Saturday, September 22, 2007


On Thursday I finally finished the baby blanket, after a little self-butt-kicking. I mean, it was almost done, what was keeping me from doing the last bit of edging? As soon as I finished it I said to myself, "OK, kiddo, now you can come whenever you want."

How prophetic. Good thing babies are small and blocking to make the blanket larger wasn't necessary. He was born about 24 hours after the last loose thread was sewn in.

This is how we sleep each night. What is that intoxicating new baby smell?

Tuesday, September 11, 2007

PSA re: Epidurals

As I prepare for childbirth, I've avoided talking to most folks about my plans. I'm planning to birth at home, and that really freaks some people out. They like to point to the many cases they know of women who needed intervention during birth. But I ask, how often is the intervention needed because of something else that was an epidural? or being forced to lie on her back in bed while she labored? or being stressed out by the hospital environment and all of the strangers sticking their hands up her every few minutes to monitor her "progress"? The statistic that makes me most confident of my homebirth decision is this: worldwide women require a Caesarian section for about 5-10% of births. This includes all women, in all stages of health and illness and complications. But in New Jersey the rate of C-section is over 35% - and most of these women go into labor having had optimal prenatal care and adequate diet. They aren't starving or suffering from malaria or other diseases that complicate labor. That means that just by walking through the door, my risk of major abdominal surgery skyrockets. Add to this the pressure to submit to an epidural, the use of routine episiotomy, monitoring that restricts movement - the women I've known who wanted to birth naturally in the hospital have found it nearly impossible. So why go there if everything is going well?

The women who've had hospital births with epidurals mark me as crazy for planning to labor and birth drug-free. One friend has been fortunate and had pain-relief without any medical intervention or delayed labor - it is possible. But there are so many others who weren't so lucky. An internet search often reveals the possible medical complications of epidurals (headache, back pain, nerve damage, etc.) along with their relative infrequency, but it is much harder to find the larger and more relevant statistics about labor complications, which I've tried to capture here. A word of warning - many reports indicating that epidurals don't cause an increased risk of *insert medical intervention here* are comparing epidural to other forms of medical pain relief, not epidural to non-medicated labor.

It isn't that I'm a fan of pain; it isn't that I'm a new-age all-natural nut. I have decided that a natural childbirth is the way to go because scientific research indicates that labors are shorter and require less intervention when epidural anesthetic is not used. If my labor is somehow complicated, if pitocin is required or a C-section, than I will appreciate the availability of epidural anesthesia. Otherwise, I'll go where billions of women have gone before.

Epidurals eliminate the ability to be upright for labor An upright posture and rocking motions are critical for helping the baby navigate the pelvis.

Epidurals eliminate the ability to be upright for delivery Back-lying positions are much harder for delivery - the baby has to be pushed up hill, and all of the pressure is on the back (bony) side of the pelvis, rather than in the front, fleshy, stretchy side.

Epidurals can slow contractions Because the brain isn't getting the labor pain signals, the force of contractions often slow or diminish. This very often results in the need for medical augmentation (read, Pitocin).

Epidurals decrease mom's blood pressure Combined with back-lying (which compresses major arteries and veins), a decrease in blood pressure can stress the baby - leading to a need to speed up the labor (Pitocin) and/or delivery (episiotomy, forceps, vacuum, C-section).

Epidurals relax the pelvic floor muscles Intact and taut pelvic floor muscles help position the baby's head. If the baby is facing the wrong way, he/she will be harder to push out (in addition to already having to push up hill), and very often results in vacuum extraction or cesarean section.

Women who receive epidurals are much more likely to tear or require episiotomy The vaginal opening is 25% larger when a woman is squatting or forward leaning than when she is on her back. Thus, when on her back something else has to happen to make the opening big enough. Also, rapid extraction by vacuum or forceps inherently damages a woman's body.

This is an excellent collection of information and experiences related to epidural usage in labor: Epidural FAQ. I've tried to find published literature about the risk to mothers from epidural use, but it's hard to find studies that compare epidural births to unmedicated births. The emphasis also seems to be on the outcome of the baby, and the mother's long-term health effects are often neglected. This article suggests that there is an increased risk of C-section after epidural administration, and they do compare to non-medicated births. They also note that doctors who use epidurals in a higher percentage of their patients have a corresponding higher incidence of C-section.

I don't advocate home births for everyone, but I do advocate educated birth for everyone.

Monday, September 10, 2007

Fabulous Fiber Friends and Family

While I've been feeling bad about not knitting anything beyond diaper covers for my little one, it seems that other people in my life have been doing their part to fill in for me. Mom (Grandma) is at work on a baby sweater - her standard recipe hoody that every mom I've known has enjoyed. Can't wait to see that one. But in addition, check out these wonderful gifts:
jodee sweater
My cousin JoDee crocheted this as a gift for my baby shower. The shocker is that I had no idea that she could crochet! Why should I be surprised, when she comes from such a crafty family - her sister is a master at ceramics, her grandma made a beautiful cross-stitched quilt for every grandchild, and her aunt (my mom) makes amazing quilts. And yet I was blown away. Check out the choice of buttons, and the finishing - very, very nice.
jodee closeup

A surprise gift in the mail came from my friend Sa, currently studying her final semester of medical school. She said it was red for good luck, and I love the shape - the bell sleeves, the wide body to fit over padded diapered bottoms. Beautiful choice of colors (don't believe the sunbleached photo - it's a vibrant red), and it is so, so soft. I'm hoping it will fit around the holidays because it's so festive. It's good to have friends who appreciate the fiber crafts - they are the best recipients of gifts (they know what it took to create the gift) and the best giver of gifts.
sa sweater

Perhaps the biggest surprise comes from a new friend. I dragged myself out to a Knit Night a few weeks ago, telling myself that it might be the last one I could get to for a while. I usually beg off to being tired, other things going on, or just plain forgetting. But it was fortuitous that I attended this time. There was a new knitter, and it turns out we have an incredibly overlapping geographic history. While we all introduced ourselves, I half-jokingly asked if anyone wanted to help me out by knitting a soaker for me. To my surprise Sarah actually stepped up and asked for patterns and yarn suggestions! We met up and I gave her two types of wool from my stash, leaving it to her to decide which one she wanted to use. But a couple of weeks later what does she hand me?
sarah's soakers
Two soakers - one from each type of wool! And she gave me two patterns I hadn't seen before! It makes me realize how much I miss my midwest friends. We're a different type of people.

As for my contribution to the baby knitting pool, I'm finishing the baby sweater blanket ("Mama was supposed to have a sexy sweater for herself this winter, but instead she got you and this lovely blanket") and trying to knit a hat that will fit a newborn. I have 5 or 6 cotton caps, but teensy heads in bulky wool look adorable. The soakers are on hold for a moment as I think I have enough of the smaller sizes to let me wait until I actually see the kid and can make some of the larger sizes to fit.