I just finished reading Elizabeth Davis and Debra Pascali-Bonaro's book titled "Orgasmic Birth." Davis and Pascali-Bonaro claim that pregnancy and childbirth parallel the experiences of foreplay and orgasm*.
Their perspective is refreshing because it is so different from the one popularly advertised: pregnancy as a medical "condition" ridden with unfortunate and embarrassing physiological changes or "symptoms" and childbirth as a painful, unbearable process (which, thanks to medical advancements, not all of us have to attempt, but which, for those of us who choose to endure it) is made worthwhile only by its result (i.e. the baby).
While I don't quite buy into the orgasmic birth concept** reading this book (and also having recently read Elizabeth Davis' other book titled "Women's Sexual Passages"***) has helped to quiet some of my original fears and anxiety around the task of giving birth. Having never personally witnessed a labor before and being the first among my friends to become pregnant, I had very little information on this topic 9 months ago. In fact, the only information I had on it was that which I had passively received from depictions of labor in the popular media (which, as I already stated, tend to be negative and SCARY).
Now, after having read a healthy collection of natural birth and obstetrics literature and viewed a number of birthing videos, I think I can say (without having personally experienced it) that I know (to some degree) what to expect. And what I expect is neither orgasmic (sorry Davis) nor scary (sorry everyone else); it is a natural, instinct-driven sensory experience that is physically challenging but not unbearable. And I am looking forward to it!
Any day now... :)
* Doing a bit of interpretation here: they never discuss foreplay, per se; however, their description of a woman's experience leading up to the labor and delivery of her baby bears resemblance (in my opinion) to some components of foreplay. For example, the authors suggest that the period of pregnancy is a time during which the woman must take care to become attuned to the sensations of her body and also to her emotions, turn off the analytic part of her brain, relax and open up, and prepare herself physically and emotionally for the experience of labor.
** I'll believe it when I feel it.
*** In this book, Davis claims pregnancy is a sexual "rite" of passage for a woman, in company with other rites such as menarche and menopause. She posits these are meaningful events in every woman's life and they must be celebrated to promote healthy self-esteem in women. Again, interesting stuff. Definitely hyper-feminist (not saying that there is anything wrong with that...), but a good read for its refreshing and different (I might go so far as to say empowering) perspective.
Thursday, May 26, 2011
My Un-Professional Medical Opinion
I think that I have a somewhat unique perspective on the progress (and treatment) of my pregnancy for a couple of reasons.
First, I have been educated in research design and interpretation (not medical, but applicable nevertheless). My education helps me to better understand and evaluate (not to mention, to proactively seek out and analyze) credible information regarding test results and the progress of my pregnancy. I've found that doctors don't usually share more information than is necessary to sway their patients toward the medically preferred* course of action. Therefore, if you want to make a wholly informed decision (one that is not biased by your doctor, the current medical fashions, or the pressures placed on the medical community), it's often necessary to seek additional information from outside credible sources to supplement what your doctor is telling you.
The rigid structure of prenatal care can make this difficult: the doctors often expect you to make your decision (read: to take their recommendation) at the same appointment, in which they provide you with the "relevant" (read: supportive of the medically preferred next step, ie shaded, one-sided) information. However, I've found that it's possible to delay just about any medical decision by at least one prenatal appointment and I do so frequently. It's a little frustrating for the doctors, but it gives me time to gather and evaluate all relevant information, thus making me feel more confident in my ultimate informed decision.
Second, I understand and feel comfortable putting my faith in statistics. This comes from both my research education and my many years of experience playing and analyzing poker hands. I understand that when there is a less that 1% chance that my baby will have <this>, the odds are pretty good (in fact, they are excellent) that my baby will not have <this>. In poker, if the odds are in your favor and you know this with a high degree of certainty, you (usually) continue with the hand you're holding. I don't see any reason why medical decisions should be treated differently.
Of course, I am less willing to gamble with my baby's life than with my money. But I find statistics reassuring. In the above example of 1%, I like my chances enough not to pursue further tests or, worse yet, to treat my baby with <choice of drug> in case she happens to be in the 1%. Especially in the latter case, 99% of the time I would be exposing a perfectly healthy baby to drugs where none are needed. This is something that I do not feel comfortable doing, but the doctors prefer it.
My medical team likes to cover all their bases and make even the most favorable odds better. In that interest, they err on the side of preventative care. When the doctors see that I am reluctant to take their recommended treatment because I "feel healthy" and/or I "like my odds" just fine, they don't hesitate to try different strategies for my manipulation. What works really well on a pregnant woman? Appealing to her (likely) emotionality and protective instinct. For example, they think that if they say something like "I've had a baby die because we didn't know to treat for <this>," then I will change my informed decision. I find this tactic to be under-handed and abusive, not to mention offensive. I imagine this works on a lot of expectant moms. However, thankfully, my rationality and faith in statistics are not easily rattled by proclamations like this.
As I already mentioned, my unique approach to receiving (read: critically analyzing and attempting to have a modicum of control over) my prenatal care somewhat frustrates the doctors responsible for my care. It also sometimes serves to make those around me nervous: how can I refuse treatment, am I being negligent, etc? Rightfully, people will form their own opinions about this. All I can say is this: I love my unborn baby (probably no less than or more than those who take a different perspective and approach to their prenatal care) and I am acting in what I believe to be (from intensive research and careful deliberation) her best interest.
First, I have been educated in research design and interpretation (not medical, but applicable nevertheless). My education helps me to better understand and evaluate (not to mention, to proactively seek out and analyze) credible information regarding test results and the progress of my pregnancy. I've found that doctors don't usually share more information than is necessary to sway their patients toward the medically preferred* course of action. Therefore, if you want to make a wholly informed decision (one that is not biased by your doctor, the current medical fashions, or the pressures placed on the medical community), it's often necessary to seek additional information from outside credible sources to supplement what your doctor is telling you.
The rigid structure of prenatal care can make this difficult: the doctors often expect you to make your decision (read: to take their recommendation) at the same appointment, in which they provide you with the "relevant" (read: supportive of the medically preferred next step, ie shaded, one-sided) information. However, I've found that it's possible to delay just about any medical decision by at least one prenatal appointment and I do so frequently. It's a little frustrating for the doctors, but it gives me time to gather and evaluate all relevant information, thus making me feel more confident in my ultimate informed decision.
Second, I understand and feel comfortable putting my faith in statistics. This comes from both my research education and my many years of experience playing and analyzing poker hands. I understand that when there is a less that 1% chance that my baby will have <this>, the odds are pretty good (in fact, they are excellent) that my baby will not have <this>. In poker, if the odds are in your favor and you know this with a high degree of certainty, you (usually) continue with the hand you're holding. I don't see any reason why medical decisions should be treated differently.
Of course, I am less willing to gamble with my baby's life than with my money. But I find statistics reassuring. In the above example of 1%, I like my chances enough not to pursue further tests or, worse yet, to treat my baby with <choice of drug> in case she happens to be in the 1%. Especially in the latter case, 99% of the time I would be exposing a perfectly healthy baby to drugs where none are needed. This is something that I do not feel comfortable doing, but the doctors prefer it.
My medical team likes to cover all their bases and make even the most favorable odds better. In that interest, they err on the side of preventative care. When the doctors see that I am reluctant to take their recommended treatment because I "feel healthy" and/or I "like my odds" just fine, they don't hesitate to try different strategies for my manipulation. What works really well on a pregnant woman? Appealing to her (likely) emotionality and protective instinct. For example, they think that if they say something like "I've had a baby die because we didn't know to treat for <this>," then I will change my informed decision. I find this tactic to be under-handed and abusive, not to mention offensive. I imagine this works on a lot of expectant moms. However, thankfully, my rationality and faith in statistics are not easily rattled by proclamations like this.
As I already mentioned, my unique approach to receiving (read: critically analyzing and attempting to have a modicum of control over) my prenatal care somewhat frustrates the doctors responsible for my care. It also sometimes serves to make those around me nervous: how can I refuse treatment, am I being negligent, etc? Rightfully, people will form their own opinions about this. All I can say is this: I love my unborn baby (probably no less than or more than those who take a different perspective and approach to their prenatal care) and I am acting in what I believe to be (from intensive research and careful deliberation) her best interest.
* From my experience, doctors' preferred course of action (at least in pregnancy care) is usually interventionist with a focus on proactive prevention rather than surveillant with a focus (after the fact) on the identification of symptoms and prescription of treatment.
Tuesday, May 10, 2011
Letter to My Daughter
Dear Holly,
My skinny baby. First, thank you for the Mother's Day card. That was very sweet of you to find a pen and willing body all the way in California to write what you wanted to say to me on paper. I appreciate both your efforts!
Thank you also for directing some nutrients to your legs to grow them nice and long. That effort is going to serve you well one day, when you're running energetically through the daydreams of young boys in our neighborhood.
I understand your hesitation to grow belly fat. I share the sentiment. You're a smart girl, so you're probably thinking it's no use storing lipids now in a place where you won't want them later in life. Of course, it seems like you'd be making extra work for yourself down the line. And, like your parents, you are probably interested in minimizing unnecessary effort. However, I want to assure you that it is okay to get a little pudgy around the mid-section. After all, you're a baby and, among other things, babies are thought to be cuter when they are round. I say that not to suggest that you should care deeply about what people think (you shouldn't), but to help you understand that being aesthetically pleasing is in your best interest: there are lots of studies that show that attractive people tend to have an easier time acquiring positions of power, for example.
Is power important to a baby? Absolutely! Think about it.
Now, the doctors are recommending that I keep you under the (Doppler) microscope so that we can monitor your growth. But, I don't want to do that to you. I have faith in you and trust that you will grow in precisely the way you intend and want to, naturally, and without the need for spectators. So, let's make a deal: I will trust you to spread the nutrients around to all areas of your body (so that you're healthy when you join me and daddy in the world) and you can count on me to keep the doctors out of your sanctuary until you show me that you are ready to come out.
Love,
Mommy
My skinny baby. First, thank you for the Mother's Day card. That was very sweet of you to find a pen and willing body all the way in California to write what you wanted to say to me on paper. I appreciate both your efforts!
Thank you also for directing some nutrients to your legs to grow them nice and long. That effort is going to serve you well one day, when you're running energetically through the daydreams of young boys in our neighborhood.
I understand your hesitation to grow belly fat. I share the sentiment. You're a smart girl, so you're probably thinking it's no use storing lipids now in a place where you won't want them later in life. Of course, it seems like you'd be making extra work for yourself down the line. And, like your parents, you are probably interested in minimizing unnecessary effort. However, I want to assure you that it is okay to get a little pudgy around the mid-section. After all, you're a baby and, among other things, babies are thought to be cuter when they are round. I say that not to suggest that you should care deeply about what people think (you shouldn't), but to help you understand that being aesthetically pleasing is in your best interest: there are lots of studies that show that attractive people tend to have an easier time acquiring positions of power, for example.
Is power important to a baby? Absolutely! Think about it.
Now, the doctors are recommending that I keep you under the (Doppler) microscope so that we can monitor your growth. But, I don't want to do that to you. I have faith in you and trust that you will grow in precisely the way you intend and want to, naturally, and without the need for spectators. So, let's make a deal: I will trust you to spread the nutrients around to all areas of your body (so that you're healthy when you join me and daddy in the world) and you can count on me to keep the doctors out of your sanctuary until you show me that you are ready to come out.
Love,
Mommy
Monday, May 9, 2011
3rd Trimester Sonogram & The (Assumed) Infallibility of Obstetricians and Lab Results
About three weeks ago, we had our third trimester sonogram for Holly. Among other things, the doctors use the third trimester sonogram to confirm their estimated delivery date (EDD) for the baby and to verify that (a) the baby is growing properly (or, as I understand it, according to the pattern that is typically observed in the population), (b) the amniotic fluid volume is sufficient to support further growth, and (c) the placenta appears normal and has not implanted at a place that would preclude natural delivery of the baby.
The results from the sonogram suggested that Holly is 2 weeks smaller than expected from her calculated gestational age. Naturally, the OB (who is trained to see pathologies, even where none exist) took this in one of the worst possible ways and suggested that my placenta may not be working properly. Note: the alternative explanations are that (a) the OB's EDD is wrong (wait - "OB" and "wrong" in the same sentence - but that's blasphemy!), (b) the fetus is perfectly normal but just smaller than typical (but that would imply that a degree of deviation from the norm is perfectly normal... weird!), (c) the ultrasound technician did a poor job with the measurements (perhaps due to being distracted or unmotivated that day; hey, it happens!), (d) the measurements are within the normal range of error and therefore normal (note: the ultrasound error rate for calculating gestational age is 2-4 weeks), or (e) there is a developmental abnormality in the fetus.
Per our doctor's insistence, we scheduled a follow-up sonogram for Holly, to allow the doctors to confirm and have peace of mind that she is in fact growing at an acceptable rate. They plan to do this by comparing the two sets of measurements. The follow-up sonogram is this afternoon.
I think that my little girl is already very smart. She heard the re-test was coming and decided to have a nice big growth spurt for the doctors over the weekend. I can tell because my baby bump grew into a baby mountain and I am now feeling her movements much more strongly, which suggests to me that she is crowding out the available space and no longer floating suspended in the middle of the amniotic fluid.
Attagirl!
If she's anything like her mother, she'll shoot the ultrasound technician a smug look at her re-test. :)
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