Wednesday, August 15, 2012

Birth Days and Craze

Aidan should be two today.  It's his two year 'due date anniversary', which isn't a day you celebrate or really even think about when your child is born alive and healthy, but somehow seems significant when your baby didn't make it home.

Two.  Wow.

I know other people feel sad on these 'anniversary' days that are related to their dead child, but over two years later, I sort of look forward to them.  His birthday, his due date, the anniversary of the day we found out I was pregnant...these are days when the veil between the time we spent with him and now seems somehow thinner.  Even though he never actually lived to SEE an August 15th, it will forever be the day that is branded into my mind as the day our family of two was suppose to grow to include a small, squishy, bouncing baby boy.

A cousin of mine (the one who we had the shower for back in April), is due tomorrow.  As her pregnancy has progressed I've been able to mentally keep track of exactly how far along she was as I can easily compare to my pregnancy with Aidan.  In late April, when I saw her at the baby shower, I mentally did this equation because it was about a week after Aidan died (so 23 weeks + 3 days + 1 more week than we got with Aidan = mid 24 weeks).  I'll probably always be able to do this with her child (Aidan's suppose to be age - 2 years exactly = cousin's baby's age).

I've been thinking about this particular cousin a lot right now because she lives in the States and is planning on having a home delivery with a midwife.  As I mentioned in an earlier post, we've recently cancelled our cable and got Netflix so when Kaia's napping in the afternoon I've been watching documentaries.  I've watched two recently that were about the state of maternity care in the States and the sky high intervention (induction, epidural, forceps, vacuum) and C-section (30%) rates.  Both documentaries were by film makers who had planned or had home deliveries with midwives and heavily slanted in favour of reducing C-section rates, and encouraging and supporting more women in having medication free, vaginal deliveries.

The talking heads in the movies (medically trained outspoken advocates for natural birth) cite many studies that show home deliveries are as safe as hospital deliveries (for healthy moms and babies, of course).  One documentary film maker even goes to Holland where 80% of babies are born at home.  In Holland deliveries are CHEAP (about $800 for the attendant) and women's attitudes towards birth seem to be "why wouldn't I want to have my baby at home? I'm not sick, so why should I have to go to the hospital?".  How novel!

Both documentaries talk about how C-sections in the States may be done for the convenience of doctors (ie: the highest rates of C-sections are at 4 pm and 10 pm. The first so the doctor can be home for dinner, the second so the doctor can be home to go to bed).  Also, they both go into how inductions are now so common (mostly done on a Monday-Friday, again for convenience sake) and around 50% of the time, result in a C-section.  The induction flow chart often looks like this (especially in cases when babies are being induced with no signs of impending labor): induction > contractions very strong, very quickly > epidural as woman is very uncomfortable > labour slows down due to epidural effects and because woman no longer able to move around > increase pitocin for 'stalled' labour > contractions increase in size and strength > baby begins having decels due to very (too?) strong contractions > physician jumps in and says "your baby is in distress I think it's time for a C-section in the interest of your baby" > baby is born via C-section and everyone says "whew, glad doctor was there to get baby out in time".  That this occurs is not at all a surprise to me.  In one of my women's studies courses in university I did an entire paper on the history of midwifery in continental Europe, and it was fascinating to see exactly how medicine (read: male physicians) took over birth as a way to increase revenue and appropriate knowledge that had always been in the realm of women, touting it as "science".  That insurance companies, time management strategies, technology and pharmacology has made things even more complex and heavily weighted in favour of hospitals and doctors doesn't surprise me in the least.

I generally agree with a more natural approach to delivery, and less intervention versus more.  People seem to have lost sight of the fact that having a baby is a natural process.  Like digesting food, or recovering from a cold, or learning to walk, things humans do every day with very little incident.  Women's bodies are MADE to deliver and carry a baby.  We were doing it for THOUSANDS of years before epidurals, and C-sections and fetal monitoring showed up and somehow the species survived.  Not to mention that all other mammals except humans seem to do just fine with very little or no 'scientific' intervention. These documentaries portray the delivery that I would have loved to have had.

Of course, my experience was a little bit different.

At her baby shower, my cousin was talking about her decision to have a midwife and how she planned to deliver at home.  She stated that of course, if there was a problem, she would obviously want to be transferred to a hospital and then said "in those cases, I think a woman knows if something is going wrong.  You just have to listen to your body".  And while I want to agree...I know from experience, and from reading many of your stories, that no, in most cases you DON'T know that something is going wrong.  You might worry about it, or wonder about it, or feel off, or feel anxious or question if something is normal or not...but rarely do you know in a way that allows you to act.  In my case, I was a nurse, with contractions every two minutes at 23 weeks pregnant with a pregnancy that I KNEW was in danger...and it took until I was minutes away from delivery and they were announcing that I was 6 cm dilated before I really GOT that I was going to have a baby and he was going to die.  I was in so much pain that any decision making at that point was out the window. I knew 5 hours earlier when I started having bad back pain that this was likely 'it', but I didn't want to let myself believe.  It's that ever helpful/harmful human state called 'denial'. 

The natural birth advocates in the documentary, who talk about the flow of hormones that are released after a woman delivers naturally without meds (which they say are impeded with an epidural), talk about it being such a 'high' and so 'critical' for the mother-baby bond.  Maybe so, but after I delivered Aidan naturally, without meds (who was all of 1lb 4 oz and less than a foot long), all I wanted to do was pass blood pressure was in the tank and I felt woozy and exhausted.  This probably has more to do with having a death to deal with rather than a 'birth' and my heart condition, but in the weeks after having Aidan, thinking of the physical pain of giving birth I remember saying to Brian "don't ever let me do that again without an epidural". much for my 'elated high'.  It also puts down the many many women who have epidurals and also give birth 'naturally'.  Did they not push out a baby too.  What exactly was 'unnatural' about that?  And if it was any other condition where someone was in pain, you'd think it barbarous NOT to have pain medication.  Take out my appendix with out anesthesia? Um, no thanks. Yank out a tooth without freezing?  Not going to happen.  I fell and broke my leg in three places...holy hell, where's the drugs??!!  Who am I to say how much is too much pain for someone else?  Should proper preparation, support and other more natural pain relievers/modifiers be available for labouring women so they feel confident and comfortable saying 'no thanks, I'll work through these contractions on my own".  Of course.  (As an aside, I wonder what the cost benefit ratio would be of employing an army of doulas/midwives and/or better trained nurses, comfortable birth suites, and other pain reducing/coping methods of child birth compared to C-sections, anesthesiology time and medical supplies?)  However, I wouldn't want to put down anyone who says "nope, I'm done, where's my epidural?".

The documentary talked about the evils of C-sections and how they aren't the panacea of awesomeness that modern hospitals would have you believe. From an NICU nurse's stand-point this is obviously true. Babies are designed to endure labour, in fact, labour often helps to 'ready' them for the outside world.  Passing through the birth canal helps to squeeze out fluid in their lungs and the stress hormones set off by labour help ready their bodies for the transition to breathing air.  It's no coincidence that babies who are delivered by C-section (especially via a 'cold C-section' where no labour has occurred) have higher rates of breathing problems at birth.  Breathing problems that keep them in hospitals for many more days then they might have been if they hadn't been delivered via C-section (cha-ching $$$).  But, C-sections can save babies lives (and sometimes moms lives) too.  They can also be mental life savers for women who have had previous losses or other traumatic birth complications.  I had a C-section, and wasn't that bad.  I had no complications and my scar healed fact, it's probably the prettiest scar I have (and I have many).  I have no idea if it impacted my future fertility (if we even see fit to use my uterus again), but I wouldn't DREAD having another C-section (under much different, healthier, happier, higher gestational circumstances of course).

It's also probably a no brain-er that most babies could be born at home, just fine.  Another cousin of mine had a midwife for her third baby.  She planned a hospital delivery, but did most of her labouring at home.  She met the midwife at the hospital *just* in time, and had her daughter.  She spent a day or so in hospital and came home with her healthy, full term, baby girl.  My cousin told me, "what they did for me in the hospital wasn't anything that I couldn't have done for myself at home".  This is probably true in most healthy, normal deliveries.  Anything that humans have been accomplishing in fields and huts, in snow and in desserts, with attendants or all alone for thousands of years can probably be done just fine in a modern, lighted, comfortable home, with a trained, knowledgeable attendant, complete with running water, towels, a comfortable mattress and strategically placed pillows. the small percentage of cases...what if being in a hospital is the difference between life and death? Or the difference between health and disability?  Or maybe less dramatically, and more likely...the difference between FEELING 'safe' and feeling 'nervous'. That most of us wear a seat belt all our lives and never need them doesn't make it smarter to not wear one or anyone less grateful that they exist. This is obviously why most people deliver in hospital...on the off chance (hopefully not CREATED by the medical establishment) that an intervention might be necessary.  It's also why the doctor who delivers babies in Holland at home says he's generally within 15 minutes of a hospital, for safety (a feat more easily accomplished in a country only 33,889 km in size, compared with say, oh, my country Canada which is 9,093,507 square km).  It's also why, my heart condition and previous birth history aside, I would probably never opt for a home delivery, even if I could have one.  I'm a worry-wart by nature.  I just couldn't be comfortable having my baby at home, no matter how 'natural' and 'low-tech' I wanted or felt I was capable of.

In any event, I'm anxiously awaiting the arrival of my cousin's baby. Hoping she has the midwife attended, medication-free, uncomplicated natural birth I always wanted, and the alive and healthy August baby I never had.  Wish that it could be that way for all of us.

What do you think of the state of birth in your country?  Hospital or home, midwife or doctor for you? Would you ever consider a home based birth?  What does your loss make you think of these types of practices?

Thursday, August 2, 2012

Olympic Melancholy

It's Olympic time again.  A time when the world comes together to play and to celebrate athleticism. Where people gather to cheer on their country or their favourite and hope to see them collect a bunch of precious medals.

Except me.  I'm not watching.

The last Olympics were held in Canada, my home country, in the winter of 2010 from February 12th to 28th.  At those Olympics, Canada won the most gold medals of any country, and placed 3rd in medal count over all. It was a proud time for Canadians and thrilling to watch.  I remember those Games very clearly because I watched almost every Canadian winning performances LIVE.  I didn't hear about them second hand, or watch a replay...nope I was glued to my TV, reveling in every moment.

The reason I could spend hours and hours watching round after round of eliminations and finals is because I was on medically ordered bed rest. 14 weeks pregnant with Aidan suffering with (what we thought was only) a subchorionic hemorrhage.

It had been a scary January 2010.  Lots of bleeding.  Multiple trips to Emerg.  Finally I was told by a kindly ER doc near the end of January that I needed to be off work, resting, so the blood clot in my uterus would bleed out/reabsorb, shrink and disappear.  Leaving behind a healthy, growing baby.  It was just a matter of time. This advice was confirmed on February 10th by a maternal-fetal medicine specialist from the high risk pregnancy program who even questioned why I was there to see him.  My pregnancy was normal (aside from the giant blood clot)...lay down, rest, everything will (likely) be fine.  See you in a month....

So it was with this comforting information that I sat for two weeks and watched the XXI Winter Olympics unfold.  I watched my countrymen and women slide, jump, skate and shoot to earn an amazing 26 medals.  I loved watching all the drama unfold only a few short (okay actually quite massive) provinces away.  I knew I would never forget Alexandre Bilodeau win Canada's first ever gold medal on home soil by sticking the landing on that amazing final jump. Or Clara Hughes win her 6th medal in speed-skating, the only Canadian to win medals in both the summer and winter Olympics  Or Jon Montgomery as he marched through a crowd of fans after his gold medal win singing the national anthem and drinking a beer. Or my personal favourite: the replays of crowds of Canadians from coast-to-coast leaping to their feet milliseconds after Sidney Crosby scored the winning goal in the men finals hockey game against the US. It still makes my heart swell with pride.

And I couldn't wait to share it with my baby.  

To say "I know you were born in the summer, but you and me baby...we watched those games together! While protecting you and making sure you were safe, you were right there with me. When those amazing events occurred, you were the size of a lemon...but you were there".

Little did I know, that even while I was watching, and feeling confident that (probably) eventually things would be was already too late.

You see, on the morning of the February 12th, unbeknownst to me, my water broke. At the time, I thought it was the clot, bleeding out, leaving me and my baby unharmed...  But it wasn't.  I know this for a fact now because my water breaking felt exactly the same way when it happened a year later with Kaia.

So while I was watching the opening night of the Olympics, happy, thinking "oh good, I'll have something to keep me busy while on bed rest the next couple of weeks" baby was in trouble...and I didn't even know it.  I wouldn't know it until over a month later when the Olympics were over and an ultrasound showed something very, very wrong. That opening night, I was blissfully unaware of the events that were about to unfold.  That in just over a month the same doctor who had been so positive just a few weeks earlier would look at us with a completely different expression on his face as he explained what he was seeing on the screen.


It's 2012 and it's Kaia's first Olympics.  She hasn't watched any of it.  Neither have I.

It's just not the same. The Olympics are in England, not Canada.  It's summer, not winter.  We no longer have cable in order to save money because we rarely watch live television anymore (who has time with a baby?  Plus with Netflix and the internet it's kind of redundant).  I'm too busy.  I'm planning my back to work schedule. Working out babysitting arrangements.  Sending lots of time outdoors with Kaia, soaking up the good weather.

The Olympics are here again.  

Too bad the 2010 baby isn't.

But the Games will always remind me of him, because during the winter of 2010 we watched them together.  Back when I thought everything was possible.

Was there a big event that sticks in your mind back from 'before'? What does being reminded of that time feel like?