VBAC Bans

I never thought it would happen here, in this amazing, theoretically evidence-based land where we have the priviledge socialized medicine. Maybe I was feeling smug in my theory that given SOGC's lukewarm support of VBAC (vaginal birth after cesarean) and their stance on patient choice caesareans, we would have protection from the rampant VBAC banning hospital crisis in the US.

Not so. The Red Deer Regional Hospital Centre in Alberta has announced that they will not allow VBAC trial of labour after January 1, 2006. What the hell? Does this hospital not realize that a caesarean section is riskier for mothers and babies than a vaginal birth? Do they realize that they cannot legally do this as it infringes on a mother's right to have a normal biological event, even after having a surgical event to extract a previous borne?

I find it ironic that this week a new Canadian study titled Severe Maternal Morbidity in Canada in the CMAJ/JAMC shows clear evidence that the rising caesarean rate has a lot to do with the maternal morbidity risks:

"The most common complications were cardiac arrest or cerebral anoxia -- lack of oxygen to the brain -- after obstetric surgery. There were 2,677 cases, and 37 deaths."

"The rate for uterine rupture increased from 0.58 per 1,000 deliveries, to 0.74 per 1,000. In all, 1,898 women had a ruptured uterus, and four died."

Hmm, 0.014% risk of maternal death from ONE cesarean risk or 0.002% risk of maternal death from a UR, the only VBAC specific risk. Now if we stopped induction/augmentation for VBAC mothers, a proven and huge risk factor for UR in all women, that UR rate would fall back to even lower rates. That does NOT include cesarean risks like...

"... blood clots in veins, respiratory distress syndrome, swelling in the legs, heart attack and severe hemorrhage requiring a hysterectomy [which have] increased 50 per cent or more over the 10-year period."

So, the RDRHC wants to set a precidence. Not without resistance, believe me. I am working on the fuel right now to counteract their VBAC fears, but it likely won't be pretty given that they are investigating a local midwife who does many VBACs, with excellent success I might add. Why do mothers have to combat the fears of physicians when working through their own fears in preparation for their upcoming birth? Welcome to "modern day obstetrics" where birth has been so screwed up by well meaning physicians they are chasing their tails and only traditional midwives can see the truth and light of this normal physiological process.

PS. Is it ironic that this week we have also seen a VBAC mother deliver her baby on the roadside enroute to the hospital because her local hospital didn't allow VBAC TOL. Not to mention, a US hospital (hopefully one of many) who are reversing their decision to ban VBAC TOL because, "choice should not be taken away simply because of potential lawsuits." Can I say something? DUH!!!

Busy in "shop class"

We have had a very fruitful weekend, school project wise. Our eldest is very interested in woodwork and our builder (who built our house last year) commissioned our family to build 20 signs for his company. You may have seen something similar, one sign in front of each residential building site with houses in various stages of construction. These signs are used not only to advertise, but to provide all of the trades the information on the house so they know at a glance the builder number (to ensure the work is being done on the right house), address, the owners, and if this is a spec or custom home.

This is the first ten with the remaining ten waiting for paint (which we will do today and tomorrow). It will be nice to have them finished and moved out of our garage and off of our parking pad.

Next week's class: Deck rail building followed by frost walls. Loads of fun!

What Horse Colour Are You?

Black


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One Crisis Per Night, Please

All mothers, all parents know that once a tiny infant joins their family that sleep will be compromised for a while, sometimes a long while. Add more children and the interruptions to sleep multiplies exponentially it seems. Things have going well in the sleep department for a while now that Breanna is usually only waking once per night, something I can deal with most nights. Except when I can't get back to sleep because of something or other on my mind.

Last night was an anomalie and I am thankful for that because it was an adventure! With the kids all tucked into their warm beds by 9:30 I had plenty of time to do sew perineums before I hit the hay. Maybe I should clarify that. I am sewing cloth perineum models that fit over pelvic models for childbirth educators. I make the whole set actually... newborn fetal model, placenta (with membranes and umbilical cord which attaches to the newborns umbilicus), cloth pelvis and perineum. They go perfectly with the knitted uterus my sister's mother-in-law knits for me.

But I digress. I accomplished a lot, all the serging is done and dropped into bed at around 10:30. I was drifting off to sleep when I heard a noise. It was the old familiar noise of scurrying rodent. Having grown up on a farm and been the proud owner of hampsters forever, I knew the sound well and a sense of dread came over me. This noise could only be from one or both of our newly aquired miniature hampsters we had obtained last week, all of four weeks old. So tiny and precious I could hardly say no when we spotted them so we purchased two females. Once home, my husband immediately asked if their being so small would be a problem with their possibly fitting through the bars of the cage. I confidently assured them they would be fine. Right.

I found one in our bedroom and nievely thought she escaped through the slightly bigger gap at the top of the door so I fixed it and was heading back to bed when son #2 came into the kitchen coughing like crazy. Cough medicine down and with him safely tucked back into bed, I returned to bed just as Allan was returning home from work around 11:15. I fell promptly to sleep after talking to him for a short while to be woken by another hampster noise. Ack. This time the little rodent was half way up our curtain between the layers. Houdini was quickly rounded up and I brought her down to her owners who put her in another cage.

I couldn't sleep thinking of what would keep those hampsters caged and suddenly it came to me, the cylindrical metal garbage containers the boys had in their rooms. Tall straight and very smooth sides would ensure no scaling of the perimeter and a hampster cage set on top to ensure safety if that failed. So I headed back down to bring the new plan to the hampster owners. They had found in that time Houdini did indeed squeeze quite easily through the standard width bars on the cage so we put the new plan to the test and wala it worked perfectly.

Back to bed I went, falling quickly to sleep again to be jarred awake by Breanna wanting Mommy. I tucked her back to bed, again I hit the bed... for the fourth time. The screaming wasn't in my dream, Breanna was again awake and I stumbled to her room quickly to avoid awaking the entire house. She was not happy and I walked her quietly in the hall until she calmed down. Ahhh, princess peanut butter was finally to sleep as the dawn promised to unfold. Exhausted I fell into a deep sleep and this time I did get some quality sleep before son #3 came to ask me to play at 7:00. Good morning.

Parenting is not for the weak, or those who need sleep.

Caesareans and such

This has been some week on the issues of caesareans hasn't it? Let's recap.

Monday HealthGrades came out with their "study" on patient choice caesarean rates increasing 36%. Reporter Shapiro concludes his article with, "Our findings of exponential growth in the rates of women receiving Â'patient-choice'” C-sections are consistent with our conclusion in last yearÂ’s report which identified that heightened awareness, increased support and advocacy, and women waiting until they are older to have their first child, are key drivers in the increasing rate of 'patient-choice'” C-sections in the United States. We further anticipate that as these key drivers become more widespread and consensus on the utility of '“patient-choice'” C-sections is achieved, demand and rates will continue to rise. We believe that these findings demonstrate the significant impact of empowerment and consumerism among selected women in the United States."

Not only is this a gross exaggeration, most women who they are finding in their study as "choosing" a caesarean are in fact women seeking a vaginal birth post caesarean who are being coerced into it by their primary caregivers who paint a very bad picture of VBAC risks and place huge fears of uterine rupture on them. Thus they agree to a repeat surgery and are charted as 'patient choice' caesarean section. Believe me I know, I have been there in the hot seat as my obstetrician berates me for my stupidity in wanting to endanger myself and my baby to have a vaginal birth. He went so far as to say, "I can't believe you are sitting here alive one day before your due date, you should have scheduled your caesarean at 38 weeks! You know you are risking your life, don't you?"Thrice sectioned I chose a homebirth for my fourth without the fears placed on me by my physicians and the hospitals. Which NJ physician was it that said any physician can make their patient choose whatever they want simply by how they word their "informed consent" discussion? Welcome to obstetrics where evidence-based medicine is rarely performed. How could it when this is the only normal physiological process which physicians feel the need to meddle with? Midwives, good ones, know that meddling cause problems, unfortunately obstetricians haven't figured this out yet. Do you think it has anything to do with it being a cash cow for allopathic medicine?

But I digress, are you pregnant post-cesarean? Learn more about your options with ICAN's support (pdf).

Tuesday a news article (not online) tells of NC's Genesis Medical Center and Trinity Health Care Systems not banning VBACs citing patient choice and patient rights. Well, one in a thousand who actually care about their patients legal rights? I am impressed.

Wednesday afternoon Britney Spears, terrified of vaginal birth, chose an elective caesarean for the birth of her son at the last minute and is now recovering with her entourage in London.

Thursday Britney's fans reacted with a mixture of elation for her baby boy and anger at her choosing a caesarean out of fear.

Friday rounded out the week with a beautiful segment on CBS's Health Watch with co-anchor Hannah Storm, thrice sectioned mother, who "can personally attest to the pain involved with caesareans." Please watch the streaming video for the best information. It was mentioned that the National Institute of Child Heath and Human Development (NICHD) was doing a study on elective caesareans next year. Hmm, I would love to be a fly on that board room wall!

Let me conclude with the awesome work ICAN has been doing in responding to these with their press releases.

PS. I forgot two things!

Wednesday Reuters reported a new study that showed caesarean can increase risk of milk allergies and ORGYN.com
reported on the potential link between caesareans and newborn cavities as well as well as Model predicts risk of emergency after previous cesarean (you may need to register to read these, but it's free). What a week!

Welcome to Our House

We have been helping neighbours with landscaping this week, in the constant drizzle. Perfect weather for growing sod, not laying it. But we all had a lot of fun and fresh air. Breanna found a great mud puddle and quickly lost her shoes so she could take full advantage of the squishy clay. Then around the house she went to go in the house and waited there somewhat patiently while I finished up. She made a great finger painting on our door as she waited, don't you think?

Family Futures

Tonight my wonderful husband is deciding the fate... er, future of our family. I mentioned our future in a previous blog but tonight I am both extremely apprehensive and excited. We are focused on two options:

1. He has an open offer to re-join his brother's firm in Camrose with a good wage increase, great hours and vacation time and a great job. Going 'back home' is a great opportunity to be near family too, with perks like another new house which we will build this time and so much more.

2. He starts working with our builder as a supervisor and we say in Spruce Grove. We have always wanted our own business and this is the perfect opportunity to learn the building trade with our future being as residential builders. Also a wage increase, the hours we are not sure yet, nor do we know about vacation time, but also a great job. Staying here is also a great option because the kids have great friends here and there are great opportunities for them. Right now they are enrolled in our homeschool groups Sports program, our church's confirmation classes, AWANA and they have a great paper route that the love the income from.

Honestly? I am feeling apprehensive because I am right now really not wanting to move to Camrose. Yes there are so many great parts of this, but I am really... really liking Spruce Grove. I have fallen completely in love with our new church and the opportunities I have had here, both professionally and personally. I have had thrice the friends and business opportunities in the first six months here than I had in 2 1/2 years in Lloydminster or 5 years in Camrose.... well the business opportunities for Camrose, I do indeed have tons of friends there. I had no idea how attached I could get to this beautiful community when I moved here!

I am so trying to be open minded but it is being very tough. Heck if it was my husband's choice he would already have quit his job and moved... but that is because he knows what he will be going back to in terms of job and right now it is SO much better than what he is dealing with at work right now.

I also am feeling resentful because the kids are just starting all of this wonderful stuff in the community this fall and again we will be moving mid-everything... joining any new groups in Camrose after the fact which always puts kids at a disadvantage. We sure learned that the hard way with the last two moves. My biggest frustration I think is leaving my infant Christian prenatal ministry at Immanuel. I am feeling very motherly towards it and am so fearful it will not flourish in my absense. Ah the joys of motherhood, in all its forms!

Comes in Threes

It is a great myth that good or bad, things come in threes. A friend of mine reminded me of that this spring when I discussed the three incredibly positive and excited opinions of the first three people I had discussed my proposed Christian prenatal program too. She added that if three positives were given in short succession that it was an important sign.

Not one to put a lot of weight on this theory, I was pleasantly surprised today to find indeed three very similar and awesome things happened to me, one right after the other, this morning. The first was to pick up my email and to find a warm note from Ann Douglas, fellow speaker and writer, she is the author of the "Mother of All..." series and other excellent books on the perinatal period. Here is her website (one of them). She just returned home from Baby Boom, a baby fair in Ottawa and had a blast. We have been emailing back and forth about speaking in general and upcoming engagements, honourariums and so forth, exciting fun! She answered a few key questions I have been wondering about, an important email for me as a speaker.

I was leisurely skimming email again when I recieved a phone call from Dr. Stonehawker. A wonderful Christian man, he founded the only shared care maternity program in Alberta (midwives work in a hospital setting and are funded through Capital Health through a unique funding program, in a province where midwifery is not funded). The hospital it is based in is a five minute drive from my house and is a very sought after program. Anyway, as a professional member of our church, he was asked to review my Immanuel's Healthy Family Ministry proposal by church council. He took it upon himself to call me to personally congratulate me on the hard work I had done on the proposal, the program itself and how excited he was to see it's inception. He also asked if I had been in contact and had discussed this program the shared care program midwives and staff. I told him that I had talked to most of them, all of whom welcomed it with open arms. They were so excited about it that they asked if they could help promote it within their facility. He closed the conversation with his wanting to sit down with me to learn more about the program and to get to know me better. He has long been an advocate of midwivery and doula support, possibly as a result of his many mission trips as a physician.

Moving on to fixing a Quickbooks glitch, which has kept me from accessing my accounting software for far too long, I finally found the answer on their forums. I had no sooner fixed the problem had it up and running - finally, when Madeleine Hegholz called. A wonderful, passionate and very knowledgable IBCLC, she is also an RN who worked for may years as a postpartum nurse. I have always referred my clients to her first if there was a breastfeeding problem. We caught up on what each other had been doing since I moved away and back again. She told me of the exciting work she has been doing as the president of the Canadian Lactation Consultants Association and her daughters journey towards her own RN degree while I told her of my work with ICAN and my fourth homeborn child who joined our family while I was away. We said our fairwells with her promising me one of her new breastfeeding pillows she had designed and made herself. I can't wait to see it!

This left me pondering if this is a sign from God, that three so incredibly positive things that happened in quick succession, was his answer to my prayers to not leave the birth industry. Hmm.

Navel Gazing

Today has been a day of reflection for me as I recall the day the Two Towers came down in New York. Where were you?

I was home in our first house with our two boys (at the time). I had not slept well and woke up late. It was an "off" day for me, I felt really out of sorts and was making breakfast when my Mom called. Neither of us ever watch TV but she called to tell me to turn on the TV, her voice was strained. Fear seized me and I immediately ran to the TV. I went to ask which channel but every channel had the same images, scared reporters telling us that an airplane had hit one of the twin towers. As I watched I saw the second plane hit and though I kept the boys from watching, it wasn't easy because they saw the concern on my face. I explained what had happened for them to understand what was happening but I kept them from seeing the riveting images, people at the top of the towers, of those who jumped, of the towers coming down, of people running, fear, screaming, terror in the streets. I never asked my Mom what caused her to turn on the TV, but learned later that my sister had called her, her morning exercise routine including kickboxing to a video and she had caught a glimpse of the footage when she turned on her video.

How ironic that I write this as my daughter's favourite DVD Brother Bear is on. The song "No Way Out" playing in the background is almost surreal. But I digress...

Many of us have changed in subtle ways since that day, many of us focusing more closely on relationships than we had before. Others have looked at what we have taken for granted and refocused on the important. Hurricane Katrina has done that again for many of us who were not directly effected. I know I have. I have also learned a lot about myself through navel gazing as I think about these things.

One of my friends blogged on Friday about her own Navel Gazing via a personality test. I took the test this morning as I contemplated how closely her personality matched my husbands (my entire family will be taking this!), and I found myself to be INFP (Introverted iNtuitive Feeling Judging). I know, I didn't have a clue what that really meant either but it seems to be a close fit for me and interesting in light of the above:

Beneath the quiet exterior, INFJs hold deep convictions about the weightier matters of life. Those who are activists -- INFJs gravitate toward such a role -- are there for the cause, not for personal glory or political power.

INFJs are champions of the oppressed and downtrodden. They often are found in the wake of an emergency, rescuing those who are in acute distress. INFJs may fantasize about getting revenge on those who victimize the defenseless. The concept of 'poetic justice' is appealing to the INFJ.

"There's something rotten in Denmark." Accurately suspicious about others' motives, INFJs are not easily led. These are the people that you can rarely fool any of the time. Though affable and sympathetic to most, INFJs are selective about their friends. Such a friendship is a symbiotic bond that transcends mere words.

INFJs have a knack for fluency in language and facility in communication. In addition, nonverbal sensitivity enables the INFJ to know and be known by others intimately.

Writing, counseling, public service and even politics are areas where INFJs frequently find their niche.

How interesting that writing, teaching, counseling, ongoing supportive work with ICAN, and the political minefield of obstetrics (which moves, at times, far away from women's rights, fetal rights, informed consent, and evidence based practice as seen poignantly with the VBAC bans in the US) is so what I am passionately involved in right now.

Organization

I will never even pretend to be organized, but I try to at least know where things are that hit my desk and where to find everything for the most part. With that in mind I am pretty proud of what our schoolroom/home office/family room is looking like too. I was near despair on Tuesday when I set to work doing the undone... moving all of the requisite computers, books, etc that have found their way throughout our house because of our not having the basement finished.
Now the end is finally in sight, I still have to box up our lesser-used books because of lack of shelf space, but the piles and piles of papers, books, computer peripherals and "stuff" of life have given way to cleanliness and organization. This is a pic of my desk with Ryan's adjacent desk (his chair is closest).

Save for the three piles on the floor above, l-r: childbirth education yet-to-be sorted and filed stuff, bag of books and teaching aids to go to my prenatal office at church, and half-started books-to-be-boxed box. I also have to make up our calendar (aka large pinboard calendar where we move the happy face each day for the little ones to learn their dates), put up our timeline (working on old testament history and delving into Canadian history a bit this year too), and find a home for all of the sleeping bags piled in the family room from our camping trip last week (below). Looks like someone was working on a puzzle! My wish list includes a BIGGER basement in our next house (I couldn't sleep last night designing our new house for when we move next) and/or carpet by winter if we stay in this one.

Pretty Flowers

Pretty peanut is on my lap so we decided to share pictures we took in our yard. This is our latest edition thanks to my wonderful sister who gave this rose to my for my birthday this summer, a Peace Rose, my absolute favourite rose of them all!

And this is the beautiful Nymphaea 'Attraction' water lily that graces our frontyard pond which it is sharing with five big goldfish this summer.

And this is a flower from a plant my sister gave me, I can't for the life remember the name!

Finally, here is a water lily flower from our backyard pond called Nymphaea 'Rose Nymphe' which I absolutely love!

Summer Kids

Meet my precious peanut! I am playing with uploading images and it is much easier than I had imagined so I will be doing it far more often!

Peanut Butter, aka my youngest daughter Breanna, loves the outdoors. Here she is picking mountain ash berries from my sister's tree. She just came in the house from playing outside with her siblings so more tomorrow!

Schools Back!

Our first day of homeschool has, as always, been an informal organization of said school rather than a structured class... that will come. It is tough to jump right in and be totally focused with summer days just a yesterday away... especially when that included spending the whole day with most of their cousins at West Edmonton Mall's World Waterpark.

I haven't yet added pics to my blog but I am going to learn given the amazing pictures we have of this summer's fun. As you can tell, I am reluctantly turning to school and schedules and the work I need to do in preparation for upcoming workshops this fall.

Now that our new homeschool room is ready for us, we spent today "moving in," getting organized, and finding how our new facility will work for us. This is our smallest formal homeschool room yet (although last year we schooled around our kitchen table with a hall closet as our "organization") and yet it isn't without it's benefits. Eric's room is adjacent so he can do his work in his room away from the distractions of younger siblings. Ryan will need to go up two floors to do his room, which he may prefer when he is needing to focus on specific projects. But for the most part, his desk is adjacent to mine but with plenty of space for him to work.

Brendan and Breanna can be close by with all of their toys and games in the family room which is a part of the same room as our school space. This worked perfectly today as we moved and sorted things, so we will see how things proceed during the year. One thing we did learn though is that the computer monitor is in direct sunlight during the morning, NOT good given that we school in the mornings only. So I am off right now to move that to the other corner of the desk (which is actually a better location overall), see you tomorrow!

Dreams

I alluded to dreams in my previous post and indeed dreams are what life is truly made of!

In high school, many of my school mates wrote their list of 100 things they wanted to accomplish in their life, their dream list. I regret not doing that, thinking it was an inane exercise in futility and frustration when looked upon and seeing the un-realized dreams remaining. So very short-sighted I was and how much I had to learn! I only had to look at simple "to do" lists to realize that something written down has a far greater chance of being realized than if is left to be forgotten.

The last two weeks have been a wonderful time of exploration and rediscovery as Allan and I have been exploring not only our career futures but also our dreams, but close to our hearts and forgotten. It is amazing when the stressors of daily life are lifted our dreams are remembered, like our long-shared dream of obtaining our private pilot licenses, and Allan to go further and become a helecopter pilot. Of course that would entail ownership of said vehicles too! What are your dreams?

Life Options

I have for eight years talked about birth options as a birth professional. I love what I do, all of it, yet in the last couple of weeks I have had to explore my options a bit, and somewhat reluctantly I must admit. Let me share my thought process with you...

We, as in my husband Allan and I, have been weighing his occupational options in light of a few considerations - both personal and professional - that have weighed on his mind and caused him stress in the last few months. We had waited until his two weeks vacation to sit down and really talk about this and explore our options. He has really been feeling like he has no options and through dialogue and our reassessing our short and long-term goals he has become much more optomistic.

In knowing his passions, and our sharing our dreams continually with each other, I have been putting out feelers in our new community in the avenue's he has always been interested in. One of those is in becoming a residential home builder, another is in computer repair, and a third in returning to his previous occupation of auto body mechanics which is loved many aspects of.

That is in addition to three distinct career avenues where he is currently employed... along his current path (towards store manager), photo lab management and loss prevention. Suddenly, in sitting down and exploring his options he truly saw having six distinct avenues he can move into. Not only that, three of those he has solid job offers in... three of them matching or exceeding his current salary.

In knowing Allan I also knew that he would lean towards the road less travelled, the most challenging road, because he has always needed to be challenged... both in career and in life. In following that road, he has also explored his options with bringing trusted and knowledgeable friends and not only have they been supportive, they want to help in various ways. No decisions yet, but he will return to work on Tuesday and two interviews in the next week will cement the decisions we have been exploring.

Which brings me to my options. I have two distinct roads... that along the same path I have been working unceasingly these last eight years, towards financial security through first supporting women, then through training those who support women. I know that this is certainly a road less travelled and I have enjoyed the journey immensely, but it has been a financial stuggle since I switched from support to training. That coupled with a few road blocks I have encountered in the last three years has left me questioning my future here.

The other road is also not a well travelled one, but one that has been my hobby since I was a teen... landscaping. From design right through to every aspect of structure, grunt work, planting and finishing... I have done it. Three residential properties which have been the envy of professionals and neighbours alike are in my portfolio. I have also recently moved on to volunteer my time in designing a 10 acre church property and the results have not only been exciting, they have been overwhelmingly approved at every step. I was just recently asked to landscape an acreage... most beautiful in its potential with a few great bones and, with effort, it would be splendid indeed.

Once in a while, in the last couple of years, I have thought about how I could combine both. That dream looked something like teaching on weekends and landscaping during the week. But as a homeschooler, that is bordering on insanity so I have left landscaping as an occasional hobby and focused on my passion, teaching birth professionals. However great the potential there is in filled workshops, the reality has not been as optomistic and though an income is had... it isn't the income I would like to see to make me feel the stress is worthwhile.

I have worked hard to let God's will be done, allowing Him to lead me in the direction I should go. That means letting go, even reluctantly, those things that I have been adhering to. That includes the possibility of relocating... again. And if that happens, landscaping is a much more viable option because starting promotion in a new location all over again is feeling overwhelming right now given the lack of workshop participants I currently have... two moves in three years has caused a huge negative impact.

My ideal is still a combination of both. If Allan does move in the direction he is leaning, he will need my support, though more in terms of business management, than ever before. The impact of that is uncertain, but the benefit of having two quickly growing young men as sons will buffer that too as they are incredibly helpful and even moreso each day. What the future holds is still wide open and I am very excited about it!