Kitzinger

For my doula training I have to read The Complete Guide to Pregnancy and Childbirth by Sheila Kitzinger.

I got an older copy out of the library (published in 1996) and in it she says that 20% of women will have CPD (cephalopelvic disproportion). Now, I'm no scientist, but my gut says that this is absolute bullshit. Historically, 20% of women didn't die in childbirth because the baby wouldn't come out. In fact, Childinfo.org reports the rate in Afghanistan (we can probably agree that birthing conditions are primitive here) is 1,900 per 100,000 births - a maternal mortality rate of 1.9%. Where is all the CPD in Afghanistan?

I have to assume that this part has been edited in current editions. Anyone know?

Maddening

I know a woman who is due in a few months. She's young (early 20s) and she's only been married a year. She's petite in build and her husband isn't. He has a big head. The doctor took one look at them and said (wait for it...), "you might have to have a c-section because the baby's head will be too big."

Arrrrgggghhhh!!!!!

She's naive. She's religious, so she's reluctant to read any groovy birthing books (even though there's no prohibition to do so). She's "thinking about" taking some sort of childbirth education class.

I live 4000 miles from her and am not close to her. I'm being updated on the story by a friend.

I just emailed my friend and advised that this woman should hire an experienced doula to be with her. I also said that, as her due date approaches, she should spend time on all fours with her bum in the air to encourage baby to wiggle his head into just the right position.

What else can I do? I know she intends to have a big family and I cringe when I think of her having 6 or more c/s. She isn't the type who would stand up for a VBAC. Oy, I can't stop thinking about her.

Ghosts

I just finished reading Peggy Vincent's The Baby Catcher.

Every home birth she described in the book I imagined taking place in my own home. It's early in the morning here - the time when the edges blur around truth and dreams. My son is curled next to me with one hand resting on my leg. His father's snores temporarily silent on the other side of the bed.

My house is full of ghosts. There's the ghost of me labouring in the bathtub, on the toilet. Another ghost cleans out my kitchen cabinets while laughing companionably with the midwives. A third ghost rests her elbows on the edge of the futon, squatting to push the baby into the world.

Nights like this are hard. I look at my son and thank G-d for every cell of his being, no matter how he came into this world. Then, I grieve for what we both lost.

I can only pray for his continued good health, and for me, a chance to try again - to replace those ghosts with my physical being.

Becoming a Doula

I decided shortly after my son was born that I would like to become a doula. I don't want any more women to have an unnecessary caesarean due to lack of information. I dream of whispering in the labouring mother's ear - reminding her to demand that her doctor give her all the information before she consents to or declines a particular intervention.

Tonight I began my training by attending the first of a 6-week prenatal class - a requirement for attending doula training this winter.

It was amazing. I had taken my own prenatal classes there. I don't know if I ignored what they said (can't imagine I did), if I was distracted, or if I'm looking through a different lens this time, but I heard things I'd never heard before.

The knee-chest position can help an asynclitic baby reposition. Doing lunges while pushing can help move a sticky shoulder past the pubic bone.

Good stuff.

It was traumatic in a way, too. I remembered vividly being in that room with my husband and my belly. I felt the hope of all the families there. I felt renewed pain for the labour and birth I did not experience. I cried more than once and felt silly - I was just supposed to observe. I didn't think I would feel it so deeply.

At times I question my motivation and it seems selfish. Is it wrong to avenge the wrong done to me by helping other women avoid intervention? I think I'm looking at the role of a doula too narrowly. We're supposed to be whatever the mom needs, right? I worry that I won't know.



Oh well, it was only the first day.

They did it!!

Not only did they publish my letter, but check out the headline they gave it:

MDs responsible for rise in caesareans

Times Colonist

Thursday, August 02, 2007

Re: "Canada's caesarean capital," July 29.

How dare the doctors quoted in the article blame the high caesarean rate on women without taking any responsibility themselves.

I, too, underwent what I believe was an unnecessary caesarean at VGH. At no time was I realistically given other options and at no time were the risks of caesarean surgery explained to me.

Labouring mothers in the maternity ward at VGH are very much on their own when it comes to obtaining information. If you as a labouring mom don't ask the right questions, no one will volunteer the information.

The only way the caesarean rate is going to drop is if labouring moms and their birth partners advocate for themselves. Doctors, midwives and nurses aren't going to do it for them.

Kelly M---,
Victoria