Boy oh boy…. CASTOR OIL

Of all my posts on this blog, the one that has stirred the most controversy is the one on Castor Oil for Induction. The article I posted wasn’t even a blog post, but a short synopsis of the research I did to support MY POSITION on the effectiveness of castor oil as an induction method.

Just today I received a rather snarky response to the article claiming that I “didn’t effectively research” and was “one-sided” putting women who might read it and “not do their own research” at risk. Oh, and that I cited an article/study that was irrelevant to the use of CO as it relates to induction. I cited many articles, many more than one, and AGAIN: I was writing this article as an assignment. I had to SUPPORT my position. And I did just that.

Geesh. I’ll approve the comment, of course, all in fairness, but I think the author went a BIT too far in her umm…. criticism? of my post.

Listen, it’s a free world out there. I post my thoughts and positions relating to birth on this blog ‘cuz it’s mine. 🙂 You are free to comment, critique, whatever. Just be fair. And remember that is IS my blog, and as such I can post MY thoughts and positions on it.

SO I will say again: I do not believe castor oil is safe for use on a scarred uterus (ie: VBAC), and may cause some really funky labor patterns in any woman’s uterus. Bottom line: I believe that induction disrupts that wonderful chemical symphony that the body (and the baby) creates to begin labor WHEN IT IS TIME. So whether it’s castor oil, prostaglandins, Cytotec, WHATEVER, fundamentally I believe it changes the energy that surrounds a birth when compared to one that begins spontaneously.  And ***I*** believe it changes it for the worst, not the better.

And again, I’m a US citizen and am entitled to post just that: my beliefs. And for the record, they are based on MOUNTAINS of research, not a “whim” and certainly not without a great deal of care and thought as to the possible implications my beliefs might have on others who read them.

I will be quite transparent: I do not believe induction is safe, healthy, natural or any of the other commonly used adjectives that commonly surround it. I believe induction is sometimes warranted, but within very limited parameters and with VERY careful consideration given to the implications of that decision. I do believe a woman has the right to choose it, but also believe she should be fully informed.

And since “anyone can google castor oil induction” and find out how to do it with little information provided on the risks, I thought a balanced response to that information was in order. 🙂

So… hit delete, or whatever you want to do – that’s cool (free country after all) but don’t accuse me of being cavalier with information that just might save someone’s life and the life of their baby. Because I certainly am not.

Advertisements

What I said…

Yeah, so here’s a very recent article showing twice the risk for cesarean when first-time moms undergo labor induction. So please, if you know a woman thinking about having an induction have them re-think the whole thing. (And it’s my position that any induction carries some risk of “failure” though this study cites medical inductions only).

And if they ask you, “What’s so wrong with a cesarean?” You can send them here:

ICAN’s Cesarean Fact Sheet (with references)

Spicy

My husband thinks I get “spicy” when I’m pregnant.

I concur.

Seems like the further along I get, coupled with the more babies I have, added to the fact that I’m not a sweet and tender 20 anymore, and you end up with a VERY spicy pregnant chick on your hands.

Spicy: Say-what-she-thinks, no-holes-barred, no-topics-uncovered, opinion-on-everything, no-room-for-compromise, tenacity-of-a-freight-train “spicy”

Now I’m not spicy in a mean way, but in a way that does tend to make people walk out of the room backwards when I get going. 🙂 It also tends to alienate people and I really hate that. But I can’t help it. You know how most people get food cravings in pregnancy? I get “issue” cravings. Like, I have to talk about it RIGHT NOW, to anyone who will listen, or not. 😛 And of course, those issues usually revolve around parenting, or birth, or relationships, etc. etc.

Today’s issue (for your viewing pleasure) is amniotic fluid levels. Low ones to be exact, being used as a reason to induce and scare women half to death. I realize this is an older article (2003) but it’s been shown again in more recent ones (I just don’t want to dig out references at the moment).

The researchers studied 262 women (131 with oligohydramnios and 131 with normal amounts of amniotic fluid) who gave birth at The Johns Hopkins Hospital between November 1999 and July 2002, comparing the babies’ health at birth. Patients with oligohydramnios were delivered sooner, but were less likely to need Caesarian sections. Babies born to moms with isolated low amniotic fluid were normal size and were at no increased risk of respiratory problems, immature intestines or brain disorders.

Study co-authors were Rita Driggers, Karin Blakemore and Cynthia Holcroft. Abstract # 318: Driggers, R. et al, “Are Neonatal Outcomes Worse in Deliveries Prompted by Oligohydramnios?”

Hello?! You’d think that would settle it, yes? No. More inductions are happening today than last week, and SO many happen now compared to even 5 years ago that it’s no wonder our nations surgical birth rate is so astronomical. Some common sense please, people? Why mess with a phenomenon that has been working without our “help” for centuries? And yes, birth really does work without intervention. To say it doesn’t is like saying that no one can have a bowel movement without medication. Ridiculous.

Induction Doubles Risk of Cesarean

Ok, so if you’re going into a hospital that has a 30% cesarean rate, and you go in for an induction, does that make your chances of a cesarean go up to 60%? Probably not, but it did make me ponder. SO many of the induction I hear about from friends, relatives, etc. end in a cesarean. To say that half of them do is not a stretch.

CONCLUSION: Labor induction is significantly associated with a cesarean delivery among nulliparous women at term for those with and without medical or obstetric complications. Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.

LEVEL OF EVIDENCE: II

(C) 2010 The American College of Obstetricians and Gynecologists

Here is the article just published with these stats:

Labor Induction and the Risk of a Cesarean Delivery Among Nulliparous Women at Term

Ehrenthal, Deborah B.; Jiang, Xiaozhang; Strobino, Donna M.

Obstetrics & Gynecology. 116(1):35-42, July 2010.

doi: 10.1097/AOG.0b013e3181e10c5c

On my soapbox again…

I just can’t believe it… I don’t WANT to believe it. That midwives (the “guardians of normal birth”) are using cytotec (also known as misoprostyl) to induce labor at home. The fact that they are using it in hospitals doesn’t shock me, makes me mad, but I just add it to their list of sins again women and babies. Nothing new there. But midwives… sweet, caring, lovely homebirth midwives. Thinking this doesn’t harm anyone. I hear it over and over again, “I’ve used it judiciously for years and have never seen a problem with it.”

Well good for you. Tell my blog-friend Anne that you’ve never had a problem with it’s use. That you’ve never seen a baby die from it, or a mother die or lose her uterus from it. Good for you. Put some flowers on her baby’s grave and say, “Well, we don’t know for SURE that cytotec caused her death.” That you have played the tables and had good luck doesn’t change the fact that this is a potentially dangerous drug that you are using for an OFF-LABEL situation. There are no safe dosing limits or instructions, no risks to inform your clients of because the company that makes cytotec has no intentions of marketing it for obstetrical use. I doubt their lawyers would allow them to. Too much of a liability perhaps?

Here is a quote about misoprostyl that sums up my own position and one that, I believe, should be taken by all birth workers:

Belinda Phipps, chief executive of the National Childbirth Trust, said she was “absolutely incredulous” that any hospital would give the drug to women outside of clinical trials.
She said: “This drug is not licensed for use in labour, and the NICE guidance is categorical on that point. In this country, misoprostol should only be used in labour if the baby is already dead, or after the birth, because otherwise the risks are simply too great.” [ click here for the newspaper story ]

I’m not likely to stop beating this drum for awhile yet. In fact, you might want to cover your ears because frankly? I plan on beating it louder.

Best ultrasound I’ve ever seen!!!

I’m so excited! With all the controversy surrounding ultrasounds and the safety of their routine use on babies and mothers, I was so pleased to find this wonderful alternative! Check it out!

 

Seriously guys… let’s take a LONG hard look at the routine use of ultrasound and doppler on unborn babies. There are many resources on the net surrounding this issue and I encourage mother’s to investigate the topic for themselves before rushing to the radiology department or free-standing 3D/4D ultrasound “suite”.

Sonogram: The New Crystal Ball?

I am So frustrated at the amount of misinformation put out there as FACT soley for the convenience of the provider! Grrrr!!!!! Some OB’s do it, some GP’s do it, some midwives do it, heck as far my experience shows some DENTISTS do it.

There was recently a comment made on my Castor Oil post from a woman who was told she was too small and couldn’t go to 38 weeks or her “uterus would rip open”. Baby was just TOO TOO big. Even if the poster got some of the semantics wrong (probably is her pelvis they are talking about not her uterus) the arguments for induction just amaze me. Of course I did not offer he any advice as to induction.

My local hospital routinely does inductions at 37 weeks. 37 WEEKS! Yeah. Ludicrous.

The main reason given to women for inductions and even cesareans is the “big baby” argument. And we have these wonderful things called sonograms to “prove” they are too big to “fit” through your pelvis. Please. Do they think we are stupid? Ignorant perhaps, but we are not STUPID.

Here is a lovely blog post by the fantastic “Unnecessarian” on sonograms and estimated size and due dates. Sonograms can be off as much as a pound either way and 2 weeks +/- for due date predictions! So if the sonogram says you are ok for an induction at 37 weeks (by the sonogram) and you induce and it’s off by 2 weeks guess whatcha get? A baby at 35 weeks with respiratory issues, breastfeeding challenges, and a myriad of other psychological implications the likes of which we have NO CLUE about yet.

And the weight predictions are just fantastical. The stuff of Harry Potter and traveling circus acts. There is some science there – just enough to be dangerous. Sure. Gaze into the sonogram screen and see your future: induction + pitocin + epidural = surgical birth.

And let me tell ya from experience: a 2nd degree tear is alot easier to heal from than a 10″ wound on your belly complete with scar tissue and a spinal headache for dessert.

Ok, so… Wow. This makes me SO mad.

ACOG issues bulletin allowing women to drink in labor. Finally.

Yeah, really? Permission to drink in labor? While it has been a long time coming and I am thankful for the thousands of women who will now be allowed to drink during the hardest marathon-work of their lives (duh). Come on!!!!! Are we serious???

Grown women, being treated like little children has long gotten my goat. Now ACOG is losening the reins a bit and ALLOWING women to “drink modest amounts” in labor? Really?

Geesh. Let’s put those same OB/GYN’s (male and female) on a 12 hour marathon race and not give them anything but ice chips. I wonder how many would be able to finish the race. And no food either. Seriously. This really REALLY gets me going.

Is this common sense (finally) prevailing or is it a token crumb of freedom being offered to women who refuse to play by “the rules”?

I wonder.

Excellent press piece

[Click HERE to go to the story.]

cover1

Quite surprisingly, this piece about  midwives and homebirth is quite balanced if not a bit to the left. Kudos. One of my favorite lines:

““All women have choices,” Rach Zeller of Buffalo Homebirth says. “They can refuse anything that they’re being asked to consent to. They need to take it upon themselves to really understand what the ramifications are of what procedures they allow.

So we are back to the old question we birth advocates keep going round and round about. The age-old question of “Which came first, the chicken or the egg?” Is it the doctors who need to change or the women who need to stand up and demand birth be allowed to progress as GOD intended? Because let’s face it – women’s bodies were created and I believe INTRICATELY DESIGNED to give birth. And like any other God-thing that we humans get our hands into, we may never fully understand the ramifications of messing with that perfection.

What About Informed Consent?

Julie and Family

I am sitting here with tears in my eyes as I just finished reading, again, the story of  a woman who died after giving birth in a hospital 3 years ago. She was, from all accounts, given a staph infection through her epidural needle and developed meningitis. She died within 24 hours of giving birth to her first child.

I wonder how the little boy is doing. The one without a mother.

How is the father, having been given a perfect gift and robbed of one all on the same day?

Three Mother’s Days have come and gone, 3 Christmas’, 3 birthdays, 3 YEARS.

And the years will keep counting up, this baby boy will grow older and older without a mother… while thousands of women are given epidural anesthesia without ANY real knowledge of the risks involved.

I’ve had 2 epidurals… in different hospitals, and never once was I given a verbal run-down of the risks involved. The paper work I had to sign before receiving it was whisked away and filed in my chart before I had time to read it the 1st time, and the 2nd time (just last year) I didn’t WANT to read it.  I was scared out of my mind. If there had been any way to have a cesarean without anesthesia I would have done it. I knew the risks. 

But how many women don’t? Of the 60% of women receiving epidural anesthesia, how many are made aware of the risks?  Did Julie know?