Posts Tagged ‘women’

Childbirth classes no longer needed?

December 3, 2007

Busy times, as usual. Classes are hectic, the holidays brought guests and much-enjoyed socialization and much-appreciated camaraderie and closeness, and traveling is on the horizon. Little time right now for the essays, my book. Now and again only can I check in with the listservs or email groups. Here is something of interest you may have already seen, though I see the blog is still getting comments even today. Columnist Tara Parker-Pope reports on her Well blog that pregnant women “cutting childbirth class.” Before going to the content, I must say how grateful I am to see her use of the word “women” rather than the usual “ladies” (yes, truly!) that I am seeing all the time on certain email groups. Ladies! Parker-Pope says:

Although women are more obsessed than ever with health during their pregnancies, they seem to have lost interest in learning about the end of pregnancy, also known as childbirth, reports the November issue of Fit Pregnancy magazine.

“Fewer women are taking classes,’’ said Jeannette Crenshaw, president of Lamaze International. Ms. Crenshaw told the magazine that she believes several issues explain why women aren’t as interested in learning about childbirth. Many women, she says, are convinced they can’t deliver a baby without epidural pain relief. Television shows often depict birth as a dangerous event, even though serious problems are exceedingly rare among women delivering in the United States. And because many women work until nearly the last day of pregnancy, busy schedules often prevent them from scheduling a birthing class.

Marjie Hathaway, co-director of the American Academy of Husband-Coached Childbirth, which teaches what’s known as the Bradley Method of natural childbirth, also told the magazine that interest in childbirth classes has waned. “Today, women are more focused on prenatal testing and monitoring the pregnancy than in learning how to give birth,’’ she said.

Research shows that there’s no real difference in pain, labor interventions or birth outcomes among women who take childbirth classes and those who don’t, the magazine reports. The classes appear to attract women who are the most vigilant about their health during pregnancy. Women who enroll in a childbirth class are more likely to have quit smoking, keep prenatal appointments and to breastfeed after birth, the magazine notes.

But today hospital-based classes tend to focus more on a tour of hospital facilities rather than techniques to cope with labor pain. The magazine argues that women’s declining interest in childbirth classes is worrisome because it’s happening even as childbirth has become more “medicalized’’ than ever. During childbirth, a number of variables can arise and women have to make informed decisions about procedures like epidurals, episiotomies, induction and C-sections. “That’s where you reap the dividends of having had a teacher who explained each possible intervention and showed you how to be your advocate,’’ the magazine reports.

What is most instructive and interesting, however, as is often the case, is to be found in reading the comments.

ICAN webmaster asks for help

November 19, 2007

The ICAN webmaster wrote in to the support group email list today asking for list members to help get the ICAN website up higher in Google searches. Evidently, her Google search last night for the term “VBAC” did not return ICAN until page 12.  I think she is right to say that “no one is ever going to go 12 pages to find ICAN.” She makes specific requests to help change the situation. One is to make a post with a link to a new YouTube video, which I am happy to do. The video is attempting to make the point that many women who were told that cephalopelvic disproportion (CPD) — “the baby’s head is too large to fit through the pelvis” — necessitated that they have a c-section. In fact, CPD is not so prevalent as the medical professionals are seemingly so quick to have their patients believe. The video documents the birth weights/sizes of the c-sectioned babies of mothers who were told they had CPD and the same stats of the subsequent babies’  born to these same women via VBAC (vaginal birth), and in some cases, HBAC (home birth). The point is documented clearly so do pass it on to those who could use this education. You can find the video here (Try to ignore the music choice!)

My hope is to have time in the near future to spend some more time on the ICAN issues, as well as other birth activism groups and issues. I have been asked many times about the information I posted so long ago about my seeking the information regarding the organization’s membership, work, goals, and so on, and I have had to continually say that I am getting to it! Sorry to report that I am still short of the time to give this the attention it deserves. However, thank you for the inquiries and for bearing with me.

Gift your organization

November 9, 2007

Every year for the holiday season in place of money we might spend on gifts to one another, my family gives a contribution to a worthy organization. This year we decided we wanted to support an organization that is doing good for pregnant women, mothers and babies. For several months now, I have been studying several organizations to see which might actually be the doing the most good. We now have decided the National Advocates for Pregnant Women will get our support this year. You can read about NAPW at their website. Here is what Katha Pollitt, The Nation, said about NAPW:

This spirited group, headed by the brilliant civil liberties lawyer Lynn Paltrow, supports the rights of poor, often minority, sometimes drug-using women to respectful healthcare and social services, and fights punitive “fetal rights” prosecutions and legislation. The women NAPW supports are at the center of a perfect storm made of antichoice politics, racism and the “war on drugs”: They need support and treatment, not to be arrested in their beds in the maternity ward, as happened in South Carolina, and clapped into prison. Pregnant women have constitutional rights too. And remember, as with all civil liberties issues, today it’s them; tomorrow it could be you. Send checks to 153 Waverly Pl., 6th floor, New York, NY 10011

I am very pleased with our choice.

Cyberbullying — thinking, part II

October 3, 2007

Online, some good information on bullying in the midwifery profession provides insight into how this may work with women on email lists, listservs, or groups. This comes from Midwifery Today .

So many times I hear it characterized as conflict among “powerful women”—as though we are bullying one another simply because we are so strong. The truth is that our bullying reflects the fact that we are powerless and fearful.

Horizontal violence — hostile and aggressive behavior by individual or group members towards another member or groups of members of the larger group

“Bullying is not about anger. It is not a conflict to be resolved. It is about contempt—a powerful feeling of dislike toward someone considered worthless, inferior or undeserving of respect. Contempt allows [bullies to harm others] without feeling empathy, compassion or shame.” This sense of contempt frees a bully to feel “[a] sense of entitlement…an intolerance to difference…and a freedom to exclude, bar, isolate, and segregate others.”

Identifying the fact that [midwives] are an oppressed group with the fears endemic to counterculture groups—such as isolation, ridicule and economic suppression—allows us to develop a language to prevent mimicking the painful behavior of the dominant medical hierarchy.

And so, to the last, substitute women who have felt victimized in place of midwives, and it is quite well understood how this can take place, this mimicking of the painful behavior — this redirection of aggression onto  other women. All in the guise of “not being politically correct” or “not sugar-coating,” as I have heard such excuses made.

But I am much too tired after a long night of work and writing, and must call it a night. I am hoping to be able to return soon to my essay, dealing with my mother and aunt and their strength of support through everything other than speech. For this, I need a quieter head and heart, which means rest and solitude.

Thank you to all my readers. It is fun to watch the stats each day climb higher and higher. I will hope to have useful information  posted soon on all I am learning about VBACs, HBACs, and, of course, c-sections.

Cyberbullying — thinking, part I

October 2, 2007

All of the following comes from  The Targets of Aggression, David P. Barash (Chronicle Website). Please read the entire article.  These are the main parts that are helping to form my thoughts on cyberbullying.

I am very interested in on one of the email lists I participate in, how much there is an encouragement for women who are suffering and in psychic or emotional pain to unleash on others and to payback others, sometimes, who have been felt to have been unsupportive or wronged them. This sometimes goes under the rubric of “not being silent” or compared to the activism of the suffragettes working for the women’s vote. Yes, really. There seems to be a dismissal of the idea that there can be a complexity in approach. That on the list, one must either rail against or one is being submissive, a good little girl. I am interested in the role of such a list dynamic in terms of fueling aggression and healing.

And now Barash:

When an individual suffers pain, he most often responds by passing it on to someone else. When possible, that “someone else” is the perpetrator, the original source of the pain. But if this cannot be achieved, then others are liable to be victimized, regardless of innocence.

Usually the wheels of mayhem are set in motion when someone is wronged, and typically the deeper the wrong, the more bloody the response. It is noteworthy that even here, in works of the imagination (where, one might think, anything goes), only rarely are bad guys presented as doing evil for evil’s sake: the mustache-twirling villain who gleefully ties the heroine to the railroad tracks because he is simply cruel, and that’s that. Almost inevitably, for a bad character to be believable, he or she must be shown to have suffered some injury. Then it all makes sense.

Redirected aggression — the passing of pain from one victim to another — is not merely the stuff of literature and drama. Art reflects our world, and sadly, the urge to pass along pain lurks behind modern warfare no less than it did behind medieval pageantry, leaving its mark in the genocidal wars of the 20th century as well as those that threaten to overwhelm the 21st. It underlies many of the most prominent, enduring themes of literature, history, anthropology, psychology, and religion. It haunts our criminal courts, our streets, our battlefields, our homes, our hearts. There is nothing new about the phenomenon. Much is new, on the other hand, in our ability to understand it.

When animals respond to stress and pain by redirecting their aggression outside themselves, whether biting a stick or, better yet, another individual, it appears that they are protecting themselves from stress. By passing their pain along, such animals minister to their own needs. Although a far cry from being ethically “good,” it is definitely “natural.”

Redirected aggression does not simply derive from irrationality or human nastiness, but — along with retaliation and revenge — is entrenched in the very fabric of the natural world, part of a continuum involving nature’s response to pain. The biology of redirected aggression goes a long way toward explaining not only its apparent senselessness but its universality as well. It shows up across the ages, as we’ve seen, across cultures, and across social units, from individuals to communities to nations.

It feels bad to be a victim, but the pain can often be somewhat assuaged by victimizing someone else in turn.

Recently physiologists have uncovered the hormonal basis for such behavior. Animals and people subjected to attack or threat experience “subordination stress,” as a result of which their adrenal hormones go up, along with blood pressure and the probability of developing ulcers. But — and this is crucial — when given the opportunity to “take it out” on someone else, victims show no sign of stress. By passing along their pain, they modulate their own internal distress while generating trouble for the next ones down the line. Think, the biologist Robert Sapolsky suggests, of the fellow who doesn’t get ulcers but causes them!

As to the evolutionary advantage of such a system, it seems clear that individuals who respond to painful situations by striking out at someone else have been more successful than those who sit back and “take it,” because such individuals are less likely to be victimized the next time around. In social species, including our own, individuals are exquisitely sensitive to a variant of Lenin’s dictum “who, whom?” The cost of being victimized includes a loss of reputation; that is, being seen as exploitable: Who did what to whom, and what happened as a result? Evolution would most likely reward victims who — even if unable to retaliate against the actual perpetrator — conspicuously “take it out” on someone else.

To understand how and why people engage in redirected aggression is to gain insight into seemingly disconnected events. For example, the power and ubiquity of scapegoating are revealed afresh: from Old Testament accounts in which the transgressions and sins of the people were placed upon the head of a goat, which was then slaughtered or driven away, to current psychological theory whereby families often establish a “designated transgressor” who is blamed for any dysfunction. At the societal level, African-Americans have undoubtedly been the foremost recipients of that dubious honor: In a now-classic study, the psychologists Carl Hovland and Robert Sears found that they could predict the number of Southern lynchings occurring during any given year between 1882 and 1930 simply by knowing the price of cotton. When cotton went down, the frequency of lynchings went up. Not that white Southern racists literally blamed African-Americans every time cotton prices declined; rather, a bad economy led to an outpouring of anger, resentment, and frustration, which was then turned against a conspicuous and powerless minority. The economic and social pain of poor whites was passed on to blacks, without any conscious awareness of the scapegoating involved. The situation was clearly cultural, the process all too “natural.”

We might also want to reconsider “justice” and ask what is really going on when victims demand punishment, nearly always claiming, of course, that they are not out for revenge. But, in fact, aren’t they insisting — although not in so many words — that their pain be offloaded onto someone else? Once the wheels of pain have begun to spin, what really seems to matter is that someone — anyone — must suffer, must be made to “pay.” By the same token, consider the fact that crime victims typically resent the presence of exculpatory evidence, which is likely to lead to an acquittal: If their interest were simply in seeing justice done, shouldn’t they applaud any information that makes it less likely that an innocent person might be punished, and thus more likely that the criminal-justice system will instead spend its energy on finding the real culprit? It appears that the accumulated burden of physiology, evolution, and cultural expectation is so great that redirected aggression typically feels better than no response at all. Revealingly, there is a deep insistence on the part of victims and their families that — by virtue of their suffering — they are entitled to a defendant’s punishment, almost without regard to the matter of guilt. Moreover, the urge among victims to redirect their aggression is so strong that society steps in to make sure that this powerful impulse is handled decorously.

Modern science may even owe its existence to scapegoating, or, rather, to those who were able to overcome the urge to redirect their anger and pain. The argument, in brief, is that when bad things have happened to innocent people, there has been a powerful tendency for those people to seek someone, or some group, to blame. And so Jews were slaughtered during the Great Plague, and accused witches were especially likely to be burned whenever times were hard. By taking out their pain on such supposed transgressors, a burden was lifted from the suffering survivors. Today, of course, we know that people get sick because of disease organisms, not the “evil eye.” The point is that in order for science as we now understand it to have developed, it may well have been necessary for people to stop looking for the causes of disasters — and thus of their pain — in scapegoats and to begin searching in the natural world. In short, we didn’t so much stop burning witches because we had developed science, but ra-ther, we developed science only when we were able to get beyond burning witches.

Denying this impulse has been harder than one might think, since it not only invites physiological and evolutionary distress but also opens other vulnerabilities. (“To err is human,” quipped S.J. Perelman, “to forgive, supine.”) Thus it is one thing to espouse compassion and nonviolence, but we live in the real world, which contains threatening, dangerous, and hurtful individuals, requiring that we ask some hard questions. Such as: What should be done about violent transgressors, notably sociopaths and other perpetrators of evil, those with “poisonous personalities” who act upon their venom? If it is not acceptable to pass along our pain, how should we respond? What will provide order, security, and personal satisfaction, as well as minimizing subordination stress, without simply passing along the pain of the victimized? And without creating new victims?

That leads to another difficult question: If people who seek to hurt others are doing so because they have themselves been hurt, does that diminish their responsibility or guilt? Should we pity the poor perpetrator? Are all victimizers themselves previous victims? And what if they are? Does that let them off the hook? When does passing the pain become passing the buck?

Fortunately, there are ways out of the pain-passing trap. Redirected aggression — and to some extent, violence generally — isn’t inevitable, even though, because of our deeper inclinations, forgiveness is difficult. The world’s great ethical systems have long struggled to define an acceptable defense of victims that preserves personal and collective security without falling into excess. That challenge is particularly appropriate at a time when the word “evil” is bandied about by politicians and extremists to condone war and terrorism, no less than wars against terrorism. Hence we might all be well advised to explore not only how pain and aggression are typically misplaced or displaced, but also how they should be placedwhich is to say, the same way that porcupines are reputed to make love: very carefully.

The world’s oldest wisdom traditions have long been concerned with just that. Pain is prominent in Buddhism, which is founded upon the recognition that suffering is ubiquitous and unavoidable, yet can be minimized. The first of Buddhism’s “Four Noble Truths,” that life inevitably entails pain, is followed immediately by specific methods to reduce suffering, called the “the Eightfold Path.” In addition, among the fundamental teachings of Mahayana Buddhism is the kshanti paramita: “the capacity to receive, bear, and transform the pain inflicted on you by your enemies and also by those who love you.”

Christian tradition, too, venerates and validates the role of pain. Christ’s agony is widely taken as crucially related to God’s redemption of humanity. Hidden within dense layers of theology is this equation, one that is, however, rarely made explicit: the more pain (the more suffering on the part of Jesus), the more redemption for the rest of us. But why? Perhaps because the crucifixion of Christ, who is considered the epitome of innocence, provides an especially potent example of scapegoating as a route to social cleansing. Insofar as Christ suffered (“for our sins”), does that suffering enhance the social, personal, and even biochemical status of the rest of us, helping to overcome subordination stress among his followers?

In a masterpiece of painfully accurate revelation, G.K. Chesterton once wrote that Christianity hasn’t been tried and found wanting; rather, it has been found difficult and left untried. Never has that been more true than in cases of personal pain and our reaction to it. Thus, Jesus urged us to love our enemies, and, if slapped, to turn the other cheek. But for millennia — before Jesus and after — hu-man beings and their animal brethren have been far more likely to respond to pain and injury with a retaliating barrage of the same sort, generating yet more injury, more pain.

Perhaps Jesus did not entirely appreciate the magnitude of the demand he was making upon Homo sapiens, because in asking his followers to refrain from retaliation — to absorb pain without passing it on to someone else — he was asking people to inhibit one of their most widely shared, deep-seated inclinations. Nonetheless, potential solutions are all based on an equally deep, equally shared truth: that human beings, perhaps unique among animals, are capable, at least on occasion, and once the issues are made clear, of acting against the promptings of their often troublesome bio-logic.

Birth Stories by Rachel

October 1, 2007

I am far behind on everything. Have been traveling and finishing grant documents that are due. I am preparing a presentation on cyber bullying. Still, trying to gain trace of my records of retired OB and no longer in existence hospital. So, so much to do but all intriguing and energizing. Meanwhile, here are Rachyl’s birth stories. Be sure to read about her MA thesis, Composing Birth.

The birth of Grey Forest Walt

The birthrite of Samuel Rune

Uterine rupture rates for classical c-section

September 26, 2007

I am considering having a baby with my new husband, which means a lot of research for me as a 38-year old with 2 previous c-sections behind me and I will only consider having a VBAC (vaginal birth after caesarean), preferably a HBAC or homebirth. My incisions were classical, meaning long and vertical and not low and transverse, or horizontal, as most are today. It has been about 13 years since the last c-section.

Here I will compile the beginnings of my findings on uterine rupture rates for incisions like mine, of classical c-sections. This is what comes to light through a cursory search, but I will add more as I find it.

As frightening as this sounds, we know through medical research that uterine scar breakdowns (and especially uterine ruptures) are relatively uncommon events, occurring in 5-12% of classical incisions and 1/2 of 1% of low-transverse incisions.

http://home.cfl.rr.com/dahmd/vbac.htm

by D. Ashley Hill, MD,
OBGYN.net Editorial Advisor,
Associate Director – Department of Obstetrics and Gynecology,
Florida Hospital Family Practice Residency, Orlando, Florida

Prior classical uterine incision is associated with a rate of uterine rupture of up to 12%.

http://www.phyins.com/pi/risk/minimize/vbacs.html

Classic cesarean delivery is infrequently performed in the modern era and currently account for 0.5% of all births in the United States (Chauhan, 2002). In a meta-analysis, Rosen et al (1991) reported an 11.5% absolute risk of uterine rupture (3 of 26 cases) in women with classic vertical cesarean scars who underwent an unplanned TOL. Chauhan et al (2002) reported that the uterine rupture rate for 157 women with classic uterine cesarean scars was 0.64% (95% CI, 0.1-3.5%). All patients underwent repeat cesarean delivery, but a high rate of preterm labor resulted in 49% of the patients being in labor at the time of their cesarean delivery.

Landon et al (2004) reported a 1.9% absolute uterine rupture rate (2 of 105 cases) in women with a previous classic, inverted T, or J incision who either presented in advanced labor or who refused repeat cesarean delivery. These rates of frank uterine rupture in women with classic cesarean deliveries are in contrast to the higher rates of 4-9% that the American College of Obstetricians and Gynecologists (ACOG) had historically reported for women with these types of uterine scars. However, Chauhan et al (2002) observed a 9% rate of asymptomatic uterine scar dehiscence (95% CI, 5-15%). This result suggests that disruptions of uterine scars might have been misclassified as true ruptures instead of dehiscences in previous studies; this error may explain the bulk of the discrepancy.

http://www.emedicine.com/med/topic3746.htm

(Australian VBAC study) Major uterine rupture, before or during labour, after a classical Caesarean section is 5%.

http://www.birthrites.org/guidelines.html

On the other hand, Midwifery Today:

There are a number of contraindications to VBACs that the vast majority of obstetricians and most midwives agree on. Most of these involve significantly higher risks to mother and baby due to increased rates of uterine rupture. There are, of course, anecdotes of successful VBACs in these situations, but the statistics reveal accelerated risks.

These situations include: classical (vertical) scar on the uterus, T- or J-incision on the uterus, previous surgery through the full thickness of the uterine muscle (example, myomectomy), truly contracted or deformed pelvis, inability to perform an emergency cesarean delivery if needed, obstetrical complications that preclude vaginal delivery (example, placenta previa), and a woman’s refusal to have a Trial of Labor/VBAC.

http://www.midwiferytoday.com/articles/vbacprimer.asp

Choosing organizations to support

September 25, 2007

For a few months, I have been participating in ICAN’s online support group, through Yahoo. I have been trying to decide if I would like to become a member of ICAN, but the website offers very little information. Last week I posted a list of my questions but no one has responded, other than to say, that they were forwarding the list to the president of the organization.

Shouldn’t this information be readily available to all? Shouldn’t anyone else be able to answer it?

I will post my email questions and list below.

Not unsurprisingly, some women on the list give answers, such as my membership fee buys me happiness at supporting ICAN’s work. But what is that work, exactly? How do you know what you are supporting? Are you supporting self-appointed board members’ travel to what end? A mission statement is fine, but where are the annual reports, the accountability that shows how people’s money is being used to support the mission statement?

Another example of answers is  “as for who gets what position, I trust the women on the board to choose who they think is best.” Imagine! The irony is that the women who are volunteering answers like this are the same women who say they never should have trusted OBs or the medical professionals because they wound up with c-sections.

Here was my email:

It looks like some good work was done. I have been reading through the ICAN website trying to learn a few things about the organization before becoming a member. But I don’t see answers to several questions:

1. To become a member you must become a member at a local level, achapter, yes?

2. How do members vote for the board members?

3. How do board members become board members if there is no membership-based nomination and procedure?

4. What are the voting rights that come with the membership?

5. In other words, what is the voice of the individual member in the organization?

6. What is the membership “buying” a member? Other than Clarion, discounts?

7. That is, if it is to do advocacy, etc, I don’t see any annual reports that show how the membership fees are being spent or
contributing to the organization’ s goals, so am I looking in the wrong place? I believe NPOs must make public these facts, right?

8. Is there a strategic plan in place? Projected plans for spending/budgets.

9. These open positions do not show on the website, where I was looking to see how one can be considered to fulfill the position. How does that happen, and what is the process for selecting the ones who fill the position?

10. If you can only join local chapter, if you move within a short time, does your membership move with you to your “new” local chapter?

Let us stay tuned to see if anyone will respond.

Simplify

September 24, 2007

There is too much to keep up with. Notes everywhere. Emails fill the inboxes and don’t stop. I need respite! So many good women, and people, and friends want to know what is going on. I have decided that having this blog here can be a good way for them to know what is happening, as well as a good place for me to put all the random extra stuff while I am doing the work on my book and other projects.

Recently, it has been found out that the ICAN “moderators” have been BCC (blind copying) private emails that they start with members of the ICAN support group list. Now I will keep all my emails public to the list, which is a shame, because there have been the starts of what seemed to maybe be the beginnings of good private email friendships with these women who emailed be privately off the list. But who can tell who can be trusted, and who is doing this and who is not? I think that this ICAN acts more like a clique or a club than an organization to be taken seriously.

No doubt I will be writing more about this as time goes on. Very disappointing.