11 posts tagged “pregnancy”

I've been doing some reading about exactly how hormone based birth control works.

In summary, according to multiple references throughout The Physician's Desk Reference, which articulate the research findings of all the birth control pill manufacturers, there are not one but three mechanisms of birth control pills:
       1. inhibiting ovulation (the primary mechanism),
       2. thickening the cervical mucus, thereby making it more difficult for sperm to travel to the egg, and
       3. thinning and shriveling the lining of the uterus to the point that it is unable or less able to facilitate the implantation of the newly fertilized egg.

The first two mechanisms are contraceptive. The third is abortive.

When a woman taking the Pill discovers she is pregnant (according to The Physician's Desk Reference's efficacy rate tables, this is 3 percent of pill-takers each year), it means that all three of these mechanisms have failed. The third mechanism sometimes fails in its role as backup, just as the first and second mechanisms sometimes fail. Each and every time the third mechanism succeeds, however, it causes an abortion.
Does the Birth Control Pill Cause Abortions? by Randy Alcor (condensation)

I'm not trying to debate if abortion should be legal or not. I'm simply saying that there are those that would choose to have an abortion and there are those that would not. For those that would not, this is extremely troubling.

The other trouble is that many medical care providers do not use the same definition of "pregnancy" that is commonly understood by most people (and in most widely available dictionaries).

From a medical point of view, however, pregnancy does not occur at the moment of conception. It occurs, instead, when an embryo (a fertilized egg that has divided over the course of a few days) attaches itself to the woman's uterus, a stage known as implantation. It is at implantation that a woman's hormonal system begins to respond to her embryo, a response that initiates a cascade of dramatic physiological changes in her body. This means that if a sperm fertilizes an egg after a couple has intercourse, but the fertilized egg never implants inside the woman's uterus, then the woman - from a medical point of view - was never pregnant. Therefore, she can be described as having menstruated, rather than as having experienced a miscarriage or a spontaneous abortion.

Some forms of what we call birth-control implicate the distinction between the pro-life definition of pregnancy and the medical definition of the same. For example, the I.U.D. (or intra-uterine device) can operate by preventing a fertilized egg from implanting in the wearer's uterus (though it can also work by preventing conception in the first place). When it prevents implantation, an I.U.D. has - necessarily - not prevented conception (and, if I were a pro-life advocate, I might accordingly say that in such instances, it does not literally fit the definition of "contra-ception").
When Does Pregnancy Begin?: A Federal Appeals Court Decision Implicates a New Abortion Question by Sherry F. Colb

The view that pregnancy begins at implantation is the view held by the American College of Obstetricians and Gynecologists (ACOG). When your medical care adviser tells you that various birth control methods "do not disrupt an existing pregnancy" (as stated in the World Health Organization's "Family Planning: A Global Handbook for Providers") realize that you both may be using the same word, "pregnancy," but the definition is not the same.

How can patients be expected to give informed consent if a word with a the commonly understood definition is being used with a definition crucially different?

Neither ACOG definition has been consistently adopted by its members whose definitions are more consistent with lay and embryologist definitions. Potentially, the process of informed consent is jeopardized by these ambiguities. The ACOG is urged to reconsider its definitions.
Informed consent and the redefining of conception: a decision ill-conceived?  by J.A. Spinnato (abstract)

People most likely ask the question "Will this method of birth control harm a pregnancy?" are most likely people who would consider pregnancy to begin at fertilization and would consider any post-fertilization effects, such as inhibiting implantation, to be harmful to a pregnancy. To dismiss the commonly understood definition of "pregnancy" and play a game of semantics does not allow for informed consent and is poor care indeed.

For those of you have had a hospital (or outside of your home) birth, what were some of your favorite or essential items to pack?

As usual, I started to write a comment for someone's post and it just got way too long. So, I decided to write my own post.

My favorite hospital bag items:

• Carmex - my favorite lip balm, my lips always got so dry
• Snacks for Dad - "Don't you dare leave this room to go to a vending machine!"
• Cash - for who knows what (there's always something) just in case
• iPod & compact iPod Speakers - I'm not a fan of the headphones during labor and I didn't like just bringing CD's, because I didn't know what I wanted to listen to until I got there.
• Tube of Lanolin - I'm a firm believer in preventative nipple care. I don't wait until I start to feel sore. I use it after every feeding for at least the first 2 - 4 weeks. I've had difficulty with breastfeeding and that stuff has been a lifesaver for me.
  
• Preemie Clothes - I had big kids (two 8 lb, 14 oz, one 8 lbs, 9oz) and none of them fit in their 0-3 months clothes until about 6 weeks, and definitely not at the hospital. I have no idea what actual preemie moms do for clothes. After my first I made sure to bring preemie clothes to the hospital so the baby looked cute in all the pictures.
• A Gender Neutral Coming Home Outfit - Maybe it's just me, but I was always paranoid of being surprised on delivery day. So, I bring, as an extra outfit, a simple white sleeper for the baby (for pictures) just in case.
• "Adult Diaper" style underwear - I know this sounds weird (and TMI), but there can be a fair amount of blood for a time (6 weeks after my first, 2 weeks after my last) after you give birth and basically I just got sick of things leaking (on my underwear, clothes, sheets, etc). I read somewhere on a mom message board a recommendation to use these and they worked great, much better than any pad, etc. combination I could think of.
• Forgiving Clothes Home - No one really knows what they are going to look like or what size they will be immediately postpartum. So, bring clothes for you to wear home that are stretchy (like elastic waist stretchy, not like leotard kind of stretchy) and forgiving. When I went home from the hospital I always looked like I was still 5 to 6 months pregnant. Also, don't be afraid to wear your maternity clothes for as long as you want to/need to postpartum. My youngest is nine months old and I wore a maternity shirt just yesterday (and no one gave a second glance). The idea of still wearing maternity clothes even though I wasn't pregnant gave me a lot of heart ache after my first birth, but after my third I just embraced it and was much happier as a result (btw, I'm now about the same weight as before I started having kids, so it's not necessarily a weight issue, it's a how the clothes fit issue).

The Business of Being Born

I've finally gotten to see this movie. Wow. Having gone through three hospital births there were so many moments in the movie where I was like "yes, exactly." When they talk about the domino effect of hospital interventions, in my experience that is extremely true. Just stupid things like "let's start the IV, just in case." After that it is SO EASY to pump in a drug based on an expert authority's recommendation.

I saw it on DVD and there was some extra footage that I image you wouldn't get to see in the theater. In one of the followup interviews with a homebirth couple the mother talks about how she reached a point in her labor that if there were pain medications available, she would have taken them. What the homebirth midwife refers in the movie to as a "rock and a hard place." Man, I know that place! The homebirth mother says "but I had it easy, I was at home." Wow. She set herself up in an environment where she could get through the pain, the worst pain, without medication and she did. She went on to talk about how she could freely move around, remove all her clothes because nothing felt comfortable (she said her mother kept giving her a robe for modesty's sake--heh!), and squat whenever and wherever she wanted, because she was at home. Even if the hospital "officially" says you can do that, that's just not how things happen. I remember going to a hospital childbirth class before my first child was born and seeing a video of this woman with no clothes on in labor moving around, squating and doing all kinds of stuff in a hospital room. When I got to that same hospital in labor I most certainly did not get "let's change your position to manage your pain," I got "let's start an IV, let's strap this monitor to you and this monitor to you, now lift your legs I need to check you, lie down on your back...."

I got a taste of what a natural birth is like with my last birth, because my epidural did not work. I managed my pain, a drug did not. Don't misunderstand, at that moment I really wanted that drug to manage my pain, but that just wasn't how things played out. I have a history of that also.  With my first birth I had partial numbing on one side and with my second I had an tolerable level of numbing from the epidural. I have never been one of those people that as a result of an epidural couldn't feel or move her legs. No, I was always in pain, just less pain (sometimes). Because of this history, I mentally prepared myself to (as I told myself) "not loose your marbles" if the epidural doesn't work. "Keep your game face on."

This last time I told the staff clearly and repeatedly that the epidural wasn't working. When the staff started feeding me the all too familiar lines "give it 20 minutes, lay on your back, lay on your left side, lay on your right side, bla, bla, bla" I thought "I'm not doing this again." I gave it five minutes of excruciating, lying on my back pain and sat up and said "This is ridiculous." The nurse then scolded me and said "Well, it's never going to work now because you're sitting up and the medicine is just going to all go to your bottom" (whatever that means!). So I said "It's NOT working. I have to deal with this and I can't lying on my back. I don't care." And it was not discussed again.

Since then I've discussed my history with epidurals with a few different health care providers and they seem to think that (as I understand it) pain medicine runs through me pretty quick. I never thought to correlate the two until after, but I also have a history of dentists not believing me when I tell them "I can still feel that!" and then give me line "it's just pressure." You gotta love that. Right, like I (along with everyone else on the planet) don't know what pain is. Anyway, even though I did have pain medicine and IV fluids (and who knows what else) in me I still got that super high after the birth that I didn't get with the other births. I just remember feeling like I have to get up and go. I have things to do and energy to do it. I guess it was because I had to deal with the pain and I was dealing with the pain. I had a lot of pain with my first birth, but I wasn't dealing with it, things were very much out of control for me. I felt like I was being dragged along to places I did not want to go with my first birth. I clearly remember after my first birth having a very fearful and shell-shocked notion of "I don't know if I can do this again." Thankfully, time heals a lot.

I still don't know if homebirth is something I can/will do in the future. But after seeing this movie and doing some more reading on it (both pro and con), I know at least some part of me really wants to. 

What are your plans for the weekend?

Have a baby, apparently!

Emma Cathlyn

I've never really considered myself to be the (excuse the term) "crunchy hippie" type, but lately it just seems like I keep having experiences that make it look that way.

I'm currently 33 weeks along and my belly is big. I mean it's really big, but that's normal for me. Both my kids have been over eight pounds at birth. Also, I'm short; there's just no place for my belly to expand except out. I look pretty uncomfortable, and well, I am pretty uncomfortable.

So, kind of out of the blue today my midwife suggests that I can schedule an induction at 38 weeks if I'm really uncomfortable. Uncomfortable!? It's pregnancy, of course it's uncomfortable, but not as uncomfortable as having a baby too early. I know 38 weeks is technically term, but I trust my body to know better than me or the doctor if everything is done cooking (so to speak). It just felt so weird me telling the medical professional that "No, I'm ok waiting until I go into labor naturally." I mean, it's one thing to schedule an induction if there's a compelling medical reason, but I hardly see being uncomfortable as compelling. I've been blessed to be able to have both my kids vaginally (sorry to pull out the v-word, guys) without having to be induced. It makes me nervous to do anything that would possibly interfere with that track record.

I don't mean to paint an overly negative picture of the practice or this midwife. I've actually been very happy there and with her, but this was just a weird experience for me.

Having two children so close together (my second and soon to be third child) has really got me thinking about birth control options. I love my children and, at the moment, haven't ruled out the idea of having more, but I really don't want to have them this close together again. Until this pregnancy, the idea of having kids so close together was a bit of a non-issue for me. Before we had our oldest son we didn't use any kind of birth control for about three years before conceiving him. So, forgive me if I didn't really consider myself the fertile type.

I've repeatedly talked to my GYN healthcare providers (usually a midwife in my case) about birth control options and the responses I get are to take something hormonal based (the pill, ring, etc.), get an IUD or use some kind of barrier method (condom or the like). None of these options are very appealing to me. I've not taken any form of birth control for the majority of the past six years (wow, that seems weird to think about in our culture), and, truthfully, I really like not taking birth control. For the short time I did take a hormonal birth control over the past six years (for about six months after the birth of my oldest son), it did not agree with me. I gained weight and at very least it didn't help things with my postpartum depression (at worst it contributed, perhaps even caused my PPD). I don't like the idea of anything as invasive as an IUD and as far as any long term use of a barrier method, well let's just say I'm married people! Are you kidding me! That's just not a realistic option for us. So, where does that leave us?

The Art of Natural Family Planning

Taking Charge of Your Fertility

1 comment

So, what are your thoughts on birth control options for married people? Do any of you have any practical experience using NFP or FAM?

That's right there will finally be another female added to the household. Now we just have to figure out names.

I recently had to write this down to send in an email to an old friend of mine I was catching up with after a number of years apart. After writing it and thinking about it, I thought it would be a nice thing to document on my blog.

I went off birth control about a year after we were married, but didn't get pregnant until about two years later and then I miscarried early in that pregnancy. After about a year-and-a-half of no birth control and not getting pregnant we decided we should do something. I was getting pretty depressed. We talked about it and decided that neither of us really wanted to pursue the infertility treatments and would like to adopt instead. So we got the ball rolling with the adoption process, which basically starts off with a series of classes. We hadn't gotten far into it when I found out I was pregnant. I was so excited and happily told everyone I could. Then only a few weeks after I found out, I miscarried. How can I explain how difficult that was? It's losing a child. I know people say (and I heard people say to me) things like "At least you didn't know it longer. That would have been much worse." or "It's just a bunch of cells", but I tell you it was as painful an experience as if I lost one of my children I have today. And it stays with you. People think that once you have a healthy baby that all the pain of a miscarriage just sort of goes away, but that's not really true. I mean, like any painful experience you learn to deal with it and continue to manage your life, and slowly good days start to outnumber bad days, but it doesn't just go away when you have a "replacement"(?!) child. Anyway, after the miscarriage I had to stop everything baby related in our life. I just couldn't take it. Then about nine months after the miscarriage I got pregnant with Joel.

Joel's pregnancy was pretty uneventful (thankfully). I ended up going into labor one day shy of being induced (I was a week overdue). My total labor lasted just over 30 hours (I was only in the hospital for 12 hours of it, though). My epidural only worked on one side and I pushed for about one to two hours (I don't have a clear memory of that part, just that it was extremely painful in spite of me electing to have pain management). My postpartum period was miserable. It felt like I bled forever, I had postpartum depression and I just could not get the hang of breastfeeding. Long story short is I eventually healed, got help for my postpartum depression and switched to formula. The first three months were so rough, though. They are just a blur in my memory. I do remember shortly after coming home from the hospital that all I could think was "I don't know if I can do this again." Of course I ended up changing my mind, but that's how overwhelmed I felt at the time. I was so nervous about getting pregnant again that I went on birth control in spite of my history with infertility.

I went off birth control about six months after I had Joel hoping that perhaps sometime around his first birthday I would get pregnant. Well, Joel's first birthday came and went and I wasn't pregnant. So I just thought that maybe he would be our only child and I had to be ok with that. Of course I got pregnant again. This time with Micah.

MIcah's pregnancy was also pretty uneventful. I had normal pregnancy side effects (tired, sickness, heartburn, etc), but nothing to jeopardize me or the baby. I went into labor with him pretty close to his due date. I was so glad. I did not want to be overdue again. His labor, delivery and postpartum period were like night and day compared to Joel's. Micah's total labor was 12 hours. Only 5 of which were in the hospital. I labored at home for as long as I could and pretty much when I finally got to the hospital I was like "Ok, I'm ready for my epidural," but it took them an hour to process me, etc. to get me to the point where I receive an epidural. That was annoying to say the least, but that was by far the worst thing. When I finally got my epidural (that actually worked) I went to sleep for a few hours. I woke up when my water finally broke. The midwife came in and, I kid you not, I pushed three times and the baby was out. Yeah, a completely different experience! My postpartum period was really well also. I healed quickly, didn't have PPD and I was able to establish breastfeeding with this one. With the great experience I had with Micah I thought it would be just a waste of money to go back on birth control. It had always taken us nine months or longer to get pregnant and I was breastfeeding with Micah, so that should give me an additional buffer, right? I did end up having complications later when my milk started to dry up prematurely. I just switched to formula at that time. I wasn't interested in fighting that battle again. And shortly after that I end up getting pregnant with this latest one (much sooner than I would have ever guessed I would be).

The idea of family planning has been such a joke to us. We've wanted all of our children for certain, but "planned" them, not exactly. All of our "plans" seem to get thrown out the window as soon as they are made. 

My doctor appointment went well today. I scheduled my get-to-find-out-the-sex-of-the-baby ultrasound appointment today. It's for early January. So, I can't really put a poll up on here (I don't think), but I would love to hear your guesses about the gender of baby #3.

I'm about three months now (a little over 13 weeks) and I think I'm slowly starting to feel a little better. I imagine I will get about three months where I'll feel like getting things done and the last few months will be huge lady misery.

My apetite has been strange this pregnancy. In past pregnancies I'm usually hungry all the time, but with this one I almost never feel hungry. I usually start to feel sick and think "Oh, I should eat something," but rarely do I have that normal "I'm hungry" feeling. It's annoying, to say the least.

I go in for a doctor's appointment today. Let's hope all's well.