What About Dads?

So it's almost father's day and I have been thinking about Dad's role during cesarean births, or for that matter all births.
In general in the last 35 years fathers have had an increasing role in the birth of their children. Gone are the days when gentlemen waited at home or in hospital waiting rooms cigar in hand. Now fathers are most commonly in the birthing room being with their partner while their new family member arrives.

The one exception to this rule seems to be father's who's babies are delivered by cesarean section while the mother is under general anesthetic. I can't seem to find any documented medical reason why this is so. In fact, I have found numerous reference to the difficult time families have after these types of births, because father's are mourning the loss of witnessing their babies arrival and the mother's fighting the irrational feeling that the baby they are given is not really theirs. I would like to issue a plea to hospitals every where:
PLEASE LET THE DADS IN.
Not only will this solve the problem of them missing their child's birth, but studies have shown that having someone take pictures during these types of births and later telling the details of the birth of their child can really help the mother's emotional healing and promote proper bonding. Who better to do this then the father?

I sure needed my partner with me during my birthing experience. In fact, one of the worst parts of my second son's birth was when I had been moved to the OR with the understanding that baby needed out quick and that a instrument delivery was likely, or perhaps a cesarean. I was alone (except for the room full of blue clad people!) when the doctor made the call to operate. I so needed my partner, but he was still in the hall waiting to be given permission to enter. He was upset and I was upset. Why couldn't he have been with me when this life changing decision was made?

I remember now the child birth class we took together and while we were talking about cesarean births the instructor told the partners "Don't be afraid to sound like a broken record by saying "When can mom see the baby?" Ask often , ask everyone, keep asking until it happens. As you know if you have read my previous post, we were lucky enough to have this not be an issue for us, but I have heard so very many stories of women waiting hours to see their new babies. So dads: KEEP ASKING FOR BABY TO BE WITH THEIR MOM.

I came across this post: "Delivery Room Football" by Dr. Emmett Miller describing the scene when after his wife's unexpected cesarean delivery. The pediatric team was getting ready to take his baby daughter away to the nursery before mom had even seen her. “Nobody’s leaving this room with that child!” he declared .“You’ll have to sign papers saying that you’re taking this child against medical advice!” countered the doctor holding the baby.
He recalls: "I imagine that if I had not been an experienced physician, I might have faltered long enough for him to succeed in an end run after all. But I had delivered enough babies to know that this one was in no immediate danger. A moment later, Lauren was there on her mother’s arm nuzzling for the breast."

You can read his whole story here:
http://www.thewellspring.com/flex/birth/2688/delivery-room-football-by-emmett-miller-md.cfm

While not many of us have medical professionals for partners , we can still advocate for mother baby contact, and if that is not possible then skin to skin with father is the next best thing.

A study from Sweden called:Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior. concluded:
"The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby."

The role of father's, like all elements of birthing, I believe is in need of greater understanding soI strongly urge you to visit:
http://theothersideoftheglassthefilm.blogspot.com/
"THE OTHER SIDE OF THE GLASS"
This is the site of the first birth empowerment film for fathers. Just the trailer made me want to cry. This film highlights the problems with the way father's are pushed aside and babies and mothers are subjected to unnecessary and practically violent procedures. Please go to the site. There is a chance to get an advance copy and help get this film finished.

So that covers what I have found out, so far, about dad's and with the birthing process. I know there is so much more to learn. Before I finish this post I wanted to add that dad's are not just helpers or extra people at the birth of their children. Birth can have a profound impact of fathers both in a positive or negative way, especially if the birth is difficult, as many cesareans are. Here is a link to a post partum dad's site:
http://postpartumdadsproject.org/ If you are a dad and are having a difficult time since the birth of your child you are not alone. Reach out to others who understand what you are going through.

We all have the chance to reach for greater and better births for every member of the family
so let's spread the word. Educate yourself, educate each other. Share your stories and a very HAPPY FATHER'S DAY to all.

Abbie Dorn

I am saying a prayer for Abbie Dorn.

I read the paper at the coffee shop the other day and there on page 11 a tiny blurb:

"Abbie Dorn's parents are fighting for her right to see her children. She was left unable to move or speak after a botched delivery of triplets in 2006."

"Botched delivery of triplets" I knew that could mean only one thing:cesarean.

A quick web search led me to:

LOS ANGELES -- A Myrtle Beach mother who is unable to move or speak - and possibly to understand - is the focus of an unusual, emotional court case to decide if she has visitation rights with her 3-year-old triplets. (http://www.thesunnews.com/2010/04/22/1435062/visitation-right-sought-for-disabled.html)

More in depth article called : "Severely disabled, is she still a mom"

Severely disabled, is she still a mom? Battle nears over visitation rights of a woman injured in childbirth April 11, 2010|By Maria L. La Ganga

Sure enough one of the articles refers to the doctor accidentally "nicking" her uterus causing massive bleeding and resulting in brain damage. I can't find any mention to "cesarean" but I can't imagine her uterus was nicked any other way.

There is mention that she won a 7.8 million dollar medical malpractice suit.

She can no longer move or talk. Her parents believe she communicates through long blinks and tears. Her ex-husband believes she is vegetative. Abbie's parents and her ex. are in court battling over whether or not she has the right to visitation with her children. So very sad.

There are so many facets to her story, but as this is a cesarean blog I'm going to comment on that.

I can't find anything about her birth story. Does anyone know what happened?

I like to hope that her cesarean was necessary. I'd like to believe that she had a trial of labour and the "difficult delivery of the third baby" refers to a emergency situation.

I hope the surgery wasn't done "just in case", or "to ensure nothing happens to the babies".

I'd like to believe that this medical mishap was come to honestly. That there was good reason to deliver her babies surgically. Mistakes do happen.

I'd like to believe that Abbie was given the chance to birth her babies naturally .

I'd like to believe these things, but I would probably be wrong.

Everyday women are told that the only way to safely deliver multiples is by cesarean.

States one article:

"While for triplets and higher-grade multiples caesarean section is the first-line mode of delivery" http://www.ncbi.nlm.nih.gov/pubmed/17440267

And another asks:

"Is vaginal delivery in twin pregnancy still an option?" http://www.ncbi.nlm.nih.gov/pubmed/19570620

The thing that I find, again and again, is that there are only a few small studies on any birth topic. Risks to the babies seem to be the primary concern. Risks to moms seems to be unexplored.

One thing I know I can believe is that we can birth babies naturally, even multiples. Just because we are being advised against it by the medical establishment does not mean that there is no other way.

Here is an inspiring video about twins and triplets birthed naturally:

http://www.youtube.com/watch?v=7E-wULAaD50


And so Abbie Dorn I say a prayer for you. I hope you have peace in your heart.
I pray that you see your children soon.

New York Hospital Changing Policies.

I just read this great article I got through the ICAN Blog.


http://www.nytimes.com/2010/04/20/nyregion/20bigcity.html?hp

It's a New York Times article about two hospitals on Staten Island, one with an increasing cesarean rate and the other with a declining rate.

The article talks about the fact that many hospitals pay lip service to the fact that the cesarean rate is dangerously high, but have not taken dramatic steps to reduce them.

The article gives credit to Dr. Mitchell A. Maiman, the chairman of the obstetrics and gynecology department the one of the two hospitals, Staten Island University Hospital, for building the goal of cesarean reduction into policy.

Some of the things that they are doing...

Dr. Maiman and his colleagues do not allow unnecessary inductions for first-time pregnancies at any point before the 41st week.

They also do not allow C-sections for no reason other than the mother wants one, stating:
“I find that most of the time, if you explain to a mother you’ll recover faster, it’s safer,” he said, “then most women will choose a vaginal delivery.”

I found that the following quote from the article to be important as it illuminates the fact that women rarely request cesareans if given good information.

"Mother-demanded C-sections are unusual enough that the policy is probably more useful to Dr. Maiman for the message it sends to doctors and patients..." (bold mine)

Dr. Maiman actively encourages VBACs. -YAY!

And I love this one:

Residents are trained not only to avoid unnecessary C-sections, but to let higher-ups know if they witness another doctor about to perform one. -Go Dr.Maiman!

Change only happens when we DO!

Woman to Woman Videos

So I've been watching some fabulous videos from Birth Matters Virginia's Video contest winners.

I particularly responded to this one called

Prevent Cesarean Surgery
http://www.youtube.com/watch?v=vxRmVciXy-g
It just says it so well. I love that these videos are made by women for women.

Here is the link to the Birth Matter's page containing all of the finalists:
http://www.birthmattersva.org/videocontest.html

So many passionate women. It make me feel hopeful to find these beautifully strong voices.
It strikes me that, like a choir, our voices are stronger and fuller together.
Each one of us adding to the harmony.

Spring Hello

Well it's officially spring today. I'm amazed that the year has turned seasons already.
I haven't blogged in a few weeks, decided to take some time to explore the world of bloggers and I want to say that I am totally impressed by the wonderful, committed, and passionate women out there. I'm going to put together a blog list, but I'm still working on it.

I'd also like to thank Michelle at BirthCut for doing a fantastic job putting together a "Positive Cesarean" page. I now believe that even the most ardent home-birth activist should protect themselves by having a "last resort" cesarean birth plan. I've spent the last 11 months trying to sort out my head from an emergency cesarean and I'm sure had I spent a short time really considering how to best cope in that situation I'd be much better off.
You can find it at:
http://www.birthcut.com/thepositivecesarean.htm

I'm going to focus my next few posts on reviewing articles that offer scientific evidence of how best to create cesarean births that achieve healthy psychological outcomes. Again, this is going into academic literature so I'll do my best but please forgive my mildly dyslexic (yes really) writing.

I'm off to tend to my garden, one of the things that has helped my healing has been connecting with the earth in a literal way. Nothing like digging in the dirt to let my inner earth mama out!

Natural Cesarean

I've got to say there are some things I just love about the web. Thanks to Karen, who left a comment on one of my posts I have been researching Prof. Fisk who is pioneering "Natural Cesareans". Yay! Now all we need to do is get this info out there.

The natural caesarean: a woman-centred technique

J Smith,^a F Plaat,^b and NM Fisk^a

"Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a ‘natural’ approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide."

Please cite this paper as: Smith J, Plaat F, Fisk N. The natural caesarean: a woman-centred technique. BJOG 2008;115:1037–1042.

Here is a link to an abstract of his article, and a chance to download to the whole thing:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/


Here is a link to an magazine article about this new procedure.
http://www.timesonline.co.uk/tol/life_and_style/health/article6028478.ece

Spiritual Cesareans

Here is another link I found.
It's about doula care for cesarean sections .
It's the reflections of a doula who took a day course with Lanell Coultas about attending cesareans.

http://doulaemily.blogspot.com/2008/12/experiencing-spiritual-cesarean.html

I wonder how many hospitals allow for doula care during cesareans?

Spiritual Cesareans

The term "spiritual cesarean" popped into my mind a few days ago, so this morning I searched the web. This link is to the Birthing From Within website and I thought it started to address the idea I feel forming. Definitely worth a read.

http://www.birthingfromwithin.com/cesarean_birth