DIED if she'd had her baby at home:

The mother is doing well, despite having experienced preeclampsia, a leading killer of pregant women in Haiti, shortly before giving birth. And when Besser spoke with the doctor who delivered the baby, he said that the earthquake, ironically, likely saved the lives of both baby and mother.

"He said that had she delivered at home, both the mother and baby would have died," Besser said.

I'm sorry--would have died of what? The cure for preeclampsia is not drugs. Not surgery. Certainly not Blackberries and television cameras! Just one thing: the birth of the baby. Which her body had already initiated (go figure) and eventually completed.

It's not the only time the media (hey, ABC news again!) has recently glossed over the facts to present us with the idea that things can go wrong at the drop of a hat and you'd better be in a hospital--just in case. Exhibit B: the Christmas Miracle Mom.

Only, maybe not so much. It's interesting how the American Medical Association and ACOG seem to have infiltrated the media in recent years; how a story involving a cardiac arrest following an epidural turns into doctors saving the life of a woman whose pregnancy mysteriously tried to kill her. Interestingly enough, just a few years ago, MSNBC ran a story about a young mother who died following a "routine" induction and epidural. It actually happened in DC, at a hospital where several of my friends used to work. I thought the article did a good job of avoiding conjecture and finger-pointing; it just reported the sequence of events, which pointed to the fact that an epidural killed Julie LeMoult.

Does that happen often? No. But it does happen. Similar to the risks of homebirth, (though different in the important respect that one is a major, elective medical procedure and the other is normal life event), the risks are rare, but there. However, while there's probably not an OB in the country that wouldn't argue for a woman's right to have a large needle, anesthetic, and narcotic injected into her spine in order to birth her baby, their professional organization is fighting tooth and nail to limit a woman's right to bring her baby into the world in the location of her choosing, despite the dissent of some of their members.

And today, what you hear are grim statistics, implicitly chalked up to out-of-hospital birth:

A woman in Haiti has a 1 in 44 chance of dying from childbirth in her lifetime, according to the World Health Organization. The comparable statistic for the United States is 1 in 4,800.

Part of the problem may be that even in the best of times, medical resources may not be accessible to many Haitians.

"About 80 percent of the population delivers outside of the hospital on a good day [in Haiti]," Moritz said.

A number of European countries have higher rates of out-of-hospital birth than the United States--and better maternal mortality rankings, by far. So clearly place of delivery is not the only factor here. Perhaps the women's bodies there aren't as defective as they clearly are here, or in Haiti? Or just maybe, they haven't been led to believe that they are.

Pregnancy and birth are neither where it begins, nor where it ends. They just tend to be where it's most visible. However, society's disdain for the female body crops up in other places, too. Breastfeeding, for example. It's a well-worn example that women's breasts are OK everywhere, as long as they're being used to sell sex (or anything else) and not to feed a baby. Women's bodies are cheap commodities for commerce and decoration--not something powerful and useful (let alone something men can't do! Gasp!) like nurturing another human being!

Menopause is another example. On the way to the gym this morning, coincidentally, I happened to hear an assinine spot involving a male DJ talking about one of his friends' wives who was going through early menopause. He went on to discuss how disgusting and abnormal this was, how she was probably a "sweaty mess," and how MAYBE his friend would stick around, but if you were "just dating" someone, the menopause would probably be a reason to "hit the road." "You add PROFUSE SWEATING to ALL THOSE HORMONES?" he said. "Come on!"

The message: women's bodies are gross, they're only good for one thing, and when they're not good for that thing anymore (as deemed by men)? Hit the road.

Come on indeed. This makes me all so furiously sad, now not just for myself and the other women out there, but because I now have a little girl. A little girl whose tiny body has miraculously transformed from 10 pounds of sweet melting baby fat into a sturdy 17 lbs of muscle and mobility, and which I know will someday be capable of further miracles. Like the one that grew and nourished her, and safely birthed all 10 lbs of her with little more assistance than a tub of warm water. And I plan to fight tooth and nail to safeguard her belief in herself and the integrity and power of her body.

Are women's bodies broken and defective? Far from it. But our view of them certainly is.

A happy new year.

Two weeks into the new year, I feel like we're in a very nice place. Certainly better than last January, when I was starting to get big, down with a cold, and lacking in energy. This year, instead of an expanding midsection, we have an ever-more-delightful, affectionate, silly and wonderful little person around.

We're settling into a nice routine, too; during the week, we get up around 6, I go to the gym for an hour, and Matt hangs out with Eden. I come home, and we spend time as a family until Matt leaves to walk to work. In the evenings, Matt usually does some woodworking, I do some homework, and after we put Eden to bed, we cap it off with an episode of Lost (two episodes on the weekends). On the weekends, I go to work, Matt and Eden have a daddy-daughter day, and we take it easy in the evenings. I feel so fortunate to have been able to rearrange my work schedule around my daughter's teething. I'm actually training up on the postpartum floor as well, to get a few more weekend hours, which is nice.

Eden is also getting bigger and a little more predictable (despite her increasing mobility). Plus, I think we're getting used to her. The more we settle into our life as parents (versus focusing on what we used to be able to do--you know, like sleep in, or have an uninterrupted conversation), the happier we are with it.

Things just feel peaceful and quiet these days--the calm before the storm. We're thankful for both.

Happy New Year!

Compared to my post about Christmas, which was celebrated on the 23rd and not posted till the 31st, my January 2nd new year's post is downright timely. Not that there's a whole lot to say about it; we spend New Year's Eve at home with Eden, who went to sleep around 9pm, while we stayed up watching Lost on DVD. Like with The Office, we're pretty much the last people on earth to discover both shows and now we're just as obsessed as everybody else, except we're about two years behind. Nothing wrong with that!

We also made homemade spaghetti and meatballs, which always tastes so deliciously decadent as to be well worth the small investment of time that it requires to make it. Since our discovery of BPA in a can, and having used up most of our frozen tomatoes, we've switched over to fresh tomatoes in all of our recipes that call for canned. It's a little more expensive, and it can't be called seasonal, but to us, it's worth it. In this instance, it worked quite well.

Besides marking our last New Year's in Reston, 2010 is going to be a big year for us. It appears to be the year we'll move back to the midwest, meaning the end of our current jobs and housing and the seeking out of new. Eden's first birthday, the beginning of my midwifery clinicals, and who knows what else will be other highlights. It was supposed to be the year I finished midwifery school, but it now appears that I'll do that in 2011 instead. Which is just fine with me. In all other ways, we're coming so much closer to accomplishing our dreams than I'd ever hoped we could, that a delay of a few months really doesn't matter at all.

Meanwhile, we're happy right now just to be exactly where we're at. Eden is growing and developing by leaps and bounds every day. Last night, while I was nursing her to sleep (or trying to), she somehow wrangled herself into a position perpendicular to me, worked her legs underneath her, and straightened them, so that she was standing up, bent at a 90-degree angle, still latched on. She's a lightning-fast army crawler and is already imitating sounds we make, making us feel like walking and talking will be here before we know it. Today at CVS, we reached two milestones: we bought her first toothbrush (a tiny yellow Sesame Street number--how impossible is it to buy a child's item that doesn't have some kind of marketing on it?!), and I also sat her in the front of the cart. Having only ever held or worn her in a store, it was amazing to look down and see this tiny, distinct person sitting in a little seat, little legs poked out through the holes, and of course trying to grab and mouth everything that went past her.

Today we also ordered some books, making use of generous gift cards and other funds given to us for Christmas (thanks, everybody!). For Matt: The Self-Sufficient Life and How to Live it. For me? A few too many breastfeeding books, so seductive because (like pregnancy and birth books) I can justify them as part of my "professional library." Including:

Child of Mine: Feeding with Love and Good Sense
The Food of Love: The Easier Way to Breastfeed Your Baby
Ina May's Guide to Breastfeeding
Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers

And, for Eden: What Baby Needs. While it's about the anticipation of a younger sibling, and we don't need that quite yet, we know someday we will and it seems like many of the more naturally-minded or breastfeeding/homebirth-friendly children's books (I am Made of Mama's Milk or Welcome With Love) go out of print quickly and then are quite expensive used. This one was under $5 shipped, and so I figured it was a bargain. Something I didn't get, but totally loved: these nursing animals (pig, cat, and dog) which have babies who "nurse" by magnetically attaching to their mother (which I'm sure is how all nursing mothers have felt at some point). Awesome! I remember how much I loved Puppy Surprise as a kid, and this is even a bit more biologically sound than dogs whelping via a Velcro abdominal pouch. (And who knew, anyway, that there were so many Surprise iterations that followed?)

So anyway. We're happily anticipating what comes next, enjoying where we're at, and already watching our baby girl grow up. And learning that, unlike the proverbial pot, she'll continue to grow and change incredibly quickly no matter how closely we're watching.