When the lights went out

We went to dinner last night at McGrath's Fish House. We we finished eating and the waiter was bringing our check. While we were loading the take home boxes with the kids unfinished meals the lights went off, flickered back on and then went off again, this time they stayed off! (just after 7PM) The emergency lights were on for a few minutes, but then those went off. The waiter came with our check, but we couldn't pay with a credit card. They were trying to figure out what the back up system was. We finally decided to pay with a check and leave. We had gone up to my parent's house in PG and on our way back through Orem, we noticed that the power was still out in this area (including a hotel and Walmart). (around 8:30PM)

Epidurals

80-95% of women today get an epidural. They are so common that most hospitals include them in their standard billing for all vaginal deliveries.

I am not against epidurals. I have had two, one with each of my previous births. They definately have their purpose and place. However, I do not think women are educated enough about them to make an informed decision regarding getting an epidural. I believe getting an epidural has become a cultural norm along with many other birth related practices.

Do you know what is in your epidural? I don't think most women do. I sure didn't! I was never told what medication I was being given and what the side effects of those medications were. The assumption I had was that they give them all the time it must be safe.

Lets explore the epidural together. An epidural is a regional anesthetic agent with a narcotic and/or antihypertensive. Caine-derivative anesthetics used in epidurals. Caine derivatives block nerve impulses and anesthetize blood vessels, causing them to relax and dilate. An epidural is normally a combination of three of these types of drugs. One of the three is a slower acting one; Bupivacaine, which lasts about 1 1/2 to 3 hours. The other two are Chloroprocaine, which lasts from 40-60 minutes and Lidocaine, which lasts from 60-75 minutes. Novocaine and cocaine are the two Caine-derivative drugs we are most familiar with. Epidural dosages fall somewhere between these two extremes.

Additional drugs may also be combined with the Caine-derivative anesthetics. In certain cases a vasoconstrictor, Epinephrine, is added to prolong the absorption of the main drugs. Sometimes an opium derivative narcotic is added to prolong the pain relief. These may include Fentanyl and Morphine. A side effect to some of these drugs is blood pressure changes in the mother. To counteract these changes an antihypertensive drug, Cloridine, is added.

All dosages are determined by the mother's weight. Sometimes the drugs are administered once, repeated, or in a continues drip. One side effect of medication during pregnancy and/or delivery is the possibility that it will cross the placenta and be administered to the baby. In The Physician's Desk Reference (PDR), a well-respected guide to all drugs, their usage, cautions, and side-effects, states the following about Caine derivatives used in epidurals:

"Local anesthetics rapidly cross the placenta (by passive diffusion) and when used for epidural blocks, anesthesia can cause varying degrees of maternal, fetal, and neonatal toxicity. Adverse reactions in the mother and baby involve alteration of the central nervous system, peripheral vascular tone, and cardiac function."

The PDR lists the possible maternal side effects for Caine derivatives: "Hypostension, (low blood pressure: harmful to the baby) urinary retention, fecal and urinary incontinence, paralysis of lower extremities, headache, backache, septic meningitis, slowing of birthing, increased need for forceps or vacuum delivery, cranial never palsies, allergic reations, respiratory depression, nausea, vomiting, and seizures." As well as increased risk of cesarean deliveries and episiotomies. 70% of women experience side effects. Some very rare, but possible risks of epidural include: trauma to nerve fibers if the epidural needle enters a nerve and the injection goes directly into that nerve; a drug overdose resulting in profound hypertension with respiratory and cardiac arrest and possible death; and central nervous system toxicity resulting from an injection directly into the epidural vein.

Considering the weight of the mother and the weight of the baby, it is possible that the baby will receive an overdose. After the baby is born it must metabolize these drugs, partly through it's liver. The liver of a newborn is immature, metabolizing these drugs increases the likelihood and severity of newborn jaundice.

Other side effects in the infant may include: lowered neurobehavioral scores, decrease in muscle tone and strength, lowered sucking ability, respiratory depression, increase in fetal heart rate variability, increased need for forceps, and vacuum.

In a previous post I spoke about how one medical intervention creates a chain reaction. An epidural is one of those medical interventions. When you are given an epidural you face the possibility of having continuous fetal monitoring (this limits your mobility, which increases your birthing time as well as increases your risk of c-section. I may talk about this more later), IV, use of additional drugs, bladder catherterization, frequent blood pressure monitoring, continuous administration of oxygen, and forceps, vacuum extraction, and episiotomies. Epidurals can prolong birthing, leading to the possible need to augment the birthing time with Pitocin.

Learning about why we tend to experience pain during child birth can help to change our attitudes about the need for routine epidurals. Natural child birth is possible. Because of my exposure to Hypnobabies I have realized that you don't have to experience any pain or discomfort during childbirth. It's not about dealing with pain, but relaxing yourself and giving yourself confidence in your body's ability to birth your baby so that no pain is felt at all. Here is a video that shows two women using hypnosis during childbirth, click here.

I've Been Tagged -- Twice!

Erin and Sherry tagged me. Does that mean I have to do 12 things about me? And I don't know 6 people who blog, so I won't be passing this along. Sorry! And I'm not really sure there is anything that is "little-known" about mean, that I actually want shared!

This is a different tag, so here are the rules:
A. The rules of the game are posted at the beginning.
B. Each player lists 6 little-known facts/habits about themselves.
C. At the end of the post, the player then tags 6 people and posts their names, then goes to their blogs and leaves them a comment, letting them know that they have been tagged and asking them to read your blog.

1. I've had problems getting pregnant.
2. I am going to have a home birth ~ ok, this isn't really "little-known", but I don't really have anything to put!
3. I'm the middle of three children.
4. I'm not a good socializer. I don't really like being the center of attention, unless it's one-on-one attention.
5. I do web and graphic design
6. I use to own a scrapbook company

Well, that's all you get! I can't think of 12 things.

Audrey

Audrey is my oldest child (6). From the moment she was born she was amazing. I remember being in the hospital room with my husband and our new baby daughter about 12 hours after she was born. She was looking around, she was looking at us and, she was looking at her hand. We were in complete amazement of her. She just seemed so awake and alert. Not only was she about 12 hours old, but she was also 4 weeks early. I expected a much less developed baby than what we had before us.

I have always felt that Audrey's spirit was more advanced than mine. She picks up on things so quickly and has always been so confident and independent. Audrey is an amazing gift in my life!

Last week there were two things that happened that add to the amazement I feel for this little girl of only 6 years old.

The first: Last Thursday she came home in tears form school. She told me while she was coming home from the bus stop how she was trying to protect a younger child from other's being mean to him. One of the girls (Audrey's same age) that was picking on the younger child grabbed Audrey's fingers on her one hand and pulled them in opposing directions.

I got the details of what happened and had an idea of who the child was. I relayed the incident to my husband and then tried to figure out what we were going to do about the situation. I'd never dealt with anything like this before and didn't know if we had to go to the parents of the other child or if we could go to the school. The decision was made to discuss what happened with Audrey's teacher and see what our options were. The next day I went to the school and picked Audrey up, hoping to talk to her teacher. Her teacher was not there. While walking to the office to leave a message for her teacher Audrey told me she made a new friend that day.

I inquired of her new friend. "It's the girl who hurt my fingers". I was in shock.

"Oh yeah, how did that happen?" I asked.

"There was a boy that we both know that was sitting by himself. I went to sit by him so he wouldn't be alone. She went and sat by him too. I told her that what she did made me feel bad. She apologized." Audrey explained.

I asked her what she wanted to do now about the situation. I wondered how she felt now that she had faced the person who hurt her. She told me she wanted to drop it, that everything was fine now. I told her that it was very mature for her to talk to the person who hurt her.

The second: Audrey has been wanting to bear her testimony at church. She sees other children do it all the time. I explained to her that bearing your testimony is not just getting up there and repeating what every other child has said (you know the standard testimony -- "I'd like to bear my testimony, I know the church is true, I love my mom and dad and brothers and sisters, I know president Hinkley is a true prophet. In the name of Jesus Christ Amen."). Don't get me wrong, this is fine. I think it helps children feel confident to be able to repeat something they've heard many times. They are more likely to follow through with bearing their testimony if they know what to say.

However, this is not what I want to teach my child. She is already very confident, she doesn't need any more confidence. What I want to teach her is what a testimony really is. A testimony is what you believe and why. By that definition, repeating what she has heard other children say is not a testimony. She may believe the same things, but she has come to those beliefs differently than other people. I also explained to her that she would need to practice bearing her testimony at family home evening (something we do with my husbands family).

A few weeks ago she bore her testimony at family home evening. Afterward she proudly announced to me that she would be bearing her testimony in sacrament meeting the next Sunday.

After the first few testimonies I started to feel like maybe she had forgotten. I should have known better. She didn't forget. She asked "Is it time now for me to bear my testimony?" I told her that they were doing testimonies and if she felt ready she could go do it. She grabbed her Book of Mormon and walked up to the pulpit. As a side note: the 1st counselor in the Bishopric got out the stool for her to stand on, but she just shook her head that she didn't need it (she's pretty tall). She began her testimony.

"I'd like to give my testimony on faith. I have a lot of experience with faith. I have a scripture I want to share with you, it's on page 2 Nephi 1:10 - 'having power given them to do all things by faith'. One of the experiences I have with faith is when I lost my shin guards and I didn't want to play soccer without them. I prayed that I would find them and I had faith. And my mom found them. I say these things in the name of Jesus Christ, Amen."

The 2nd counselor in the Bishopric got up to bear his testimony. He said "I have been impressed with the testimonies that have been shared today, particularly, Young Sister Hunter's...." People came up to me afterward and expressed their amazement in how composed she was and the things she said. I felt a bit badly about saying "thank you" to their compliments. Even though I have taught her things that may have helped her to do what she did, it is her that took those things and applied them in her life and used them. Also, I had nothing to do with her being so confident, she was born that way. She has always had a radiating confidence in herself.

Paradigm Shift

As you know from a previous post we are having a home birth assisted by a midwife. Due to the nature of the situation I had been considering pain management techniques, since I will not be having an epidural or medical pain relief. I knew a little bit about hypnosis during childbirth so I decided to do more research about that. I also asked my midwife what she recommends.

She gave me some brochures for different providers for hypnosis during childbirth in our area. Two were for teachers that taught hypnosis and another one that was called Hypnobabies. I wanted to know what the difference was. I found that for hypnosis during childbirth you had to lay down and relax to be in the hypnosis. Hynobabies taught hypnotic anesthesia and eyes open hypnosis. These techniques made it possible to have completely pain free childbirth while still being able to walk and talk. Hypnobabies is also a complete childbirth class.

I signed up to take Hypnobabies from Laura Lund. It is a six week course. Taking this class has opened my eyes to many of the routine procedures hospitals do. In the classes, we have discussed how many of these procedures basically put you on a course to child birth failure. I always just thought you had to do what the hospital said and you had to follow their rules and that they knew best. I have come to realize that this is not the case.

Despite many studies and facts hospitals still continue to have routine procedures that, for normal pregnancies and births, have more risks than benefits to the mother and baby. One standard procedure that I found very interesting was the clamping and cutting of the cord. It wasn't something I gave much thought until our class at Hypnobabies.

This is my experience with clamping and cutting the cord; after the baby is born and the doctor suctioned the baby with a bulb syringe (another routine procedure) the baby was placed on my stomach and the doctor clamped (a clamp was put near the baby's skin and then the remaining blood in the cord was pushed back toward the placenta. The cord was then clamped again a few inches from the first clamp with a surgical clamp) the umbilical cord and handed my husband a pair of surgical scissors. My husband was then instructed to cut the cord between the two clamps.

Trusting the hospital like I did, I never thought this could actually be harmful to the baby. I am still unsure as to why they do this routinely, what benefits do they see to doing this? Some risks include:

• Asphysiation - after birth the baby is still learning to use it's lungs. They are not use to breathing in air and therefore do not function fully in bringing oxygen into the body. The umbilical cord, however, has oxygenated blood in it that is meant for the baby and, left intact, will continue to give the baby the oxygen it needs. If enough oxygen is not delivered to the baby's brain it may cause brain damage.
  
• Inadequate pulmonary perfusion - As your baby tries to breathe for the first time, additional blood volume is needed to fill the blood vessels that go to the lungs to pick up oxygen. If there's no blood flowing in from the umbilical cord, your baby may become hypovolemic, meaning it doesn't have enough blood.
• Educator Joseph Chilton Pearce in his book "Magical Child" makes reference to studies that were done on primates who gave birth in captivity and had early cord clamping. Autopsies of the primates showed that early cord clamping produced unusual lesions in the brains of the animals. These same lesions were also found in the brains of human infants when autopsied. (REFERENCE)

After a normal birth the baby should be allowed to stay attached to the mother through the umbilical cord. This also allows the baby and mother time to get to know each other and the baby to adjust to it's new surroundings in a very loving and gentle manner. When the umbilical cord stops pulsating and the placenta has been delivered, the cord can then be clamped (although not necessary, the cord will clamp itself when it is done delivering the blood) and then cut.

I will write later about other routine procedures that complicate birth and have a domino effect that can lead to unnecessary c-sections.