alexist

I was discussing Caesarean recovery with some friends. blah blah blah, give my experience, "I don't know what exactly they put in the epidural for post-op pain, but apparently diamorphine is the standard, so I assume that's what I got."

Friend (CNM): "Dude. Diamorphine is heroin."

Um. No wonder I felt fantastic. That explains a LOT.

Long Island College Hospital is closing its maternity unit. It's not the greatest hospital, but there are some really excellent midwives delivering there and I'd considered going to one of them next time. No idea where they're all going now (I know one has gone to St Vincent's in Manhattan and a bunch of the OBs have gone to Methodist).

I'd like a midwife next time as private midwives in the US attend you throughout the birth (if you have an OB, which most people do, you get assigned an L&D nurse who does most of the work. She's usually got more than one patient, you've never met her before, and she might be good or she might suck.) Since I'm going to be a VBAC patient (hopefully) I don't want to deal with a lousy OB nurse and I want to have choices (like not being on the EFM the entire time).

All the hospitals in Nassau County have awful stats (all, save 1--the welfare hospital!--have CS rates over 40%--LIJ on the county line squeaks under it) and while I don't think they have no-VBAC policies (aside from 1 or 2 of the smaller ones that don't have 24/7 anesthesia coverage) they aren't supportive. Queens is about as bad. I'm going to have to go to Brooklyn or Manhattan.

I had an awful experience last time and I am really anxious to avoid a repeat.

1) "Trust birth" is a nice slogan and a fallacy. Especially since it implies that if your birth doesn't go well, you just didn't trust it. (Law of the contrapositive.)

2) When someone posts that they had preeclampsia, the answer is not "pre-e is completely preventable through the Brewer diet". The Brewer diet is pregnancy woo. (it's a claim that a high protein diet will prevent preeclampsia. No one ever duplicated Brewer's results, and it goes against current, evidence-based theories of preeclampsia.)

ETA: this kind of stuff makes me REALLY angry. I had preeclampsia (no one used that word at the time, and it still irks me [I was treated like I was little better than a child] but I talked to the GP later) and I have the emergency C-section scar to prove it. I know someone who had a 24 weeker because of her pre-e. And I know plenty of women whose fabled "instincts" didn't kick in.

http://lifeandhealth.guardian.co.uk/women/story/0,,2276237,00.html (from the highly annoying Joanna Moorhead, who I believe wrote that "Epidurals are for wimps" article I mentioned some months back). I'm pretty pro-NCB and I think that midwife-attended homebirth for low risk women is safe, but poorly written nonsense like this drives me up a wall.

1) Homebirth is not "banned in 10 US states". It is not possible to ban a woman from giving birth at home. What is banned is having a midwife attend you at home. It's a small but important difference. A woman faces no legal risk from birthing at home regardless of her state's laws (unless the baby dies and you get a zealous prosecutor). The attendant is the only one taking a risk.

2) "Only 8% of women are able to use midwives, who specialise in natural birth, and instead have to see obstetricians, whose metier is highly interventionist hospital delivery." Well, way to set yourself up there. One, you're applying the UK model to the US. While I don't feel that having an OB handle all patients is the best model, this feeds into the stupid, pointless "bad OB, good midwife" idea that's rampant amongst NCBers. While OBs are trained in a more interventionist model, there's a lot more involved than training. A lot depends on the individual practitioner and the constraints under which they are forced to practice. A great OB or midwife is useless if they're put into a hospital with 1970s practices and a VBAC ban.

3) ""Sure, there will be babies who die at home who wouldn't have died in hospital," says Horn, "but the other side of that is there are babies who die in hospital who wouldn't have died at home - the ones who get MRSA among them."

*headdesk* This is the kind of magical, false, bad science home birth thinking that gives NCB/HB advocates a bad name. The risks of being in a hospital do not outweigh those of being at home. Even the most pro-HB studies only show an equal perinatal mortality rate, not an decreased one--and that's for carefully selected, low risk women, which is why official NHS guidelines are so strict on who can home birth (although because of the duty of care, all you have to do is refuse to go to hospital--they HAVE to send a midwife then). And the MRSA is stupid, bad science thinking. The biggest infection risk to a newborn is... its mother.

Of course, the article is irrelevant. Homebirth rates in the UK will not rise for one very important reason: a homebirth requires at least 2 midwives (one to attend the birth, then a 2nd comes to take care of the baby at the end, and if birth is prolonged the first midwife may have to be relieved). In London hospitals, midwives are looking after 2-3 women at a time. The government will not fund the midwives necessary to make homebirth possible. So it doesn't matter what women want: the NHS will do everything possible to discourage further taxing of limited resources.

Barnet Hospital closed its doors to women in labour 101 times last year.

And they still want to close/downgrade Chase Farm (the other hospital in the trust). Both Barnet and Enfield are growing in population. Please tell me, where ARE women going to give birth? (Not at home--both PCTs are HB-unfriendly because of staffing. Homebirth takes 2 midwives to one woman. Co nsultant-unit birth is 1 midwife to 2-3 women.)

They've also closed the birth centre at the Central Middlesex, claiming women don't use it (and that they don't want to because it's midwife-only). Amazing, how women in Edgware are fine with just midwives (Edgware birth centre is popular), but not in Park Royal. I'm suspecting 1) steering (GPs/midwives here are bad at explaining birth options) and 2) financial issues at North-West London Hospitals.

Remember how I posted about a woman I know who was told she couldn't have an epidural?

She gave birth recently. 48 hour labour with nothing but gas and air--at that point she was still only 5cm dilated so they gave her a C-section.

But most women "get through it", right? Shyeah.

I went back to the hospital today to have my wound looked at. It's better, apparently, but they put more Surgi-Strips on. It hurts like hell. In fact, it's been getting progressively more painful over the past few days. The visiting midwife will check it again tomorrow and I'm going to tell her that I'm really unhappy with it. It's not healing well because it's in a skin fold (I just know the midwife and doctor were discussing my weight when they moved away so I couldn't hear the conversation, based on the way they'd been looking at me and each other, and that didn't make me pleased. Aside from which, I imagine this is an issue with most C-sections especially if you had any sort of stomach pre-pregnancy.) I'm also almost out of co-dydramol :( And my damn back keeps spasming.

Meanwhile, my milk still isn't in and I'm trying not to worry as I know it's being delayed by the section, pain meds, and iron deficiency. I'm getting a little colostrum with the Swing (pumping regularly!); the Symphony arrived this afternoon, and I'll be switching to it tonight. Neil's already cracked the cow jokes (he's being very supportive so is allowed to say "moo" and pretend to be frightened at it). No "baby blues" yet but the antidepressants might have something to do with it. The SoftCup feeder really is good, much easier than cup feeding would be and almost as fast as a bottle! (the bottles have been relegated to mixing and storing, so we cna have several feeds waiting to go, and just wash out the feeder between uses). The only trouble is, it doesn't let her comfort-suck like a bottle or breast would (she does get the breast but not enough) so we're reduced to letting her suck on our fingers.

Aliza's looking particularly adorable today in a yellow velour sleep suit :) I might take a photo if she wakes up in a bit.

We've switched to the SoftCup feeder and she's taking to it nicely, so we'll get a 2nd tomorrow. I also managed to pump a bit :) (Just been using the Medela Swing [figured I'd planned to buy one in 6 weeks or so anyway, so it wasn't a waste to get it now] since I got home as my Symphony is being delivered tomorrow--I called too late yesterday for next-day delivery). I should get better results with that as it's hospital grade and does a better job before your supply is established. I wasn't expecting to get much at all with the Swing but at least it provides stimulation. Aliza's also managed to latch on, and stayed latched for a bit, which was nice. The NCT counsellor gave me some tips, and we'll see how it goes. I'll ask the midwife about counsellors/consultants who do home visits, in case she still won't latch on.

I haven't mentioned, though, that feeding issues aside, Aliza is adorable and lovely (and is currently all cute and snuggly in a Winnie the Pooh sleep suit) and I do like being a mother! Except when she screams. She has quite a set of lungs on her. Perhaps we should have chosen Shira instead... ;) (means "song")

Meanwhile, my stitches are hurty. Well, not exactly. You see, they took them out yesterday, and discovered things haven't healed properly. So I was patched up with Surgi-Strips, bandaged, and told to come back on Thursday. I now hurt worse than I did before they removed the stitches. :(

I am a walking pharmacy. I have:
3x Effexor, 1x/day
100mcg Thyroxine, 1x/day
2 10/500 co-dydramol, every 6 hours
1 Diclofenac, every 8 hours
2x 200mg ferrous sulphate, 2x/day with food
500mg penicillin, 4x/day, 1h before eating
And now, 15ml Lactulose every evening, to counteract the surgery, co-dydramol and iron tablets...

At some point, I'm going to mix things up!!

Aliza just has folic acid in a little dropper, which hasn't posed a problem.

Title: Monday
tags: aliza, feeding, birth

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