Saturday, May 11, 2013

Birth in Sri Lanka



Birth in Sri Lanka
 



I became curious about Sri Lanka when my nine year old daughter had to create its flag as part of a group project. I was curious about exactly where Sri Lanka was. I thought it might be in India. Sri Lanka is an island in the Indian Ocean south of India (cia.gov). I am glad I looked into birth in Sri Lanka because I discovered that a country with a per capita income as low as about 800 US dollars a year can still ensure safer births for its women. About one third of Sri Lankans live below the poverty line, but "maternal mortality ratios are among the lowest in the developing world” (WHO, para. 1). The maternal death rate was only 35 deaths per 100,000 live births in 2010 (Index Mundi). The infant mortality rate was 9.47 per1000 live births in 2012 (Index Mundi). This is compared to 5.98 per 1000 in the United States and 46.07 per 1000 in India. Sri Lanka attributes its success to the high priority it gives to female literacy and health care. “Today, over 96% of deliveries in Sri Lanka are attended by a skilled birth attendant and over 90% take place in a health facility” (WHO, para. 4).
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Friday, May 10, 2013

A Birth Story


A Birth Story

            This is the story of my only home birth and the birth of my only son. It turns out that all nine of my children had different obstetricians. It is amazing how different circumstances come together to bring about what doctor or a woman chooses and what type of birth the woman has. When I had a three year old and two year old daughter, and was six months pregnant with my son, my husband received a call from his sister asking us to adopt her three month old daughter. We agreed to move from Colorado to California to adopt this daughter. It was our good fortune to find a home birth doctor in California, and I really wanted a home birth because I did not want to leave my other children. My two previous births had been Caesareans, and I was hopeful that a home birth would prevent another Caesarean. It did turn out that everything I wanted to accomplish by staying at home for the birth was accomplished. I was so happy that this was my first vaginal birth and that I was able to be very present for my young baby daughter for all but 4 hours. I was also very happy that from the minute my son was born we could all continue to be our six person family in our own home.

            On the night before my son was born, I thought I was in labor. I called the doctor and told him and he told me to call back later. Later, I felt a very big motion in my belly. It was bigger than any baby movement I have ever felt while pregnant. It felt like a somersault in a very tight space. After the somersault, my labor suddenly stopped. I went to the doctor’s for my weekly check the next morning. After this, my husband and I and our children went out to eat. I was having contractions throughout the day but I had had many contractions throughout much of the pregnancy. I had broccoli cheese soup for lunch. I then went to the bathroom where my water broke. We called the doctor and drove home. For my birth I had a doula and the doctor had a nurse. The trip home was about 45 minutes on a twisty road that seemed to make my contractions come faster.

 The doula got to my house about the same time I did at 5:00 PM. During my labor, I spent a lot of time walking from the bed to the bathroom. I kept thinking I needed to go to the bathroom. After spending a little bit of time in a hot bathtub, I was sick and tired of walking back and forth and had pretty much decided that I would no longer be walking to the toilet. While in bed, I felt like a bowel movement had snuck out of me. I asked the doula to check. She said that it was not a bowel movement. She seemed amused and went to tell the doctor in the other room.

When the doctor came back, they checked how many centimeters dilated I was and they told me that my son’s foot had already come out and that he was in a breech position. He was a footling breech. The doctor had a special chair he had designed for births. It had stirrups, but it was made to sit in and gave the woman a good way to push against the stirrups to keep steady while pushing out the baby. The pushing stage was very short and easy for my son as it was for all my babies. Before I pushed, the doctor had to pull out my son’s other foot. There were three pushes at the most. One of the pushes pushed out my son’s butt and one pushed out the head. The doctor did have to help my son breathe and clear out his air ways.

My son was born with only about one third of his skull. Most of his head was soft spot. This is probably why my son flipped over the night before he was born the doctor said. The pressure was probably hard on him and turning alleviated the pressure. This doctor believed in the wisdom of nature. He did not believe in turning babies or in Caesareans for breech births. He said that my son’s birth allowed him to be delivered safely without having his head grabbed too hard by anyone.

When I first took my son for his two week check, the pediatrician thought he had an abnormality because of his head and his hands she said. She wanted him to have a spinal tap. I told my husband and we talked to the doctor who had birthed my son. He asked if my son was nursing well or acting different. I said that he nursed great, but when he was unswaddled, his arms and legs did not curl the way my other children’s legs did. The doctor thought he was fine. We took my son for a second opinion. This doctor thought my son had a chromosomal abnormality. There was nothing we had to do, but the doctor thought my son would be mentally retarded. Before we saw another doctor, my son was baptized when he was three weeks old with his sister who was six months old. I remember crying that my son would never read or write or do many other things and also praying that what the doctor said wasn’t true. One and a half weeks later, we went for our third opinion. My son’s soft spot was bigger than normal, but it was only a third or less as big as his skull now. The sides of my son’s head which had been soft were now filled in. He said there was nothing wrong with my son. It seemed like a miracle! I will never know for sure, but even what can be explained scientifically can still be considered a miracle.

This is what I think happened. The doctor had asked me not to take the baby aspirin that helps the placenta nourish the baby despite a mother’s hypertension. I had hypertension before during and after this pregnancy. Later, the doctor had me wean off of my hypertension medicine, but eventually my hypertension was very high. The hypertension caused my son’s malnourishment, so he didn’t get enough calcium. When my son was born he started nursing. He got plenty of calcium. The calcium fixed my son’s skull. My son was probably three weeks early because he needed to get out in order to be nourished better. My son was five pounds at birth, but he is now only 5’3” as a grown man. My husband and I are both short as well.

Today, my son recently won the single academic award for both the general literature major and the early Christian literature major at the university where he graduated. He understands Latin and Greek. He will attend the University of Kentucky on a full scholarship and he will be an undergraduate teacher assistant. His sister, who was six months old at the time, just received her Master’s in social work. She was the graduate resident advisor for the undergraduates living on campus. The reason I chose this birth out of my nine births including a miscarriage was that it is like births in many undeveloped nations, a home birth. It also included some dangers, but I had what many women in undeveloped nations do not have, a choice. The whole birth was a product of my choices, and after that birth, I chose not to use a doctor who asked me not to take aspirin or hypertension medicine. I have discovered that doctors have many different opinions and that choices can’t be made without what the pregnant woman herself knows. Once, I tried to have a birth in an unattached birthing center. The doctor was afraid the aspirin would cause hemorrhage and he was also telling me that I needed to eat more protein so I would gain more weight. I was a vegetarian, and I had discovered from previous pregnancies that if I ate a lot early in the pregnancy, it was very hard on my kidneys, and this caused me to be very nauseated and lose weight in my last month of pregnancy. I switched to a vegetarian doctor. Because I had not taken the baby aspirin during part of this pregnancy, my daughter for this birth had low amniotic fluid like my earlier daughter did before doctors knew about baby aspirin. Fortunately, the second time I had low amniotic fluid, they broke my water and added fluid to cushion my daughter so that I would not need a Caesarean because of fetal distress. It is important for women to take responsibility for their unborn children’s safety. Doctors are still learning and can’t be blamed for not knowing everything.

I think that a good birth impacts a child’s development, but I also think that no matter what happens, a birth does not dictate the rest of a child’s life. However a child is born, bonding is important for healthy brain development, but if bonding does not happen at birth all is not at all lost. I saw my oldest child for one second before she was whisked away to the neonatal nursery because she was two months early. They did not let me see her for a week because of my hypertension. My sister, who is a doctor, said that was very odd even 27 years ago when my daughter was born. My daughter has a great relationship with me, however. She is also a successful electrical engineer. She is also very shy. I am not sure if her birth and very early life contributed to that. We also moved her school four times between kindergarten and first grade. Before this she had had some friends. I did not bond with my adopted daughter when she was born, but I bonded with her when I began to take care of her when she was three months old. She is very happy and has many friends. Like everything else in child development, it is too hard to take away a child’s genetic personality from a child’s experience to find out what causes what.