Wednesday, October 29, 2008

Me, a hypocrite?

Lately I have been reading a lot of the Cochrane reports on all types of medically related stuff. These reports represent the most unbiased, comprehensive analysis of evidenced based medicine that exists. Not just birth related stuff, all sorts of health issues. The Cochrane Institute is a great resource.

But reading these reports has me thinking. I often gripe (mostly to Super B) about how I wish OBs would practice evidenced based medicine and I get frusterated when I see them recommending things that are proven to pose risk to moms and babies with little to no advantage to be gained.

However, in the normal birth camp, we often talk about recommending chiros, accupuncture to induce labor, evening primrose oil to prep the cervix, rasberry leaf tea for uterine toning, even moxbustion to turn a breech baby. According to the Cochrane Reports most of these practices are about as evidenced based as constant fetal monitoring, which means, not at all. Now some of that doesn't shock me, I never have been able to fully swallow that burning an herb on your big toe (mox) causes baby to flip. To be fair though, constant fetal monitoring carries a fair degree of risk to mom and baby whereas a little tea never hurt anyone. But still, neither appear to be evidenced based.

So I am a hypocrite, right? I get miffed that OBs routinely recommend stuff that is clearly not evidence based, yet I have chiros and places to buy herbs listed in my doula notebook. In some ways I wonder if we are not both doing some of the same thing - which is basically working from the worldview we know and in which we are most comfortable. I honestly find myself pretty comfortable sitting between a healthy skepticism and openess to each group, but looking at it from the perspective of differing, rather than competing, worldviews makes me more comfortable walking a mile in the shoes of someone else's thinking.

Friday, October 10, 2008

MOPs article-natural ways to deal with being sick

(I am writing little articles for my MOPs newsletters, so I thought I would just cut and paste these articles into my blog as I have the time. This is a copy of the third one I have written and it is about natural ways to deal with common illness. Please know that these are very short descriptions, I only have an allowance of about 300 words! This article is written to go along with the speaker, a local ped, talk entitled "The Five Most Common Questions A Pediatrician is Asked".)

Tired of eating an apple a day? Here are some ideas for natural remedies to common health issues. You might find you can avoid a few trips to the pediatrician and most are cheaper than a co-pay. (Everything I list can be bought at Walmart.)

1.Warm olive oil and mix with raw, crushed garlic. Pour a small amount into sore or infected ear. Garlic is antibacterial and the warm oil soothes the ear pain.

2.A washcloth soaked in lavender oil and water can be placed on a tummy or head to help relieve pain. Lavender oil is calming, so it can be helpful in soothing a child who needs to stay calm for further treatment, ie a splinter removal.

3.Peppermint oil can be smelled to relieve nausea.

4.Fill a clean sock half way with rice and knot the top. Heat in the microwave and use sock as a heating pad for boo boos, cramps and earaches. No outlet necessary.

5.Netti pot- Relieves allergies and sinus issues without medication.

6.Boil a few tablespoons of grated ginger and let steep for an hour. Add honey or sweetener of your choice, and drink as tea to help with nausea. Doing the same with fresh parsley helps bring down swelling and high blood pressure.

7.An effective heartburn remedy is drinking an ounce of Apple Cider Vinegar. This does not taste good, so take it like a shot.

8.Apply duct tape over an unwanted wart. Leave on continually, replacing the tape as needed. The wart usually disappears in a week or two.

9.Arnica and tea tree oil can both be used topically instead of antibacterial cream. Arnica not only fights infection, it takes the pain out of a cut, and reduces swelling and bruising.

Thursday, October 2, 2008

A tale of two births

I have attended two births this week and I don't think I could have gone to two births that differed so radically from each other. In fact, they were so different, it is almost hard to beleive that the two events were a demonstration of the same biological process.

A few days ago I attended a beautiful homebirth that happened very quickly. Baby was born into his fathers arms after only a few hours of labor. Mom labored in a birth tub under dim lightening. She drank a rasberry smoothie and was offered other snacks. Don't get me wrong, it was a beautiful birth, but mom wasn't just sitting there having a day at the local spa. She contracted hard and moaned and all the other things laboring moms tend to do as baby is coming down. The midwife there listened to the baby's heart beat a few times, did some perenium support and made some"you go girl" comments, but otherwise her main duty during this birth was to hold the flashlight so the dad could catch the baby underwater. (And please know I am not minimizing a homebirth midwife's role at a birth. The midwife is the guard that watches for issues and knows both how to prevent and take care of them should they arise so that the role of flashlight bearer is even a possibility.)

Yesterday I attended another birth. After 24 hours of hard labor, mom delivered her baby into the arms of a surgeon she had never met before under the harsh lights of a surgical suite. In the prior 24 hours she had 9 different wires going into or out of her. She was stuck10 times with needles, denied food and even water despite having lips that were cracking from dryness. Various strangers walked into the room without knocking. She was touched and examined by countless and mostly nameless staff. She was made to lay completely still on her back even though she asked to sit up and to walk so that baby could use gravity to help bring him down. Eventually she was told her food and gravity deprived body was not capable of birthing the baby, and that the baby was in trouble. Then she was left alone (well with just me anyway) for over two hours waiting to have the baby that was in such immediate distress "saved" by surgery.

I admit I do like homebirths and I think the statistics are clear that homebirth is far safer for most women and their babies, but I am not saying one was good b/c it was at home or that one was bad because it was at the hospital. I have been to rather unpleasant homebirths as well. I am also not saying that all the interventions in the second birth were unnecessary, because I simply don't know. I tend to think most were and the ones that weren't necessary probably created the need for the other ones but regardless, the outcome could have been the same. Actually. I don't know if I am really saying anything at all, except that I have gotten 3 hours of sleep in the last 50 plus hours and feeling down after a lousy birth.

The fact of the matter is that the second birth discribes how most births occur in this country. Maybe not with the major abdominal surgery at the end (though with a 30-50% c-section rate at most area hospitals, that is the way it will be soon enough), but with the wires and nameless strangers in and out while mom is confined to the bed. I can't help but believe though if you put the right ingredients together, you can tip the odds in favor of things being different....better. I thnk the right ingredients start with empathy, willingness to respect mom as an individual and most of all a basic trust that God's design is a good one that man shouldn't mess with until a good reason comes along.