Friday, January 15, 2010
Thousands of Women in Hundreds of Countries Cant ALL Be Stupid...Can They?
I was born in a hospital under the watchful eye of a physician after weeks of bed rest, medications and even surgical closure of my mother's cervix to avoid preterm delivery. By the time the doc decided it was ok for me to come out I was over the whole thing anyway and decided I was staying. My mother had an induction, episiotimy and forceps to bring 7lb me into the world. It is a day my mom says she will never forget.
I was born the week my mother was due to graduate Nursing school. It would be ten years before I would sit in the driveway of Mary Breckenridge's Homestead 'Wendover' in the hills of Kentucky and watch my mother graduate from the Nurse Midwifery Program. It would be three more before I would attend my first birth and another seven after that before I would find myself (unintentionally) alone (due to a tremendous snow storm) attending the Christmas birth of a little boy.
I am older now and friends all around me are parents, pregnant or trying to become pregnant. I am thinking about it too now that I am on the door step of married life. I spend a lot of time thinking about what it will be like to be pregnant, if I can even GET pregnant, how I will handle my type-A-ness in concert with my "daughter of a midwife-ness". I think about how much aversion I feel to the idea of hospital birth. In most states out of hospital means a limited choice of providers as it is largely the Lay Midwife population (no nursing certification or master's degree for those who care)who catches the home births or birth center births.
I am well aware that there are bad lay midwives out there. There are bad mechanics and bad dentists out there too. That doesn't mean you buy a new car every time your oil needs to be changed or that you have an oral surgeon do your routine cleaning. Birth is high stakes, I get it, I really do. However, we have an utter inability to trust women and babies and their bodies in our culture. We think that giving birth in a room with the machine that goes bing, to quote Monty Python, means everything will be perfect or that we will be able to fix anything that is not perfect. This is a bummer!
I was in PALS this week (Pediatric Advanced Life Support). It is a class for EMS, RN, MD folks who may be responsible for recognizing and caring for a child in a very bad situation. We spent the two days running what they call "mega codes". Kids were doing everything from simple upper respiratory infections to horrible trauma and cardiac arrest with shockable and unshockable rhythms. I am not saying any of this to horrify any of you dear non-medical readers, however, my take home message was kids will choke on things, stop breathing, seize and arrest...be ready. Bbbbrrrr gives me the willies just thinking about ever having to intubate or cardiovert a newborn. But it happens and it is important to be ready and to know your drugs and the doses and the algorithms to use in each situation.
I got started on this whole topic because one of the instructors was giving the radio dispatch to set the scene for the call we were about to run and she said something to the effect of "You're called to a home where a mother has just given birth assisted by a midwife *gratuitous eye rolling*, the baby was born under water *more eye rolling* and now is blue and breathing "funny" per the midwife". The lead medic started in on questioning and asked about the labor and delivery and if it was normal, any excessive bleeding, how many weeks mom was, if she had any prenatal care and what the one minute APGAR score was. Great Questions! The instructor replied "this is a lay midwife, *disapproving tongue click* not a medical person, she doesn't know APGAR. And the mother hasn't had any "real" prenatal care. These women never do *eye roll, tongue click*. They have their babies underwater and then wonder why they can't breathe".
I was PISSED!!!! After the scenario was over I talked to the instructor and informed her I felt it to be a pretty toxic and biased view for her to be slamming all home birth mothers as stupid and irresponsible as well as all Lay Midwives as uneducated and negligent. I acknowledged that she probably only ever saw the really bad stuff but that doesn't mean that they are all high risk, stupid or end badly. She said she just presents the scene as she saw it. I said I think she did a lot more than that and I did not think it particularly helpful to impose her biases on a fresh batch of medics. We agreed to disagree and I went away pissed off.
This really chaps my ass, as if you couldn't tell...Childbirth is not an illness women have been dropping babies in the fields of Cambodia, Mongolia, West Africa, Egypt. Hell, even European and Chinese women have higher rates of home birth and lower rates of c-sections and associated complications than we do. Why do we think we are so friggen special?! Why are we so unable to trust ourselves and the providers we chose to care for us? Why must we always have some machine tell us things are 'OK'? Its sad ladies!
Now, lest any of my expecting, or trying, or been there done that got the onsie monkey friends think I am dissing their particular choises I am not. I understand that every woman comes to this situation with her and her partner's own context. I am simply observing the fear mongering and undermining of our intuition that is so rampant in our American culture. It makes me sad that something that is so wonderful has become a medical procedure and in many cases is not in the hands of the woman or her partener at all. It makes me angry to hear and see perpetuation of this behavior in the education of EMS, RN and other "medical professionals".
Fitness Day 29
NO real exercise to speak of in the last 2 days! How depressing! I have simply been exhausted and utterly lacking in time durring all of this PALS stuff. They have been almost 13hr days if you count wake up, travel time, class time and eating (yes I count eating). That's a L-O-N-G day for learning at high speeds. So, I have been working hard to eat sensibly and decrease the calories with the exception of the beer I had last night as my "F yeah I survived this day from the underworld" celebration. I hate drinking alone in bed on nights that the Hubbs works....Anyway, I am at work now and will be headded to the gym here in about 2 hours to get my fittness on before I go home to bed, thus ending my 27hr day! Yay for redbull and green tea!