Birth Trauma

Mamas on Bedrest: A Call for Compassion, Not Crucifixion

October 10th, 2012

On October 5, 2012 Jeanne Faulkner, R.N. posted on theFitPregnancy Blog about Tragic Teen Pregnancies. Seems yet another young teen aged girl hid her pregnancy and gave birth alone and scared in the bathroom. She subsequently killed the baby and disposed of it in a garbage bag. The baby was later discovered and the girl arrested.

From time to time we hear of such tragedies. I happen to know of one personally, and saw a few others working as a PA in a teen health clinic. It’s a really difficult situation. Those on the outside looking in are appalled by the young mothers’ actions.  The media is crucifying them. And many want them punished to the full extent of the law.

But I like Faulkner’ take on the situation. These are young girls, often as young as 14 or 15, having babies. Babies are having babies. For whatever reason, the girls choose not to tell their parents (a question for a whole other post!), friends or teachers. They hide their pregnancies, childishly hoping they’ll go away. But what can we expect-THEY ARE CHILDREN!!! I could go on and on about the first grievous mistake being that they are sexually active in the first place, why is this happening and where are the parents/guardians? But that is all water under the bridge. The more important question is how do we help young girls who are caught up in such situations get the (mental/emotional and physical) help that they need so that they can recover, grow up, become productive adults and eventually have children of their own?

Jennie Joseph, CPM, was quoted in the article and I think that her words bear repeating. Joseph describes “labor madness”, a trance-like state many women enter into during labor, a sort of primal defense mechanism from the pain and overwhelm of the situation.

“Women from all walks of life disappear into an inner place (during labor). They retreat from the fear and pain and the overwhelming nature of what their body is doing. They don’t really know what’s going on and without help some panic. When a woman is supported by a caring midwife, nurse, doctor, doula and family we can call her back from that place. We can support her, help her and get her through the experience. But when a woman is alone the terror, pain and hormones kick some women into autopilot where they panic and do whatever they have to do to save themselves from this life-threatening situation.”

“And if it’s a young teenage girl, all alone, in pain, not fully understanding what’s going on, terrified of what will happen when her parents find out…that’s a recipe for labor madness right there.”

Labor madness. I like that term and I believe that it is fitting. We all like to believe that pregnancy, labor and childbirth are these ethereal states in which a woman experiences her truest feminine self. This occurs for many women. But for many of us, pregnancy, labor and childbirth can be fraught with hellacious complications, fear, chaos and at their worst, catastrophic if not deadly complications.

As mamas on bed rest, we’re on the front lines of complicated pregnancy. Yet most of us are grown women. Many of us are married or at least with a partner in the picture and if not, we have family, friends and a support system. We’re on the internet, reading websites, chatting with other mamas and gathering information in order to best prepare ourselves for whatever may lay ahead. This is the difference between pregnancy in a woman and a girl. As women, if we don’t have a support system, we know how to find one.

Young girls aren’t necessarily that savvy. Yes, many have grown up women’s bodies, but not the wisdom of age. Think back to your teen years. Were you fully equipped to manage all the feelings and emotions you were experiencing? Now add pregnancy, and all its physiologic (hormonal) changes, and you can readily see that trainwreck poised to happen.

I am not saying that what this young girl did was right. It absolutely wasn’t. But there are so many levels at which things went wrong I would find it difficult to prosecute her for a crime. I highly doubt that her actions were premeditated or that she acted out of malice or guile. She was afraid. It’s that simple. And she’ll be further traumatized by the criminal justice system. Will she ever receive counseling? Will she ever heal? I mean really heal???

I see this story as another reminder that women of all ages need support and compassion during pregnancy. For young girls, they need not only support but also caring and compassionate guidance-preferably before they become pregnant but most certainly after-to help them understand the complex physical changes they’ll experience as well as the myriad of emotional changes. Oh what a different story this would have been if this young girl had been able to talk to someone about what was happening! Oh what a difference it makes forMamas on Bedrest to have this support network!

I don’t know what will be next for this young girl or others like her. What I do know is that rather than crucify her in the media, we all need to show her compassion. She needs help so that she can heal.  And we as a culture need to be thinking about what we can do to help end this type of tragedy in teen pregnancies.

Mamas on Bedrest: It’s okay to have a C-section

August 10th, 2012

Whaaaaat?????

Yes, you are reading correctly, I am saying that it’s okay to have a c-section.

I realize that much of my platform here is about normal birth and allowing mamas (and babies) to come into and move into this world naturally.

Yet, I have had 2 C-sections.

Yup, 2 C-sections!

So how come I am such a proponent of “normal birth?”

I’ve often berated myself for not “trying harder” to deliver vaginally. I should have at least tried, shouldn’t I? These feelings welled up once again as I was about to pen another post about the virtues of normal, vaginal birth, this time about how normal birth is now associated with important positive brain proteins in babies. Then just when I was about to get started, I looked over at my 2 sleeping children (I’m writing this in a hotel on my way back to Austin from Summer vacation) when I had to stop myself and ask, “Are my children somehow brain deprived because they were delivered via c-section? Are they in anyway developmentally impaired or otherwise “less than” because they were c-section deliveries?” My children are beautiful and as healthy and cunning as they come!  

I also know that without c-sections, neither of my children (or myself for that matter) may be here. My daughter’s birth, my first c-section delivery was emergent, traumatic and both of us are lucky to be alive! I don’t remember all the details of her “coming out” but according to my husband, she was in distress, blue and the neonatologists worked on her for a bit before she cried. I was vomiting profusely from the pregnancy (I had all day sickness all 9 months!) and the anesthesia only made things worse. Added to that, my uterus was lacking in tone, so once my daughter was born, it didn’t contract but was kind of like a stretched out balloon. And I bled. I’m not talking a little sputter, I’m talking this side of hemorrhage! Everything started to move more quickly, there was a lot of clatter as more instruments were opened and soon I was given something in my IV to “calm me down” (translation-make me out of it so that I’d stop trying to see what was going on and getting more agitated in the process.) I watched my OB’s eyes over her mask; they were set, focused and soon you could hear a pin drop in that OR suite. I knew that things were not good.

But I lived to tell about it and I am thankful that I and my almost 10 year old sassy girl are just fine. And I can tell you, there is no brain deficit in this one! In fact, that smart mouth is about to drive me crazy!

Same with my son. My darling boy was born at 39 weeks via c-section. While his birth was much calmer, my uterus was again an overused balloon, lacking in tone and contractility. This time, my baby was put to my breast and with a bit of pitocin, I was stitched up, good as new (sort of!).

I know that I may not be here to write this blog or to critique and share the various articles that I read had I not had 2 c-sections. I would not have the 2 children that I adore beyond words without my 2 c-sections.

 “So how are my words affecting mamas who may have had a C-section or are about to have, a truly medically necessary, a C-section?”

I hope that my words will give you some solace. Sometimes you have to do what is right for you, and if a C-section is what is needed for you to have a healthy baby-and to survive yourself, then by all means, go for it! Yes, C-section rates in the United States have reached unacceptable rate. They are also often performed for “unnecessary” reasons. And there is no denying that c-sections carry with them risk. So if you can avoid having one, I prayerfully ask that you do. There really are benefits to having a normal vaginal birth for both mamas and babies. I look at it this way: If this is the way in which Mother Nature designed us to have our young, it must be good because she’s not been wrong so far!

But I am also very thankful for medical science and technology for evolving and developing such that I was able to have my children and live to tell about it! Without seeming mellow dramatic, I am quite convinced that I would be dead otherwise.

We do need to curtail the number of c-sections performed in the United States. I do believe that health care providers need to meticulously scrutinize each situation to evaluate if a proposed c-section is truly necessary. But if a health care provider, after careful analysis of the situation deems it in you and your baby’s best health interest to have a c-section, it (you) will be okay!

Mamas on Bedrest: Minority Mamas are More Likely to Die Giving Birth

August 8th, 2012

At least that is what statistics released by the US Centers for Disease Control and prevention indicate. According to a recent report, minority women in the United States are more likely to die during and immediately after childbirth than Caucasian women. According to their report,

“Black, Hispanic and Asian women – and a handful of white women not born in the U.S. – accounted for 41% of all births nationwide between 1993 and 2006, but for 62% of pregnancy-related deaths.”

The actual numbers are really quite eye opening. For every 100,000 babies born to white women, between 7 and 9 mothers died from complications related to pregnancy. Yet, in comparison, 32 to 35 black women died for every 100,000 live babies, while deaths among Hispanic and Asian women (born in the US and elsewhere) were closer to rates for white women, at around 10 per 100,000. Older mothers were also more likely to die during and just after childbirth in all groups, eighteen white mothers ages 35 and up died for every 100,000 babies born, while 99 older black women died for every 100,000 births – almost one for every 1,000 babies.

In a country as rich as the United States and with exceptional health care resources, it seems unfathomable that women, particularly women of color, should have such a high rate of perinatal death. These numbers beg the question, is access to care the issue? We know that if women don’t have acces to quality health care, they are more likely to suffer complications. But the numbers seem to transcend economic status. So what else can be contributing to these large disparities?

Researchers found that heart problems,  general cardiovascular disease and hypertension were the most common causes of death in childbirth for both white and black women during the latter half of the study period. The researchers wondered if genetic disorders or other unknown health related issues could also account for the disparities. To date, they are unable to explain the disparities.

While similar disparities have been noted in other countries, the fact of the matter is that it is unacceptable for a segment of the population to be at increased risk for death by what should be a natural act-childbearing. Sure, childbearing has risks. But when ethnic and genetic differences have been taken into account, women should have the same opportunity-and risk-to have a healthy baby and the data to date is saying otherwise.

If there are differences in access to care, we should correct those differences. Complications such as post partum hemorrhage, which is a huge cause of perinatal death worldwide, should be appropriately managed.With the barrage of medical treatments and technologies available, most pregnancy complications, especially those that occur in the US should be quickly and thoroughly managed.

The researchers are not able to explain the disparities and are calling for and carrying out further research. As a Black mama, very thankful for her babies, I certainly hope that they are able to find the cause (s) of the disparities and narrow and/or eliminate the gap.

Resource

Race, Ethnicity and Nativity Differentials in Pregnancy-Related Mortality in the United States: 1993-2006.

Creanga, Anndrea A. MD, PhD; Berg, Cynthia J. MD, MPH; Syverson, Carla, RN, MPH; Seed, Kristi; Bruce, F. Carol RN, MPH; Callaghan, William M. MD, MPH

Obstetrics & Gynecology: August 2012 – Volume 120 – Issue 2, Part 1 – p 261–268
doi: 10.1097/AOG.0b013e31825cb87a