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Fertile Ground is an editorial column
that will be appearing here periodically at Virtual Birth Center,
whenever the inspiration strikes me. It reflects my opinions
only, and should not be taken as medical advice in any form.
If a topic interests you, please research it for yourself, confer
with your caregivers, and then make up your own mind. I welcome
any feedback on the topics, and please feel free to suggest future
topics as well. In the meantime, I hope you enjoy the column.
February 2000 -- Scare Tactics
by Toni Rakestraw, © 2000
I read the following post on several email lists I'm on, and
in a newsletter I receive. It is entitled "Where to Deliver"
and is the ending of a longer article originally published in
a newsletter distributed by ChildSecure.com. It has been verified
that it was written by a group of pediatricians. Most of the
article offers basic advice on feeding your baby, avoiding smoking
and drugs, etc. This ending, however, reads: "Where to deliver
your baby is your decision. As pediatricians we feel that you
should strongly consider delivery at a hospital with adequate
neonatal medical services. Many women plan to deliver at birthing
centers or at home with the use of a midwife. We feel that this
is a very dangerous situation for both the mother and the baby.
As pediatricians we all spent years "on call" at hospitals
where we were called in hundreds of times to normal, healthy
deliveries due to sudden surprise complications. In many of these
cases if a pediatrician (and equipment) were not present to resuscitate
the infant the baby would not have survived. We saw so many cases
like this that we feel that delivery outside of a hospital is
simply too risky. We have made great strides in obstetrics and
pediatrics so that childbirth need no longer be a danger to the
mother or child. Why go back to the days when it was?"
Now. I take issue with this statement for three main reasons:
1. Homebirth and Birth Center births can be better for some women.
2. According to this statement, not even all hospitals are good
enough, and what if you don't have a choice where you can go
for your birth? And 3. This statement does not detail the situations
in these "sudden emergencies."
I admit emergency services are needed for some births, and
if you are a woman with increased risks during pregnancy, please,
plan to go to the hospital. If you are in the low-risk category,
and you have done your homework and taken responsibility for
your decisions, then what is wrong with having a baby at home
or in a birth center? Generations were born at home before hospitalization
became the norm. And is there something dangerous with choosing
a midwife? The midwives I know do not take clients who are beyond
their scope of practice, and if something "suddenly goes
wrong" are the first to order an immediate transport. They
are trained in resuscitation, so can administer to the infant
or mother if needed until emergency care arrives. They even spend
time supporting the mother in labor. They do the monitoring themselves,
not passing it off to an overworked, understaffed nurse who may
have more than one patient to monitor as well as a stack of other
work expected of her on her shift. In a study by Rondi Anderson,
CNM, MS and David A. Anderson, PhD., homebirth was found to be
both safe and cost-effective for many families. This study was
published in the Journal of Nurse-Midwifery, Volume 44, No. 1.
Some women have had terrible experiences with hospital births,
only to have the best outcomes staying home.
The pediatricians who made the previous statement don't even
want a woman to go to the local hospital if it does not have
"adequate neonatal services." Exactly what are "adequate
neonatal services"? In my area, there are three hospitals.
One is a level III, with a complete neonatal intensive care unit.
One is a level II, which can take care of some, but not all infant
emergencies. The third used to be a level I, with minimal facilities
in this area. It recently closed, then reopened, so I do not
know its current status. Obviously, hospitals differ. What if
there are no choices in your area? What if you only have a level
I or level II hospital? Does this mean you are endangering your
baby if you go there? What if your insurance dictates where you
can and cannot go, and the well-equipped level III hospital isn't
the one on your policy? They neglect to mention the dangers of
being in the hospital as well. Infection rates are extremely
high at most hospitals. In the hospital almost 1 in 4 women may
expect to deliver by cesarean, some of which result from "routine"
interventions, such as pitocin augmentation or failed induction.
My own fourth child was almost a "do-it-yourself" birth
IN the hospital! The doctor had been there for some time and
never even looked in on me until our doula ran out into the hall
yelling for assistance while the baby was crowning.
On the third point, the pediatricians issuing this blanket
statement do not cite details of any of the cases they mention.
Were any of these women with sudden surprise complications induced?
Were they in premature labor? Were they on pitocin to strengthen
contractions which were lessened by pain medication? Were the
babies born with anesthesia complications? Maybe it was truly
an unforeseen emergency like a prolapsed cord or an abrupted
placenta. I know these things can happen. Even in big, well-equipped
hospitals, some babies are born compromised, and some even die.
But why use scare tactics?
Pregnant women are in a vulnerable state. This makes them
prone to worry, it does not mean they can't make an informed
decision. Follow the advice given in the very first sentence
of this statement. "Where to deliver your baby is your decision."
Yes, it is. Women need to weigh the risks of any given situation
and choose what they are willing to live with. For some, this
will mean going to Intervention General Hospital. Others will
go to birth centers in hospitals with either doctors or midwives.
Still others will choose free-standing birth centers or even
in the comfort and privacy of their own home. Don't scare them...
give them facts. Give them the opportunity to make the choices
that are right for them.
January 2000 -- How Many Children?
by Toni Rakestraw, © 1999
As a mom of 5 children, I am often asked if I plan to have
more. The more I read, the more inclined I am to say yes. Why?
Because I believe our bodies were made to have a larger quantity
of children to maintain optimal health. Well, that and I just
love my kids. But, back to the question at hand.
Our foremothers had six to twenty children in their lifetime.
They did this with poor nutrition, no prenatal care, little to
no emergency care, and working tremendously hard days every day
of their lives. We are taught that it was childbearing that wore
them down before their time, and that the advent of birth control
meant freedom.
Well, it did, in a way. But it also brought along its own health
problems. More freeing was the advent of modern conveniences.
We no longer have to raise the sheep, shear the sheep, spin the
yarn, weave the cloth, and sew the clothes. We can conveniently
buy most items at the store, and have machines to wash the clothes,
the dishes, and to generally make our lives much easier.
With birth control, we can now choose to have only 2.3 kids
tagging at our heels, freeing us up to be all that we can be.
But at what cost? In "Listening to Your Hormones,"
Gillian Ford states that, "In previous eras, women had many
more pregnancies and about 40 or 50 menstrual cycles over a lifetime.
Women today have about 400-500 cycles, with ovulation taking
place many more times." Why is this important? Because EVERY
time we ovulate, we don't just use 1-2 eggs, but between 20 to
1000. Most of these produce estrogen and die, leaving only 1
or 2 to mature per cycle. The more frequently we ovulate, the
more eggs we use up. Gillian Ford states, "...as women age,
they tend to use up eggs more rapidly, and between the ages of
38 to 44, the average woman uses up about 50,000 eggs."
And what happens when you run out of eggs? Menopause sets in.
Don't get me wrong, menopause is supposed to happen. But it
seems there are a lot of women going through early menopause.
More and more women are having to accept hormone replacement
therapy as a way of life. We are pumping our bodies full of synthetic
hormones first to prevent conception, then to regulate menstrual
problems and aid conception, and finally to help us in later
life because all of our own hormones have been used up.
In many indigenous peoples, their children are naturally spaced
2-4 years apart due to exclusive breastfeeding. They are not
perpetually pregnant or "saddled" with a baby every
year. They also do not have the problems us "civilized"
women have with our hormones.
A recent study widely publicized in the mainstream newspapers
stated that for optimal baby building, conception should take
place 18-26 months after the previous pregnancy. So, it would
seem that not only is somewhat-close spacing good for the next
baby, it's good for the mother-to-be. She goes through minimal
cycling before conceiving again, thus lessening the continual
release of her limited supply of eggs.
So, what do we do? What our foremothers did. Have children.
Ovulation is naturally suppressed during pregnancy and a large
part of breastfeeding, preserving our eggs and natural estrogen
supply. During pregnancy, estrogen is supplied through the placenta
instead. Breastfeed our babies as long as possible. This has
been proven time and again to be most beneficial to the child
as well as the mother, since extended breastfeeding helps with
breast cancer prevention. The truth of the matter seems to be
that if we'd stop messing with nature, we'd all be better off.
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