Quote, Dr. Michel Odent

"Unfortunately, the role of obstetrics has never been to help women give birth. There is a big difference between the medical discipline we call "obstetrics" and something completely different, the art of midwifery. If we want to find safe alternatives to obstetrics, we must rediscover midwifery. To rediscover midwifery is the same as giving back childbirth to women. And imagine the future if surgical teams were at the service of the midwives and the women instead of controlling them." ~ Dr. Michel Odent, MD

Birth Control

It always surprises me how little people know about the medications they are taking. They don't know the names, they don't know what's in them, and they don't know how they work. This is especially true of contraceptives.

I'm not going to get into whether or not birth control is "right". That's a whole other can of worms. I will say, though, that it's shameful for a doctor or midwife to write a prescription for a woman without going over the basic info of the drug or instrument they are prescribing. By the same token, it's irresponsible of a woman to accept or take the meds without asking questions, or at the very least reading the fine print and educating herself (guilty as charged).

So, here's a link about hormonal contraceptives http://www.contracept.org/hormonal.php
Basically, here's a run-down:

"How Hormonal Methods Work
All hormonal contraceptives have at least three mechanisms of action. Artificial female hormones are the active ingredient in all hormonal contraceptives — estrogen and progestin. Some products contain both hormones and others progestin only. Using both hormones together is somewhat more effective than progestin alone, but the estrogen component is responsible for most of the serious health hazards associated with hormonal methods.

Hormonal contraceptives prevent ovulation. No egg is released so sperm cannot fertilize it. It is widely agreed that this is a major mechanism of hormonal birth control.

A woman may ovulate anyway. Hormonal contraceptives may also prevent fertilization by changing the consistency of natural secretions in the vagina, making it harder for the sperm to reach the egg. It is not clear how effective this mechanism is in preventing fertilization.

A woman may ovulate anyway, and sperm may still reach the egg, resulting in fertilization. When this occurs, hormonal contraceptives make it difficult for the embryo to implant in the uterus by keeping the edometrium (lining of the uterus) thinned. This results in the death and expulsion of the embryo. Most scientists agree this occurs, but it is not clear how often. Some doctors do not prescribe hormonal contraceptives because they find this mechanism objectionable. [more about this...] "

For IUDs: http://www.contracept.org/iud.php

"Hormonal IUDs: Hormonal IUDs prevent pregnancy by releasing the hormone progestin, which thickens the cervical mucus, acting as a barrier to prevent sperm from entering the uterus. This type of IUD also affects the lining of the uterus to prevent a fertilized egg from being implanted, should fertilization occur. Progestasert IUD must be replaced every 8-24 months. Since this IUD was discontinued in 2001, any woman who had one implanted should have had it removed by now. The Mirena IUS is the next generation of hormonal IUDs and can be used for up to five years. More about the Mirena IUS...

Non-hormonal IUDs: For copper IUDs, the metal itself seems to exert a spermicidal effect. The copper also affects the lining of the uterus by not allowing a fertilized egg to implant, and it stimulates the production of prostaglandins, chemicals that affect the hormones needed to support a pregnancy. ParaGard is a long-term IUD that may be left in place for ten years. More about the ParaGard Copper IUD... "

So, women, ask questions! Get educated! It's not presumptious to ask your health care provider to sit down and talk for a few minutes. If they don't have time or answers for you, then look elsewhere. A pharmacist is usually much better prepared to answer questions on drugs, and it's their job to take that extra time to discuss it with you.

As for contraceptives, in the end, it comes down to this - when does life begin? If you believe, as I do, that it begins at conception, then this is a good time to evaluate what birth control you are using. Educate yourselves!

Doula Bag

I packed my doula bag today. My client's official due date is the 22nd of January, but if we go by her dates, it's the 15th. She's 100% sure of when she conceived, so I'd rather not take any chances. The 18 week routine ultrasounds can be up to 2 weeks off either way.

I'm not a big gadget fan when it comes to doula bags. I find that if you bring too many accessories, you tend to want to use them all even if the mom doesn't need them. In my experience, the mom gets forgotten amongst all the machinery and doo-dads. My goal is that throughout her labour she will feel that I am paying attention to her needs, rather than trying out whatever new doula fad is going around that particular month. I bring the necessary stuff, and even so, it seems really heavy and bulky to carry around! Here's what goes into my backpack:

*massage oils and massage tool (I prefer using my hands. It's warmer, and it grounds the mom)
*hot and cold packs, both microwaveable and the kind you crack to get the temp going
*water bottle
*essential oils
*rebozo (long scarf to help with back pain)
*fake flickering candles & holders
*hair ties
*suckers
*disposable gloves
*sanitizers
*deck of cards (it can get pretty long!)
*paperwork & birth plan
*The Birth Partner book by Penny Simkin
*enough food and cash for me to last a day
*change of clothes & toiletries for me
*other stuff if I think the mom might need it

The hospitals I work at already have showers, jacuzzis and birth balls. There are many positions and tricks you can apply using the walls, halls, stairwells, chairs, and the birth partner. I'm looking forward to this birth!

Doctor Knows Best?

I was having a visit with a pregnant mom recently. Typical "high-risk", she was in her early forties, previous c-section, and severe vaginal varicose veins. She spoke over coffee, and I listened. She was frustrated and confused. Her general practitioner had warned her not to have a vaginal birth, that if she tore she could easily bleed to death. She had seen a new specialist in the city as well, and he had given the go ahead for a safe vaginal birth. She was afraid to go against her doctor's wishes, and although she wanted to avoid the surgery for all the usual reasons (difficult recovery, trouble breastfeeding, trouble bonding, pain, not being able to care for her baby and family, needing to get back to school immediately...), she scheduled the cesarean anyway. I urged her to get a 3rd opinion from an OB, but our conversation ended with, "Well, my family doctor knows my body better than anyone anyway."

That pretty much sums up the mindset I deal with everyday. How does giving a yearly pap smear and quick 15 minute appointments make a person an expert in your body? Doesn't living in your own body for 20-30-40 years make you the person who knows your body best?

Some of us have bodies who are malformed because of injury or disease. That's true. In this case, it's wise to seek counsel from our midwives and doctors. And that is the message I wanted to convey to this mom - ask! If your gut is telling you one thing, and you're getting mixed messages from the professionals, then keep asking. The peace of mind is worth the work.