de facto ban

de facto - ACTUALLY : in fact : in reality

In other words, when something is de facto, it has the force of reality without being spelled out in so many words.

A hospital here in Houston, West Houston Medical Center, has placed a de facto ban on the "risky" procedure of women having a vaginal birth after a cesarean section (VBAC) by no longer guaranteeing the availability of anesthesiologists after normal working hours for VBAC patients. You can read an article from a couple of weeks ago in the Houston Chronicle here. Without the promise of available anesthesiologists, in case of emergency, few doctors will be willing to allow women to have VBACs, forcing them into the new reality of "once a cesarean, always a cesarean".

Some physicians cite the risks of the procedure - mainly the 1 percent chance [actually, less than 1%] the uterus will rupture along the C-section scar - as reason to perform repeat C-sections instead.
But C-sections, too, carry risks, particularly those associated with surgery, such as infection. So which option is better for a woman often hinges on her pregnancy, including whether she's likely to have the same complications that required a C-section during the previous birth.
For doctors, C-sections can be more appealing because there's less chance of a lawsuit. In the small percentage of VBAC cases that result in uterine rupture, an unpredictable complication, a C-section must be performed immediately to save the life of both the mother and the baby. (from the Chronicle article)

What this is really about is not the women's health, or about the safety of one option over the other. This is simply about two things:

1. doctors fear lawsuits, and their insurance companies fear them even more, and
2. doctors like schedules and dislike having to be available 24/7 waiting for a birth to happen naturally when they can set it for 8:00 Monday morning and be done with it in an hour.

Right now, there is something you can do about this. A petition is being gathered (a real one, not some goofy add your name to the e-mail chain) that can be signed on-line. Go sign the petition, and it will be presented to the hospital per their stated mission of listening to the community.

This is something that Mrs. E and I are very passionate about. The birth of our little boy, now nine months old, was through VBAC. It was perfectly safe, and low risk, with the only problems coming from medical staff who indirectly expressed their disdain for us nutballs who make their life hard. Birth is not about the hospital getting it's way, and it is not about the insurance company finding the cheapest solution and maximizing their profits. Birth is about a mother, a father, and a child coming into the world. Give them the options to birth that baby in the best way possible for them, not for some third-party's interests. Please join us in signing this petition.

Tags: VBAC, Ban, Cesarean Section, Petition

Impaneled

A few weeks ago, my darling wife acted in the Birth Play (by Karen Brody). After the last performance, the cast and family/friends gathered at Star Pizza to chow down. At that time, the organizer of the play here in Houston noted my "excellent co-parenting skills"; as a result, she has asked me to sit on a dad's panel at this Saturday's Birth Fair. Being a good husband, and of course and "excellent co-parent", I accepted this honor. And so, from 11:25 until noon, me and two other guys will sit and talk about giving birth.

Don't laugh.

Really. Stop it. Now.

Why can't a group of men sit around and talk about birth, expressing their opinions on how it should be and how the system should be different? Without reading from cue cards prepared by his significant other, or being castrated, that is.

Seriously, though; if you think a man only sits the sidelines in this, then the man you're thinking of is leaving his wife out in the cold. From spending nine months of marginal sleep (when one can't sleep, neither sleeps) to running to get a bowl when the chuck comes up. From getting that bowl of pickle gelato from the Kosher/Italian deli she heard about in Parents Magazine, to comforting her through contractions and birth pains. The man is involved. While she may curse us for making a donation and leaving her to do all the hard work (especially when the baby is crowning), a good man is there the whole time to support and encourage. And, despite where the bambino grows, it took two to get there and it takes two to go from there.

So, on Saturday I'll be talking about why we (and I emphasize we) chose to have #2 naturally. Even after a cesarean section. Even after Prudence, the triage nurse, constantly belittled us for our stupid decision.

But, I only have one stipulation. This ain't gonna be no froufrou panel. Expect a manly belch or fart, if called for. And I may take a fifth of Jack, just to let the newbie dads know you won't have to wear a fake pregnancy belly or induce male lactation to be a part of this experience.

Can I get a boo ya for manly birth and child-rearing?

Tags: Birth Fair, Birth Play, Natural Childbirth, V-BAC

Prayer answered

Our friends Connie and Joel write:

We started working with a second adoption agency a couple of months ago. Almost as soon as our paperwork was in (not a small task!), they presented us with a birthmother in Las Vegas, Nevada. They told us she was due toward the end of July, then at the beginning of July. We were thinking about it and trying to get more information when we got a call last Monday saying the birthmother was in labor. If we were interested, we needed to get to Las Vegas ASAP. We hadn't yet committed, but in the three hours after we first discussed it, we decided to go, we packed us and Matthew for an unknown number of days, we drove to Connie's brother's house to drop off Matthew, and we got to the airport, where we sat around waiting to see if we could make it on a 10:30 flight as standbys (Thanks, Mom!). Finally, the 10:30 flight boarded a little after midnight, and we made it on as standbys #24 and 25. Then we arrived in LV, found a hotel, took a suicidal taxi ride, and finally got to bed around 4 am Texas time.

OK, that's the first few hours. The next few days are a blur, but four hotels and LOTS of stress later, we are in possession of a beautiful baby girl (sounds like a crime, doesn't it?) that we can bring back to Texas in 7 to 10 business days. The details of the past few days should fill many e-mails or telephone conversations, so they'll have to wait for now.

Connie and Joel have been trying to adopt a second child for two or three years now (it's been so long I've lost track of the time). They have an adopted boy and now, at long last, a little girl as well! It has been a long road, with multiple birth mothers backing out after the child was born (under circumstances that lead to the belief they never intended to give the child up for adoption in the first place) breaking their hearts. But now the wait is over!

Rejoice with them today, and pray that they all make it back home safely and soon.

Tags: Adoption, Friends, Joy

Blessed

Today, our new son turns one month old. Besides being truly blessed with my beautiful wife, this little boy, and his big sister, we have been blessed in many ways this month. Little Euphrony has had no problems so far with having a new baby in the house. She loves him so much; we have more problems trying to get her to give him some space and not smother him than anything else. She wants to hold her little bro, leans over to give him hugs and kisses on the forehead constantly, and wants to help with everything - including changing his diapers. (Hearing her help to sooth Lil'er E during a diaper change by singing "Grace Flows Down" (Christy Nockels) to him absolutely melts my heart.) We worried that she might act out and become jealous of the attention he gets that we once solely lavished on her; this has yet to happen. She may act like a three-year old girl, but that is normal; she loves her brother and seems to understand the needs he has and how mom and dad must respond to him.

Our family has been blessed with food. I mean, a lot of food. We have not had to cook since Lil'er Euphrony was born; not once. We have had people bringing us food every other day for a month now, and we still have people bringing food for the next week or so. It is absolutely amazing how much this has helped us out, freeing up time that might be spent in the kitchen or having to run get something and allowing us to relax and spend more time together as a family. To everyone who has brought food: thank you, from our whole family, for your love and care for us right now. My only complaint about the food is that it is too good. These people brought their "A" game, and we've eaten more good, rich food than we usually do. I won't confess what the scales say, but they are a showing a little higher number than before Lil'er E was born. How's that for a complaint?

I had mentioned that I was pretty sick shortly after Lil'er E was born. I was basically out of the game for four days, conveniently the first four days we were home alone with no family to help us. A few days after I was getting better, my father forwarded this note from a preacher in northern Ghana (my dad has spent a great deal of time there doing mission work):

My Good Elder, this is to brother Jason: may he get better each day, may the Lord put upon him the balm of gilead. More than expected, his recovery shall be amazing. He will get well soon.

This is to Elijah: As it pleases the Lord to protect him up to the day he was born, so shall it please Him to keep him in the shelter of his love now and forever more.

My Good elder, it is really not easy at the time a child is been born your are faced with such challenges. All will be well.

Reading this note, from someone I've never met or talked to, really touched me. That someone half a world away, who knows little to nothing about me or my family, cares this much about us is amazing and a testament to the heart of Christ that is found in His body.

One more thing that I find myself, personally, having been blessed with is God's working on my heart. I posted recently about my struggles in my walk with Jehovah. While I find that I still struggle in the areas I detailed then (and likely will for a while, as I work to grow) God showed me this past weekend that He has continued to work on my heart to mold me into His image. He has just been doing it in ways that I had yet to recognize until now. I've always boasted about Mrs. Euphrony and her soft heart and care for the lives of other people. This is, honestly, something which was never strong in my heart; to me, compassion seemed to be more conceptual than something to be acted out. Mrs. E has always encouraged and taught me in this, with her loving heart, and brought me to righteous actions that I may never have become part of before. But now, after a brief encounter this weekend, I find that Jehovah has worked on my heart - through Mrs. E and others - to soften it to the needs and plight of others. He is making me kinder, more compassionate and generous, and I had not realized it until now. My life may be a struggle to walk in His word and in faith, but while I struggle in one area I find that He is blessing me with faithful growth in another. That encouragement in yet another blessing from God this past month.

It's been an interesting month, full of fun and joy and struggles and work. But we have been truly blessed.

Tags: Thankfulness, Joy, Peace, Friends, New Baby, Big Sister, Gifts, Compassion, Jehovah, Kind Heart

Lil'er Euphrony is here!

It wasn't easy. It never is, really. But our son is here! Mrs. Euphrony started having serious pre-labor Friday night, with contractions at night every 5-8 minutes (harder when she was laying down) and during the day every 15-30 minutes. With such nightly fun, and having a three year old jumping with energy during the day, Mrs. E got very little sleep over the weekend. Saturday night and Sunday night were identical, so by Monday we were both exhausted. I stayed home from work to help with Lil' E and we took Mrs. E in to see her midwife for a check-up. Apparently, all that pre-labor was doing something, because she was dilated to a 4. Since she still was not in consistent labor, we went on and saw a chiropractor for a "labor" adjustment (stretching the back and pelvic muscles, relaxing to prepare for labor), after which we went home. By this time, Mrs. E was in steady labor with contractions every 4 minutes, and we called our doula to come and help until we were ready to go in to the hospital.

We checked into the hospital at about 9:00 p.m., with Mrs. E doing just fine and dilated to around 6-centimeters. Once the nurses there got used to the idea that we did not want and IV, and that she would actually (gasp!) eat a little food during labor to keep up hydration and strength, they were very supportive. Since Mrs. E had a previous c-section, they required her to have constant monitoring of the baby's stats (she was in almost no risk, but the legal system is all over medicine - that's why we were in the hospital instead of at the birthing center in the first place). Their constant fiddling to adjust the monitors to keep track of the baby was the most annoying thing. Not once, though, did anyone ask Mrs. E if she wanted an epidural; and she didn't need one, either.

Our midwife was great, and the doula was a terrific help throughout the whole birth. By the time it was time for Mrs. E to be pushing, she was pretty well worn out (between several sleepless days and around 11 hours in active labor). We had me, Mrs. E's mom, the midwife, the doula, the nurse, and our old midwife and personal friend there to help encourage Mrs. E on. She did great! After about an hour of pushing, he was here! All exhaustion was gone; we have a new boy and we were (and still are) thrilled!

Lil'E is thrilled to be a big sister. She's feeling a little loss of mom and dad being distracted right now, but we'll all be home together today. We're happy as larks right now; still in euphoria from the birth but not strained from the sleepless nights yet. We had taken Lil'E to Build-a-Bear to make herself a bear and she made little brother a puppy dog (in the picture above) as her present to him. We're doing well, and we appreciate all the prayers that everyone has given for us through this pregnancy and birth.

Tags: Pregnancy, Natural Childbirth, Midwife, Doula, Hospital

He's on his way!

More news to come, but Lil'er E is on his way!

Split Blogging

Baby Lotto We went in for another baby checkup yesterday. The official due date is March 6th, 11 days from now. Mrs. E is already dilated 2 centimeters, 50% effaced, and Lil'er Euphrony is dropping like a rock. Will she make it, folks? What do you think; take your best guess. Tags: Pregnancy, Poll, Lotto

Downhere in Houston Thanks to the amicability of the lovely Mrs. Euphrony, and some kind friends who thought it would be nice to watch Lil'E for a few hours to let us relax before D-Day (Delivery Day), Mrs. E and I got to go to the KSBJ Brownbag concert last night - featuring downhere. For those not from the Houston area, KSBJ (the monolithic local CCM radio station) hosts a monthly mini-concert, sponsored by and located at a Chick-fil-A®. And since downhere is a Canadian band, they don't get, well, down here very often. I've liked their music since their first self-titled album came out in 2001.

Let me set the mood for this concert. First, this was at a Chick-fil-A inside a mall, so they were rocking the food court. Mrs. E and I get their, stand in line at Chick-fil-A for a quick bite to eat (they give me free music, I'll give them my dinner money) and I see the guys from the band munching on their (likely free) Chick-fil-A sandwiches and nuggets before they go up to belch out a few numbers. (Sorry, guys, but I couldn't eat like that before getting up to do a show.) As we sat for the show, we were simultaneously brought some good Canadian rock with the message of Christ and washed over by the aromas of fresh-baked cookies from Great American Cookie Company. Sweet!

The guys put on a good set. The way the brownbags work is the band does a approximately 40-minute set, breaks to sign autographs, then repeats (rock, rest, repeat). They open the set with "The More", the lead song on their newest album Wide-Eyed and Mystified - a good rock'n opener - then segue into "Larger than Life" from their first album Downhere. After a few words to the crowd, they go into their audience participation song "Rockstars Need Money" (we can't live on bologna sandwiches), a hidden track also on their debut album. After introductions of the band and a short message describing the inspiration for their next song, the play two songs from Wide-Eyed - "Little is Much" and "A Better Way", both of which have been getting airplay, and the second has been sitting on the top-twenty charts for a little while. They then closed the set with "What It's Like" from their sophomore album So Much for Substitutes.

It was a fun set; lots of energy from the band and from the crowd. I've got no idea when I'll next get a chance to see downhere (or any other band, with the new baby getting here soon) so I was relishing every minute of the show. I like their music, and they have a good message that they present in a good way. If you haven't heard their music before, you can check out a couple of their songs on their Purevolume page.

Tags: Downhere, KSBJ, Music, Concert, Chick-fil-A, CCM, Christian Music, Canadian Rock

Birth Plan

Below is the birth plan we have put together, to be given to those attending the birth. It is all aimed at allowing for a natural child birth, allowing the child to come when the time is right without induction or cesarean section.^1,2

The Euphrony’s Birth Plan

Mrs. and Mr. Euphrony, with their daughter Lil'E, would like to thank you for the rolls you are playing in the birth of our new son and brother, Lil'er E. Our doula, Debbie, will be assisting Mrs. E and our midwife³, Karen, during the birth process. We have a few requests that we hope you will recognize to make this the best possible birth experience for our family.

• We recognize the need for care for the infant during the birthing process, and ask that such monitoring be minimal.
• We request that no IV be administered to Mrs. E. (We recognize the importance that the mother be well hydrated and plan on using clear fluids for this.)⁴
• Please do not offer medication for pain relief. We would like to use the tub and shower for pain relief, and will request medications if needed.
• We also request that no aggressive coaching for pushing ("purple pushing") be offered.⁵
• We would rather allow for natural tearing, rather than have an episiotomy⁶, and that forceps not be used.
• Please wait for the placenta.
• We ask that no routine post-partum pitocin be used. If necessary, please use an injection of pitocin in the thigh.

Thank you for becoming familiar with our wishes for a smooth and natural birth process.

Fact Sheet:

1. Induced labor tends to be more intense and painful for the woman, often leading to the increased use of analgesics and other pain-relieving pharmaceuticals. This cascade of intervention has been shown to lead to an increased likelihood of caesarean section. Currently, in the United States, 41% of mothers get induced.
2. The World Health Organisation estimates that the rate of caesarean sections at between 10% and 15% of all births in developed countries. In 2004, the caesarean rate was about 20% in the United Kingdom. In 2005 the cesarean rate was 30.2% in the United States. During 2001–2002, the Canadian caesarean section rate was 22.5%. In the United States the cesarean rate has risen 46% since 1996.
3. In the United Kingdom, midwives are the lead healthcare professional attending the majority of births, mostly in a hospital setting although home birth is a perfectly safe option for many births. In the United States, Nurse Midwives are advanced practice nurses who have specialized in the practice of obstetrical and gynecological care of relatively healthy women. In addition to a registered nursing license, many nurse-midwives have a master's degree in nursing. Nurse-midwives practice in hospitals and medical clinics, and may also deliver in birth centers and at home. They are able to prescribe medications in 48 out of the 50 states.
4. In the United States, 85% of mothers are connected to an IV line during labor and only 15% of mothers were permitted to eat during labor.
5. Purple pushing, during which the patient holds her breath for 10 seconds while pushing, is safe in the approximately 80% of women with low-risk pregnancies. But that doesn't mean it works best. Furthermore, in physiologically high-risk cases, the baby can't tolerate that kind of pushing. In the United States, 57% of mothers who give birth vaginally are on their backs while giving birth. A squatting position will provide the most intrauterine pressure and is safe in low-risk patients. Higher-risk patients, such as those with fetal heart rate changes should avoid this position; in those cases, a side-lying position will improve heart rate patterns and Apgar scores. Other positions to consider include semirecumbency, standing or leaning, and hands-and-knees positioning. Some patients may prefer use of a birthing chair or stool.
6. Routine episiotomy is a major cause of infections, some of them fatal. Recent studies indicate that routine episiotomies should not be performed, as they may increase morbidity. Having an episiotomy may increase perineal pain in the postpartum period, resulting in trouble defecating. In addition it may complicate sexual intercourse by making it painful and replacing erectile tissues in the vulva with fibrotic tissue.

Tags: Birth, Natural Childbirth, Doula, Midwife, Purple Pushing, Episiotomy, Pitocin, Cesarean Section, Induction

BIRTH Story

No, the baby's not here yet. We have a mere 2 1/2 weeks until the official due date. The actual timing could be anywhere from today to St. Patrick's Day (but we're hoping it doesn't go quite that long). However, I am going to start talking a little bit here about some of the choices we are making in the birth process (and by we, I mean "we" and not "me" - I am not imposing anything on Mrs. Euphrony, but we agree on these things and I support her 100% whatever she wants to do). For a resident of the United States, this will be a non-traditional birth, though it is the way most of the world (even the industrialized world) goes about it. No drugs. No doctor; we have a midwife (yes, they still exist as a profession). We want this birth to be viewed as a natural process and not as a medical condition that requires treatment, or as one that needs to be scheduled to avoid the inconvenience of waiting for ourselves or the doctors. Not that we are granola-crunchy; not at all. We do firmly believe that the medical wonders we live with are great things, but not nearly as necessary as we have been lead to believe.

To start the conversation, I give you an excerpt from the play BIRTH, by Karen Brody, with which Mrs. E has been involved. It is a collection of the true birth stories of seven women, some good and some bad, and gives a fair representation of the different ways some women birth: planned Cesarean sections, induced labors, emergency C-sections when complications arise during labor, births in the hospital with drugs, births at home without drugs. This is the introduction of the play, and will give you something to think about.

We always had animals growing up. I remember seeing puppies and kittens being born just about every year in our house. I believe that human beings are, you know, we're animals.

When I was growing up you never took a puppy away from its mother. You left the mother alone in a dark, safe place away from noise. It seemed to me the best way to bring life into the world. The worst thing you could do to a dog is stick them under lights, start poking them and taking the babies away.

Sometimes I'd watch a dog in labor all day until she moaned and groaned so loud it sounded like a whale giving birth . . . a howling chant. Her hips swayed back an forth with smooth rhythm. I loved that moment, when the dog knew she was ready and we knew it and the babies started coming out.

Nobody was scared. The dog was in pain, but everyone knew it was going to be alright. One by one the wet puppies appeared and snuggled up to their mother. Some fell asleep. Other sucked on her nipples. I wanted to touch those puppies so bad, grab one for my own, but then I'd remember my mother's words: You never take healthy puppies from their mother.

Never. A mother needs to feel her babies next to her after they are born. A mother giving birth needs some space. Give her some space . . . love . . . touch . . . words of encouragement. This is her moment.

I wanted that same thing preserved when I gave birth.

I wanted what my dog got.

Tags: Birth, Karen Brody, Pregnancy, Euphrony, Cesarean section, Midwife, Induced Labor, Childbirth