Birth Story

Today is the American Thanksgiving, and I am counting my blessings, which are more numerous than these turkeys.

As always, I am grateful to be here for another Thanksgiving. Maeve and I could so easily have died during her birth — or we could have suffered horrific brain damage. I never forget that, and I think of the people who saved our lives nearly every day.

I lost my job this year, but that has given me more time to work on Birth Story. Yay!

Of course, the fact that my husband has a job helps my outlook a great deal. My prayers are with people who have not been as fortunate as we are.

Our family has shrunk with our daughter Nora's graduation and subsequent move to California. That's a tough one to celebrate, but she is following her bliss, and I believe she is grateful to be making her own way.

And we will have a nice Thanksgiving dinner, just the three of us, with a turkey breast for the first time instead of a big ol' turkey, but still with all the trimmings. We'll be grateful for pumpkin pie, I know that.

And I'm glad I'm not a turkey.

What are you grateful for? I would love to hear from you. Happy Thanksgiving!

Image courtesy of Wikimedia Commons

Annie Murphy Paul's new book, Origins: How the Nine Months Before Birth Shape the Rest of Our Lives, is getting the star treatment. It is the subject of a Time magazine cover story (written by Paul), and an article by the New York Times' Motherlode blogger, Lisa Belkin.

And why not? Paul has written what looks to be a fascinating exploration of the explosion of research on the effects of the environment human beings encounter while developing in their mothers' wombs.

In a guest post for Motherlode (the link is above), Paul writes, "Startling as it may seem, qualities ranging from our intelligence to our temperament to our health, and our susceptibility to diseases as varied as cancer, asthma, obesity, diabetes and mental illness, are affected by our experiences as fetuses decades ago."

We have already considered one aspect of this research here at Birth Story, how a mother's weight gain during pregnancy can influence her infant's lifetime chances of being able to maintain a healthy weight. But Paul covers the waterfront in this "new chapter in the long-running nature-nurture debate," as she calls it.

In her Motherlode guest post, Paul raises and then downplays the likelihood that mothers will be blamed for anything that goes awry with their children, given the new understandings of the importance of what goes on in the womb.

Love Paul's optimism! And, I'm impressed she researched this book while she was pregnant. I'm looking forward to reading it.

September is Be Kind to Writers and Editors Month, and as both writer and editor here at Birth Story, I intend to take advantage of this important event. I've been writing some long posts, but I'm hoping to keep them a bit shorter this month.

September is also Baby Safety Month, as well as National Preparedness Month, two interrelated observances, you could say, as planning ahead could help keep that baby safe.

Jane E. Brody's Personal Health column in the New York Times Science section today, for example, suggests that moms should adopt a healthy regimen, and maintain a lean frame, even before they get pregnant, if they want to help their children avoid becoming overweight themselves.

Brody's piece is a survey of the present understandings of how a mother's weight while pregnant affects the health of her fetus.

Her chief reference is a recent Lancet article that sought to tease apart the influence of genetics from the effects of more-than-adequate weight gain during pregnancy.

A separate study in Circulation "found that a woman’s weight before pregnancy was even more important than excessive weight gain during pregnancy in predicting a number of risks for the baby" that included childhood obesity," Brody writes.

"The new findings suggest that Americans are now caught in a vicious cycle of increasing fatness, with prospective mothers starting out fatter, gaining more weight during pregnancy and giving birth to babies who are destined to become overweight adults," Brody writes.

The latest recommendations from the Institute of Medicine, a subsidiary of the National Academy of Sciences, call for these weight gains during pregnancy:

¶28 to 40 pounds for thin women, with a B.M.I. of 18.5 or lower.

¶25 to 35 pounds for normal-weight women, with a body mass index of 18.6 to 24.9.

¶15 to 25 pounds for overweight women, with a body mass index of 25 to 29.9.

¶11 to 20 pounds for obese women, with a body mass index of 30 or higher.

Image courtesy of Wikimedia Commons

This segment from the British comedy group Monty Python's 1983 film, "The Meaning of Life," is unsettlingly relevant twenty-seven years later.

This is my 101st post! With summer winding down, I'm heading into triple digits.

I love this time of year because it promises a fresh start. Shopping for school supplies with my daughter Maeve, I like to buy a few pens and notebooks of my own, just to get that sense of excitement a new school year brings.

What ideas do I have for Birth Story this fall? I have been an independent writer for 10 weeks now, but more of a full-time mom, really. Now I have to get back to work in earnest. I'm looking forward to it.

One resolution is to do more multimedia posts. This morning, I took my trusty camera (a Mother's Day present) to Foster Beach, a mile or so from my house in Chicago. I wanted a picture to evoke the end of summer — an empty beach. As you can see above, I got that picture. There was indeed a stretch of sand and birds and little else.

However, I can show you other aspects of Foster Beach as it looked this morning as well. I can show you this:

And even this, from a tiny dog beach at the north end:

This weekend, Foster Beach will host two entire triathlons plus a leg of another one. It will look very different from the way it looked today.

I couldn't help thinking, while I was framing my "empty beach" shot on this busy strand, that every one of my posts  is a kind of snapshot as well.

No one of them tells the whole story. Even all 101 taken together don't tell the whole story. But I am telling the Birth Story as I understand it, one post at a time. Thanks for joining me.

Remember, dear reader, I said there would be tangents. Now we are embarking on a trip to Baltimore, Md., and childbirth will barely be mentioned for a while.

In his groundbreaking 1982 book, The Social Transformation of American Medicine, Paul Starr plumbs the source of mainstream medicine's authority. Simply put, it comes from the public's dependence on the doctor's superior competence, real or perceived.

As the title of Starr's book suggests, doctors were not always able to lay claim to that authority. Indeed, before the germ theory was proved and methods of administering anesthesia devised, making possible the development of effective surgery, physicians had very little to offer. (That didn't keep them from practicing, though.)

But in Baltimore, late in the 19th century, with new technologies and understandings developing rapidly on all sides, events were unfolding that would help solidify the medical profession's authority.

Image by permission  http://creativecommons.org

I have seen a couple of blog posts lately grousing that the "mainstream media" is choosing not to cover this or that event or development, as if to suggest that a conspiracy is afoot to keep people in the dark on a particular topic.

As a staff writer for the Chicago Sun-Times, I am a member of the mainstream media, and I wonder if people have a good sense of what's happening in our industry. Ad revenues have been dropping, mostly as a result of services available on the Internet, and hordes of writers and editors have been bought out or laid off in recent years.

Fewer bodies mean less time per project -- less time to learn about a new topic, and often no time to take on a tough topic.

Just for example, I have seen complaints that many important aspects of childbirth, the topic I address here in Birth Story, don't get the attention they deserve in the media. I couldn't agree more, but I also know that a good airing of the issues would require a depth on the bench that simply isn't there at most media outlets right now.

The Tuesday Science section of the New York Times is one of the rare dedicated sections left that cover science and health. Natalie Angier, a Pulitzer Prize-winning writer for the Times, said she has noticed that that section addresses health topics more than science ones these days, in a story posted by Mallary Jean Tenore on the Poynter Institute's website.

Readers appear to want stories that relate directly to their own lives, said Angier, who has written a number of science books, including Woman: An Intimate Geography. Her latest is The Canon: A Whirligig Tour of the Beautiful Basics of Science.

"One of the things I try to do when writing about science is make it seem like it's part of your life already by making things into characters and protagonists, even if they're just molecules," she said.

Charles Petit, chief tracker for the Knight Science Journalism Tracker, agrees that strong articles on science topics are becoming scarce.

While such issues as stem cell research and global warming still appear on newspapers' front pages, they are less likely to be written by reporters who have a solid understanding of those topics. So the stories are superficial, and readers don't get what they need to understand them, Petit told Tenore.

Even scientists are worried about this trend. In a Pew Research Center study published last year, nearly half of scientists polled said oversimplification of scientific findings in the media is a major problem. A whopping 85% of scientists said that the public’s lack of scientific knowledge is a major problem for science.

Let's interrupt our Women's History Month programming to consider the news. The National Institutes of Health today begins a three-day session on vaginal birth after Caesarean, a hot topic, given that this practice, which was commonplace 15 years ago, has become scarce in the United States, at the same time that the Caesarean section accounts for nearly one-third of American births.

The VBAC has some passionate champions. While it isn't for everyone, it can work for many mothers, enabling them to avoid major surgery, and perhaps also to enjoy birth as they have always imagined it. The VBAC's decline has attended a steady rise in reliance on the Caesarean section, in part because the VBAC does carry a risk of rupture to the uterus, which can be life-threatening.

So it will be exciting to see what comes out of this conference, which aims to bring the best research available to bear on determining the safety and efficacy of the practice.

The VBAC is also one subject of an article by Denise Grady in the New York Times on Sunday, about a hospital in Tuba City, Ariz., where 32 percent of women who previously had Caesarean sections delivered vaginally, compared with a national average of less than 10 percent.

The rate of Caesarean births at the Tuba City Regional Health Care Corp., where about 500 babies are born a year, is 13.5 percent, less than half the national rate of 31.8 percent. The hospital is run by the Navajo Nation and is partially funded by the Indian Health Service, and it largely serves a Native American population.

What I love about Grady's account is how well this small, poor hospital appears to be doing in addressing one of the major tensions in the modern birth story -- how to keep the blissful experience of childbirth from being swamped by the technology that has been developed to keep it safe.

Bring on the party hats!

I started my blog on Jan 3, full of trepidation about whether I would be able to keep up with posting three times a week about pregnancy, childbirth, medical history, maternal mortality, etc. After all, I have a job, a family, a dog, and on and on.

But I can do this! And I've learned a lot!

What's next?

My most popular post so far was "Birth in Haiti." You could've knocked me over with a feather.

My own favorites were the two posts I wrote after interviewing Robbie Goodrich, who lost his wife, Susan, last year to amniotic fluid embolism. Robbie was kind enough to talk with me while planning a big birthday celebration for his son, Charles Moses, and honoring Susan's memory on the anniversary of her death.

Career adviser Penelope Trunk tells bloggers not to succumb to the temptation to start that second blog. Penelope, you read my mind! I have been thinking how much fun it would be to lighten up a little, loosen up the voice, write about something else besides the point in childbirth at which bliss and safety concerns intersect.

But you know what? Penelope is right. "Birth Story" is my topic, because for 12 years, since I survived an amniotic fluid embolism during my younger daughter's birth, I have been fascinated with extreme childbirth. So I am going to stay with the difficult stories, the life-saving innovations and all those mixed emotions.

I enjoy the immediacy of blogging, and "meeting" other bloggers, many of whom are moms as well. I've settled into a Monday/Wednesday/Friday publishing schedule. And I'm still finding my voice.

So now we'll embark on the next leg of the journey. Maybe every couple of months I'll drop in a totally irrelevant picture like the one above and celebrate a little, just like today!

See the figure below on the right? It’s called a tangent bundle, which means something to mathematicians. To me, it’s a circle with many tangents, or lines that go off in different directions.

That is how I envision my new blog, Birth Story — a purposeful exploration bristling with side trips. When Birth Story, the book, comes out (sooner rather than later, I hope), I don’t want you, dear reader, to say, “Hey, I already read all this on her blog!” I want you to say, “This is so interesting! I didn’t know any of this!”

So the blog Birth Story will present stories, factoids, hypotheses and other musings that have come out of the research for my book but probably won’t appear in it. They will be interesting (I hope), relevant (more or less) and guaranteed to make us all smarter about the progress medical science has made in making it possible for women to survive difficult births.

The central topic here at Birth Story is obstetrics, defined as “the art and science of managing pregnancy, labor and puerperium (the time after delivery).” For the most part, I will be investigating the approach Western mainstream medicine takes to birth.

In addition to sharing stories I have come across doing research for my book, I am also looking forward to commenting on current events, reviewing the odd book and responding to readers.

Let the blog begin!

Image by permission  http://creativecommons.org