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A long time ago I promised someone who emailed me that commented on my blog that I would write an entry that was something close to this. Tonight I had to write a paper for a class I am currently in. It fit the request enough to where I think I can kill two birds with one stone by posting it as a blog as well. Unfortunately, I was very pressed for time and I had to wrap it up kind of fast at the end, especially after I realized I was 3 pages over the suggested limit.

Should “Public” Schools Be Reformed?

 

When I first began college, I entered it with the intention of becoming a schoolteacher. Whether or not that was in a public school or a private school was still to be determined; although most universities education programs assume that you are going to be a public schoolteacher. As I was nearly done with my education degree, I began to seriously question the government school system that I was intending on immersing myself in.  Then, one day, I came across an article late at night on the Internet by a gentleman that goes by the name of John Taylor Gatto. The title of the article was, “I Quit, I Think”. It was originally published in The Wall Street Journal in 1991 and served as Gatto’s public resignation from the government school system. It’s not a long article, but in the ten minutes or so that it took me to read it, my serious concerns about the school system turned into a serious reality. In less than a page long article, this man, who was a retired public schoolteacher of 30 years and two time winner of New York State’s “Teacher of the Year” award, managed to put to words every feeling and then some that I had ever had about the government school system.

Gatto states,

“I’ve taught public school for 26 years but I just can’t do it anymore. For years I asked the local school board and superintendent to let me teach a curriculum that doesn’t hurt kids, but they had other fish to fry. So I’m going to quit, I think.

I’ve come slowly to understand what it is I really teach: A curriculum of confusion, class position, arbitrary justice, vulgarity, rudeness, disrespect for privacy, indifference to quality, and utter dependency. I teach how to fit into a world I don’t want to live in.

I just can’t do it anymore. I can’t train children to wait to be told what to do; I can’t train people to drop what they are doing when a bell sounds; I can’t persuade children to feel some justice in their class placement when there isn’t any, and I can’t persuade children to believe teachers have valuable secrets they can acquire by becoming our disciples. That isn’t true.

Government schooling is the most radical adventure in history. It kills the family by monopolizing the best times of childhood and by teaching disrespect for home and parents.

An exaggeration? Hardly. Parents aren’t meant to participate in our form of schooling, rhetoric to the contrary. My orders as schoolteacher are to make children fit an animal training system, not to help each find his or her personal path.

The whole blueprint of school procedure is Egyptian, not Greek or Roman. It grows from the faith that human value is a scarce thing, represented symbolically by the narrow peak of a pyramid.

That idea passed into American history through the Puritans. It found its “scientific” presentation in the bell curve, along which talent supposedly apportions itself by some Iron Law of biology.

It’s a religious idea and school is its church. New York City hires me to be a priest. I offer rituals to keep heresy at bay. I provide documentation to justify the heavenly pyramid.

Socrates foresaw that if teaching became a formal profession something like this would happen. Professional interest is best served by making what is easy to do seem hard; by subordinating laity to priesthood. School has become too vital a jobs project, contract-giver and protector of the social order to allow itself to be “re-formed.” It has political allies to guard its marches.

That’s why reforms come and go-without changing much. Even reformers can’t imagine school much different.

David learns to read at age four; Rachel, at age nine: In normal development, when both are 13, you can’t tell which one learned first — the five-year spread means nothing at all. But in school I will label Rachel “learning disabled” and slow David down a bit, too.

For a paycheck, I adjust David to depend on me to tell him when to go and stop. He won’t outgrow that dependency. I identify Rachel as discount merchandise, “special education.” After a few months she’ll be locked into her place forever.

In 26 years of teaching rich kids and poor, I almost never met a “learning disabled” child; hardly every met a “gifted and talented” one, either. Like all school categories, these are sacred myths, created by the human imagination. They derive from questionable values we never examine because they preserve the temple of schooling.

That’s the secret behind short-answer tests, bells, uniform time blocks, age grading, standardization, and all the rest of the school religion punishing our nation.

There isn’t a right way to become educated; there are as many ways as fingerprints. We don’t need state-certified teachers to make education happen–that probably guarantees it won’t.

How much more evidence is necessary? Good schools don’t need more money or a longer year; they need real free-market choices, variety that speaks to every need and runs risks. We don’t need a national curriculum, or national testing either. Both initiatives arise from ignorance of how people learn, or deliberate indifference to it.

I can’t teach this way any longer. If you hear of a job where I don’t have to hurt kids to make a living, let me know. Come fall I’ll be looking for work, I think.”

After reading that article I had to read more about Gatto and his comments on the system. I immediately picked up his best-known work, titled, “Dumbing Us Down: The Hidden Curriculum of Compulsory Schooling” and read it in a day. I couldn’t put it down. The next day, I quit the Education Department at the University of Central Florida and transferred to the Interdisciplinary Studies Department simply because it was the option that lost me the least amount of credit hours. I was completely disgusted by what we all refer to as the “public education system” and refused to be a part of it. I don’t even like to refer to it as the “public education system” anymore. After all, there is nothing all that public or educational about it. I call it what it is, government schooling.

Many people, especially my fellow future educators that I was leaving behind, believed my decision to be brash. They immediately got defensive about their future professions and started touting off about how they planned on “reforming” the system they so sedulously believed in, even if it was only within their own classrooms. I understood where they were coming from; I used to say the same things. I had a naïve optimism that said that I could change things, and do things differently in my own classroom and that it would work so wonderfully that it would spread to classrooms throughout the country. Lead by example, be the change you want to see, right? I was determined that learning would take place in my classroom and that the system would catch on to what I was doing right. Of course, in order to believe that the system is going to change according what is good for the children, you have to believe that the system is actually there for the good of the children. Unfortunately, so far, I haven’t seen any good evidence to show that this is the case.

Let’s take a quick glance at what we consider the “founders” of modern government schooling had to say about education:

“The children who know how to think for themselves spoil the harmony of the collective society that is coming, where everyone would be interdependent.” – John Dewey (Educational philosopher and proponent of modern “public schools”)

“Education, then, beyond all other devices of human origin, is the great equalizer of the conditions of man, – the balance-wheel of the social machinery.” – Horace Mann (considered the “father of public education”)

“Our schools have been scientifically designed to prevent over-education from happening. The average American (should be) content with their humble role in life, because they’re not tempted to think about any other role.” –William T. Harris (Commissioner of Education U.S. 1889)

“Our schools are, in a sense, factories, in which the raw products (children) are to be shaped and fashioned into products to meet the various demands of life. The specifications for manufacturing come from the demands of twentieth-century civilization, and it is the business of the school to build its pupils according to the specifications laid down.” – Ellwood P. Cubberly (Dean of Education at Stanford from 1917-1933, considered a “pioneer” in the field of educational administration)

So where am I going with this? Am I suggesting that the system we put so much faith, so much money, and so much time in isn’t producing an enlightened population? That’s exactly what I am suggesting. In the very eloquent words of American author H. L. Mencken, “That erroneous assumption is to the effect that the aim of public education is to fill the young of the species with knowledge and awaken their intelligence and make them fit to discharge the duties of citizenship in an enlightened and independent manner. Nothing could be further from the truth. The aim of public education is not to spread enlightenment at all; it is simply to reduce as many individuals as possible to the same safe level, to breed and train a standardized citizenry, to down dissent and originality.” At first glance, this claim may seem very heavy-handed and even dramatic. However, spend a day or two in any public school classroom in the country with this statement in mind, and the candor in it will be come unavoidable. Whether or not it is intentional, or unintentional, it is the reality of what the government schooling system produces. It produces equalized dependent consumers that do not know how to think or question. How does it do this? It does it by standardizing everything. It does it by compartmentalizing everything. It does it by taking everything out of context. It does it through public humiliation. It does it by grading, labeling, and packaging.

The government school system doesn’t even attempt to create an environment conducive to learning. The very nature of the classroom makes it nearly impossible to learn anything in context. Children are segregated from the rest of the world for 8 hours a day in the same room, with the same people, of the same age, the same social class, etc. Diversity is little to none. Where else in the real world do you find this type of environment? We cut children off from the rest of the world and then we attempt to teach them about the world.

Socrates once said that, “Education is the kindling of a flame, not the filling of a vessel.” The current system we use most assuredly views education as the filling of a vessel. Children are required to memorize the facts that a small group of people, known as a school board, deems is necessary and good to know. Not only do they determine the information that is to be taught; they determine, to a great degree, how it is taught, when it is taught, and in what context it is taught. To make sure the filled vessel has sufficiently digested this information, the state pays large sums of money to testing companies to deliver what we call “standardized tests”. The passing or failing of these tests don’t actually have anything to do with measuring a persons intelligence. All it really does is measure whether or not a student is able to regurgitate the facts that the state wants him/her to memorize. What the state really wants to know is, “Has this student been standardized?”

The government schooling system tries to turn what is an incredibly individual journey into a collective endeavor. Proponents of the current system will try to say that this isn’t the case and that “good” teachers work very hard to tailor the curriculum to the needs of each child. I don’t doubt that well-meaning teacher’s do attempt to do this. What I doubt is the possibility of that happening to any significant degree. The very nature of classroom management doesn’t allow for it. There are specific amounts of time devoted to specific “subjects” and when the bell rings and your time is up, you are required to withdraw yourself from that learning experience whether or not you were ready to be done. Not only is this disastrous for education as it hijacks any lasting, beneficial learning experience, it’s a disastrous habit to teach children in general. To again use the words of Mr. Gatto, “By bells and many other similar techniques they (schools) teach that nothing is worth finishing. The gross error of this is progressive: if nothing is worth finishing then by extension nothing is worth starting either. Few children are so thick-skulled they miss the point.”  Basically, government schools teach children not to engage in the truest form of education, self-education. Schools teach that you will be told what to start, how to start, when to start, and even when to stop. It doesn’t take long before children lose this skill themselves.

So, all of these points bring us to the original question of this paper, should “public schools” be reformed? We certainly hear those words, “education reform”, thrown around a lot during every election. Both the Republicans and the Democrats claim that they have the plan that is going to “save” the “public education” system.  The problem is, save for a few politicians, nobody wants to talk about whether or not government schooling should be saved. We seem to automatically jump to the conclusion that we simply must do something to make the “public education” system “better”.

Why would anyone want this failing, disaster of a system to be not only “saved” but also be propped up even more by giving it more money? The reason is because we have been raised to believe that without the “public education” system, no one would know how to read or write, or add or subtract. The ironic part of all this, is that it is government schooling that has taught us to think this way to begin with. We’ve been tricked into believing that we need to save the very system that is failing us. In the words of Ivan Illich, “School is the advertising agency which makes you believe that you need the society as it is.” People simply cannot imagine how people would become “educated” without government schooling.

This kind of discussion leaves many people wondering, “So, what are we supposed to do about the public education system?” Should we reform it or get rid of government schooling altogether? The answer to this, of course, depends on several things including your personal beliefs on the existence of “public education” to begin with. Ideally it would be best for everyone if government stayed out of the business of trying to control and provide education for everyone. So far, the results haven’t been positive and I certainly wouldn’t say it has produced an “educated” society. However, most people realize that this isn’t going to happen overnight. At the very least, we need to have a serious discussion on whether or not we want to reform our current system instead of just blindly trying to “save” what we already have.

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On Tuesday, November 17h, I had the pleasure of being doula to a dear friend of mine, Kalie Drake. She delivered at South Seminole Hospital in Longwood, FL. A hospital I will now recommend to women who want a natural birth, but are uncomfortable with the idea of delivering at home or in a birth center. They respected all of her wishes, left her alone except for the intermittent fetal monitoring, let the cord stop pulsating before they clamped it, and didn’t even bath or do anything else except vitals to baby for a couple of hours. So cheers to you South Seminole! And CNM, Donna (not sure of last name).

I left a home birth to get to the hospital before things really started to get going. I like to be there early enough to help my clients find a rhythm before the contractions get the better of them. Kalie, however, was a total natural and quickly got into the groove of finding a rhythm. The biggest challenge, almost across the board, seems to be finding a way to make sure you are not tensing your body during the contractions. I’ve seen it in all my births I’ve attended, I’ve experienced it first hand, and it’s certainly understandable.

Right when I got there we got up out of the bed and went for a long walk around the hospital. When we came back, at around 8 pm, they checked Kalie for dilation and she was 4 cm dilated. I was slightly surprised as her contractions seemed to be really bothering her and stopping her from being able to walk, talk or do anything else. Of course, I wasn’t concerned since dilation doesn’t really mean anything! And Kalie would certainly prove this to everyone later on.

She decided after her 15 minutes of of required fetal monitoring that she wanted to labor in the tub for a while. The minute she got in she was so much happier. No surprise there of course! She labored in there for another 45 minutes. The contractions seemed to be picking up in strength but were still only lasting 30-45 seconds. This made everyone think she was still a ways away from push time. 45 minutes passed and it was time to get out and sit on the fetal monitor again. Kalie was absolutely dreading doing this and I can’t blame her of course. It seemed like as soon as she got into a good rhythm it was time to interrupt it again. This is one of the major downfalls of hospital birth; the interruptions are constant, even in this hospital which was much better about leaving moms who wanted to birth natural alone.

After this round of fetal monitoring Kalie sat up at the end of the bed and found it was a quite comfortable position for the time being. She got into a great rhythm, rocking back and forth, breathing fantastically, and I would massage her back and do doulble hip squeezes during contractions because she was having some back labor. The time flew by and again, it was back to the fetal monitor.

The contractions, as expected, always got worst when she had to lay on her back. However, this time it was much worst than the time before. She was having a much harder time staying on top of the contractions and she had a about 3 that really got away from her. You could tell by her body movement, her breathing and vocalization. Then, she started to grunt a little! Those grunting noises like your trying not to push. The nurse and I heard it and were both quite surprised and slightly confused. Even though she was showing signs of stronger contractions, she never looked like a woman going through transition. Kalie asked to be checked again because she felt she had made a lot of progress but the midwife was skeptical. When the nurse told her she heard Kalie grunt like she needed to push, the midwife went ahead and checked her. In a very surprised voice she said, “oh, she’s fully dilated!”. I was so happy for Kalie I almost cried! Haha. I had never seen anything like it. Kalie went through some tough contractions, to be sure, but I think she transitioned in about 3, not terrible, contractions. It was incredible.

The midwife and the nurse went ahead and had Kalie try some pushing. The baby was already down super low and Kalie caught on to pushing really fast. Within 10 minutes or so baby’s head was already starting to make an appearance. So, the midwife and nurses got everything set up to go and Kalie started to put some real effort into pushing. Baby was coming so fast that the midwife actually had Kalie slow down a little in order to try and avoid tearing (which was successful, yay!) Within about 30 minutes later, baby Miley Renee made her debut, all 8.8 lbs. and 21 inches of her! Kalie was absolutely hilarious as soon as Miley came out and was put on her chest. She looked up at everyone in the room and said, “it really wasn’t that bad you guys! I don’t know why everyone makes such a  big deal out of this!”. I loved it, it was so Kalie.

Kalie laid there with Miley commenting on beautiful she was while the placenta quit pulsating. After it was done, daddy cut the cord and the nurses did her vitals and apgar scores. Kalie started to nurse her immediately (bypassing the routine shot of pitocin they like to give in the hospital) and her uterus started to contract again and begin it’s journey back to it’s original size. Kalie and Miley were uninterrupted for the first couple of hours after Miley’s birth and it was so beautiful to watch. It never gets old seeing a new mom and her brand new baby interact for the first time, and it never ceases to make me cry.

All in all, it was a beautiful birth experience and Kalie got everything she wanted out of it. Both Kalie and Nick were wonderful and I was so honored to be a part of the experience. Kalie, you were meant to birth a lot babies! Hah.

Below are some photos of the beautiful family, courtesy of Nick, the happy new Daddy, who luckily for Kalie, is also a photographer.

In the past, I was never all that interested in and never paid that much attention to economics and certainly not economic philosophies. However, in the last few years I have become a very libertarian person, and with that has come a greater understanding of how much economics affects our liberties and freedom. Now a days I’ve become so interested in the subject that I have actually picked an economic philosophy to align myself with, the Austrian School. Probably not surprising to people who know about libertarian philosophy. I don’t intend for this to turn into a long post, as I just wanted to share this speech given by Ron Paul at the beginning of this year on the “failure of the Keynesian state”. I know it’s semi-old now, but it’s a great speech that I believe is well worth watching still.

Once you watch the video the title of this post will make more sense. Just remember, if you have a million dollars in the bank right now, that’s not going to mean anything when the dollar crashes. Your much better off having a million dollars worth of gold and silver.

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“Paper money eventually returns to it’s intrinsic value–zero.” -Voltaire

“Tyranny is defined as that which is legal for the government but illegal for the citizenry.” – Thomas Jefferson

So, with this much needed good news, mama felt like she had the strength to keep going and that maybe she still had a chance at a vaginal birth. Since she was on an epidural at this point, we were very limited in what we could do. I continued to do some acupressure every so often to help bring the baby down and help open the cervix. This went on for another 5 hours until the next vaginal exam at 3 pm. And thankfully, more progress! 8 cm, (of course still completely effaced) and baby was now at station 0, finally engaged! So, with that, we were allowed to continue on. A couple more hours past and she had another vaginal exam at 5 pm. 9 cm and baby still at station 0! At this point I began to talk with her about the benefits of letting the epidural wear off. I was concerned that with the epidural she was going to have a hard time pushing, especially since this baby had been very stubborn about wanting to come down. She was apprehensive about the idea at first. She didn’t want to have to experience the pain if she was going to have a cesarean anyways. A cesarean was still looming in the back of her mind, and I can certainly understand why. Everything about this situation pretty much screamed cesarean. However, she eventually came around to the idea and began to let the epidural wear off. It took around an hour for her to really start feeling labor pains again. Oh, and I can’t forget to mention that one time the nurse came in a pushed the epidural button again without asking the mama if she wanted it. So that set us back  a little again. For the next couple hours my job was mostly about trying to make her comfortable through these last transition contractions that she could partly feel. It was incredibly frustrating to hear the nurses come in constantly and remind her that she could push the epi button such and such amount of times per hour.

At 9 pm they did another vaginal check. Same, still 9 cm and baby still at station 0. Thankfully, by this time she started to have enough feeling back in the lower part of her body that we could get get into and kneeling and squatting position on the bed to help continue to bring baby down and open the cervix. We rotated a few different positions for the next hour until they came in and did another vaginal exam. It was now 10 pm, and she basically 10 cm but a little bit of a cervical lip left. The nurse had mama try some pushing while she tried to push the lip back behind the baby’s head. Thankfully, by this point, the epidural had worn off enough to where mama could do spontaneous pushing instead of directed pushing. After about an hour of this, the lip was finally out of the way. After about an hour was also about as long as I could stand to see the mama pushing on her back and barely making any, for lack of a better word, progress. So, I asked mama if she wanted to try squatting and pushing. We had previously talked about how beneficial squat pushing was during one of our prenatal visits, so she was well aware that it could really help her along. The nurse, on the other hand, was not convinced, and it took a few exchanges to convince her to help us do it. We  finally got her arranged into a squatting position (on a hospital bed, no easy feat) and she immediately noticed a difference. She said that she could actually feel the baby coming down this way and that she felt like her pushing was much more productive in this position. We got to do this for about half an hour before the OB walked in.

I really wish I could’ve taken a picture of the OB’s face when he walked in that room and saw what we were doing. Just through his expression he was saying “What the hell is going on? and There’s no way I’m dealing with this”. As expected, he made her get back onto her back to check her. After he was done I could tell by the look in his face that he wasn’t pleased. And then it came, the ultimatum. In so many words, he basically said that the baby wasn’t coming down fast enough, and that he could one of two things. The first, was of course a cesarean, the second option was a vacuum extraction. Without hesitation the mama chose vacuum extraction. He then went on to explain the risks of the vacuum and the mama almost didn’t even want to hear them, she just said, I don’t care, use the vacuum.

With that, they began to set up the room for what seemed like was never going to happen, the delivery of this baby. While all of this was happening we were still on the bed, pushing and trying to use every contraction to it’s fullest potential. After everything was ready to go, the OB turned around with a pair of forceps in his hand and I gotta say, my stomach was in my mouth at the thought of having to witness this. Obviously, a vacuum extraction isn’t something I was ever hoping to see up close and personal. He then explained that the forceps were going to be used to hold the baby’s head in place, that way baby didn’t slide back up in between contractions. After a few pushes baby’s head was low enough for the OB to get the forceps around his head and hold him in place. With the next contraction she pushed him low enough for the OB to get the vacuum on the baby’s head. And of course, it slipped off the first time (I cringed), and he had to do it again with the next contraction. So then, between her pushing, the OB pulling, and a severe episiotomy, the baby was finally delivered within the next few contractions.

They clamped and cut the cord in about 3 seconds, and baby wasn’t starting to breath. This of course, was quite frustrating for me to see, for a couple of reasons. The first reason being that perhaps the cause for him not breathing was because baby’s still breathe through their cord for a short while after they are born and maybe we could avoid many of these resuscitations that occur if we would just let the cord stop pulsating before we cut it. Of course, most OB’s will tell you that it’s dangerous to leave the cord attached! Unbelievable! The second reason is that, even though I realize that it’s standard for the baby to be taken and checked over after this kind of delivery, why can’t this be done on mom’s chest? I watched what they were doing, it wasn’t anything that couldn’t have been done on her chest. Anyhow, at last baby was breathing and crying, but they wanted to take him to NICU. In their birth plan, the arrangement was that dad would go anywhere the baby went should there be a problem and the hospital had told them that this was fine. However, of course now that there was a problem, dad was being told that he wasn’t allowed to go into the NICU at first, and had to wait until they performed certain tests on the baby. This started a whole new argument and eventually came to the agreement that dad could go but would have to wait outside the room until they were done “doing what they needed to do”.

Mama got to hold and see her baby for about 2 minutes before he was rushed off to NICU. It was heartbreaking. I can’t imagine what that must feel like. To finally give birth to your child and not only not get to see him, but immediately lose control over what was happening to him.

While mama was being sewn up and cleaned up, I went out to the waiting room to explain to her family and friends what was going on and answer the many questions they all had about everything. After I was done with that I went back to the room, made sure mama was good and had everything she needed, spoke to her for a little while about all that had just happened and then at around 2:30 am decided to head home.

All in all, this was an amazing learning experience and a fantastic test of what I could handle. I still love what I do, and I still plan to do hospital birth. Especially considering only 1% happen outside of the hospital! What choice do I have?! It helped that mama was very grateful that I was there.

Birth is a normal, natural occurrence. It is not a disaster waiting to happen. This experience didn’t change that view at all. All it did was further convince me of the consequences of our meddling with birth.

So mama has been on pitocin now for 3 hours and still no real contractions. This brings us to around 2 pm on Saturday. At this point, the nurse came in to up the pitocin by 1 more mu per our request to do it as slowly as possible. At this point they also wanted to do another cervical check but thankfully mama denied. Again, the logic is astounding, we can’t get up and walk, but it’s cool to keep doing cervical checks that shove bacteria up into the vagina, significantly increasing her risk for infection. At this point in the game we were simply rotating different labor positions to help to bring baby down, and get contractions moving. We were limited though. She couldn’t walk but maybe 2 ft. and she was hooked up to a host of IV’s which basically caused her to not be able to use her left arm. And on top of that, we had that incredibly frustrating electronic fetal monitor to contend with. After another couple hours of being up and trying to get things moving along, the nurse came in again, and this time informed us that the OB demanded she have a vaginal check. So, mama went along with it got the check. Still 1 “almost 2” cm, 50% effaced, and baby was still way high up at station -3. So, of course, we got to hear those lovely words again, “no progress”. Thankfully, baby had been doing just perfect this whole time, and mama’s temperature never indicated infection, so there was no justifiable cause for concern talk.

Fast forward more of the the same for a few more hours until the next cervical check and when the OB finally decided to make his first appearance of the day. The next cervical check happened around 9 pm. Mama was now 2 cm dilated, 50% effaced, baby at -3, and incredibly discouraged. She knew that the OB was going to be coming in any minute with the C word on his mind. Finally the OB waltzes in, and I could drag this out with details, but instead I’ll give the short version which is that he was basically saying that she had until 1:30 am on Sunday (exactly 24 hours from the time her water had broken) to make some more “progress” and that beyond that a cesarean would become necessary. Mama was totally crushed at this point and was beginning to resort herself to her perceived fate, which was a cesarean. I did my best to comfort her and explain to her that we still had another 4 hours to show some kind of change. At this point she also faced another decision, whether or not she wanted to up the pitocin. She decided to let them bump it up because her thinking was that she needed that change to happen within 4 hours, and that even if it caused her to want an epidural, she would rather have that than a cesarean. So with that, they began upping the pitocin dose more frequently and with more mu’s at a time. At around 2 am she finally began to start feeling some more painful contractions. We worked through these as best we would with the means we had. We made it to yet another cervical check at midnight. And thankfully, by the grace of God, she was 3 cm, 60% effaced, and baby was still at station -3. But that cervical change is what the OB cared about, so we got it! Baby was good, mom was good, we got the green light to keep carrying on as long as mama could stand it and as long as she continued to have cervical change. She was in the for long haul. She was such a trooper.

At this point, we were all completely exhausted, we had been up for 30 something hours, and even though the mama was in pain, she was so exhausted that she was actually beginning to fall asleep in between contractions. This began to seriously concern me that she wasn’t going to have to energy required for the pushing stage (especially since she was in the hospital and couldn’t eat, though we did sneak some food in her once in a while, it wasn’t anything substantial). I suggested that she take a break from all the labor maneuvers and get back into bed to try and rest up for a little while, before we got into real active labor, and then of course, the very challenging part, transition and then pushing. Her husband, who had been sitting in a chair nearby during all this, was so exhausted that he had fallen asleep sitting up. We got mama into bed, and it didn’t take any time at all before she fell asleep. She’d briefly wake up for the contractions, and then fall right back to sleep. Up until this point, I was doing pretty good. I’m generally pretty good at ignoring the fact that I’m exhausted and continuing to go. However, sitting in a quiet room with only sleeping people was starting to get to me. All of a sudden I felt completely exhausted. Usually, I would never leave a mom during labor. However, this was an unusually long labor, there was nowhere else to sleep in the room or anywhere else and my house happened to be 7 minutes away from the hospital. So, I asked the mama if she felt comfortable with me going to home to take a quick nap, while she napped. After all, I needed to be able to be alive for the tough parts ahead too. She was totally comfortable with it, so I went home a took a nap.

When I got home it was about 3 am and I was expecting to have about a 3 hour nap and then get a phone call. However, 6 hours later I got a phone, and those extra 3 hours were incredibly appreciated. She let me know that everything was basically the same but that she had decided to get an epidural at around 6 am because they continued to up the pitocin and she was too exhausted to deal with the more painful contractions that were starting to happen. I could tell she was discouraged because she also said “and why deal with the pain when I’m bound to have to have a section anyways?”. I felt terrible that this was how her birth experience had gone so far. It seemed that everything was working against her.

I got ready to get back up to the hospital and got there at around 10 am. As I was walking in the room a vaginal exam was being done and I was just praying that there would be some kind of significant “progress”. I knew that if she was still 3 cm, like she was at  4 am, that this may be it for a vaginal birth. And the, again, but the grace of God, she was now 6 cm and 100% effaced! AND baby was now at station -1! I was so happy I wanted to start jumping up and down and clapping. But I didn’t, because I am a professional you know (ha!). However, on the inside I was a very giddy little girl. Thankfully, this little bit of news boosted her spirits a little.

Ok, looks like this is gonna have to be a 3 parter after all… Can you believe DONA wants me to sum this up in 700 words?! Haven’t quite figured out how I’m gonna do that yet… check back for part 3 which will be very soon to come I promise! You know you wanna hear how the birth went…

This past weekend I had the privilege of attending and witnessing yet another birth. This was different for me though as it was my first doula experience in the hospital. And I have t admit, I was  a little anxious about how I would deal with some of the interventions that were very likely to occur in the hospital. All in all, it was an amazing learning experience and an incredible eye opener.

Mama’s water broke at around 1:30 am on July 31st and she immediately called me when it happened. I asked her what color it was and she said clear, so we knew baby wasn’t in distress. Then I asked her if she was having any contractions and she said not yet. So, I recommended that she wait it out at home for a few hours and not rush to the hospital, and even suggested for her to try to go back to sleep, though she said she couldn’t go to sleep, I know she was too excited. So, I told her to call me in a couple hours and let me know what was going on. I was already awake when she called, and I figured I’d use the time to gather up my things and get ready rather than go to sleep for a very short time. Something I would regret later on. A couple of hours later we spoke again and she said that there still wasn’t any action. At this point she was asking me how long she could wait to go to the hospital after her water broke, which of course is one of those topics that is very debatable. However, I explained to her that the reason her OB wants her to come in as soon as her water has broken is because of the risk of infection. However, the risk of infection when you are at home, and no one is performing vaginal exams on you, is incredibly low. Your risk of infection actually goes up significantly as soon as you get to the hospital since one of the first things they do is perform an unnecessary vaginal exam. So anyways, I explained to her that it was perfectly safe to wait a while longer if she felt comfortable but that the decision was completely up to her. She said she was gonna talk about with her husband and call me back. I was thankful that I didn’t get a call back until around 5:00 (even though I still hadn’t gone to bed) saying that they were getting in the car to go to the hospital. So, I said that I would be following shortly behind them.

I arrived at the hospital at 6 am and thankfully, they were already in a room. After getting lost in one of the most confusing and understaffed hospitals I’ve ever been in, I finally made it to the labor and delivery floor and into her room. When I got there, she was already in the bed, with IV’s in her arm, and a electronic fetal monitor strapped to her belly. I sort of stood there in shock, the hospital had gotten a lot accomplished in half an hour. Mama updated me, basically just telling me that they were still filling out papers and doing all the administrative junk. I asked if they had done a vaginal exam (something I was hoping would be avoided for as long as possible) but of course, they had already done one, and she was 1 cm dilated, 50% effaced, and baby was at station -3. It took every bit of a couple hours to finally get all the paperwork done. Then shortly after the nurse who was going to be caring for her the next 12 hours came in and updated us on her “situation”. We were all quite intrigued by what the “situation” was as well. In my mind I was thinking, I’m pretty sure the situation is that this woman is having a baby but correct me if I’m wrong. Very casually the nurse said, “well, we’re gonna start pit around 9:30 am” (it was about 8 am at this point). The mama and I both looked at each other and then the mama looked at the nurse and said, “but I don’t want pitocin and my Dr. knows I don’t want pitocin”. Then the nurse, already agitated by this simple desire, said, “well then we’ll have to call your Dr. and see what he has to say about all this”. Before she left to call the Dr. we also stated that we want to get out of bed and off the fetal monitors and walk around to get things moving along. The nurse looked at us like we just asked her her if we could perform some sort of animal sacrifice in the room. The of course she said, “well, you’ll have to ask your Dr. that too. As of right now, he’s ordered you to be on continuous fetal monitoring.” I hadn’t been there 3 hours and I could tell what this experience was going to be like. I already felt bad for the mama, she was discouraged, and almost the entire staff was being very unpleasant. They also hated me before I even said a word. I was warned this hospital didn’t appreciate doulas, but sheesh!

Not too much longer the Dr. called the mama on the room phone. He stated to the mama that he wanted to start pitocin because her water had broken 8 hours ago and there still wasn’t any “progress”. Now, I’m already annoyed by obstetrics definition and use of the word “progress” but I almost never want to hear the word again after this experience. When the mama told him that she didn’t want pitocin because it would make a natural birth harder and she would rather get up out of the bed and get moving to see if things could get started naturally, he told her that because her water had broken, she couldn’t get out of bed to walk around due to the risk of infection and prolapsed cord. The mama had me listening on the phone with her and I have to say, the way he was talking made him sound like a real jerk, and I wasn’t at all looking forward to meeting him. We tried to negotiate with him, but there was no negotiating at this point. Discouraged again, she hung up the phone and we began to rack our brains about what to do. Mama wanted to know more about the risk of prolapsed cord and I explained that it was incredibly rare, around a half a percent. It was even more rare since she was only a cm dilated and a cord can’t fit through a cervix that’s 1 cm dilated. After her and her husband discussed it further they decided that they wanted to push the issue more. She told the nurse she wanted to walk anyways, and then the nurse stated that she would have to sign a “Refusal of Medical Care” form, which basically stated that she was placing herself and her baby in danger by going against medical advice and that the hospital wouldn’t be held responsible for anything that may happen because of it, and she understood that. Just when she was about to sign it, the charge nurse waltzed in and explained that insurance may or may not cover the birth if she signed the form. So naturally, this made her have to think even harder about what she was about to do. Not many people can afford to pay for a hospital birth out of pocket.

It was a very emotional decision, but in the end they decided not to sign the form because they couldn’t afford to lose their insurance. She really felt like she was trapped in some sort of prison. So now we were back at what to do about getting this labor going. I was doing as much acupressure as I could while she was in bed, and we were getting some contractions with it, but nothing consistent. After 5 hours had passed in the hospital without any solid contractions, the mama began to worry about the ticking clock that she was very aware of. As a general rule of thumb, if labor hasn’t started within 24 hours of your water breaking, the hospital will usually perform a c-section. Not all, some will wait longer, some not as long. However, the average seems to be 24 hours. Needless to say, she began to worry that her time was running out and her biggest goal was to avoid a c-section. With that, she decided that she would agree to start pitocin so long as she could get up and move around as far as the electronic fetal monitor would allow (which isn’t very much room at all). Another one of our stipulation’s for starting pitocin was that it be started at the LOWEST POSSIBLE DOSE and be raised VERY gradually every few hours until active labor was established. This way, we could hopefully stay on top of the contractions and avoid an epidural. After 3 hours on pitocin, still no strong labor contractions…

Ok, I am going to break this story up into a few parts because it would be incredibly long to read all at once. So, more to come tomorrow!

The Big Baby Myth

First of all, I wanna say sorry for the complete lack of posts lately. I blame the horrible case of writer’s block I have been enduring lately.

So, it seems that as of late, I hear about more and more mamas being induced or having cesareans because their “baby was too big” Or at least, was supposed to be too big and ended up being a mere 7 lbs. It’s always the same story, they go in for an ultrasound a couple weeks before their due date (an entirely different issue) only to get the news that their baby is growing too fast, and will be far “too big” to deliver if they wait for the baby to come on it’s own time. So then the mom’s are generally given two options, a planned induction, or worst, a planned cesarean. And of course, the former of those two options is still very likely to end up as the latter anyways. And despite the fact that even ACOG doesn’t recommend induction for suspected  macrosomia (big baby syndrome) OB’s are still using this as an excuse to persuade women into being induced or having a cesarean well before their due dates. Aside from women in this country just generally not feeling empowered about birth and being grossly misinformed and uneducated, OB’s manage to scare women into these interventions usually by  playing the should dystocia card.

What is shoulder dystocia you ask? Should dystocia is a very scary and serious obstetrical emergency (yup, one of those times when we really need OB’s!). In short, shoulder dystocia is when, following the delivery of the head, the anterior shoulder of the infant cannot pass below the pubic symphysis, or requires invasive maneuvers to pass below the pubic symphysis. And in very simple terms, it’s when a baby gets stuck at the shoulders. The good news is, shoulder dystocia is also INCREDIBLY rare; occurring in approximately 1% of vaginal births. However, even as incredibly rare as this obstetrical emergency is, OB’s are still scaring women every day with the idea. I understand the principle of making women aware of the possibilities, but it seems that many OB’s are using this as an excuse to jump at the bit to induce or cut. The other problem with this excuse is that suspected macrosomia is not a clear cut indicator as to whether or not shoulder dystocia will be an issue. In fact, shoulder dystocia can happen without macrosomia!

Another piece of this is the way macrosomia is being “diagnosed”. Basically, there is no completely accurate way to detect macrosomia. Even ultrasounds are notoriously inaccurate at telling the weight of the baby. I’ve lost count of how many times I’ve heard that a baby was expected to weigh 9 lbs. and then weighed 6 lbs., or vice versa. That’s right, ultrasounds can be more than a few pounds off! I personally know a mama that experienced the inaccuracy of ultrasounds, hers was off by 3 lbs.! Thankfully, this doesn’t really matter because the pelvis can do amazing things when we allow it to! We are getting way too stuck on weights; especially since it is so rare that birth weight is an issue. Women’s bodies were made to do this, and 9 times out of 10 their bodies are not going to grow a baby that is too big for them to birth. Maybe too big for them to birth laying on their backs  pushing in the most counter productive position one can think of, but not too big if we let women get into the positions that feel the most natural to birthing their babies (usually squatting). Of course, they have to be able to stand to do this.

Knowing all of this, it’s completely insane and morally wrong to continue to subject women to these dangerous, unnecessary interventions on basis of macrosomia or fear of shoulder dystocia. And unfortunately, in the worst cases these excuses are used because the OB’s PREFER to do a cesarean, which is completely inappropriate. The real problem here is women not being education about normal birth. Women in our society are taught that birth is this very unpredictable dangerous event that they can’t possibly do without the help of a trained surgeon (for which I am thankful exists should a true emergency occur). As a doula, part of my job is to educate women on these issues. However, as a whole we must encourage women to take control of their births instead of scaring them into giving up all their rights, because the only people who can birth their babies, are the women themselves.