A month or so ago, I was contacted by a reporter, Justine van der Leun, who told me she was a reporter with AOL Health.  She said she had come across my blog while doing research for a story on C-sections.  She said she found my experience interesting and asked if I would be willing to be interviewed for her story.

I haven’t written about C-sections for a while.  I haven’t had a lot of extra time for several months to write a lot of blog posts.  This sounded like a good opportunity that could help raise awareness on C-sections, so I agreed to the interview.  Justine called me a few days later and we spoke for about 30 minutes.  She asked great questions, and said she had been learning a lot about birth because some of her friends were having babies, and also because of the story she was working on. 

Justine thanked me as we were concluding and told me she was going to interview a doctor and then write the story.  I felt like Justine would write a balanced story, but I was cautiously optimistic until I could read the final story.  Sometimes viewpoints and words get misconstrued or used out of context.  

Last week Justine notified me the story was finished and published.  I was on my way out of work, and skimmed it quickly on my phone and I was pleased.  But I wanted to read it when I had more time. When I did I was extremely happy.  Justine did a terrific job with conveying my thoughts on C-sections and birth.  I posted the link to my FaceBook Fan Page, and finally had time tonight to post the link to my blog.

I’d like to thank Justine here, for writing an accurate and balanced story on C-sections.  I hope it will assist women who are researching C-sections.

Here is the link to Justine’s story on AOL Health: Unwanted Cesarean Sections, Getting The Birth You Want

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In September, I met my friends for a girl’s night out.  We all met each other and became friends within 6 months or so of us having our first babies- way back in 2004. 

There are nine of us, Brandy, Amy, Nicole, Heather, Alison, Melissa, Danit, myself, and Julie.  I met Brandy, Amy, Heather, and Julie through a Yahoo parenting group Brandy had started.  Ryan was about 6 months old, and I had no friends who were moms.  I had no idea, or could have known at the time, how vital these friends would become in my life.  Eventually our group branched out into a mom’s night out, and I met Melissa, Nicole, Danit, and Alison. 

Once a month we would meet to just have some time away from the kids, to talk, and to compare notes.  This was before Facebook was up and running, so we stayed in touch every day through the Yahoo parenting group board. I remember at times that seemed like my life-line.  Whenever there was an issue I was facing with parenting, one of my friends was dealing with the same thing.   

Even though we couldn’t meet every day and chat in person, we had access to each other through the phone, computer, the occasional play-dates, and that support helped all of us. We all invited each other’s kids to birthdays, baby showers, and family events.  Most everyone’s husbands became friends too.  We met each other’s parents when they were in town, and somewhere along the line, we became more than just friends- we became a kind of a family-a community. 

Brandy, Julie, and I told each other on the same day in September 2005, that we were pregnant with our second children, and we were all due within weeks of each other in May.   Some days it seemed like we could barely manage what we had, and now we were going to be adding another person to the mix.  Julie and I had also had C-sections with our first children, and we were both determined to have a VBAC birth with our second baby.  That was a leap of faith- going against what the medical ”norm” advises and deciding to trust my body.  I was fortunate to have Julie right there with me, as she decided the same thing.

As the weeks turned into months, and May rolled around, I remember sitting with Julie one morning in her beautiful garden. Julie is a master gardener and always has the most amazing yard.  She was hosting a play group, and our two-year olds were off playing the sand.  Julie and I’s belly’s were so big, it was warm out, and we had a hard time even sitting.  We talked about the impending births, and the way our lives were going to change with a second baby.  After that morning most of my fears were washed away.  I saw an extremely strong, determined, confident, and capable mother in Julie. I knew if she could manage I could too.

Julie had her daughter, Lily, a few weeks before Cole, and she had a successful VBAC.  I was so happy for her.  Her successful VBAC encouraged me that much more that I could avoid another C-section.  When Cole was born two weeks later, it was via VBAC, and when Trajan, Brandy’s son was born a week later, he was born at home. 

In July, 2007 our little group got smaller.  Brandy and her husband, Dax, were moving to Georgia, so he could attend graduate school.  It felt weird we were losing the person who had brought us all together.  We had new moms come and go through the group. But our core was always there.  This was our last girl’s night out before Brandy moved:

Back to front, clockwise, Amy, Me, Nicole, Brandy, Julie, w/ Lily, Heather

Brandy and her family eventually moved back to Colorado last year, but to another part of the state.  Even so, we’ve been able to see her a few times since she has moved back.

 April 2009,

Back to front, clockwise, Heather, Amy, Julie, Nicole, Me, Brandy, Melissa, Danit

In January of 2009, I started a difficult divorce process.  In April I was diagnosed with thyroid cancer, had surgery and recovery for it in the summer of 2009, and in February of this year, my mother passed away suddenly.  My immediate family lives about 50 miles away and was not always able to help me- especially when I was recovering from cancer.

My friends became my family in the town I live.  I would not have emerged from a divorce, cancer, and my mom’s death without their support and love.  Anything I needed, they provided. I didn’t even have to ask- they just came over and did what they saw needed to be done.  One day when I was recovering from cancer, I was barely strong enough to get up from the couch.  I had the boys and it was all I could do to look after them.

There was a knock on my door, and when I opened it, it was Julie.  Julie always has a smile on her face.  I think “sunshine” when I see her.  She had food for me, a book, and flowers.  She had done all the prep work so all I had to do was open the container and eat.  All my friends did things like this for me, but I mention Julie, because this post is about her.  :-)

Julie, her husband, and their two children, are moving to Finland this month for an incredible job offer her husband received.  This was the news Julie told us a month ago at our girl’s night out.  I am thrilled for her and her family- but I am also sad.  I don’t want Julie to move for purely selfish reasons- I am going to miss her.  We all are going to miss Julie- more than I think we care to admit. 

For 6 years now, we have gone through everything together.  From having infants, to post-partum depression, to toddlers, to preschoolers, to school age children, to losing our parents, to adoption, to soccer practices, to cancer, to other medical issues, to moves, to relationship issues, to divorce, to fitness, to Twilight (and Twizzler’s in the nose) obsessions, to once-in-a-lifetime-opportunities-when it has happened to one of us, all of us have felt it.  And we have been there for each other through everything. 

Last week we had our last girls night out for awhile with Julie.  It was fun, and it was like it always had been.  It’s our time to reconnect, talk, discuss, laugh, relax, and enjoy the brief pause in our lives when we aren’t in mom-mode. 

I don’t feel like saying “good-bye” is quite the right thing- I know we will see Julie again, and thanks to Facebook, and blogs, we will all be able to stay in touch  just like we have always done.  But it is her presence – her smile, her laugh, and her warmth, that will be gone from our group- for now. 

 We’ve been through more things in six years thatn some people ever face.  We were all new, clueless, sleep-deprived, scared, and isolated moms when we became friends.  Six years later, we are stronger, wiser, healthier, and less sleep deprived (except for Nicole who has a 4-month old)  , and we are all still friends.  Our children brought us together, but it is our characters that have kept us all friends. That is a unique gift we have all found in each other. 

It is a new start for Julie and her family, and a new adjustment for us.  It would be very easy to put some sad parting words here,  but as I told Julie the other night, I like this quote when thinking about her moving away:

Don’t cry because it’s over.  Smile because it happened. ~Theodor Seuss Geisel (Dr. Seuss)

October, 2010

Left to Right: Alison, Heather, Amy, Julie, Melissa, Me, Nicole

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I’ve wanted to attend the annual BlogHer Conference for four years now, and I was so excited a month ago when my plans were finalized, so I could attend. It is being held in New York in August.   I was also very excited I would be going with one of my best friends, Amy from Crunchy Domestic Goddess.  Amy sparked my interest in blogging years ago, and she inspired me to start my own blog.   

Amy and I live in neighboring towns, so we have been working on getting our airfares, so we can fly to New York together.  While we were exchanging e-mails yesterday, she asked if I heard that Stouffer’s, who is owned by Nestle, was now listed as one of BlogHer’s ’10 sponsors?  I had seen a tag-line or two on it, but had not had time to read up on it.  Amy sent me Annie’s, from PhD. in Parenting, blog post, on this subject. 

As I read Annie’s post and did a bit more research myself, my excitement over BlogHer ’10 turned to disappointment.  Nestle is one of the most boycotted companies worldwide since 1970, for engaging in many questionable ethical business practices.  I personally have an issue with their constant efforts and marketing to undermine breastfeeding.  I avoid buying anything Nestle when at all possible.  Like Annie though, I don’t question others about it, or ask my friends if the chocolate chip cookies they made contains Nestle chocolate.  Like most big businesses, it is nearly impossible to avoid Nestle and their brands completely. 

Eating a chocolate chip cookie from a friend is different though, when faced with the knowledge the conference that I really want to attend is being paid for in part, by Nestle.  Another dilemma I have is my conference tickets were wait-listed.  BlogHer specifically said if they were able to get more sponsors, then more tickets would be available.  Nestle was not listed as an original sponsor. It isn’t too far of a reach to conclude the reason I even got a ticket in part, is because of Nestle’s sponsorship.  

I am frustrated that BlogHer would even consider, let alone accept Nestle as a sponsor.  I accept advertising for my blog through BlogHer, but I have specifically opted out of accepting any formula companies, such as Nestle.  BlogHer is aware of the boycott and the issues surrounding Nestle.  I would have rather not received a wait-listed ticket, and not have been able to attend the conference, than attend with this now black cloud of controversy surrounding it.

It bothers me BlogHer, which supports women in so many aspects, accepted Nestle as a sponsor, when their business practices hurt so many women and their children, especially the most vulnerable in developing countries. 

As a member of the American Cancer Society Blogger Advisory Council, there is an event in New York the day before BlogHer, they are sponsoring for me.  I will be in New York to attend that event.  That is a silver lining- I will be able to see firsthand some wonderful programs the American Cancer Society has, and have no moral quandaries about participating in it.

I wrote my beliefs about the blogging event Nestle hosted last October, and the responsibility we have as bloggers. Two sentences I wrote jumped out at me as I re-read my own words, in light of this dilemma:   

…as bloggers, we need to be responsible to something greater than just a company’s marketing campaigns.

People turn to blogs for honest and trust-worthy information.  If we allow ourselves to be “bought” by any and every company that comes a-callin’ should we be surprised when our collective reputation as a source of unbiased, accurate, and honest information is tarnished and eventually weakened?

Do I attend BlogHer and justify the reasons for myself?  How can I stand by what I wrote about being “bought” when for all practical purposes, I am doing the same thing, now that I am aware Nestle is a sponsor? 

There are bloggers who are boycotting Nestle who are still going to attend, and try to raise awareness on this issue. Others are boycotting BlogHer ’10.  That is their personal decision they have every right to make for themselves.  I am not saying they are right or wrong, but I am going to have to decide for myself what the right decision is.

I have missed BlogHer every year, and right now I feel I could missboycott BlogHer ’10 because Nestle is a sponsor, and I would be fine.  Yes, I’d be bummed, and I would miss out on a lot of good information, community, friends, and fun.  But I would also be able to know without a doubt, I did not compromise on an issue I feel very strongly about when it mattered.  Integrity is easy to maintain, when there is no pressure to maintain it. 

I am considering all my options, and will make a decision soon.  I have spent the last three and a half years, building a loyal readership of my blog, and I appreciate every reader I have.  I feel I have a responsibility to my readers as well.  I don’t want to be a blogger who writes about how important breastfeeding is to babies, women, and our society, and then attends a conference sponsored in part, by one of the biggest companies who undermines it on a global scale. 

One truth is the swing of the sentence, the beat and poise, but down deeper it’s the integrity of the writer as he matches with the language~ Don DeLillo

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I’ve been working with Ryan and Cole for a few weeks now, on cleaning up their playroom, and organizing everything. It is amazing at times how two boys can be so messy.  We started with the bookcase.  I took out every single book- all 500 of them (so it seems) and kept the ones that are age appropriate, and packed up the baby ones. 

Then we started in on the cars, trucks, trains, and anything else with four wheels.  Then I started finding  tire treads everywhere.  Evidently, Cole likes to take the tread off, and then throw all of them behind larger objects in the playroom. 

Every toy has many other little parts, and trying to find all the parts to the toys to put them away is taking so long.  Cole has been practicing cutting with scissors.  There are always scraps of paper everywhere that makes the floor look like Times Square after New Year’s.  Add to that, Ryan now uses the playroom as his “classroom” to play school.  Everytime I pick up a marker, or put a book away, he tells me he needs that- those are his teaching materials.   He really does have a class too.  He’s recruited the neighborhood children, and after they are all home from real school, they are now assembling in our playroom to play school.

The room is a wreck, and on Friday I finally had some more time to work with the boys and I was determined we were finally going to get the playroom clean and organized.  All was going well until five minutes into it, when I discovered “spit balls” all over the place.  When I asked what they were, Ryan said that was his science experiment- he was making paper.  

I told the boys that there was to be no more water in the playroom.  Then I uttered those five words- those five words I heard growing up: “This room is a pigsty!”  The boys looked at me. The rest of the interaction went like this:

COLE: Mommy, what is a pigsty?

ME: A pigsty is where pigs live, and it is dirty, messy, and gross.  Just like this room.

COLE: But we aren’t pigs- we are boys.

ME: But your room looks like where pigs live.

RYAN: Pigs live on the farm, in mud. There’s no mud in here. 

ME: Yes, but their sty is where they live on the farm, and there probably is mud in here- we just haven’t found it yet.

RYAN: When did you see a pigsty? 

ME: I see a pigsty every time I walk in this room.  

RYAN: Pigs like to be dirty.

COLE: Yea, pigs like to be dirty, and we like our playroom.

ME: Well I don’t, and we aren’t going to keep this room like a pigsty anymore.  We are going to clean it up, until we are done.

RYAN and COLE (silence and then): OINK, OINK!

On Saturday we worked all day, and we made a lot of progress.  After the second trash bag was filled, I realized I am a full-fledged pigsty expert. And I remembered this: (watch at the 3 minute mark to 4 minutes)

Clearly, I’m following the universally-accepted-standard-mother sayings.  When we start in on the pigsty room again, I”ll just have to step it up a notch and tell the boys, “if you think this room is going to stay a pigsty, you have another thing coming.” 

I am sure the response will be the same: oinks, and they will probably ask what is the other thing coming is.    

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On February 2, 2010 California Watch, published a story about California’s maternal mortality rate.  It reported the maternal mortality rate in California had increased from 4.3 deaths per 100,000 births in 1996 to 16.9 deaths per 100,000 births in 2006 (the last year statistics are available).

The article cites some factors that are thought to be contributing to this upward trend, and it was not a surprise to me to read that C-sections, and repeat C-sections are one of the main factors officials are finally now considering for the increase in deaths.   The article points out that C-sections are now the number one surgical procedure performed in the United States.

How can California, have such a high maternity mortality rate?  One would think, after the way modern medicine is used in birth today, that the opposite would be true.  This trend is actually not just being seen in California- the entire US maternity mortality rate has also been increasing to the point that it is worse than in some developing countries.  As of 2007, the United States ranked 41st in maternity mortality out of 171 countries.

Officials are now conceding that the increasing C-section rate, might have something to do with the maternal mortality death rate.  As the California Watch article points out, “doctors face a condition called placenta accreta, where the placenta grows into the scar left by a previous C-section. In surgery, doctors must find and suture a web of twisted placental vessels snaking into the patient’s abdomen, which can hemorrhage alarming amounts of blood. Often, doctors must remove the uterus.”

Along these lines, while researching this blog post, I came across an interesting report from The Joint Commission dated January 10, 2010 on preventing maternal death.  It cited a study by the CDC which listed the six leading causes of maternal deaths between 1991 and 1997. The second leading cause was was hemorrhaging, causing 17% of the deaths. The fourth cause was infection at 13%.   The report goes on to identify and cites two out of the four common preventable errors that lead to death were: failure to pay attention to vital signs following a C- section, and hemorrhaging following a C-section.

It is interesting that a leading cause of maternal death is hemorrhaging, and one of the most common errors that leads to death is hemorrhaging after a C-section. The CDC reported on these findings thirteen years ago, and officials are just now seriously considering there could be a link between C-sections and a significant rise in the maternal death rate?   It doesn’t seem like this has been a hidden fact, or that the research wasn’t being done.  This seems more like a case where statistics and research has been emerging for years, but has been largely ignored or brushed off by medical officials.  Until now.  When California’s maternal death rate is worse than some countries like Bosnia or South Korea.

I have my own theory that the higher a state’s C-section rate is, the higher the maternal death rate will be.  While the CDC reports on the C-section rate for every state, not every state publishes their maternal death rates.  I could only come up with an handful of state statistics for 2006 on maternal death rates.  It’s not enough to draw a definite conclusion.  But consider that  Pennsylvania had 19 maternal deaths and their C-section rate was 29.7 percent.  Washington had 20 maternal deaths and their C-section rate was 28.4 percent.  Compare that to California who had 95 maternal deaths and a 31.3 percent C-section rate, and Texas, who had 90 maternal deaths with a 33.2 percent C-section rate.

It’s no secret that other countries who have lower C-section rates also have lower maternal death rates.  In Ireland for instance, the C-section rate averages around 21 percent.  A joint UN/WHO report in 2007 found that Ireland also had the lowest maternal death rate in the world for women dying during or after pregnancy.  Only one out of 47,600 women died, compared with one in 4,800 in the United States.  The C-section rate in the United States in 2006 was 31.1 percent.  It has been projected (but not confirmed yet) that the C-section rate in the US for 2007 will be 31.8 percent.

The California Watch article tells of a medical director in California, Dr. David Lagrew, who in 2002, banned elective inductions at his facility before 41 weeks  or pregnancy, except in rare incidents.  Inductions more than double the chances of C-sections.  The article says,  “as a result, Lagrew said, the operating room schedules opened up, and the hospital saw fewer babies admitted to the neonatal intensive care unit, fewer hemorrhages and fewer hysterectomies.” (bold print mine)

This should have been great news, but as expected, the hospital lost money.   On average a C-section costs twice as much as a vaginal birth.  Yet, we are constantly told that revenue has nothing to do with the increasing C-section rates.  It is because the C-section is “medically necessary.”

If Dr. Lagrew was able to decrease “medically necessary” C-sections in California, right when the maternal death rate was increasing, it ought to be done elsewhere. If Ireland can have the lowest maternal death rate in the world, despite not having all the technological advances that the United States has, and has a considerably lower C-section rate than the United States, that should tell all the officials out there who are trying to figure out why the maternal death rates are increasing, that C-sections are a significant factor in maternal death rates.

It is the white elephant the medical community, and hospitals in general won’t admit, despite research pointing them in this direction for years-decades in some instances.  And yet, the C-section rate continues to climb, and more women are dying during pregnancy and childbirth.

I looked up the modern version of the Hippocartic Oath that doctors take upon graduation.  After reading these, it is hard to be convinced that most doctors have these oaths in mind in regards to C-sections and births in the United States:

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,…”

and the last one:

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

Maybe it is as simple as that.  Maybe if more doctors and hospitals realized a woman’s body is capable in most cases of giving birth without surgery, and let their bodies do what they are capable of doing-just like Dr. Lagrew did, maternal mortality rates would drop in our country. Maybe when ”Big Business” gets out of the birthing process, C-section rates will decline, improving maternal health.

The answers to solving the increasing maternal death rate are out there, and have been for years. The question that demands an answer is, when will the majority of the medical community stop ignoring the answers?

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