Category Archives: birth

Why I decided not to have a home birth

This blog post has been in the making (in my head at least) for months if not years. Normally I write a blog post in 10-15 minutes after having thought about it for a while, but this one has taken me way longer. It has had different titles and different angles, but I think this is the final version.

When I was pregnant with Little Brother I was debating whether to have him at home. I wanted to blog about that process but I was afraid that my search of where to give birth would turn into a heated debate and I didn’t feel like putting on my meat pants. So I kept this search to myself. I do however want to share the process after the fact.

“Why would you consider a home birth?” one might ask. I think for the majority of women having a home birth in the US it isn’t about putting videos of your birth on YouTube. It’s about looking for an environment where you feel safe and have your wishes respected where possible. I considered a home birth for what you might call selfish reasons: wanting to sleep in my own bed after having given birth, not wanting a nurse to have to take my temperature while I was pushing a baby out because that was exactly an hour after she had last taken my temperature, not having to drive to the hospital while already in labor, because otherwise contractions might stop on the way in. So I asked my midwife (CNM, not CPM) at my first visit when pregnant with Little Brother whether she thought a home birth was an option (the CNMs in this practice attend births at a hospital, not at home). She told me that even though she thought I would be a good candidate (young, healthy, relatively smooth first birth), she couldn’t refer me to any CNMs because there are no CNMs attending home births in my area.

So I turned with my question to the lady who was my doula at BlueEyes’ birth. She was also the person who gave a child birth class, not hindered by much scientific knowledge (for example explaining how the cervix is a sphincter, which it’s not). And, as an important aside: this is what I hate about the current “child birth industry” as you might call it in the US: it is nearly impossible to find people to educate you about what kind of choices you can make regarding birth, and especially unmedicated birth, that are driven by scientific evidence rather than personal opinions.

So my former doula sent me an email with a bunch of names of CPMs in the neighborhood. I googled them and found some of their names on a listserv talking about learning to suture at someone’s kitchen table. And since I had a third degree tear with BlueEyes birth, that was too difficult for my midwife to suture and required the trained hands of the head of OB/GYN at the hospital, I started to get a bit hesitant about having a home birth attended by someone who learned to suture at someone’s kitchen table.

-For those of you who are going to say that if I wasn’t in the stressful environment of the hospital I wouldn’t have had a third degree tear: I don’t think that was true. I was laboring on my knees without anyone telling me how to push (which seems to be better for your urodynamic factors) but BlueEyes came out in one push with his hand next to his face. Little Brother’s birth taught me that even with very gentle pushing, a super comfortable environment, and my midwife having her hand on my perineum, a hand next to the face still meant a second degree tear in my case.

Also: what would I do if I switched to a CPM for a home birth but my baby would be breech or it would otherwise not be a low risk birth anymore? Then I could probably not easily switch back to my wonderful CNM practice. And would I trust this CPM to know if my baby was breech? And, the most important factor in my decision: you can’t argue with data. The recent release of the home birth death rate shows the home birth death rate in the US is 450% higher than hospital birth. (although these data weren’t there yet when I was deciding whether to have a home birth or not).

Another important reason was that in The Netherlands, where many low risk births happen at home, a significant proportion of women need to transfer at some point during or right after birth (sorry I can’t find this stat anymore, will keep looking to link to it!). What would happen if I would need to transfer in a country where this isn’t happening on a daily basis? Would the CPM dare to go to the hospital or would she be hesitant to take me there because of her fear of a law suit? Would I be in time? And how would the OB on call react to someone having attempted a home birth? What would my insurance say?

I have no answers to these questions because this is where I stopped my search and decided to have Little Brother in the hospital, with the same midwife practice as BlueEyes. It is a great practice where they encourage you to express your wishes and try to adhere to them as much as possible within the boundaries of science and reason. Looking back I don’t even know why I went on this quest of deciding to have a home birth or not but I guess it was necessary to feel that I made the right choice. I might have decided otherwise if I had lived in my homecountry or if my midwifery practice hadn’t existed.

Unfortunately, my midwifery practice is having a hard time staying in business. Not because they have too few patients -they are flooded with patients- but because apparently hospitals are hesitant to have women come in with birth plans and doulas. As Emily Willingham wrote better than I can say it:

“The obvious solution to the controversy is to offer choices that reduce perinatal stress, minimize interventions, and personalize birth—the great appeal of home birth and midwives—while ensuring a safe outcome with well-trained attendants and access to emergency facilities. The absence of options in the United States leaves this solution elusive, especially where hospitals lack a homey, low-stress environment and local midwifery care fails to meet the gold standard. Strange, isn’t it, that our nation, in the 21st century, can’t offer more uniformly safe choices for a low-risk pregnant woman seeking a healthy, low-stress birth for her child … and herself?”

I really wish the kind of care that I had was available for anyone.

I avoid the words “childbirth experience” because it makes it sound like you’re looking for the thrill of a rollercoaster ride instead of the safe and supported process of having a baby. I also avoid the words “natural childbirth” as a synonym for a pain-mediation free birth because what is natural these days? Can you drive your car to the hospital for a natural childbirth? Can you eat GMO-containing food after your natural childbirth and still call it that? I think it’s a weird word. 

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Filed under baby, birth, cultural differences, decisions, doula, health insurance, pregnancy, safety, science

Social media make my maternity leave so much more enjoyable!

I’ve written before that when BlueEyes was just born I had a hard time enjoying all of it. Now that Little Brother is over two months old I think it is safe to say that this time I am enjoying my maternity leave. So what is different this time?

First, I think a major difference is that I knew what was coming. I’m already used to the fact that I am someone’s mother: my personal space is no longer mine alone. I no longer decide when I wake up or how long I sleep, and I got used to caring for someone without having that feel like a huge burden. Also, Little Brother’s birth was a lot less intense than BlueEyes’.

Second, when you’re used to dealing with a toddler, a newborn is really not that much work: they eat, sleep and need clean diapers but that’s it. No arguing about what to wear, no wanting to climb in the carseat by themselves, etc. I have to add that I’m lucky that BlueEyes continues to go to daycare while I’m home with Little Brother. I get quite a lot of work done while Little Brother sleeps in the sling or on my lap. And this is nice, because then at the end of the day I feel like I did something useful.

Third, what really helps is that in my mind, Little Brother going to daycare is really far away. With BlueEyes I felt like I HAD to enjoy every second that I was home with him because soon he would go to daycare. Now, Little Brother is only going to start daycare after we have moved to Europe. And I can tell you that a looming transatlantic move is a really good way to keep your mind off of other things (I have to add though that it is also quite an expensive and time-consuming way to keep your mind off of other things).

But the most important difference is that when I was home with BlueEyes I felt pretty lonely. Going from a busy lab with colleagues to being home all day with a baby was quite a shocking change. Now on the other hand I feel surrounded by funny, interesting and caring people through social media. When I feel lonely I know there’s always people on twitter I can talk to. There’s blogs to read and Pubscience videos to watch. Even though I might not actually see someone IRL all day, at the end of the day it feels like I’ve interacted with lots of people and I find that this makes me very happy. So thank you!

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Filed under attachment parenting, baby, babywearing, birth, blogging, daycare, maternity leave, Pub-Style Science, twitter

The real test to know whether you’re in labor

So you know those lists that help you identify whether you’re in true labor or not? Turns out, the only real way to know is whether you walk out of the hospital with a baby inside your belly or outside*.

This is what he looks like and we’ll call him Little Brother on the internet.

*coming from yours truly, who had to go to the hospital THREE times before actually having a baby. Turns out, you can go to 4 cm dilated with hours of very regular contractions and baby all descended and what not and then go home and wait another 6 (SIX!) days before having said baby.

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Eating dates to speed up your due date?

When you’re very pregnant, even if you’re a rational scientist-type person, you can sometimes not help but googleing “ways to induce labor”. My google even already autofilled it for me, it must know more than me about myself. And instead of reading scientifically sound pieces about what might determine when the baby comes, I find myself reading about acupuncture, castor oil and all that. But wait a minute, what does it say on the bottom of the page? Something about a recent scientific study showing that eating dates has a favorable effect on labor and delivery? I had to check that out.

The paper is from a group of scientists from Jordan, published in a journal with the astonishing impact factor of 0.55, and looks at two groups of 45 and 69 women. One group of women eats at least 6 pieces of date fruit in the four weeks prior to giving birth, whereas the other group eats none. It’s a prospective study, meaning that the women who eat dates are not assigned to that group, which I think is important to notice. The researchers find that in the date-eating group, the women arrived to the hospital more dilated than the non-date-eating group, had their membranes intact more often, had more spontaneous labor, and the use of Pitocin was lower. Also, the duration of the first stage of labor was shorter, but I wonder if that isn’t just the case because they arrived at the hospital more dilated. I don’t know about Jordan, but I could imagine that the group of women who eat 6 dates each day, is a different group of women to begin with. They might be the women who refuse induction with Pitocin, stay home longer before going to the hospital, refuse to have their membranes artificially ruptured, etc etc. We might just be looking at two different groups of women who happen to be different in their date fruit consumption. The researchers conclude: “that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomised controlled trial.” I totally agree with that final sentence.

And for those of you wondering, I have not been eating any date fruits over the last couple of weeks.

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#PubScience #scimom edition


Yesterday I stayed up past my normal bedtime to participate in #PubScience organized by @DrIsis and @MTomasson. We talked about being a parent in science, and you can watch the episode here and below (do it! It’s a lot of fun and an interesting conversation).
I had to leave about an hour in because BlueEyes woke up and needed some comforting. And then I fell asleep, because as I said: this was past my tired-pregnant-self bedtime. Talking about being a scimom.
What I wanted to clarify is that when I talked about one of the parents stepping back to make sure the other can excel in their job, both Dr. Isis and Dr. Rubidium said that that was a very privileged situation being able to take a step back. I agree that parents that have to work double shifts at McDonalds in order to be able to support their families probably have a way harder time than us academics do. But while there are usually people that have a harder time than others in whichever aspect of their life, for me this is still an issue in my life and therefore worth discussing. I see people around me where one of the parents decide to take a step back, taking a job where you are not expected to travel to meetings, you are not expected to work late nights to make deadlines and you don’t need to be in the lab on the weekend because your experiments require that. By doing this, they give up the dream of becoming a tenure track scientist. Even though I think doing this will increase the chances for my husband (and the other way around) neither of us is ready to do this.
Also, while we were discussing all this, on twitter some people were wondering if, after hearing all this, they were ever going to want to have babies. I have this to say about that (and I may have said this before on my blog or anywhere else): For me, having a baby was an entirely different desire than wanting to be a kick-ass scientist (preferable in academia). I know I would be very sad if I would be forced to leave science because I cannot work hard enough/publish enough papers/get enough grants, but I would have been heartbroken if I didn’t have kids. So for me it’s not kids or career, it’s kids and then see how far I can get in my career.

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Filed under baby, birth, blogging, parenting, Pub-Style Science, twitter, work-life balance, working mom

On enjoying your new baby


When BlueEyes was just born, I was overwhelmed to say the least. I read a lot about birth, but almost forgot that the process is supposed to end with the appearance of a baby. I remember when he was just born I heard a baby cry in the room that I was in too, and all I could think was: “please make that annoying sound go away!” It took a fairly long time before I realized that that sound came from my baby. My baby. This little person that I was now responsible for. I was not only supposed to feed and dress this little person, but I was also going to be his mom for the rest of my life. Wow. I hadn’t fully realized that until then. And all of this happened at a time when you’re body is flushed with this ridiculous amount of hormones that changes you from a normally functioning person to someone who will break down in an ocean of tears over nothing.
Add to this the fact that when both your parents and your in-laws live on a different continent they don’t just come to visit for an afternoon, but rather for a week of two, and you might imagine that it took me a while to regain myself. And so when people told me to enjoy the time with my new baby, it sounded a bit like people saying you should enjoy the waves when there’s actually a tsunami. Just making sure BlueEyes was fed and slept and not hijacked by his grandparents was all I could accomplish for a day. Enjoying that really didn’t seem feasible at the time.
Was this postpartum depression? No, I think it’s just normal; I just hadn’t anticipated it. I promised myself never to tell people they should enjoy these first weeks with their new baby, because I had felt how much of a burden it was to not only do all those things, but to also have to enjoy them.
But apparently you forget these things, because today I did just that; I told someone to enjoy her first weeks with the new baby. Apparently I had forgotten about how it really was, and I just thought about a cute little baby and how wonderful it is to hold it and feed it without all of the reality around it. I guess you forget these things and that’s probably a good thing.

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Guest post: Making the postpartum transition easier with a doula

 
Recently, Katie Moore contacted me and asked whether she could write a guest post for my blog. Here it is:
Any mother can attest to the fact that giving birth and the time afterwards can be a challenge.  Many women opt to have a doula help them through the transition into motherhood. Doulas are trained to help a mother before, during and after childbirth. Their skills actually allow them to be useful long after the birth of a child, not only the immediate days following birth.  The use of doulas is associated with increased maternal health and can be helpful to a mother throughout her postpartum period.
The job of a doula is to help a mother learn and enjoy the experience of raising a child.  When used before delivery, a doula can be an educational resource, teaching the mother about options like pain management, umbilical cord blood banking, immunizations and circumcision. They can work with a mother to create a birth plan and work to have that plan carried out in the delivery room.
A postpartum doula performs a variety of jobs in an effort to allow a mother to experience success in raising her child, and to eventually diminish the need for a doula.  Postpartum doulas will stay with a mother as long as she is needed.  This can range from just a few visits to a few months of service.  Depending on the needs of the mother, a doula can be with the mother and child during the day, night, or even overnight. 
Doulas are very helpful during the postpartum period because they give the mother tips on how to handle their new child.  A doula will help the mother gain confidence and experience so that when the doula is gone, the mother has successfully transitioned into motherhood. 
The main concern that many mothers may have is worrying about developing postpartum depression.  While a doula is not a trained counselor, she is very helpful in preventing this type of depression.  A doula is there to ensure a new mother isn’t thrust headfirst into motherhood alone.  She can help a mother slowly transition into her new role. Doulas will also coach the mother on how to eat right and make sure she gets enough sleep.  All of these tasks will make sure that becoming a new mother is not overbearing for the mother, and may help prevent postpartum depression.  
Another worry that some women have is that a doula could interfere with their planned parental approach, but this is simply not true.  Doulas are trained to support the mother’s particular parenting approach regardless of what it might be.  A doula is not there to tell a mother how to raise her child; she is there simply to assist the mother in doing so.  Doulas will listen to the needs of the mother and child, and even encourage the mother to develop her own parenting styles and philosophies. 
Katie is an active blogger who discusses the topics of, motherhood, children, fitness, health and all other things Mommy. She enjoys writing, blogging, and meeting new people! To connect with Katie contact her via her blog, MooreFrom Katie or her twitter, @moorekm26.

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