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cesarean interview #6

Today you get to hear from my dear friend Mandy. We met our freshman year of college at the sweet age of 18 and we became good friends right away. We’ve been Maid/Matron of Honor in each other’s weddings, I’ve probably seen more concerts with her than anyone else, we’ve shed tears of joy and tears of immense sadness together, she was by my side when we met and simultaneously said goodbye to our firstborn and she’s a trusted confidant through thick and thin. I had the honor of being with her during both of her labors and was one of the first friends to meet each of her girls. Thanks for participating in this project, Mandy - I love ya!

How many children do you have and how many were born via cesarean? I have had two children and they were both born via cesarean section.

If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? Neither cesarean was planned. The first one was for ‘failure to progress’. After that delivery I aimed to have a VBAC (vaginal birth after cesarean) and planned to have a homebirth. All was well and progressing as expected, but during labor I got the feeling that something was not going right and asked to transfer to the hospital. It turns out that a childhood injury led to my tailbone having a malformation and I am unable to deliver vaginally. The doctor estimated that if I have small babies (less than 6 pounds) that I might have been able to deliver vaginally, but both of my babies were near 8 pounds.

Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was extremely unhappy with the first experience and extremely happy with the second. The first time I felt as if I had failed, that my body had failed. I thought that maybe if I had been healthier or stronger I would’ve been able to do it. The second time I felt like had done everything to bring a healthy baby into the world with as few interventions as possible. For me, the least interventions turned out to be a cesarean. It was an incredibly healing experience, much to my surprise. Having a repeat cesarean was my worst fear, but it ended up seeming as if I needed to be cut again to be healed.

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I had some experience with shaming and questions. Most were what I assumed/hoped were well intentioned by other women who were in a similar life stage. It went both ways. I had some women who had planned/unplanned cesareans and were puzzled why I was struggling with my birth experience after my first child was born. Other women wanted to know what had happened and what led to me needing a cesarean. It seemed as if they wanted to know how they could prevent it for themselves. Perhaps that was not their intention, but that is how I felt.

I was unsuccessful at breastfeeding with my oldest child and that is where I experienced the most shame. Each time I gave a bottle I felt a little judged. No one really said anything to me about it, but the shame was palpable from me. It was even worse when I had to begin supplementing with formula. I cried big fat tears when I mixed that first bottle. In a way it did get easier, but I still felt like I had failed and like others thought the same thing.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? Not with my first, but with my second I was! By the time we were being wheeled out of the OR my second daughter was nursing. It was the best feeling ever!

Was there a clear, see through drape between you and Baby at the time of the operation? No, it was a regular white sheet.

If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? Yes, both times.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? The recovery with my first delivery was awful. I developed a hematoma and an infection at the incision site and was very sick while also dealing with postpartum hormones and what I now know was depression. I think I tried to do too much too soon and caused the healing to go slower. It was so much worse and longer than I expected. For a full 5 months my incision seeped and wouldn’t close. I had to actually have it re-cut and stitched in order for it to finally close. The second time was a breeze in comparison. I had little to no pain. I was up and walking the next day (for short trips around the hospital floor)and took it easy. I credit a lot of the ease of recovery to my husband who had more time at home with us the second time around. I was able to rest and recover while he cared for our oldest child and the home.

What are three things you’d like the world to know about cesarean birth?

  1. That women who deliver by cesarean section GIVE BIRTH too. It is not the shortcut or easy way.

  2. Go slow with recovery. I pushed myself to be up and moving and completing tasks on my own before I was ready. It caused me both physical and emotional harm. Hire a postpartum doula, receive the offers of support being offered and allow yourself time to just feed the baby and rest.

  3. If something about your body or your mind seems off, seek help. It could be the incision, breastfeeding, your postpartum hormones/depression/anxiety. There are people and resources that can help!


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cesarean interview #5

Today’s story is from Julie Leonard of Strong Body Strong Mama. If you need a prenatal or postpartum trainer, she’s your girl! Unfortunately, Julie’s first-time birth story is an all too common one laced with trauma, fear, regret and to say the very least, a less than ideal experience. In the years since her child’s birth, she’s worked through her emotions related to how things went and has had two other birth stories that have been redemptive in some way. Thanks so much for sharing this part of your heart, Julie. I really appreciate you.

 How many children do you have and how many were born via cesarean? I have 3 children and 1 was born via cesarean, which was my first birth.

Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? My cesarean experience was very traumatic. I had an emergency C-section with anesthesia. My husband wasn’t allowed in the room. When they wheeled me down to the OR, they started putting belts around my body so I couldn’t move. I was fully dilated, in transition, and my son’s foot was out. I was having intense contractions and was completely restrained. I literally felt like I was on my death bed. I was terrified, alone, and completely out of control. I didn’t get to see my son for hours after the surgery and felt so drugged up when I woke up that when I saw him for the first time, I pushed him away. My whole experience felt very surreal. So, no, I was not happy with my experience at all. I am also not happy with how the staff dealt with my situation. Everybody was freaking out and no one was paying attention to me. I just wish someone would have held my hand or whispered “You will be ok”.

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? No, I didn’t feel any shaming from others. However, I personally felt shame in the fact that I ended up with a cesarean. I felt guilt that I wasn’t able to hold my baby for hours after the birth. What kind of mom is not completely in love with her newborn baby? I felt resentment toward my baby like he was somehow responsible for what happened to me.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? No, I did not since I was unconscious.

Was there a clear, see through drape between you and Baby at the time of the operation? No, I was unconscious.

If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? I didn’t get to see my son until 3-4 hours after the surgery. I tried nursing him at that time but I was still very drowsy. My son was also very drowsy.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? My recovery was way harder than I expected. Part of the problem was that I was completely unprepared for a cesarean birth yet alone the recovery aspect of it. I had spent very little time thinking about a cesarean or what it would entail. I knew a c-section would be painful and recovery would be difficult but what I didn’t really think about was the emotional trauma that could arise and the identity shift that would happen for me as a first time mom. Physically, I was in a lot pain for weeks. I felt numb around my incision for months. Emotionally, I would say it took a year for me to start feeling better. I felt a lot of resentment and sadness associated with how my birth went.

What are three things you’d like the world to know about cesarean birth?  

1.    Cesarean birth is major surgery: you will need lots of rest and time to heal afterwards. Please ask for help.

2.    There is no standard protocol for rehabilitation after a cesarean. Seek help and advice from a qualified pelvic floor therapist or postnatal trainer to help you get started with healing your body.

3.    Cesarean birth IS birth. Make sure you talk about your experience with a partner or a friend to help process your birth experience.

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cesarean interview #4

Carol is the woman whose story you get to read today and goodness, is she a special woman in my life! For the first four years that Matt and I were married, we lived in Bowling Green, OH away from our families and our close-knit friend group. We often felt very isolated, lost and alone up there. Carol and her husband welcomed us into their home for meals, to celebrate holidays and helped care for our young daughter. After a short time, Matt and I felt much less alone and like we had family in our new town. Carol and her husband were (and still are) like parents for us and our children have affectionately referred to them as their grandparents. Though Carol’s cesarean took place over thirty years ago, I’m so thankful for the detail with which she’s able to tell her story. Thank you, Carol!

How many children do you have and how many were born via cesarean? 2 children, 1 cesarean

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I have not experienced this.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? I was given a general anesthesia, so the answer to this is no. Plus I don’t think that this was a thing in the 80s.

If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth?No, because of anesthesia.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? I didn’t think that it was uncomfortable. I nursed the next day without even giving it any thought that I had surgery.

What are three things you’d like the world to know about cesarean birth?

  1. It’s not a failed birth experience. A healthy baby is the goal.

  2. A c-section doesn’t have to mean all births are c-sections. Depending on the reason, ask about a VBAC. Don’t just settle for a repeat without questioning why. My VBAC was in 1986.

  3. After many hours of labor and pushing, it was disappointing to need a c-section. Don’t judge any mother for this happening. You weren’t there. Nor are you likely a medical professional.

Anything else you'd like to share about your experience(s) or that you want the public to know about cesarean birth? I missed out on the first 12 hours of his life because of the anesthesia. Ask before labor about the anesthesia options for an unplanned cesarean. And a c-section shouldn’t mean that you can’t nurse because of the incision. I didn’t even give it any thought.

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cesarean interview #3

Today’s interview is with a woman I’ve never actually met in person! When I was chatting with The WellRounded Midwife about this series she said she had a previous client that might be interested in sharing her story and that’s how we get to hear from Christina today. Thanks so much for your help with this, ladies!


How many children do you have and how many were born via cesarean?
We have two children, one was a cesarean birth.

If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? My 5 year old was born at home and we were planning on a second home birth but during an ultrasound they discovered I had Complete Placenta Previa. So my midwife transferred me to an OBGYN and had a scheduled cesarean at 37 weeks.

Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was pretty disappointed and terrified at first. I really wanted another home birth and with all the potential complications with Placenta Previa. I felt like I just had to do what I was told by the hospital and doctors. My midwife stuck by our side and still gave us her support. She showed me that just because I was having a cesarean didn't mean I couldn't make what I wanted out of it. I took her positive influence and made a birth plan and she discussed with me with my doctor. Everyone stuck to it the best they could, including allowing me to have a music play list. So I guess the answer is yes, I was happy with my experience, not the one I wanted but yes happy with it.

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I have not experienced this, I got more shaming from having a home birth. And having experienced both sides, a cesarean is not the "east way out". I have heard people saying these things in the past but not to me thankfully.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? I was able to do skin to skin in the OR. Since I was early full term, the nurse checked him out to make sure he was okay and then immediately put him on my chest and was able to hold him for the rest of my procedure and she monitored him while he was on me.

Was there a clear, see through drape between you and Baby at the time of the operation? I had a blue drape but once they got my baby out, they removed a piece so I could see him while they cut his cord. Once he was out they put the blue piece back up.

If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? I think it was pretty close to the first hour. He wasn't quite ready in the OR. My midwife was waiting in the recovery room for me. I'm not sure if they would've offered support if my midwife wasn't there but I didn't get any until I got up to my room which was a few hours later. But with my midwife there she was able to help me right away.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? Both, some parts were a lot harder than I thought and some things were a lot easier. I had such anxiety leading up to it that I was so relieved when it was over so the emotional side was easier than expected and I had amazing support excepting what was going to happen. The spinal made me super sick so the first hour in recovery was hard but I had amazing nurses helping with the other stuff. I also built walking for the first time up in my head that when I actually did it, it wasn't so bad.

If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? I did feel prepared between my midwife and my doctor. They tried to help me as much as possible. I also had an amazing team that talked me though everything and they understood what I needed to make me feel comfortable. Everyone did the best they could to stick to my birth plan as much as possible.

What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!)

  1. Just because you're having a cesarean birth doesn't mean you can't make it what you want. Make a birth plan for one, if its planned or not. I like to joke so I tried to make mine as fun as possible.

  2. You still need support!! I would recommend still having a doula or midwife with you. Everyone at the hospital was busy and having her there to support me and my husband was amazing and I'm not sure I physically or emotionally could've done it without her.

  3. Cesarean birth is hard!! I thought it was way more difficult than a vaginal birth and I had fairly uncomplicated recovery with both of my births.

    Anything else you'd like to share about your experience(s) or that you want the public to know about cesarean birth? I know not all women have the same experience that I did, mine was perfect, yes I would've preferred a home birth but this is our son's birth story and yes its very different than my daughter's, but I wouldn't have changed a thing. Don't feel like your body has failed you or your baby, embrace what your body has done, creating this perfect tiny human.

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cesarean interview #2

Today’s interview is with my dear friend Summer who was one of the first girls I met back in our freshman year of college. Back then, Summer was the “mom” of the group always trying to keep us on task and reminding us of what we needed to accomplish at any given moment. It’s no surprise that in the years since then, she’s been an excellent elementary teacher, children’s pastor and mother to her young boys. She had a rocky and scary start on the motherhood journey through her experience with her first son, but she’s risen above the challenge in the way that Summer always does. I’m thankful for her participation in this project.

How many children do you have and how many were born via cesarean? I have 3 children, 2 were born c-section

If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? My first son was a vaginal birth with an epidural. I had nerve damage and I was unable to walk to or even get myself up from a position without assistance. I had to undergo physical therapy and retrain myself to walk again. I had certain areas around my knee that we numb for 6+ months after his birth. I still have numbness on both big toes 10 years after he was born. Since they were unsure what caused this and I have big babies, I opted for a c-section the 2nd and 3rd times because I didn't feel like I could go through that again while having toddlers running around.

Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? Yes I was, I almost passed out after my first son and got to see him much less, I didn't have the strength to hold him very well after he was born. With my c-sections I was blessed to have a nurse from church in the OR with me and she told the doc that if these babies were fine mom was going to hold them immediately. I actually got to do skin to skin and see my second son much faster then my vaginal delivery. My third son I had the same nurse, but he was born with Cystic Fibrosis so they did a few more checks on him, so I had him in my arms as soon as possible.

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I don't feel from any of my friends I have felt that way, no. However, I have felt that vibe from society in general. Social media and just the general vibe.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? Vaginal, not immediately, 1st c-section quicker then my vaginal, and 2nd 2 c-section yes, but it took longer.

Was there a clear, see through drape between you and Baby at the time of the operation? I don't remember (not the girl who wants to see) but my husband was able to see.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? Better then my vaginal due to my experience. I felt like after my first c-section I knew what to expect with my 2nd.

If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? I would say yes.

What are three things you’d like the world to know about cesarean birth?

1. Baby's and Momma's heath are #1. No shame in that game.

2. Making clear your desires can help a lot even through c-section may not be your first choice.

3. You still did it!!! Gave birth.... no one needs to take that away from you!

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Cesarean interview #1

The first interview in my series for Cesarean Awareness Month is with Rebecca Hendrixson, the mother of a dear friend of mine. (She has a fun, sassy blog of her own - go check her out!) She’s experienced three cesarean births over the span of about ten years and while many things have changed in relation to how cesareans are approached since Rebecca’s experiences, there are still things today that could stand to improve. I’m grateful for her perspective on all of this and for her willingness to share this little bit of her story with the world wide web.

How many children do you have and how many were born via cesarean? I have three children and all were born via cesarean.

If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? My first child was 8 pounds 14 ounces and was in a breech position. His little butt was trying to push its way into the world first. My second child had a scheduled cesarean but the plan was if he arrived beforehand, we would experience a vaginal birth. His scheduled date arrived and he was born cesarean. He, too, was a good size, at 8 pounds 4 ounces. My third child was a scheduled cesarean but my water broke two or three days before that date. He was delivered cesarean also. His birth weight was 7 pounds 13 ounces.

Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was young, only 20 years old, when my first child was born. I was scared. I remember feeling the discomfort of pressure on my abdomen during his birth. I also remember the discomfort of the healing process. I feel I wasn’t adequately prepared for that, education-wise. But oh, the joy, the joy of that baby. The other two births were without issue, except I did experience the spinal headache after the birth of my third child.

Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I do not recall having any feelings of being “less than” from external sources because I had my children via cesarean. I think I was a bit hard on myself about it, though. I felt a bit cheated, perhaps, that I did not experience the “normal” process of bringing my babies into the world. Of course, I realized that those feelings were not true.

Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? My children are adults and I know that processes have changed through the years. I do not recall skin-to-skin, unfortunately.  

Was there a clear, see through drape between you and Baby at the time of the operation? No, I believe there was not.

If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? I did breastfeed all three of my babies. I do not remember if it was within the first hour.

What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? As mentioned above, my first recovery was more uncomfortable and for a longer period of time than I assumed it would be. I remember my brother visiting me in the hospital and we laughed about something. He felt so bad because the laughter hurt my belly so much I ended up crying in pain. Funny now, not then :) I also remember after all three births, wanting to pop right back to normalcy in every area of my life, as my sisters did and as my mother, who had six very easy births, had done. The length of recovery physically and emotionally was more of a process than I was expecting.

If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? No, I did not feel very prepared. I had full trust in my health care providers, which is a good thing, but I would like to have had more education for myself. Again, these births were in the late 1970s to mid 1980s. Processes have evolved.

What are three things you’d like the world to know about cesarean birth?

  1. Cesarean births should not be viewed negatively. The reasons must be for the health and wellness of baby and mother, which is always, always the goal.

  2. Try to feel ready. Understand the process. Have all of the information needed to go confidently into the procedure with sweet anticipation, not fear or anxiety.

  3. Regardless of process, all women work hard to carry and deliver a baby.

Anything else you'd like to share about your experience(s) or that you want the public to know about cesarean birth. Yes : ) Cesarean birth is simply a vehicle to bring a life into the world. The process is unique for every woman but the end result is the same - a gift.


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preecclampsia: real stories

I found this story (about an Ohio woman!) on this website and I think it is so encouraging!

A survivor's story: From ICU to 26.2! 

Rachel Yencha in Lakewood, Ohio, knows what it takes to overcome challenges; she suffered preeclampsia, HELLP syndrome, and placenta accreta with her pregnancy in 2015. Rachel nearly lost her life twice during the medical ordeal and spent several days in the hospital's Intensive Care Unit (ICU). The after-effects were also challenging -- Rachel was diagnosed with anxiety, depression, and post-traumatic stress disorder.

Fast forward three years and Rachel has taken on another challenge -- to run the London Marathon in April as a way to raise money for the Preeclampsia Foundation! That's 26.2-miles! She's running as an example of overcoming adversity for her healthy three-year-old daughter.

Rachel is also an example to other preeclampsia survivors and families that commitment to the cause can take many forms, including fundraising. She's already hit her fundraising goal of $2,600 and continues to receive donations from family and friends. Her secret? "You just have to ask," says Rachel. "I'm introverted by nature and I found that setting up a Facebook page for the event helped a lot."

I share this story not to say that every survivor of preeclampsia should strive to run a marathon, but as an encouragement that there is hope and can be triumph after such a scary experience. If you've had preeclampsia and have a happy story to share, I'd love to hear about it in the comments!

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Postpartum Preeclampsia

What, Kelli?! POSTPARTUM Preecclampsia?! I thought that in your other posts you said this is commonly known as a condition in pregnancy and can be treated or cured by the woman giving birth. Well, yes. These things are true, but so is the chance of this taking place after birth.

To say that birth can "cure" the condition leads us to believe they we're in the clear and no longer after delivery. Unfortunately, 97% of maternal deaths related to preeclampsia happen in the postpartum period.

97%.

Thankfully, most women with preeclampsia will deliver healthy babies and fully recover from the condition in the weeks after birth. However, some women will experience serious and often, life threatening complications. A woman’s condition can progress to severe preeclampsia, eclampsia or HELLP syndrome quickly. Delivery (even if pre-term) is sometimes a necessary intervention, but once delivered, moms still need to receive care if she is experiencing high blood pressure and any related preeclampsia symptoms.  

Hear that ladies? Remain vigilant after delivery. 

97% of maternal deaths related to preeclampsia and other hypertensive disorders of pregnancy occur within six weeks after giving birth meaning that the majority of deaths due to preeclampsia happen AFTER a baby is born, when new moms and dads are least expecting their story to turn tragic.

Delivery isn't always the cure for preeclampsia. Any woman can develop preeclampsia after her baby is born, whether she experienced high blood pressure during her pregnancy or not.

Insist that your healthcare provider monitors your health closely after birth, it could save your life.

Learn, memorize and recognize the following warning signs and seek medical attention immediately. If you can't reach your persona physician, midwife, etc. call 911 or get to your closest Emergency Department and let them know you've recently given birth and are experiencing some/all of these symptoms:

  • Blood pressure higher than 140/90
  • Changes in your vision
  • Stomach pains
  • Severe headache
  • Persistent nausea and/or vomiting
  • Swelling of the hands and/or feet

If you experience any of these symptoms, for sure call 911 or have someone get you to the Emergency Department right away:

  • Blood pressure higher than 160/110
  • Shortness of breath or overall difficulty breathing
  • Seizures
  • Seeing spots

Know the signs. Take action. Save a life, ladies. For more information and frequently asked questions about postpartum precclampsia, visit this page and scroll down a ways.

 

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preeclampsia & hellp

If you've never heard of HELLP, you might've seen the title of this post and thought I'd misspelled something, but nope. Its an acronym that stands for:

H (hemolysis, which is the breaking down of red blood cells)
EL (elevated liver enzymes)
LP (low platelet count)

HELLP syndrome was named by Dr. Louis Weinstein in 1982 and it is a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth.

HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren't present. Its symptoms are sometimes mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or other conditions.

Globally, HELLP syndrome is estimated to affect as high as 25% of the population which is why it's critical for expecting mothers to be aware of the condition and its symptoms to try and receive an early diagnosis and necessary treatment.

 

Pregnant women developing HELLP syndrome often experience one or more of the following symptoms, which may at first seem like precclampsia:

  • Headache
  • Nausea/vomiting/indigestion with pain after eating
  • Abdominal or chest tenderness and upper right upper side pain (from liver distention)
  • Shoulder pain or pain when breathing deeply
  • Bleeding
  • Changes in vision
  • Swelling

These symptoms are usually accompanied by high blood pressure and/or protein in the urine and are not things to be ignored. As you've read several times on this blog, I always think its better to play things safe and even seem a little paranoid about things. Be your own advocate for your health and for the health of your baby. If you aren't willing to do it, you can't expect anyone else to do it for you. 

The most common reasons for mothers to become critically ill or die are liver rupture or stroke (cerebral edema or cerebral hemorrhage). These can usually be prevented when caught in time.

If you or someone you know has any of these symptoms, please see a healthcare provider immediately.

Most often, the "treatment" for women with HELLP Syndrome is the delivery of their baby. During pregnancy, many women suffering from HELLP syndrome require a transfusion of red blood cells, platelets, and/or plasma. Steroids can be used in early pregnancy to help the baby's lungs mature. Some healthcare providers may also use certain steroids to improve the mother's outcome, as well. 

Much of the information you've read here can be found on this site and if you'd like more detailed information about HELLP, it is an excellent resource. 

Yes. HELLP (and Precclampsia) can be scary, life-threatening to a mother and/or her unborn child and these things are far too often missed in prenatal and postpartum care. This post is more of a dire one, but its so important to give you the facts and educate you about what can happen. I believe knowledge empowers and I hope that by reading this you feel more well-equipped to take on what could potentially affect your pregnancy or the pregnancy of someone you know. 

Did you have HELLP? Do you want to share your story? I'd love to hear from you.

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preecclampsia

May is Preecclampsia Awareness Month.

This will be the first of four posts related to Preecclampsia. Preecclampsia is a very serious, often very frightening condition during pregnancy and it is important to know some of the facts about it for when/if you or a loved one becomes pregnant. Preeclampsia is sometimes referred to as toxemia or pregnancy-induced hypertension so it is wise to make yourself familiar with all three terms. Read on to learn more about the condition, common risk factors, warning signs and treatment options. 

Facts

Preeclampsia is a disorder that occurs during pregnancy and affects both the mother and her unborn baby. It is a condition that can progress rapidly and is characterized by elevated blood pressure, swelling in various parts of the body and protein in the urine. The cause of Preeclampsia is still not fully understood, though the disease was recognized and described nearly 2000 years ago.

If undetected, Preeclampsia can lead to Eclampsia which is one of the top five causes of maternal deaths, affecting an estimated 13% of maternal deaths worldwide.

Approximately 5-8 % of pregnancies are affected by Preeclampsia which means that more than 6.6 million women worldwide suffer from the disease.

In the United States Preeclampsia is responsible for approximately 18% of all maternal deaths.

Preeclampsia causes 15% of premature births in industrialized countries and it the number one reason doctors decide to deliver a baby prematurely. 

Risk Factors

  • Women who have had more than one pregnancy.
  • Women who are obese.
  • A medical history of chronic high blood pressure, diabetes and/or kidney issues.
  • Previously diagnosed hypertension, kidney disease, connective tissue disease (i.e. lupus, rheumatoid arthritis)
  • Pregnancy in early teems or past the age of 40

Warning Signs

Unfortunately, in the majority of cases, warning signs of Preeclampsia aren't noticeable. Women might experience frequent headaches, blurred vision, upper abdominal pain and/or unexplained anxiety... but many pregnant women complain of these things and aren't preeclamptic so it can be hard to detect.

Dramatic weight gain, an inability to urinate freely (or a great decrease in amount released), and persistent nausea, often paired with abdominal pain may be reasons to watch a woman more closely for the development of Preeclampsia which typically (but not always) occurs in the late 2nd or 3rd trimesters of pregnancy.

Treatment

The only true way to "treat" severe Preeclampsia is for the woman to give birth. Doctors take the baby's gestational age, the stage of the baby's development and the mother's overall health condition before proceeding with plans for early delivery, of course. 

If detected early enough and the mother has a good home support system, sometimes she can manage mild Preeclampsia with bed rest, frequent OB visits, and she might need to monitor her blood pressure at home on a regular basis.

If you're pregnant (or someone you know is pregnant) and end experiencing any of these problems  or if you've read through this and question if you have Preeclampsia, call your healthcare provider right away. And if the person on the phone doesn't take you seriously, ask to speak to someone else in the office and carry that on until someone hears you out and gets you an appointment as soon as possible. Maybe its nothing, but maybe its something and its always better to play it safe when your life and the life of your unborn child is concerned.

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cesarean interview #7

What an amazing month this has been hearing from the brave women who've been so kind to share their birth stories with me and all of you. I hope that by reading through these real life accounts of birth you've not only learned something new, but have also realized that you're not alone. Whether you've given birth vaginally or through a surgery like the women I've featured this month, you're likely to have encountered some of the same thoughts and feelings as they have. Birth unites us as women and more than anything, we have this incredibly miraculous superpower in common. Let's stop comparing and shaming and replace that with holding each other up and finding that the list of our similarities as women far outweighs the list of our differences.

The final interview of the month is from my dear friend Lindsay. I met her when her first child was a few months old and we hit it off right away. When her second child was born, she had just moved halfway across the country and I couldn't support her in the ways I wanted to as she recovered from birth. Its been a journey with her as she's processed her birth stories over time and I'm proud of how far she's come.

  1. How many children do you have and how many were born via cesarean? I have two children who were both born via cesarean.

  2. If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? I had my first via cesarean, which was not as I planned and so tried for a V-BAC with my second child. I labored naturally all night and then after another nearly four hours of pushing, my baby girl's heart rate started to drop (similar to what happened with my son and my first birth) and the doctors were very concerned because she was not descending. I was rushed into an emergency cesarean and my uterus ruptured immediately. My daughter was not breathing on her own but she began breathing fairly quickly so they did not have to intubate her. We had survived.

  3. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? So hard to answer... I would not say I was happy with my experiences of having two cesareans, but that I have over the years made peace with how my births went and that I am beyond grateful to have two beautiful, awesome (if exhausting at times:)) children. I think that in my first birth I would have liked to have more knowledge and information to empower my decisions before going into it.. I had read and made a birth plan, but I do think having a doula might have helped though my midwives were amazing. Once my son's heart rate began dropping multiple times, my "plans" went out the window and I only cared that he was brought to this side of Earth safely!

  4. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I definitely carried shame and maybe embarrassment for years about not having birthed naturally-often brought on mostly by my own expectations of what ideally motherhood should start as (which I soon learned is that motherhood is full of ideals and ideas that can be overwhelming and NO one can live up to what is "ideal",  that's the part of us all being human in my opinion that can level the playing field in a wonderful way). 

  5. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? I was not able to do skin to skin with my first child- I remember them putting him close to my face as tears rolled down but the fact that I was strapped down on the table was so frustrating- at that point I was so out of it because of the epidural (huge impact on me where I felt nearly paralyzed from the neck down), and so again my thoughts of what I wanted that first hour to look like disappeared (I don't think I was informed as I was with my second about the importance of that first hour).. I was not able to have any skin to skin contact with my daughter as she was rushed to the NICU and they were trying to save me from a complete hysterectomy (they were able to repair my bladder and uterus). It was so hard to not be able to even see her or touch her, again not what we planned.

  6. Was there a clear, see through drape between you and Baby at the time of the operation? There was no clear drape in either cesarean.

  7. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? I was not able to try nursing in the first hour with either, and with my daughter they began giving her formula before I was even able to see her (it was hours but I had not been able to consent). 

  8. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? I don't know of recovery from a fully natural birth so I only have my experience. However, with my second cesarean, I had labored and pushed so much that I had the pain of the incision from the cesarean as well as the lovely pains from pushing too (though I wouldn't have traded being able to experience the natural birth experience for less pain). It was incredibly frustrating to feel like there was "less I should do" because of having had surgery and for me it added an emotional weight and sense of shame that I wasn't able to mother the way I wanted those first few days and weeks. With my second, I learned to listen a little less to others and trust my body more but still had to be careful.

  9. If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? Neither were planned so while I felt I had great providers (especially for the first birth), I think it might have been helpful to even talk about it ahead of time so there may have been less surprise, fear and more knowledge and feeling empowered on my part. I think in my mind there was a sense of denial about it being a possibility (because I didn't want it to be an "option") but in reality it might have prepared me a little more to feel like I could have some sense of control when things felt very out of control.

  10. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) 

    1. There is NO easy. Cesareans are not the "easy way out". Bringing a child into the world, whatever way possible is the most incredibly, amazing, challenging thing a human can do (in my humble opinion).

         2. To medical professionals: The person in front of you is not just another medical record or patient, this person is a person who has fought to bring her baby into this world, treat her and this baby with respect and dignity; Slow down and treat them as people (that is why you went into this field I hope, you maybe like people); Give them space to make informed decisions. To family members: Give space and support, less words and "wisdom"... women know their own bodies and have done an amazing thing by giving birth, so support and trust them.

     3. Helping women feel freedom to share their birth story without shame and with power can unite us so we can encourage and learn from one another (I have this great friend, Kelli Blinn who taught me a thing or two about this and is continuing to do amazing work). 

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cesarean interview #6

Today's questions were answered by yet another wonderful neighbor of mine, Pam. I've gotten to know her through chats at the playground, lots of text messages, frank conversations about the highs and lows of life, and some social hangouts. Her oldest is five years old and her youngest was born in September of last year. Like so many mamas I speak to, much of Pam's first experience with labor and delivery was traumatic and it absolutely bums me out. I hope that one day we all live in a world where first-time birth stories involve far less disappointment, trauma, heartache and grief. 

  1. How many children do you have and how many were born via cesarean? 3 children all delivered via cesarean

  2. If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? I had my 1st cesarean after 30+ hours of labor, an unreal amount of pitocin and other drugs, and declining maternal health. Another doctor came in to consult. His opinion was there was a slight chance vaginal labor could still be an option, but if it was they would need forceps and the delivery would likely cause a fair amount of trauma both to my body and the baby. I remember feeling that my family and medical staff wanted a vaginal delivery for me because they knew that’s what I hoped for so they kept pushing for it. It never occurred to me that I could say let’s stop this and do a cesarean. Once the other doctor offered cesarean as an option I remember feeling very certain it was the best plan.

    My second cesarean was scheduled, however after a regular office visit the doctor sent me to the hospital to deliver early because of my declining health. I never questioned having a second cesarean. It felt like the safest option for me.

    I remained healthy throughout my third pregnancy. We scheduled a cesarean fairly early and I really didn’t question it until the final weeks in my pregnancy. All my numbers were good, I was actually going into delivery healthy. I did ask my doctor if she would consider doing a vbac. We discussed it and ultimately she said no. I was ok with that answer, I wasn’t really sure it was what I wanted but I knew I needed to have a conversation about it.

  3. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? My first was very traumatic. I went into it very ill and exhausted from hours of labor. Because of the pregnancy complications I wasn’t allowed to eat or get out of bed for 24 hours post delivery. I was also not allowed to be alone with my baby for the 1st 24 hrs. I was confused, sore and pretty sick.

    My second was a completely different experience. But I wasn’t prepared for the lack of support. Because I had been under pretty intensive care with my first I wasn’t able to decipher what was “normal” and what was the “exception.”

    My third was seamless in comparison. By this point my body knew what to expect, my expectations were realistic.

  4. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I ask this because many women have shared that they’ve almost felt bullied by other women who had vaginal births and have been told that cesarean was “the easy way out” or “not real childbirth”. I hate to even bring this up, but its a real thing in our culture and I’d love to hear your take on this if it is something you have experienced. No. I have mourned that I won’t experience a vaginal birth and along with that I have experienced judgement about my sadness.

  5. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? My first no. Second, a nurse held her on my chest for a few minutes, the baby was swaddled. My third we were skin to skin within 8 mins of delivery. I think part of this was because I started the conversation early and often. 

  6. Was there a clear, see through drape between you and Baby at the time of the operation? No

  7. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? My first I really don’t know. My second yes. Third she began to nurse on the operating table. 

  8. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? For my first it was overwhelming and I was not prepared at all. I was exhausted and sore. I was both physically and emotionally drained and really no one in my network seemed to understand what I was experiencing. Many tried to be supportive, but just didn’t know how to support. My second was easier than my first, but still painful. My third felt easy by comparison. 

  9. If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? My preparation only came with experience and subsequent cesareans. 

  10. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) 

    *The scars are both physical and emotional.

    *I grieved not being able to deliver vaginally.

    *I don’t think your body ever completely recovers.

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a letter

This morning I want to address the mamas out there who have had cesarean sections (or c-sections). Grab a cuppa your favorite drink, get cozy and take a minute to breathe and read some words of love from yours truly.

Dear Mama Bear, 

I'll just come out and say it: Some women feel shame, disappointment, resentment, guilt or a sense of failure after having a c-section and well, this is so sad to me. Regardless of how your baby enters the world, you gave birth to new life that was once inside you and is now out and free in the world! You're a mother, your baby is your baby. Period. There are no strings attached when your baby is born via an incision made by a physician. It doesn't matter. For some, its the best option for birth due to health issues for Mom or Baby, the need for an emergency c-section, the position of the baby, etc. and for others it is just a preferred option for birth. And it is all okay. Women are amazing, fierce, incredibly creatures who should only be celebrated and encouraged after birth, nothing else. 

If you've ever felt "less than" among your friends who gave birth vaginally, I want you to shed that negative lie right now. Maybe those mamas did have an amazing birth experience and wouldn't have wanted it any other way. Maybe. Or maybe, and probably way more than you think, they probably have parts of their birth stories that they don't love too and wish they could've done things differently. For some women, it can be easy to make the birthing process sound all peachy when underneath, they're crying and feeling their own sense of shame, guilt or disappointment over the process. 

My hope is that one day women will be able to rise above - above the noise of self-doubt, above the stress and fears of what others think of them, and waaaaay above the need to make someone else feel bad about themselves so that we can feel good - and leave the childbirthing experience feeling supported, loved and able to hold our heads high. I hope you always have at least one safe woman to talk to and that you'll pay it forward, being a safe refuge for other mothers who come after you. 

You're magnificent! Don't ever let anyone tell you otherwise. 

Love, Kelli

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cesarean interview #5

Today we'll hear from my younger (and only) sister, Kristi. When she gave birth to her first, she lived in Michigan, Since then, she's added two more kids to her bunch, but now she's in the Central Ohio area and we're all a lot happier having her and her family much closerl

  1. How many children do you have and how many were born via cesarean? I have had one child via emergency cesarean.

  2. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I don't know that I'd say I was 'happy' with the experience since it was an emergency and completely unexpected, but I was relieved that the hospital staff was experienced and everything turned out okay. I was induced 4 days prior to my delivery date due to concerns the doctor had about the baby not having grown much in the previous week.  I was given an oral medication to induce labor and everything was fine in the beginning. After about 4 1/2 hours my blood pressure was sky rocketing and the baby's heartrate was dropping, so the decision was made to perform an emergency cesarean. 

  3. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I ask this because many women have shared that they’ve almost felt bullied by other women who had vaginal births and have been told that cesarean was “the easy way out” or “not real childbirth”. I hate to even bring this up, but its a real thing in our culture and I’d love to hear your take on this if it is something you have experienced. I have not personally experienced shaming due to having a cesarean.  In my case when people heard about my situation they were more concerned.

  4. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? I was able to do skin to skin with my son in the recovery room but not immediately after the procedure in the operating room.  If I remember correctly it was only a few minutes before the nurses brought him to me.

  5. Was there a clear, see through drape between you and Baby at the time of the operation?There was a drape up during the procedure but it was not a clear see through drape.

  6. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? The recovery experience was about what I expected. The nurses as well as my OBGYN  spoke with me quite a bit about some of the difficulties I would have, ( pain while sneezing or coughing, needing to sit with a pillow against my abdomen to help ease discomfort, constipation, being unable to drive right away or lift anything heavier than the baby,  etc) so I wasn't totally in the dark. It was tough being at home with an infant, my first child, and not being able to do as much as I wanted with him.  It was painful for me to get up with him several times during the night, I couldn't bend easily to place him in the bassinet or change him.  It made me feel a little helpless.  Luckily my husband was able to take quite a bit of time off of work and he filled in where I was lacking. 

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cesarean interview #4

Today we'll hear from sweet Maggie who gave birth to her first child, a daughter, a little over a year ago. I met Maggie sort of by happenstance through mutual friends just a few days before her daughter was born. Soon after the birth I got to visit with her in the hospital and she later became one of my clients... and a friend! 

  1. How many children do you have and how many were born via cesarean? One child born via cesarean.

  2. Was there a reason your baby was born by cesarean? I was diagnosed with chloestasis when I was 37 weeks pregnant. I was 0cm dilated and 0% effaced when my doctor informed me I needed to be induced immediately. After being in labor for 40-hours, pushing for four long excruciating hours and trying to suction the baby out three times with no success I told my doctor I had no energy left to give. We both agreed it was time for an emergency c-section.

  3. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was so happy to be almost done with the birthing process; I was tired, hungry and utterly exhausted, so a cesarean sounded heavenly at that point! The recovery was far more involved than what I had anticipated. Being 14-months post-pregnancy, I am so pleased with how my body and scar have healed. I still experience numbness, but knew that going the c-section route was what was best for myself and the baby.

  4. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? Thankfully, I have never experienced any shaming or insensitive questioning from others.

  5. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? Unfortunately, I was unable to do skin-to-skin due to the head trauma my baby experienced from the suctioning. It is something I still struggle with, but I was able to the following day in the NICU.

  6. Was there a clear, see through drape between you and Baby at the time of the operation? No, a blue tarp was provided. My husband and I both wish that was an option!

  7. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? Again, because my baby's condition was unclear after she was first born I had to start pumping right away. Thankfully, I was able to attempt breastfeeding the following morning in the NICU.

  8. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? I definitely wasn't prepared for the amount of recovery that was ahead of me. The not driving for 8-weeks was particularly frustrating. Because our birthing story was so traumatic, I was very emotional (and still am!) and not being able to do the physical things that I used to after coming home from the hospital was difficult.

  9. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) 1.) Embrace it - wear your scar with pride! 2.) Women with c-sections work just as hard as women who have vaginal births 3.) Keep up with your medicine - just because you aren't in pain or discomfort at that moment doesn't mean you won't be in an hour.

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cesarean interview #3

These questions were answered by my neighbor, Molly. She has two boys the same ages as my two kids and they all go to school together. In the last year I've gotten to know her more, mostly through chats on the playground after school or play dates for our boys. I love how just by ten simple questions I'm getting to know the women I've interviewed better and I'm really thankful for everyone's participation.

  1. How many children do you have and how many were born via cesarean? 

    2 children. Both born by cesarean.

  2. If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? 

    If not, what happened in the birth that ended up resulting with a repeat cesarean?

    Both were planned. First son was breech. With my second, I felt more comfortable knowing how everything would go based on prior experience. I got an extra day at the hospital, which I especially appreciated after my first as a transition to post-baby life. Doctor would have allowed VBAC but I wasn’t really interested.

  3. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was happy with both experiences.

  4. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I ask this because many women have shared that they’ve almost felt bullied by other women who had vaginal births and have been told that cesarean was “the easy way out” or “not real childbirth”. I hate to even bring this up, but its a real thing in our culture and I’d love to hear your take on this if it is something you have experienced.    I am familiar with this. I don’t feel as though I’ve experienced it from anyone else. I probably do more self-shaming on this by assuming people think these things. I know that they lived in me for over 9 months and they came from me.

  5. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? No.

  6. Was there a clear, see through drape between you and Baby at the time of the operation? No. There was a drape but it was not see through.

  7. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? I did breastfeed but definitely wasn’t able to do this within the first hour for either child.

  8. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? I imagine whether you deliver naturally or by c-section one is drained both physically and emotionally. My recovery went well, probably better than expected as I didn’t have any complications. For my second, I knew what to expect and recovery went just as well.

  9. If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? 

    Both were planned. In general, I had no idea what to expect. I think that’s what I wanted. I really trusted my doctor and I felt comfortable with her guiding me. When I found out my first was breech I just felt like I had no control over it. My husband read up on methods to “turn” the baby and I wasn’t really interested in pursuing those. I felt more in control by setting a date and time and just working toward that date. I would have had a much harder time just waiting for labor.

  10. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) 

    It is major abdominal surgery.

    Your core takes a long time to fully strengthen. Almost 5 years after my 2nd surgery, my core finally feels strong again.

    It took a very long time for the nerve endings to repair themselves. The area around the incision felt “numb” for a VERY LONG TIME.

    I hate to hear of women who labored for many hours then having surgery. I think the recovery in those situations would be harder.

    Motherhood comes in many forms and fashions whether delivery is natural, through surgery, adoption, etc.

     

     

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black mamas are dying

Yesterday concluded Black Maternal Health Awareness Week and to say that my eyes have been opened and my heart has felt heavy in the last eight days is a serious understatement. The statistics are out there, the evidence is real, the stories are aplenty and the heartache is felt across the nation. Black women are dying - as they welcome a child into their lives - and frankly, its ridiculous.

Black women are 243% more likely to die from pregnancy or childbirth-related causes than their while counterparts. 

243%.

Why, you might ask?

Black women are less likely to have insurance and if they are eligible for something like Medicaid, they'll often lose coverage once the baby is born. 

Black women are more likely to have chronic health issues such as diabetes, hypertension, obesity, etc. which can mean that giving birth is far more dangerous than a woman who doesn't have these problems. 

Facilities often aren't in as good of condition or aren't of high quality as those where white women deliver which can lead to higher rates of life-threatening conditions.

Black women often feel disrespected, talked down to, an overall lack of support, devalued, discredited... Need I go on? NO ONE wants to be treated this way or feel this way and NO ONE should be handled in this manner!

Specifically in Ohio...

(The following information was taken directly from Cleveland Regional Perinatal Network.)   

"In 2009, the pregnancy-related mortality rate was 17.8 deaths per 100,000 live births, compared to an all-time low of 7.2 per 100,000 live births in 1987. Ohio’s preliminary pregnancy-related mortality rates are at least comparable to the national rates and are likely higher. Causes of this increase in mortality are not completely understood. Factors which play a role include an increase in underlying chronic diseases along with maternal age in the obstetric population.

Ohio re-established a Pregnancy Associated Mortality Review (PAMR) system in 2010 to ensure that all maternal deaths are identified and preventive actions developed. A review had not been done in Ohio since the 1980’s. The Ohio PAMR was developed with funding from the Agency for Healthcare Research and Quality and is now supported with funding from the Title V Maternal and Child Health block grant. It has completed four years of review. The fifth is underway."

Making sure you really caught what you just read:

In 2009: 17.8 deaths per 100,000 live births

compared to 

1987: 7.2 per 100,000 live births - what had been an all-time low.

Come on! We have to wake up! We have to take a stand! I hate to say it, but I think that our stats, almost ten years after the 2009 information are worse.

How can you help? Stay tuned for another post about local organizations that are working towards towards an end to this ghastly epidemic.

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cesarean interview #2

The next mama that we'll hear from is my friend Sarah from college. We've traveled the world together, laughed so hard we cried and our sides hurt and we've wept with each other in some of the lowest moments of life. I'm thankful for her honest participation.

  1. How many children do you have and how many were born via cesarean? I have one child and he was born via C section.
  2. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was very nervous at first to have this type of birth but I didn’t have a choice due to the heart rate dropping every time I had a contraction so of course I knew this was best for my son. 

  3. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I ask this because many women have shared that they’ve almost felt bullied by other women who had vaginal births and have been told that cesarean was “the easy way out” or “not real childbirth”. I hate to even bring this up, but its a real thing in our culture and I’d love to hear your take on this if it is something you have experienced. No, I didn’t have anyone make me feel less bc of C section. 

  4. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? No, unfortunately I was not able to do skin to skin right away but later after I left the OR I did.

  5. Was there a clear, see through drape between you and Baby at the time of the operation? Yes

  6. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? Not within the hour, it took several hours for me to get to nurse. 

  7. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? Recovery was harder than I thought. The next morning getting out of bed was very emotional. I knew then, I would have to take it easy so I could recover and be available for my baby. 

  8. If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? The C section was not planned but we knew after a couple hours of contractions that we were going to the OR. The anesthesiologist came in to talk with me and the doc talked me through what to expect. 

  9. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) It’s okay to have a c section. You are no less. Recovering is hard so take it easy. Let other people help you. 

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cesarean interview #1

Earlier this month I reached out to women in my circle and asked  if they'd be interested in answering a few questions regarding their experience with birth. Thankfully, several of them agreed to help me with this little project and I'm happy to bring you their thoughts here over the next few days! 

Each mama received the same ten questions and they were encouraged to answer as many or as few as they wanted, giving as little or as much detail as they felt comfortable with. Vaginal birth is often what we see depicted on TV or in movies, it's what the celebrities write about or what many women around us experience, but there's another side. I wanted to shine a light on cesareans this month and normalize it a bit.

Renee was the first to reply to my message and vulnerably shared details about when she welcomed her two sons into the world. Read on to hear from her directly. (Many people refer to cesareans as cesarean sections and abbreviate it to C/S which you'll see below.)

  1. How many children do you have and how many were born via cesarean? Two children. Both were C/S.

  2. If you’ve had more than one cesarean, were the others planned? If so, what was the reason? If not, what happened in the birth that ended up resulting with a repeat cesarean? The first C/S was not planned but the second was. I did not want to attempt a V-back since my first baby was 9 lb 15 oz and my OB said my second baby would be the same size; and he was at 9 lb 14 oz. After my first son was born my OB informed me that his head may have fit through the birth canal but that she likely would have needed to break his clavicle to get his shoulders out if we had done a vaginal birth. The reason we had the first C/S was due to an induction the night before my due date and laboring for 30 hours with only progress of 2 cm. So eventually we decided to just go get him.

  3. Were you happy with your experience? If you’ve had more than one cesarean, were you happy with one and not with another? Explain? I was happy with my second C/S, but not the first so much. The first time since it was unplanned, I had been awake for so long and on anesthesia that I don’t remember much and felt delirious. I also remember feeling immense pain during my first C/S, not just the standard pushes and pulls. I think my anesthesia was not working properly. The pain came after he was born during the closing up procedure. My second C/S was much better. It was planned and was in the afternoon so there was time for rest and preparation. The anesthesia also worked well that time.

  4. Have you ever experienced any shaming or questioning that made you feel uncomfortable after your cesarean? I ask this because many women have shared that they’ve almost felt bullied by other women who had vaginal births and have been told that cesarean was “the easy way out” or “not real childbirth”. I hate to even bring this up, but its a real thing in our culture and I’d love to hear your take on this if it is something you have experienced.    I have not personally felt shame from other people, only internally. I’m a woman who lives by “shoulds” on a daily basis, so of course I went through the thought process: “I should have had a traditional birth”. I remember crying after deciding to have the surgery the first time after the 30 hour labor with no progress bc it wasn’t my plan. I eventually got over it when I saw how big my son was and realizing that my small body and my sweet baby would have likely gone through hell if we had done a traditional birth. I hold on to that today whenever I feel jealous of women who had a natural birth.

  5. Were you able to do skin-to-skin with your baby immediately after the birth, even before leaving the operating room? I honestly don’t remember having it with my first born, I’m sad to say. I know for a fact we had skin to skin in post op for two hours. With my second, I know for sure we did have skin to skin during the closing up portion of surgery.

  6. Was there a clear, see through drape between you and Baby at the time of the operation? The first C/S was a blue drape with no window. The second surgery had a blue drape and a window flap that they opened whenever he was delivered so I could see him.

  7. If you chose to breastfeed your baby, were you able to try nursing your baby within the first hour after birth? Yes.

  8. What was your recovery like: Better or worse than expected? More emotionally or physically draining than you were prepared for? My first recovery was a long road but that was because I had fallen on my wet front porch steps a couple weeks after surgery and took a hit to some nerves in my back that I have never fully recovered from. I am currently still in recovery from my second C/S and it has been better than the first time, although more challenging since I am chasing an almost three year old around all day.

  9. If your cesarean was planned, did you feel well-prepared for the procedure itself, what to expect regarding recovery and was your healthcare provider willing to work with you to get the birth experience you desired? The first time felt more like a blur, so yes and no. The second time I would say yes and it felt more collaborative.

  10. What are three things you’d like the world to know about cesarean birth? (If its too hard to narrow it down to three, list more!) First, It’s okay to ask for help, say “no” to things, and know your limitations. Even though you have an infant, your recovery is just as important. Second, A mother is a mother is a mother, no matter how that baby came into this world. Third, Belly-bands were my best friend. Fourth, It takes a few days to learn how to pee and shit again, be patient ;)

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World Doula Week!

World Doula Week kicks off today and more specifically, today is World Doula Day!

The purpose of World Doula Week (WDW) is to empower doulas all over the world to improve the physiological, social, emotional, and psychological health of women, newborns and families in birth and in the postpartum period. March 22nd was chosen because it is close to the spring equinox which represents the return of fertility in many cultures.

There's a LOT of information in this article from Midwifery Journal, but I found it to be super interesting. If you need some new reading material, check it out!

Labor Doulas, Postpartum Doulas, we're all in this for the same reasons: We care deeply about mamas and their babies and we want to see the best possible outcomes for each family. And the statistics are out there. In 2013 The Seacoast Doula Group sought to answer the question: “Is there evidence-based research backing the advantages of having a postpartum doula?” The following is taken directly from their site:

"Research by experts tells us what many have long suspected: that those new parents who have support and feel secure and cared for during this time are more successful in adapting than those who don’t. Studies have shown that cultures in which women are cared for by others for a defined period of days or weeks and are expected only to nurture themselves and their babies during that time have superior outcomes in postpartum adjustment (1-2). We know that women who experience support from their family members, care providers, counselors and peer groups have greater breastfeeding success (3-10), greater self-confidence (11-15), less postpartum depression (16-21) and a lower incidence of abuse than those who do not (22-24).

There is also evidence indicating that timely referrals to competent, appropriate professionals and support groups can have a significant positive outcome for the family (11, 18, 20, 21, 25). Parents benefit from education on what to expect from a newborn, baby-soothing skills, feeding, bonding and attachment and coping skills (3, 13, 26-30). Rather than being told to “help out”, partners and other family members benefit from concrete instruction and role modeling on how to support a woman during the weeks after birth. Research tells us that support for and from the partner can have a significant impact on their partner’s own experience as well as the emotional adjustment of the mother (3, 8, 17-21, 31-36). (References)"

It is my great privilege to get to serve families as a doula, its some of the best kind of work on the planet. 

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