Monday, March 28, 2011

Hwk 40

Note: Because of my religious beliefs it is very unlikely for me to attend what you call a "cocktail party"...so I decided to make a few changes to the outline...

Last weekend I decided to attend a seminar where Marsden Wagner would be present. He decided to discuss his ideas regarding our flawed maternity system. Towards the end, I was lucky enough to have a conversation with him...

Me: "Hi! Nice to meet you; I would just like to persoanlly thank you for writing Born in the USA: How a Broken Maternity System Must be Fixed to Put Women and Children First. The main idea you wanted to convey to your readers was that women in the United States have lost all control over their childbirth; they are brainwashed into giving birth at hospitals unaware of all the risks they are willing to put themselves into. You want women in the United States to realize this bitter fact and open their eyes to alternatives when thinking about how they will give birth; one alternative is having a home birth with a midwife. The way you carried out your main idea throughout the book with the use of a variety of evidence really made me rethink about birth and pregnancy.

Wagner: "Really, which parts were most effective or important for you?"

Me: "Well, in the last third of the book you focused on trying to come up with alternatives to make our maternity care system better and safer for both the mother and her baby. You were able to open my eyes while providing me with the steps on how as a nation we can help women attain the power to choose how they want their childbirth to occur. You also took what is going on in reality as of now and made the reader aware of it; such as the high amount of trust women have put on doctors, unaware of how this trust is in high risk of being taken advantage of. This connected back to the first 2/3rds of the book. But let me be more specific:

1. On page 205 you stated: "In the midwifery model of care, a midwife develops a close relationship with the pregnant woman over many months and ordinarily discusses whatever is going on in their prenatal visits. With these close relationships, midwifery care is, by nature, much more transparent than obstetric care and midwives are more accountable to the women they serve in such a close, interpersonal way."

2. On page 209-210 you stated: One reason women have been so willing to give up their autonomy when it comes to childbirth is that they are afraid, and much of this fear is the result of ignorance. In modern American society, where most people live only with nuclear family members, there are rarely opportunities for young girls to actually witness childbirth and ask questions. What we have instead are a lot of childbirth books that tell women to trust doctors and turn their care over to them because birth is a medical event and demands highly trained experts."

3. The Patients rights that seem to be ignored by doctors (discussed on page 173-174)

Wagner: "But what could I have done to make this a better book - that would more effectively fulfill its mission?"

Me: "Well, let's be clear - your text sought to provide narratives, historical analysis, journalistic analysis, policy analysis from the perspective of a medical doctor, and an author of many books based on child birth and maternity care, for the book-reading-public to better understand pregnancy & birth in our culture. Given that aim, and your book, the best advice I would give for a 2nd edition of the text would be, to be keep it short and simple; don't repeat yourself. Instead, try to use strong powerful words that will get your point across once and for all. But I don't want you to feel like I'm criticizing your work. I appreciate the immense amount of labor you dedicated to this important issue and particularly for making me think about all the power which is taken away from women in the United States now a days. When comparing ourselves to other societies such as the Middle East, we tend to call their women "oppressed"; yet we don't have enough time to recall events occurring daily throughout our nation today, which seem to show that American women are also oppressed by their societies. It is almost like a burden for these females to choose their birthing plan based on what their society wants from them. In this case, women tend to be brainwashed by the media, therefore causing them to have all decisions made by the doctor with little or no consent at all. Your book has helped me view birth and our maternity care system through a new lens. In fact, I have a totally different view on my future regarding birth.

Wagner: "Thanks! Talking to you gives me hope about our future as a society!"

Tuesday, March 22, 2011

Hwk 39

Wagner, Marsden. Born in the USA: How a Broken Maternity System Must be Fixed to put Women and Children First. University of California Press, 2008. Print.

I would say most of the content discussed in Born in the USA is similar to what is being viewed in Business of Being Born. The main argument is what type of birth the mother should choose; which one is safer for her and her baby? As read in the text and seen in the film we can state the obvious: hospitals are basically factories that are being paid to unnecessarily drug and perform surgeries on females to make way for a new addition to this world. Wagner discusses part of this earlier in the book talking about how many times doctors are not even present at the actual time of delivery. He talks about the good and the bad of having a home birth vs. a hospital birth; Wagner takes his side with the midwives. Later on he discusses parts of the human body such as the nervous system and the role it plays while a woman is giving birth. Both the movie and the text are trying to get the same idea across, but try to approach it using different methods. Business of Being Born lets the viewer decide what sets apart wrong from right. It keeps jumping off from showing a home birth vs. showing a hospital birth. In Born in the USA, Wagner decides to take a side and stays with that side throughout the book. He tries to prove that having a birth in a hospital will only fund a dangerous and sometimes deadly cause.

Where should you plan to have your baby? at the comfort of your home or in the midst of all the hustle and bustle of a hospital? Wagner discusses midwifery in America, then merges into the topic of where a baby should be born. When it comes to giving birth, the mother usually tends to worry about where she wants to have her birth causing her to forget about what matters the most; the actual process of giving birth. I think this is all because of our society; they make pregnant females fear about the unthinkable by forcing unnecessary information into their systems. All this unnecessary information distracts them from what they really need to be caring about.

- The (actual) role of a midwife (pg. 101)
- “Childbirth is not under the conscious control of the woman giving birth...” (pg. 104)
- The legal rights of women (pg. 172)
- Giving birth at home vs. at the hospital, at home the mother-to-be is well aware of her surroundings where as in a hospital it is as if she is being cured for an illness. (pg. 187)
- Cytotec is a deadly drug commonly used to induce labor (discussed throughout the book)

Wagner states: “Fear and anxiety stop intestinal mobility, stop any chance of orgasm. And stop labor. Any intervention that increases a laboring woman’s fear or anxiety will interfere with, slow down or even stop the birth process.” (pg. 104) After doing some research I was able to further prove true to myself what Wagner had stated. There is a limit to how anxious a pregnant female should be; but when this anxiety reaches a certain height, it is not considered the most beneficial for her and the baby. Most women have anxiety because they are not able to share their worries with their partners or care givers. Having high levels of stress can cause a higher chance of delivering an underweight baby or going into pre-term labor. A study shows that because anxiety is a form of arousal, it means that it is able to influence hormone levels which in return cause complications. There are certain types of anxiety such as psychosocial stress or fear of childbirth which have shown connections with complications such as C-section or prolonged labor.

Monday, March 14, 2011

Hwk 38

Born in the USA begins with the author discussing the nightmarish atrocities that are involved within giving birth while living in America. It then starts to talk about different aspects of giving birth such as the option of having a midwife, or where in the USA a woman may want to give birth. The author then decides to end it with a conclusion of his idea of a better way of being born and how we as a country may be able to make an attempt to approach such a theory.

Born in the USA tries to answer a number of questions:
-Why do women living in the USA have a higher chance of death (70% more likely) due to childbirth when compared to places such as Europe?
-Why are methods to deliver a baby such as C-section so commonly used when a wide range of alternatives are available?
-What causes doctors to use such dangerous drugs and procedures in order to have a childbirth take place?

For the last question I think it’s the way our society is set up. We follow a strict set of norms and when someone tries to change it we are oh so surprised. As a society we tend to rely on drugs much more than we need to. We give it to patients who may not need it at all, while others are dying because they are in need of drugs but have little or no access to them.

The main insight so far is that majority of the females giving birth in the United States are prone to following their societal norms of giving birth. They are unaware of the deathly risks they may be taking by making it their choice of how they would like to experience their childbirth. We do not seem to consider the negative effects of making such decisions; instead we automatically tend to do what we have seen or heard others doing. Referring to the hospital has been an old action trigger in our society. When something out of the ordinary occurs having to do with our bodily functions, we simply join the epic race of contacting a doctor. When women are asked how they would like to have their baby delivered (by a doctor or a midwife) they usually have their answer ready “I like the doctor aspect of it.” (Business of Being Born). I think as a society we rely too much on what else but our society; little do we know is that these this is evil entities (doctors in this case) are willing to unnecessarily drug pregnant women, and attempt to perform dangerous surgeries on them, sometimes without their consent.

-Women in America are 70% more likely to die because of childbirth than those in Europe.
-Obstetricians use dangerous, unnecessary drugs and procedures in order to have a childbirth take place.
-Procedures such as a C-section are used when not necessary and almost readily used.
-The current misconduct crisis has been aggravated by the scare of responsibility.
-28 countries have lower maternity-mortality rates compared the USA, while 41 have lower infant-mortality rates.

The evidence used throughout the book so far refers to different types of evidence. Some of it refers to stories about mothers that have had experiences within the “broken maternity system” carried out in the U.S. Some references were made to much bigger branches such as the CDC, ACOG and FDA. Some pieces of evidence were obtained from other texts such as papers written on the topic and guides/books. There was also statistical data obtained from a survey taken at a hospital in Seattle. I feel that the evidence Wagner uses is accurate and reliable. The way he gathered this information from various sources and presents it seems quite honest to me.

Tuesday, March 8, 2011

Birth Book Part 3

Peggy Vincent, Baby Catcher Chronicles of a Modern Midwife, Scribner, 2003.

Precis:
Allah’s Blessing: Hameed and Naeema are a young couple who are very close to giving birth to their second child. Naeema seems to be really calm about this birth; she combs her long hair as if it is a task being used as a distraction towards her nervousness. Hameed has had a total life style change since he became a father with his first child. Collin and Hameed are around the same age; while Collin attends College in Santa Barbra, Hameed attends community college and works two different jobs in order to raise his family and have another addition as well. As a Muslim convert, it is Hameed’s job to fulfill his duties as a Muslim father. Right after his second child is born; Hameed brings his mouth to the baby’s right ear and says an Islamic saying.

Quotes:
“Collin and Hameed skateboarded together a few times after Naeema’s first birth, but those days were part of Hameed’s past. He now shouldered more obligations than people twice his age. While Collin surfed through his sophomore year of college in Santa Barbra, Hameed carried a full schedule in a community college. Four afternoons a week he worked at a camera store, and on the weekends he sold Muslim prayer beads from a booth at a flea market.” (pg. 271)

I feel like young couples don’t realize how big of a responsibility having a baby is. This is often common with females, but this baby hunger takes over the individual and seems to blind them from reality. Unless you have a stable job and a stable lifestyle you will have an extremely hard time to raise your kid. In Hameed and Naeema’s case I feel like they didn’t really take much into consideration before having kids. From what was said about Hameed, it seemed as if he doesn’t have a stable lifestyle for himself let alone his family. He is a young kid himself, but he is forced to act as a mature adult because of the sudden increase of responsibilities. I feel that it is a struggle for him to provide for this family, but at the end of the day he is doing the best he can do with what is in his hands.

“Hameed gulped and sputtered through his tears and put his mouth next to the wailing baby’s ear. His duty as a Muslim father demanded that Allah’s name be the first words his baby heard.” (pg. 274)

This is a really important part of a birth occurring in a Muslim family. I remember when my little sister was born, my uncle said the Azan to her right ear. This is in order to welcome the baby to the world in an Islamic way. I think this is an interesting way for a birth to stand out. It is not common in the states to have this ritual take place. In regular births, the family doesn’t really know what to do right after the baby is born, so they decide to hold it and cuddle it. In Islam you are given a set of rules to follow for each and every situation, so that you never feel lost; especially in such an intense moment such as birth.

“As I packed to leave a couple of hours later, I thought again of the special family this couple had created, bound by youth, love, and their common faith. But I wondered about that Islamic blessing being the first thing this baby girl had heard. Personally, I felt absolutely certain that she’d heard the vacuum cleaner loud and clear, but I decided not to argue the point.” (pg. 275)

From what I have read and heard, babies cause changes between the relationship of the mother and the father. These changes may be for the better or for the worst. In Hameed and Naeema’s case it seems as if this second child has created a closer bond between the family. I feel that this is because both parents tend to be playing their role well. Hameed sacrifices his young age for achieving a study and working two jobs. He has converted to Islam in order to make a straight path that should be followed by his family. I think that this decision will have many positive affects in this family.

Thoughts:
Each religion has a different approach to everything; it depends on the individual and how closely they are willing to follow it. I feel like Islam has a good way of getting its followers to live their life a certain way. Since you are born you are given a certain way to live, you hear Islamic sayings a few moments after you have entered this world. I am not well aware of how other religions welcome new beings to the world, but I feel that Islam provides you with a certain pathway to follow, whereas for others it’s all up to you. In Islam you know right from wrong because it is all given to you, it’s like you have a set of rules you need to follow, whereas in other cultures/religions you have to play this guessing game which tends to become an extra hassle.

Birth Book Part 2

Peggy Vincent, Baby Catcher Chronicles of a Modern Midwife, Scribner, 2003.

Precis:
When Mom is a Midwife: It’s not very common to hear an individual tell you that their mother or wife is a midwife. Peggy’s husband and kids live a different lifestyle when compared to those of their friends. Their mom is always out on call at any time of day 365 days in a year. They can never rely on their mom for being with them at all times. Peggy is lucky to have a husband who has a flexible work schedule which allows her to attend her patients and give them all the time they need. Her kids and husband often find it weird to have a midwife as a mom since its very uncommon to find a frozen placenta in the freezer, and have a mother/wife who has daily conversations with women about their sex lives or the color of discharge they had spotted that day.

Quotes:
“Midwives are risky dinner guests.” (pg. 153)

I think it’s a tough job to keep this label upon ones self. Many people tend to lose contacts and good relations when they miss out on such functions. I know in my culture when someone does not attend a wedding or any other special occasion it is looked bad upon them. I am sure the same applies here; but Peggy has a good excuse and she is well known for obtaining a career as a midwife, so I believe that not many people give her as big of a problem as they would to a common individual.

“With my patients permission, I took ten-year-old Jill to eight births, and she soaked up the drama like someone seeing Swan Lake performed for the first time.” (pg. 155)

I personally don’t feel that it’s appropriate to have your 10 year old daughter accompany you while you help women give birth. In the culture I am from, kids at this age are not used to be aware of such a topic and I feel that this is how it should be. I don’t really have much of an explanation to why but this wasn’t how I grew up. Growing up in a community where it is common to have such topics discussed openly compared to where I am from I feel pretty awkward coming across these situations. If I were to be given such a chance at this age I would deny the offer.

“So Dad’s known as The Midwife’s Husband, and now I’m known as The Placenta Lady’s Son. Great, mom. Just great.” (pg. 157)

I think if I were in Collin’s position I would react the same way. In our society we are not used to being different from others; everybody has this urge to fit in and not stand out amongst others. In this case having a mother as a midwife is something that our society is not commonly known for. When people in the neighborhood heard about their next door neighbor being a midwife their ears stood up; this was something completley different for them. I personally wouldn’t want to be referred to as “The Placenta Lady’s Daughter” because it sounds different and we don’t use this word commonly in our society.

Thoughts:
Most of the reactions I read about from Peggy’s husband and kids were all something I would expect. I would have reacted the same way if I were to be in their position. But I realized that both her husband and kids were really supportive throughout her career. I have never known anyone who has or has had a career as a midwife, but after reading about Peggy and her family’s reactions towards her career I feel like I know all I need to know about a midwife and how she is treated by others in the family. It seems to be a job that not all families can handle. There is a lot of team support needed from all sides of the family in order to help the mother have a successful career as a midwife. There were times throughout this specific chapter where Collin and Rog minded a few things about Peggy’s career, but at the end of the day they accepted that Peggy is a midwife and that’s that. I know if I were to be in the same situation I would be forced to do the same; Even though it would be something I would need to get used to, I would have to accept it and have a positive attitude.

Birth Book Part 1

Peggy Vincent, Baby Catcher Chronicles of a Modern Midwife, Scribner, 2003.

Precis:
Painless Birth: Peggy Vincent talks about her personal experiences of giving birth to her son Collin and daughter Jill. While giving birth to Collin, Vincent experiences some complications caused by her infused tailbone which is normally supposed to function like a swinging door. While in labor she refused to take drugs because she had set her mind on having a birth without taking any medication. But after dealing with hours of unexpected excruciating pains she is forced to ask for half a dosage of drugs. After giving birth she regrets this decision. Once again, 2 years later Peggy finds herself pregnant; this time being in labor isn’t as bad as her first experience. This time she is able to have a natural birthing experience, without any use of drugs and for this she is very proud.

Quotes:
“That little blue book of lies had said, “Pushing is a relief. Finally you can work with your body.” I’d believed it. I’d said it myself to rooms full of unsuspecting, pregnant women. “Pushing will feel wonderful. You’ll love it.” Bullshit. Pushing hurt worst of all.” (pg. 51)

Having obtained a career as a midwife, Peggy believed that her experience with birth would be no problem at all. Little did she know that she knew almost nothing about giving birth; while giving birth to Collin she behaves as if she is totally new to the topic of birth and being in labor. I guess the quote “It’s easier to say than to do” applies here. As a midwife it is Peggy’s job to make the environment as comfortable as possible for mothers who are expecting. Before experiencing labor and birth on her own, Peggy had an opposite approach to such a situation, but after experiencing it herself she feels shameful knowing that she wasn’t much help to mothers she helped give birth.

“Your tailbone’s fused.” The tailbone should operate like a swinging door; mine was latched.” (pg. 51)

From what I have heard being in labor and giving birth is an experience of its own. Each and every woman has a different view on this topic based on their own thoughts, feelings, and what they have heard from others. In Peggy’s case I feel that the situation with her tailbone was like a cherry that topped an ice cream sundae. It was one extra thing she had which made her labor and birth experience special. It was a bittersweet factor which was unexpected and painful at the time, but I am sure that when she recalls this moment she feels somewhat proud of being able to get through this very tough situation. Even though there were some drugs used for Collin’s birth, I feel that Peggy played a fair game.

“We went home the next morning . Joy flooded my whole being, and right behind it came pride. I felt so smug. Smug that I’d figured out how to labor painlessly. Smug that the thought of drugs never entered my mind. Smug that I had a boy and a girl. Smug at how terrific I felt, like miss America with a tiara, cape, and a bouquet of long-stemmed roses. “ (pg. 54)

I don’t really understand why mothers feel so proud about bringing home a new being to their home. I am sure that I will have the same response in the future but why is this? I think this may be a sense of achievement. Dealing with the whole process, such as making all the doctor visits, eating carefully, making sure to take good rest, etc. After giving birth it seems like you are given a reward for all this hard work. You finally get to see what you put all your hard work into; you finally get to see what he/she looks like and what you had been taking such well care of. I think it’s only after giving birth when it all comes true. Before giving birth, mothers seem like they are aware of a fact that is almost impossible to believe, but when they actually get to see that tiny little creature that came from within, only then they are able to believe the truth without any doubt.

Thoughts:
After reading this specific chapter I realized that no matter how much research one may have done on a specific topic, you have learned almost nothing until you have experienced it yourself. I remember earlier in the unit I asked the question “how helpful are parenting books?” As I was reading this chapter I thought back to when I asked this question. Everybody has a different view on each and everything. For birth it seems to be the same case; some mothers have an easier time going through it while others have a harder time with their experience. One child may be born with greater difficulty while the other is born without giving much complication. I think the same applies for the question I had asked earlier. There are a number of methods out there that may help mothers deliver their babies with much more ease, but the author has almost no knowledge until she has experienced it herself. I don’t think these books really do much help to the expecting mother; instead I feel as if it creates more tension for the parents to be, especially the mother. It gives them a number of unnecessary things to think about and gives them an opportunity to think about negative outcomes as well, in return causing overwhelming amounts of stress.