Tuesday, August 25, 2009

What Not To Say Blog - Rebirth Carnival

Rebirth Nurse's "What Not to Say" carnival is here! I highly encourage you to head over and read the entries - they're fabulous!

Meanwhile I'll be eeking out one of the last bits of summer here in Maine, down at the lake. After a humid and rainy weekend thanks to Hurricane Bill (we even had a tornado warning!), we're very happy to dry out a bit.

Hope the sun and a warm breeze is finding you, too.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Saturday, August 22, 2009

What Not to Say to a Pregnant Woman

Rebirth Nurse is hosting a the second Rebirth Carnival about "what not to say to a pregnant or laboring woman". There have already been some excellent posts on this topic on other blogs I follow, and I'll be sure to put a link to the carnival once it's published so you can read them too, if you haven't happened by yet.

Since I was venting this story to my mom just last week - more than four years after it happened (again and again), clearly it made an impression on me. I found it infuriating at the time, and it still rankles now.

A little backstory: this only happened when I was pregnant the second time, after my 20-week ultrasound. My first child was a little girl, who was 2 while I was pregnant - she has the appearance of being a very girl-y girl since she wore lots of dresses and hairbows etc. At the ultrasound, I learned that my second child was a boy, so I could finally answer the first question my friends, acquaintances and strangers usually asked: "Do you know what you're having?"

"Yes! A little boy!" I would say.

I cannot tell you how many people then went on & on about how wonderful it was that I would have one child of each gender. And some went even further, "Oh, Daddy must be so happy to have a son!" And way too many people ended with a comment along the mind-boggling lines of this: "So now you can be done! One child of each - that's enough!"

Um, what? Assuming much are we?

Knowing that these people meant well, I said very little about how rude I found these comments. First, because of Assumption #1:
Everyone wants children of both genders.
Is this true in many cases? Surely. But it is it true always? Surely not. For a variety of very personal reasons, from medical to family history, some people may have a preference for one gender or the other.

Some people may in fact be offended that someone would assume that they somehow are experiencing more joy because a child is a boy and not a girl. I would have been overjoyed to have another girl. On some level, I was in fact hoping to have another girl, since I knew we were probably only having two children, and another girl meant my daughter would have a sister. And while I love my two brothers very much, there is no doubt I have much stronger relationships with my sisters. And I experienced a bit of trepidation around having a boy because of personal history. This is not to suggest that I wasn't overjoyed to have a son: I was very, very happy. And I love him very, very much. Because he's my child. Not because he's my son.

By the way, the people who simply commented: "Oh, one of each!" and made no value judgement were fine, in my book. It's the ones who went on & on about how great it was I was pregnant with a boy who I found irritating.

Assumption #2 may be even bigger, and more offensive to some people, the final comment that some people tacked on:
"Two children are enough."
Well, it turns out that two children are enough. For my family. But some people want three children, or four, or more. I come from a family of five children and have heard many, many comments about it directed to my mother, including:

  • What a lovely Catholic family! [We're not Catholic.]
  • Are all those YOURS???
  • Aren't you busy!!!
  • You do know what causes this, right? [wink wink]

    and I'm sure many, many comments she could add. She didn't appreciate them, I know that much!

    It's true that, in America in general, as well as in the area where I live, many families do have two children - that's definitely the norm. But I have a bunch of friends who have three children, and know plenty of families with more. I would never presume to suggest to someone that I knew how many children they were planning/hoping to have in their family!

  • So this isn't an exhaustive list, you'll have to go check out Rebirth Nurse's carnival for more no-no's! If you've heard some good ones, feel free to add them in the comments. It's unbelievable what some people find to be topics of appropriate conversation when they're talking to a pregnant woman!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Friday, August 21, 2009

    Commencement: Copyright 2009

    I just finished a very enjoyable book, called Commencement, about the experience of four young women at Smith College and their "commencement" of life outside of Smith. I especially enjoyed it, I think, because I lived in Western Massachusetts at the time the novel was set in, and it was interesting to read about a place I passed on a regular basis.

    There were a few things I didn't like about this book though. First, there was what felt to me like a big plot stretch to include lots of information about girls and very young women being forced into prostitution. It's not that this issue wasn't related to other issues explored in the book, around freedom and feminism and the choices women make, or aren't able to make and why... it's more that the plot felt driven by it in a way that didn't feel realistic.

    What really annoyed me, though, was this scene, when one of the four central characters, Sally, is in the hospital giving birth:
    "'Sally, we're having a little trouble getting the baby's shoulders out,' the doctor said. 'We're going to have to do a small episiotomy.'

    'How small?' she said.

    'Small,' the doctor said. 'I promise. Seven stitches, max.'

    Stitches? Celia reminded herself to get on the waiting list for a couple of Romanian orphans as soon as she got home.

    'No,' Sally said, shaking her head. 'I don't want it done.'

    Celia was about to speak up, about to say that these damn people needed to listen to Sally, and really, hadn't the poor girl been through enough without slicing her open?

    'Babe,' Jake said gently [Jake's her husband & the baby's father]. 'I know you didn't want one, but it will heal so much better than a jagged tear.'

    Bree's eyes nearly popped out of her head.

    The doctor grinned. 'I see Daddy here has been reading What to Expect When You're Expecting. He's right, I'm afraid.'

    'Oh okay,' Sally said. 'Just get this thing out of me.' She put her head back, resigned.
    Okay, maybe this scene infuriated me. I'll admit it.

    I don't know where to start. The fact that the doctor promises the number of stitches it will take to close the episiotomy? How would he know?? Especially since from all the research I've seen many of the worst kinds of tears happen more frequently after an episiotomy.

    In case you're wondering, this is what the very mainstream Babycenter.com says about perineal tears:
    "A third-degree laceration is a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus). A fourth-degree tear goes through the anal sphincter and the tissue underneath it." . . . and that "It's possible to tear even if you have an episiotomy. In fact, an episiotomy may raise your risk of getting more severe tears."
    And here's a bit of what Henci Goer writes in Obstetric Myths Versus Research Realities about episiotomies, "The major argument for episiotomy is that it protects the perineum from injury, a protection accomplished by slicing through perineal skin, connective tissue, and muscle. Obstetricians presume spontaneous tears do worse damage, but now that researchers have finally done some studies, every one has found that deep tears are almost exclusively extensions of episiotomies. This makes sense, because as anyone who has tried to tear cloth [or paper] knows, intact material is extremely resistant until you snip it. Then it rips easily" (276).

    I do that demo in class, with paper. When we talk about circumcision, almost always the dads turn a bit green. The episiotomy demo has the same effect on the moms.

    This is an excerpt from Chapter 32 of A Guide to Effective Care in Pregnancy and Childbirth:
    Although episiotomy has become one of the most commonly performed surgical procedures in the world, it was introduced without strong scientific procedures of its effectiveness. The suggested beneficial effects of episiotomy are: a reduction in the likelihood of third-degree tears; preservation of the pelvic floor and perineal muscle leading to improved sexual function and a reduced risk of fecal and/or urinary incontinence; reduced risk of shoulder dystocia; easier repair and better healing of a straight, clean incision rather than a laceration . . . On the other hand, a number of adverse effects of episiotomy have been suggested. These include: the cutting of, or extension into, the anal sphincter or rectum; unsatisfactory anatomic results such as skin tags, asymmetry, or excessive narrowing of the introitus; vaginal prolapse; rectovaginal or anal fistulas; increased blood loss and hematoma; pain and edema; infection and dehiscence; and sexual dysfunction.

    Liberal use of an operation with the risks described above could only be justified by evidence that such use confers worthwhile benefits. There is no evidence to support the postulated benefits of liberal use of episiotomy. Controlled trials show that restricted use of episiotomy results in less risk of posterior perineal trauma, less need for suturing perineal trauma, fewer healing complications, and no differences in the risk of severe vaginal or perineal trauma..." (295)
    Then, the fact that, in a book with a 2009 copyright date, full of thoughtful examination of women's independence and women's choices the author writes, with no evidence of criticism the passage quoted above... this passage that feels like the baby's dad and the doctor pull a paternalistic act of "reassuring" the "ignorant", "hysterical" laboring woman, with LIES, makes me feel a little crazed!

    Where is the critique? Where is the "speak truth to power"?? Where is the sense of outrage???

    Instead we get "She put her head back, resigned." We get one observer whose eyes nearly pop out of her head and another who is so traumatized and horrified that she wants to adopt children instead of give birth. We get What to Expect When You're Expecting.

    There are 29 holds on this book from the Maine library system. People, probably mostly women, are reading it. And on the whole, it's a good book. Which makes the above passage all the more insulting, in my opinion. And all the more damaging.

    What would possess an otherwise well-informed, sensitive, thoughtful author to write it? Any ideas?

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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    Wednesday, August 19, 2009

    New Birth Stories

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    Tuesday, August 18, 2009

    Classes, Moms Group & More!

    And... I'm back! We've had a wonderful summer in many ways, with terrific company, fun times at the ocean and out on the boat, and a few precious lazy days. Must work in more lazy days for next year! And respectfully request more sun - that was sorely lacking this year, but we surely did take advantage of what we got, going to the ocean and lake beaches, whenever there was a sunny and hot (or even warm-ish!) day. Like today in fact, and yesterday! Now I'm getting ready to enjoy fall, and another school year with the children, who are attending 3-day a week nursery school and homeschooling. Fun times!

    I've changed times and format for the moms group... and it has a new name: Mamas and Muffins. It's still free, of course, and open to all new mamas and their pre-crawling babies. I invite all mamas and their "little muffins" ;-) to drop in anytime from 9 to 10am, have a muffin and some tea, and enjoy chatting with other new moms. From 10am to 11, there will be time for women to share their experiences, ask questions & get support.

    Groups will be held on the 1st and 3rd Mondays of each month, from 9-11am at the Winthrop United Methodist Church (58 Main Street in Winthrop), upstairs in the nursery. Use the side Wonder Awhile Nursery School entrance. Signs will be posted.

    September 21st, 2009
    October 5th & 19th, 2009
    November 2nd & 16th, 2009
    December 7th & 21st, 2009

    I am scheduling group and private classes for this fall. If you're expecting your baby in October, November, December, or January, give me a call at 512-2627 or email me!

    Preconception & Early Pregnancy Class

    An introduction to pregnancy, with activities and discussion on nutrition, exercise, and self-care for a healthy, comfortable pregnancy as well as tips on choosing a care provider and putting together a supportive birth team. Enrollment is limited to women and their partners who are trying to conceive, or who are less than twenty weeks pregnant.

    Thursday, September 24th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.

    Coping Strategies for Labor and Birth

    Introduces a wide variety of coping strategies for labor and birth, including breathing, relaxation, massage, visualization, position change, and water therapy. Some practice time and a short video will help you start thinking about which strategies might work best for you. This class will also be helpful for the birth partner, providing lots of concrete ideas of how to be supportive during labor and birth. Enrollment is limited to women who are in their second or third trimester. Participants are encouraged to bring a support person.

    Monday, November 9th, 6-9pm
    Winthrop Middle School Library
    Fee: $20/couple

    To register, contact the Winthrop Adult Learning Center from 8-2:30 Monday thru Thursday at 377-2265 or Friday 8-10am.

    I am very excited to be working on a Pregnancy Wellness Fair - if you support women during the childbearing year (pregnancy, birth, postpartum) and are looking for ways to share your expertise, please contact me! I am especially interested in connecting more women with "outside the doctor's office" services with benefits that may not be well-known, like chiropractic care, massage therapy, accupuncture, doulas, and more. If you're pregnant, or trying to conceive, check back for more details!

    I am also planning a film screening or two for the fall & winter months!

    Christina @ Birthing Your Baby
    Independent Childbirth Classes for Central Maine
    Mamas & Muffins: New Moms Group

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