We’re #1!

The U.S. is a pretty great place to live.  Freedom, bounty, all that.  We Americans tend to think we’re the TOP country: the strongest, the richest, the homest of the freeest and the bravest; just the best in general.  It’s true that we rank at the top of the list when it comes to stuff like military spending, average number of cars per person, number of hours of daily TV watching, and other important indicators of clear superiority.

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We’re also #1 in the Western world in maternal mortality.  In other words, of all the wealthy countries in the world we are the WORST when it comes to taking care of pregnant women.  And it’s not just wealthy countries that are better than us at keeping moms alive: If you are a pregnant woman, you are more likely to die if you live in the U.S. than if you live in Lithuania.  Or Bahrain.  Or Bulgaria.  The U.S. number of maternal deaths per 100,000 women is the same as in Iran and Hungary.  If you are a pregnant woman, you are twice as likely to die if you live in the U.S. than if you live in Macedonia or Cyprus.  Three times more likely than if you’re from Qatar or Israel.  Seven times more likely than if you’re in Greece or Singapore.  If you are pregnant, you have a better chance of surviving your pregnancy if you are in one of 48 other countries in the world.  Ok, I’ll stop, you get the point.

What are you, the pregnant lady, supposed to do about it?  Just this: demand better care.  There is NO reason a country in which people have more access to calories and movies than any other country can’t also have access to high-quality healthcare.  There is no reason for American women to be dying from childbirth at rates only marginally better than those in Saudi Arabia and Uzbekistan.

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(I know, I know, I said I’d stop with the comparisons… it’s just so counterintuitive – in so many ways we are one of the most medically advanced countries…)

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Back to what you can actually do about it: question, question, question.  Question everything your OB-GYN tells you you need to do.  Even if she sounds very confident about it.  And if she doesn’t appreciate the questions, if she gets offended when she sees you really want to understand your medical treatment and know about all your options, tell her the U.S. has a really high maternal mortality rate, that you strongly believe in taking an active role in your own health and medical care, and that you’d prefer not to die, thank you very much, so could you please answer the question or get back to me when you have an answer.  Ask for data.  Ask for the research.  Ask for proof.  Ask for alternatives.  Ask what the risks are.  Ask what would happen if you chose another course of action.

Then: don’t take their word for it.  Do your own research.  Many doctors will not like this, not one bit.  And I get it.  They’re the ones who went to med school, studied, see patients every day, blah blah blah.

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Well, that’s the same medical training and practices that are putting us at the glorious ranking of 49th in the world in maternal mortality.  So honestly I don’t think they have a very strong argument when they cite their credentials and experience.  Nothing but real, hard facts, studies, and research should convince you to accept medical advice.

I visited an OB-GYN exactly once during my pregnancy.  I asked her what the C-section rate was in her practice – in other words, what’s the percentage of women under her care who end up delivering by Caesarian rather than vaginally.  She tried to maintain a pleasant expression as she answered: “Oh, that’s a case-by-case basis.”  And then quickly changed the topic.  HUH?  I ask for a RATE, an AVERAGE, and she tells me it’s case by case?  She either didn’t know how often her practice resulted in women giving birth by C-section, or she didn’t want me to know (I found out on my own that it was near 50%, waaaay higher than the 10% recommended by the WHO).  Either way, pretty pathetic, and very unprofessional.  I didn’t go back after that first appointment.  I was lucky enough to find a midwife-run birth center that had a patient-centered philosophy (and whose C-section rate was much closer to the WHO’s recommendation).

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Just remember: the doctor works for you.  You hire, and you can fire.  They perform a service.  If you don’t like the way they treat you, you owe it to yourself to find another person to perform the service.  A lot of us feel a little shy around our doctors; a little in awe of their status.  We don’t want to displease them or appear rude.  But we need to learn to be assertive and to reclaim our place right at the top of the list of people who make decisions about our bodies and our health.  People are probably pickier with choosing who cleans their toilets than with who gets to stick things in their hooo-ha and helps them bring their child into the world.

So just remember: this is not paranoia, it’s not rejecting science and modern medicine, and it’s not saying all doctors and nurses are evil people (most of them are doing what they have been told is the right thing – even if that means totally violating their patients’ rights…).  It’s looking at the facts and acting on them.  It’s realizing that things are not as they should be, that the system we take for granted as good and functioning has serious issues that result in real women and babies dying needlessly; it’s refusing to go along with the crowd,

Shaun-The-Sheep-6-1024x819it’s taking a small step to change the status quo.  It’s deciding that your health and your baby’s health are worth stepping outside of your comfort zone, worth making waves and ruffling some feathers.  You and your baby deserve the highest-quality, most supportive, and safest health care system in the world.

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Stuff You Need to Know But May Wish You Didn’t

I would like to share a concept that I had no clue of before I got pregnant and started paying attention to the what it means to be pregnant in this culture and time.  It’s very different from what I thought it was.  I had imagined a model where everyone is doing their best to take care of you, medical experts are there to help you have the best experience possible… I thought that it was infinitely better to be in a modern country with access to hospitals and doctors for pregnancy care and childbirth… I thought that living in a wealthy Western nation like the U.S. was as good as it gets in terms of the experience of being pregnant and giving birth.  I thought giving birth itself was a pretty terrible ordeal and the only thing that made it bearable was that it could be done in a professional setting, under the direction of professionals, with the help of professionally administered drugs.  I thought pregnancy was a risky, dangerous state to be in and that there were all kinds of rules you had to follow, and indeed that the pregnant woman had to be followed and monitored by a medical professional to stay safe.  Basically, I thought: thank God for doctors and modern medicine when it comes to pregnancy and childbirth. They save so many women and babies from having terrible experiences and deadly outcomes!

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I’ve done a 180.

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I learned about birth rape.

It’s a controversial term; some prefer to call it medical assault; but personally I feel it is sexual in nature, as it involves the sexual organs and is directly linked with sex – the birth part of sexuality, not the conception part.  This article in the Huffington Post puts it well:

“Rape is really to do with having your body disrespected, contorted against your wishes, without your consent. The way the medical establishment sees it is, when you’re on the hospital bed, you have already given consent. Some men say the same thing about the marital bed, or any bed that you get into with them.”

But by any name, it’s horrible and traumatic and so, so unnecessary.  Worst of all, it’s common.  Don’t know how many times a friend or relative has told me her birth story and it involved the doctors or nurses doing something that was MEDICALLY UNNECESSARY to her body without her knowledge and/or against her explicit wishes.  Of course we’re not talking about taking action in emergency situations without waiting for the patient to sign a form allowing the action.  We’re talking medical practitioners routinely breaking women’s waters, “checking” progress (this means inserting their entire hand up the vagina), and more.

In this article, a midwife describes how she unknowingly participated in birth rape.  The sad thing is that so few medical practitioners ever come to recognize their role: “You don’t have to look very far to find stories of women who were yelled at, sneered at, made to feel bad somehow (even stupid), forced to lie in bed, physically moved from a comfortable position into an uncomfortable one simply for doctor convenience, given unnecessary vaginal exams, given rough vaginal exams, cut unnecessarily, sutured unnecessarily, not given anesthesia for the suturing, etc. And this can happen even with “nice” midwives and “nice” nurses and “nice” doctors, which is the most troubling fact.”

The thing is, it’s not even that shocking that assault by medical professionals happens during childbirth, when you start to really look at our medical system.  It’s not just during labor that women’s bodies are violated: pelvic exams are routinely performed on women under anesthesia, without their consent, and for the sole purpose of giving med students some practice.  This article is by a doctor who tells how he, as a medical student, was ordered to (and did) stick his fingers inside a woman’s vagina while she was unconscious.  And how it was deemed totally normal for him to do so, despite the fact that he had never met the woman, was not her doctor, and certainly did not have her permission to use her body to gain medical experience.

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The point is: Do not maintain the illusion that the way medicine is practiced in this country has any concern for a woman’s rights over her own body.  Do not assume that your bodily integrity will be respected, do not assume that your consent will be asked for.  Do not assume that medical practitioners always have your and your baby’s best interests in mind.  Even if they do, they may be working off outdated and incorrect knowledge of normal pregnancy and childbirth.  Or they may be tired, or impatient, or blase, or in a bad mood.  They do this birthing stuff day in and day out – they are NOT emotionally invested in the individual woman’s experience.  They can’t be, or they’d burn out in a matter of weeks.

I hate to be negative and fear-mongering but the situation merits serious attention.  I believe the system is broken.  Any woman who takes an active role in her own health and who wants to ensure the best possible birth experience for herself and her baby (and partner too, for that matter) must become aware of the huge failings of the traditional medical paradigm when it comes to birth.  Inform yourself; don’t kid yourself that it’ll all be fine if you just leave it to the experts; be your own agent and be prepared to fight for your rights.

This is not how it should be, and it is never a woman’s fault if she didn’t know to become informed and prepared – we should not have to fight to retain control over what happens to our own bodies!  But we have to deal with the situation as it is, not as we’d like it to be.  All the while, we’ll be working towards a system that respects everyone’s rights to be the ones who make decisions about their own bodies.

Birth Without Fear

 

WHAT ARE YOU EATING?

I wrote this “diet plan” a while ago for a non-preggo friend.  About as non-preggo as you can get actually: a guy.  But there’s no reason a pregnant woman can’t do it.  Really.  Don’t consult your doctor, etc.  It’s common-sense and not at all extreme.  Just some habits to drop, some to pick up, some adjustments to make.

I think it’s a pretty doable way of eating, and definitely healthy.  Tell me what you think!

PLAN TO HEALTHY EATING HABITS:

The short and sweet:  Eat food.  Not too much.  Mostly plants.  Much of them raw.  Go organic (here’s why (preggos, take a good look at #2 and #5), and especially if you’re pregnant).  Go non-GMO; here’s why (especially if you have had infertility issues.)

By “food” I mean stuff that doesn’t come in a box or can.  Stuff that is kept in the “walls” of the grocery store, not in the inner aisles.  Skip the aisles altogether.  If it can be stored outside of the refrigerator longer than a few days, avoid it.

By “not too much” I simply mean eat when hungry and not when you’re tired, bored, depressed, etc. (which is what many people do).

By “mostly plants” I mean cut out much of your dairy, meat, and grain consumption.  Most of your plate should be fresh vegetables and fruit.

The other terms are self-explanatory.

What I would recommend to someone on the Standard American Diet (SAD) is to progressively, taking as long as you need to:

1)      Work on becoming aware of, and thankful for, every meal and snack no matter what it is or how healthy/unhealthy.  Food, plentiful food, is such a gift and a pleasure.  Maintain attitude of gratitude and joy throughout each subsequent step, and through challenges and setbacks and “cheats.”

2)      Cut out all soft drinks, whether diet or not.  Replace with fizzy water + fruit juice or lemon, or, even better, with Kombucha (available at Whole Foods, etc.) or Kefir Water (homemade).

3)      Add as many fresh vegetables and fruits to your day as possible.  Also add nuts, especially raw nuts.

4)      Cut out all wheat.  That means most breads, pastas, couscous, cakes, brownies, donuts, many breakfast cereals… You can replace some favorite items with wheat-free/gluten-free versions (e.g. wheat-free pancakes or brownies once in a while) but don’t go replacing every item with the gluten-free version.  Replace the wheat items with veggies instead.  E.g. spaghetti squash instead of spaghetti, sliced zucchini instead of lasagna, extra fruit and nuts in the morning instead of toast, a square of dark chocolate instead of a brownie.

5)      Banish high-fructose corn syrup.  If it’s listed on a label, don’t eat/drink the product.

6)      Add wild-caught, sustainably harvested fish to your diet.  Ideal is 2-3 times a week.

7)      Switch to organic meats, dairy and eggs while reducing overall consumption of these items.  (The average American consumes way too much protein.)  About 2 eggs a day plus meat or chicken 2-3 times a week is plenty.  Best dairy is plain, organic, full-fat yoghurt (to which you can add honey or fruit jam), plus cheese (no Kraft singles please, that’s not cheese!)  Start the “Meatless Monday” tradition.

8)      Switch to organic vegetables and fruits while rediscovering your local farmers’ markets.

9)     Cut down consumption of sugar as much as possible.  When you do need a sweetener, use raw honey.  Some prefer agave but I think raw honey has benefits agave doesn’t.

10)      Instead of white rice, eat brown rice, wild rice, quinoa, and other “unusual” grains like amaranth.

11)    Cut out corn and corn products (there are a lot) except for the occasional fresh corn.

12)    Make it a habit to eat raw veggies.

13)    Discover the joys of making your own fermented products, especially sauerkraut, yoghurt, Kombucha, and Kefir.  It’s kind of like having a chemestry set, kind of like cooking, and kind of like gardening.

14)    Move to a cave and live off lichen and insects.

Just kidding.  14) is only for when the zombies arrive.

I don’t do all these things all of the time but I try to keep them in mind when making food choices.  This is not a particular named diet that I know of.  It’s neither completely vegetarian nor completely Paleo.  I think it’s doable and moderate.  The most important item is #1.  If sticking to a particular diet becomes a  source of great stress, I think the negatives start to outweigh the benefits.