2009. A new year - with new challenges, new experiences, and best of all....new babies!
Happy New Year to all who drop by here. And especially warm wishes to the mums, babes, and families who have shared their birthing journey with me in 2008. Thank you for opening up such an intimate and personal life experience to me. I am blessed to have walked the road with each of you.
May the new year be filled with love and laughter, for you and your beautiful babies.
Incidentally, one of my resolutions is to update here regularly. I have been improving over recent months, but I can do better. Lets see if I can make a post every week. Stay tuned.
Image via WikipediaBrowsing the Brisbane Times this morning I came across this article discussing an apparent increase in the number of women requesting elective caesareans for psychological and social reasons.
It's an interesting article for a few reasons. Everyone knows that the caesarean rate has been steadily climbing in the last 10 years - to the point that at 30% nationally, it is now almost triple the rate advised by the World Health Organisation for a developed country. Even the RANZCOG admits that our caesarean rate is too high - that is not in dispute. What has been in dispute though, is why.
Obstetricians argue that we are having babies later, we are fatter, and we are generally more unhealthy during childbearing than our mothers were. They have also been the loudest to proclaim that women are asking them to perform caesareans because they don't want to birth vaginally. Which brings me to the article - I quote.
A National Institute of Health and Welfare report on mothers and babies reveals...a total of 1197, or 6.5 per cent, of caesareans in Queensland were for "psychosocial" or "patient choice" reasons.
So, of all the caesareans being done in Queensland every year, only 6.5% are maternally requested. Six in every hundred. Or put another way, 93.5% of women having caesareans probably got pregnant planning for a vaginal birth. Yep, it seems we are bashing down the doors of obstetricians to book elective caesareans in order to save our pelvic floors, or avoid the agonies of labour.
Our maternity system has some major obstacles to overcome if we are to lower the caesarean rate to anything near acceptable levels. It's incredibly unhelpful to lay blame at the feet of women, and looking at the data near impossible to justify. How on earth have we gone from a caesarean rate of 17% in Queensland in the late 1990's, to double that in only 10 years? It's obvious that there are systemic factors involved here - we didn't all get that old and unhealthy and incapable of birthing babies in just 10 years. Humans just don't "devolve" that quickly. It doesn't make sense.
Hopefully the release of this report will put to rest the claim that large numbers of women having caesareans are asking for them with no medical reason. There are certainly implications here too for the private vs public debate - maternally requested caesareans are often blamed for the massive discrepancies seen in caesarean rates between public and some private hospitals. It looks like that argument won't really stand up any longer either - particularly for those hospitals with rates over 50% (and yes, we have some of those in Queensland).
Late last week my oldest, dearest friend gave birth to her second baby. Like many new mums, the early days of breastfeeding haven't been without their challenges. So by way of welcoming baby Christian earthside, here are some breastfeeding resources that I've found especially useful, both for myself and for my mums.
The ABA is a major source of support for breastfeeding mothers, Australia wide. Their website is a wealth of information - check out their index of articles for detailed, accurate information on literally everything to do with breastfeeding newborns, babies and toddlers. Whether it's a supply issue, attachment problem, breastfeeding in public, or returning to work - you will find help here. The ABA also run free counselling services providing over-the-phone assistance for specific problems. Mothers can also access support groups in their area, enrol in breastfeeding classes during pregnancy, or purchase breastfeeding items via Mothers Direct.
While midwives, GP's and paediatricians may be able to provide basic breastfeeding advice, it might surprise you to learn that their training only covers the fundamentals of human lactation. Lactation Consultants have specific, specialised training in all aspects of human lactation. They are the breastfeeding experts! Their knowledge and experience in breastfeeding will far exceed that of any other health professional - so if you're having problems it is worth cutting to the chase and seeking out an LC. Many will visit you in your home, which has the added bonus of them actually seeing you feed your baby, instead giving advice in a more general context. You can locate an LC near you via the ALCA site.
This video shows infant-led attachment to the breast immediately after birth. Many of my clients are now asking to be supported in this after immediately after birthing. We know that there are many benefits to the establishment of breastfeeding in not separating mother and baby in the first few hours after birth, and in keeping disturbances to a minimum. Hospital routines such as weighing and measuring baby, administering Hep B and Vit K, and physical exams can be left until at least an hour or two after birth to give you and your baby this precious time - mostly it's just a matter of letting the hospital know that this is your preference in your birth plan, and having your partner or doula remind them of this after your baby is born.
Kellymom is one of the most comprehensive and authoritive sources of breastfeeding information and articles online. The site is maintained by Kelly Bonyata, an international board certified lactation consultant (IBCLC). Kellymom also offers an excellent collection of free handouts on breastfeeding and related issues.
The growth charts used to assess normal growth in babies are derived from data obtained from formula fed infants. Babies who are fed formula tend to gain weight differently to breastfed babies - and comparisons between the two can lead to the mothers of healthy breastfed infants being told their baby is not gaining enough weight. This often leads to weaning, or the introduction of supplementary formula. The World Health Organisation (WHO) has now released revised infant growth charts based on the normal growth of breastfed infants. These charts are slowly finding their way into use within the mainstream medical community.
When my first child, Emily, was born four years ago I expected the first months of her life to be a haze of sleep deprivation. After all, that's how it had been for all of my friends who'd had babies - everyone I knew with a newborn had endured that craziness for varying lengths of time. I was prepared for it, and I wasn't going to be caught off guard!
Emily was breastfed, and at ten weeks old she "slept through the night" for the first time. I woke up at 5am, a good eight hours after her last feed and my blood ran cold. I tore into her room to find her sleeping soundly just as I had left her.
She has done this every night since, except for a few nights here and there when she was unwell. Even when teething, she continued to sleep 12 hours a night, uninterrupted.
So two years later, when my son Toby was born - I knew it all. He was also breastfed, and he would be sleeping through too by ten weeks, because hey! - I was an expert. Those of you with more than one child probably already know what's coming. Yes, karma bit me on the backside, hard. No matter what I did, Toby had no intention of sleeping through at 10 weeks. At 10 months he was waking up almost hourly, and I was nearly beside myself coping with a toddler during the day and no sleep at night. That is when it started.
Suddenly, I was inundated with advice, most of which had a common theme: "You need to wean him". Everyone from my husband, my mother, my friends, to our GP said that at his age, he would never stop waking up until I stopped breastfeeding him. Suddenly, this wonderful gift I was giving my son was a tool for everyone around me to use to make me feel that my suffering was somehow self-inflicted - and that unless I was prepared to "do" something about it (ie. wean him), I should just stop complaining.
I didn't wean him because I just knew in my heart that he wasn't ready. He continued to wake at night for a breastfeed, even beyond his first birthday. While it was never as bad as it had been at 10 months, he still woke twice a night without exception. By the time he was a year-and-a-half old, I had long lost any expectation that he would ever sleep through the night.
About month ago, we celebrated Toby's second birthday. And two weeks ago, completely out of the blue, he slept through the night - and he has done it every night since. He's still breastfeeding and nothing else has changed. He was just ready. I know that for him, weaning him early would have achieved nothing in the sleep department - and we would have lost not only our breastfeeding relationship, but probably even more sleep getting up to heat bottles in the middle of the night when he continued to wake up anyway.
Now that he has night weaned by himself, I'm so glad that I kept breastfeeding through the temptation to quit. Breastfeeding babes do sleep through - sometimes at 10 weeks, some not until two years - but just like every other baby, they do it when they're ready and nothing will make them do it before that magical, blessed day arrives.
Now, if you're listening Toby it would be lovely if you'd wean completely by Christmas. But if you aren't ready yet, that's OK too.
Being pregnant and birthing in a society that mostly has an ingrained and widespread fear of birth, is not an easy job.
The messages can be relentless. Birth is dangerous. Birth is degrading. Birth is messy. Birth belongs behind closed doors. Birth is a spectator sport. Birth is the domain of medicine, not of women.
This post is an antidote to all of that. Here are some of my favourite articles and videos that remind me that birth is beautiful, powerful and transforming! Enjoy.
This article has been around for quite some time now. If you've ever been told your pelvis is too small to birth a baby, or this is something that you've wondered or worried about - read and be amazed.
This video shows an unassisted (no midwife/doctor/birth attendant present) waterbirth. Even if you'd never in a million years consider a homebirth or an unassisted birth, this video is still amazing viewing. A little boy is born gently and easily into his mother's waiting hands. I love this video because through it, we can see what is possible.
The first time I read these articles they blew my mind. Sarah's work just appeals to my common sense. So often we hear generalisations about our "hormones and endorphins kicking in" or "just knowing instinctively what to do" in reference to labour. These articles explain exactly how this happens. As well as presenting a bucketload of information on the relationship between birthing hormones, breastfeeding and bonding. I challenge anyone to read these articles for the first time and not have their view of labour and birth changed forever.
Cervical dilation has become shrouded in mystery since birth moved into hospitals. It's so empowering to have the confidence to do this yourself, and really easy once you do it a few times. If you're worried that this is dangerous, think about this - are you more likely to be injured picking your own nose - or letting someone else do it for you? Many women check their own cervix pre-pregnancy as part of natural fertility management, and this is really no different.
If you can't get hold of a copy of the classic book, this article is a fantastic summary and starting point. Janet Balaskas reminded women the world over of what their bodies already knew about the benefits of birthing actively, and putting the mother at the centre of birth.
2009. A new year - with new challenges, new experiences, and best of all....new babies!
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