Who doesn't love Mothering? The support for natural family living, the huge online discussion board, the lack of infant formula advertising, the pictures of natural births... I could go on and on. I've been reading Mothering magazine since the summer of 2002 and I'm still a fan.
After watching yet another episode of "A Baby Story" tonight where a couple decided to induce labor because the mom was 41 weeks along, I'm thinking we need a new way to express when a baby is due. Like an "arrival month" or a "possible week or birth." I know, those aren't good enough, but there's got to be something. Something that clearly communicates that we have no idea what day this baby's supposed to be born, but we're guessing it's probably in July.
The words the parents on the show tonight were powerful and really communicated that they felt like their baby had failed to arrive on time. "My due date was a week ago." "She's 8 days past her due date now." The beginning of the show was them keeping track of how late the baby was.
As the episode went on, they were at the hospital for the induction, she "failed to progress," the doctor told her that either the baby was too big or her pelvis was too small (not that the induction wasn't working) and proceeded to do a C-section that resulted in the birth of a 6 pound, 9 ounce baby (not too big, I'd think). It got me that the doctor assumed that there was either something wrong with the baby or the woman, not the way they were going about things. Nobody said, "Hey! Maybe you just weren't ready to have the baby and that's why you're not progressing!"
The show tonight illustrated how we need to move away from the idea that there is an actual day by which the baby is due. Healthcare providers who work with these moms need to step back and let the pregnancy be, as long as everything is going well with mom and baby.
Whether you're 38 weeks or 42, when your body goes into labor on its own is generally the time that your baby is ready to be born. I personally had three babies at 39 weeks and one at 40+3. I've attended births where the moms were 42+5 weeks and 41+1 weeks. Babies finish gestating on their own schedule.
My question is: What should be call the new "due" thing? What is a good way to tell people about when the baby will arrive without planting the idea of a date in the heads of parents and providers?
Ok, so maybe they're not saying it out loud, but from the way some people react when you tell them that you're having more than one baby, you would think that you were about to explode. Although twin births in the US are now up to 3 in 100, many medical providers are still treating moms of twins like they could not possibly have a healthy pregnancy or a natural birth.
I am lucky enough to have a doula client right now who is pregnant with twins. In order to better serve them, I've been doing lots of research on twin pregnancy, natural birth with multiples and breastfeeding twins. It turns out that when parents educate themselves and use caregivers who support their choices, it iscompletely possible for them to experience healthy pregnancies with natural births and to breastfeed successfully.
The catch here is that, unfortunately, parents will likely not achieve the results they desire by simply leaving their care in the hands of doctors and hospital policies. Many OBs are more comfortable with delivering twins by Cesarean and will encourage parents to consider surgical birth. Some hospitals require that twins be born in the operating room, even if mom is planning on delivering vaginally, so that a Cesarean can be performed quickly. There are doctors who try to require mothers to have an epidural placed so that they are ready to do surgery if they decide to. The C-section rate for twin births with obstetricians is roughly 50%. Bottom line: If you are having your babies in a hospital with an OB, they are most likely planning to perform a Cesarean.
It is up to you to educate yourself about your choices for your birth, write a birth plan, talk with your partner about what you want,and hire a doula who will help advocate for you. Some parents who want a natural birth decide to use the services of a doula and give birth in the hospital, while some decide to have their baby at home with the help of a midwife.
Pregnancy Today's article, "A Guide to Vaginal Twin Birth," has this to offer:
"•Choose a doctor who is committed to natural childbirth and comfortable doing breech deliveries.
•Maintain an excellent nutritional intake, including a liter of water a day, which will contribute to the health of the twins and help to avoid complications.
•Have a midwife, doula or other supportive birth professional in attendance at the delivery.
•Stay upright and mobile during labor as much as possible and make sure that the hospital supports this option. You should be able to eat, drink and walk while in labor.
•Be informed about possible medical interventions. Read, research and ask questions before and throughout your pregnancy.
•Show up for the delivery armed with a birth plan and discuss it with your doctor/midwife in advance.
•Believe in your own power to give birth to two babies naturally and without surgical intervention. If you can visualize something, it is more likely to happen that way."
Some good resources that I've found for couples who are expecting twins are:
Spirital Midwifery by Ina May Gaskin- has a short but incredibly valuable section on multiple births.
"I love your tattoo! Did you get it when you were pregnant?"
"Actually, I got it because I'm a doula."
"A what?"
"A doula. I help moms when they're having a baby, during labor. Pretty much whatever they want me to do, like rubbing their feet or making a sandwich."
"That's cool. What a great job."
The tat in question is new. I got it the last week of June, when Melissa kicked Tim and I out the house and watched the kids for us. I showed the tattoo guy the picture from my doula facebook page and told him that I wanted it to be an outline, like my nursing mom tat. I'd been wanting to get it done for a while, and after I had it I felt like I had finally gotten something that had been missing.
What I didn't think of is the tattoo being a conversation starter, since I'm generally pretty covered and it's on my back. But yesterday, I was at the kiddie pool at the East Y with James and Ben while Patrick and Delilah were having their swim lesson, so I had on a tank top and a shorter skirt. Since the lady saw my tattoo and liked it, I got to talk about my doula work.
The next meeting of the CNY Doula Connection, the new doula networking group in Central New York, is coming up on July 14th. Our business meeting will be from 6:30-8pm, with plenty of time afterwards for socializing. We are meeting at the Barnes & Noble cafe at the Barnes & Noble in Clay, NY on Rt 31.
I can't say enough good things about the group. We are a doula networking group, with a yearly membership fee. We don't take a percentage of what you make or charge you per birth. Your income is your business, not ours'. We have monthly meetings for networking, socializing and planning our marketing. We do marketing events as a group and are starting to make a presence for ourselves in the community.
If you're a doula who wants to know more about our group, you can email cnydoulaconnection@gmail.com Membership is open to independant doulas who attend births in Central New York.
Is your doctor recommending inducing labor? Have they told you what your Bishop Score is? No, you say? I didn't think so. A Bishop Score is a tool that can be used to give an idea of how sucessful an induction will be in terms of it resulting in a vaginally born baby. Generally, when I ask parents if their OB has told them their Bishop Score before induction, they will look confused and say no.
I believe that doctors don't share this information for two reasons. One: a less informed patient is a more compliant patient. The less you know, the less you argue with the experts. Two: at the end of the day, it doesn't matter to them if the baby comes out vaginally or surgically. They still get paid.
Here's what you need to know: The Bishop Score is a group of measurements that can be used to determine if an induction would be sucessful or if it would be better to wait or to try cervical ripening methods before doing things like breaking your water or using pitocin.
The Bishops Score generally follows this scale: Score Dilatation Effacement Station Position Consistency
0 closed 0 – 30% - 3 posterior firm
1 1-2 cm 40 -50% -2 mid-position moderately firm
2 3-4 cm 60 -70% -1,0 anterior soft
3 5+ cm 80+% +1,+2
A point is added to the score for each of the following:
Preeclampsia
Each prior vaginal delivery
A point is subtracted from the score for:
Postdates pregnancy
Nulliparity
Premature or prolonged rupture of membranes
cesarean rates: first time mothers --- women with past vaginal deliveries
scores of 0 – 3: 45% 7.7%
scores of 4 - 6: 10% 3.9%
scores of 7 - 10: 1.4% .9%
In other words, the closer to 10 your score is, the more likely it is that your induction will end with a vaginal birth. The lower the score, the more your risk for a surgical birth increases.
If your doctor is talking induction, ask them "What is my Bishop score? What are the benefits of inducing now? What are the risks of waiting? What if I want to wait?"
