Sunday, June 26, 2011

Pregnant in America.............


Your Typical Maternity Ward in Houston......
I watched the film Pregnant in America last week and thought I would share some of it's findings and some of my own thoughts as well.
It's an interesting film and everyone needs to realize that it is not an exaggeration. Really. Majority of our labor units in Houston are like that.....many woman get Pitocin (next post topic)....unless of course she presents completely (or near it) dilated and needing to push.

 But, the problem with that is that in the majority of OB practices, women are not given really good sound guidance about their labors and when to really come to the hospital. Meaning, that if you call your OB in the late evening or night hours ( when most labors start),  you will be told  "Go to L and D."  Well, you may only be in your early, latent phase.  So, you get there and guess what?  You are  3 centimeters, and they keep you. And, then in the morning....Start Pit please.....your OB says to the RN.  

 You need guidance. You need the truth spoken to you. But, if you get to 39 weeks you will be scheduled for your induction.....really...... do we really need to schedule so many labors?  Well, open the OR, cause half these women will be riding in on their gurney...babies don't like to be pushed out that hard......you don't really want to take the risk unless the risk outweighs the real risk of staying pregnant alittle longer. (For example: high blood pressure in pregnancy, true oligohydramnios-little fluid-, poor fetal growth, any preexisting medical condition in mom that would be complicated by keeping pregnant. Most women will go into labor by 41+ weeks-like God intended).

We know that the majority of our mommas at the Birth Center if under the management of a typical OB in a typical practice would have gotten Pitocin during her labor to "speed things up". Well,  I am here to tell you that most women don't need it.  It is not a race and real labor is a process.  It has a beginning,  a middle and an ending.  And not every woman does it fast ......the baby needs time to adjust itself and work it's way down the pelvis.  Don't rush it, don't push it.

 Most OBs nowadays are not experienced in normal, natural labor. It's not their fault.  It's their training. Period.  They don't get a chance to see it. They are trained to "manage" stuff.  So, they have to manage it. And in their defense, if you have 20-30 pregnant women a month, plus all your gyn surgery, etc,  you have to make it "doable".  Meaning something has to give, and that is your labor patients. Got to have a  life. So they have to control it in some manner. Not saying it's right. Just reality.    I can make it go faster.....I can make it pain free and quiet. I can cut it out.  I'm trained for that. In fact I trained all of my residency for it. Let's go! Neat, tidy, done. Next!  (Watch the movie....you'll get it).

I am being sarcastic and I truly hope I don't offend any one.....really.
Women, Pitocin is a great drug when it's truly needed.  It actually is a synthetic hormone that we all produce naturally in our bodies.   Wow.  Oxytocin.    Really cool hormone, at that.  Most hormones are really cool.    But, they like to be in balance.  They need to play nice nice with each other. When one of your hormones gets alittle overbearing.....your bodily functions can get out of whack.  That's why being in a calm, relaxing environment it soooooo necessary for the laboring woman.  I will repeat to make my point. That's why a CALM, loving environment is so vital to a laboring momma. It allows for her stress hormones to back the heck off and let her oxytocin do what it was designed to do.  Contract her uterine muscle in just the right efficent way to move her baby down, melt her cervix away and release her baby into her arms. Thank you very much.   Done.  

 It is so doable, women.   Really.  Normal labor is so right for your baby and your body.  It's not dangerous.  It has no  "side effects".   Pitocin does. Epidurals do.  I am not against them.....some women benefit from them.  Have no problem with my mommas wanting one.  Let's just know the when and the how to do it.....to lessen the side effects, the risks,  etc.

But, and there is a but. You have to design your birth team and your birth enviroment.  Because, as I said, " in a calm relaxed loving enviroment".     And, unfortunately, most hospitals are the EXACT opposite.  Again, not their fault. Just their design, and reality.

So, if you are desiring a natural birth in a hospital.....know that you will be trudging UPHILL. Going against the WIND.  Hitting BRICK walls...fighting for your life, unless you have made a significant effort to bring your TEAM together.
 Either hire a nurse-midwife with hospital privileges ( the perfect TEAM!) or hire a good doula to  support you through your labor process. You cannot, I repeat, cannot do it alone.  Not in the hospital. You will not be given laboring  options. You will most likely be strapped to a continuous fetal monitor with  Pitocin coursing through your veins,  banging out contractions like crazy. You will BEG for an epidural. I mean BEG.  That's suffering.  That, mommas, is NOT natural labor and birth.    
Remember what I just said about your hormones?  Talk about stress on you.....oops! Where's my oxytocin when I need it?  Sorry, mom, your stress hormones, fight or flight, just took over.......(.And let's not get started about the risks to baby.........next post.)

 Okay, I'm being melodramatic, but I am so passionate about this as most midwives are.It's like we have this wonderful secret and not too many women want to hear it.....why?  Most women think that we are less than competent for their care.  They need a doctor, a real doctor.

 Certified Nurse-Midwives are highly trained, educated. We are your normal pregnancy and birth experts. And we are  educated in complications and can handle majority of them. And when you find a midwife team with excellant OB collaboration, it's a "win win" combination.   Because, I have seen all this I am talking about.  At least our hospital is "midwife friendly". Meaning they  'allow" Polly and I to admit mommas there, manage their care and catch their babies.
Also, we have three of the most amazingly supportive Obstetricans as our collabortive sponsors. We are so lucky. 
 Women need to know about our practice in Houston because, unlike the popular midwife practice in the medical center, we have more options for our moms, and all three of our OBs are so wonderfully nice and gracious to our moms when their services are needed. They are available 24/7. When we call, they're there.   Period.   And women need to know that. We are a very unique practice. Only one of it's kind in Houston.   I want the secret out. I know there are women out there who would be relieved to come to us. To find a place where they feel at home and well taken care of. It's our purpose, our mission, our passion.      For now...Janet

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