Saturday, April 02, 2011
Birth Camp!! Eugene!!
This past week I took my annual trip to Eugne Oregon for the annual Midwifery Today Conference--where midwives, doulas, childbirth educators learn about how to promote normal, healthy birth. Topics offered included, "Shoulder dystocia and malpresentaitons, 3rd Stage Management, Prevening Preterm Birth...
The thing I love about this annual conference is its a chance for all health care providers to all work towards the same goal--HEALTHIER BIRTH. There were lots more OB nurses this year than I ever remember before...nurses wanting to make positive changes on their L&D floors. I met a wonderful gal, Jen-who is an OB nurse in a hospital in Corning, NY--not far away from Ithaca where I went to college. Jen is absolutely fun, excited about helping moms have healthy births and we hung out lots between going to sessions together and eating meals in between. It was really fun to connect with her. She has such positive spunky energy and I think the moms and babies in Corning NY are VERY lucky to have her as a nurse! She really thinks outside the box.
The presenters I went to were all experienced midwives-most with 25+ years of experience. The most famous one was Ina May Gaskin. She wrote "Ina May's Guide to Childbirth" which I have several copies of in my clinic and refer to her teachings a lot. She has been a midwife for 30+ years, has written many books on birth and is a strong advocate for healthy birth--The Farm, is where she works and teaches in Tennessee. She gets asked to teach at medical schools and help promote normal birth.
I say 'normal birthing' to mean physiological birthing. What happens in birth if midwives, doctors, nurses don't intervene (aside from intermittent occasional monitoring of mom and baby) because many nurses and MD's in today's trainings never see a birth that is without intervention--so there isn't any concept of what a normal uninterrupted birth looks (or sounds) like. Why does this matter? Because unnecessary interventions into birth can cause trauma (physical or emotional) trauma to the mom. And the more medicine intervenes when its not necessary, the more moms and babies get sick during labor/birth. (I cannot emphasize enought.... there ARE times when medical intervention are vital for the health of the mom and baby. It is the overuse of the interventions that is the challenge)
For example, a mom who has an epidural has a 30% higher chance of needing a vaccuum extraction to help birth the baby. This can be very hard on a moms pelvis and pelvic floor muscles. This isn't to say that every epidural causes problems, but some epidurals can cause temporary or long term damage to the woman's body. As a physical therapist I work with women who have post-birth trauma to their back or pelvis from a traumatic childbirth. Pelvic floor trauma can also cause urinary incontense, chronic pelvic pain and sexual dysfunction.
Emotional trauma presents in the form of post-traumatic types of syndromes. Women who felt like they didn't have a say in their birth experience and chain of events lead to unexpected outcomes for them or their baby. This can stay with a woman for days, months or the rest of her life.
Birth can be a powerful, positive experience but it can also be traumatic if a woman isn't allowed to birth as she desires. Medical interventions can (and do) save lives, if not over used. What has happened in our culture of birth, they have been significantly overused and has resulted in a 30+% rate of ceserean section. This means 1 out of 3 women is having major abdominal surgery to have a baby, and this isn't a healthy trend for our birth culture. (the world health organization recommends somewhere between 10-12% cesarean rate for most countries).
On a positive Kodiak Birth note, I looked up the 2009 Birth vital Statistics for curiosity--Kodiak was at an 8.4% Primary C-section rate--this is good progress! The last 5 years, it was inching upwards of 11 percent and now we have the second best rate in the state. (Providence Anchorage has a primary cesarean section rate of 33%! Ouch!! That is seriously high!! Granted, they are getting the high risk moms flown there...which impacts the rate somewhat, but not THAT much? I'd be curious to learn more about their number). There is variability in the c-section rate depending on the year--but it was 4.8% in 2000 and 6.3% in 1999. I think we could get back down to 5% with a little more effort, in whatever form that would be. More Childbirth education, doula support?
I also met up with Patty and John Mahoney who live there now. We went out to dinner and went to their house afterwards where I saw all the wonderful improvements to house and yard they've made since I was there last 2 years ago. My time flies!!
Also--I very much welcome any and at all comments about birth in Kodiak and Alaska. I always enjoy the discussion with friends and family about birth. Share your thoughts, ideas, concerns, etc as a comment...or send me an e-mail! How can we make birth better and better in Kodiak or Alaska or the USA or the world?
INA MAY!!! Her books are (have been and always will be) such an inspiration to women all around the world.
Jen and I!
Elizabeth Davis (yes she is holding a placenta with umbilical cord)
Patty and John in Eugene.