Today is International Women’s Health Day.
Women’s health is terribly underfunded despite the fact we make up 50% of the population and in most cultures, women are the foundation of healthy families. A woman’s health affects her family and community. This is an issue that effects all people. We need to do better!
- In Canada, less than 4 % of medical research dollars go toward women’s health.
- Globally, half of all pregnancies are unplanned. While people may embrace these pregnancies, it’s a hardship for most. It can be a risk to their mental and/or physical health. For many, unplanned pregnancies are a fast-track to life-long poverty. Why so many unplanned pregnancies? This is a complex issue but most commonly they’re due to lack of availability of – and limited or no options in birth-control.
- Globally, 800 women die daily (one every 2 minutes) from preventable pregnancy and birth complications. In many parts of the world this number is decreasing, however in North America maternal death is on the rise. Maternal deaths are most commonly due to postpartum hemorrhage, perinatal and postpartum infection, unsafe abortions, complications in birth (often due to mismanagement of labour), and preeclampsia. Generally, these are preventable and treatable issues. Women of colour are almost 3x as likely to die in childbirth compared to white women.
- In almost all geographic areas, rates of postpartum mental illness far outweighs available treatment options. Women have no options or are told to wait 1-3 months for an appointment.
- 1 in 10 women globally suffer from endometriosis, yet the first Canadian study into this condition began in 2019. Ten percent of women (190 million!) suffer from endometriosis. They are mostly dismissed and left without treatment options that exist, or they live in an area where there are no treatments options available.
- In many places, women with fistulas after birth are shunned from their communities and left to fend for themselves. Many do not survive.
- The stats on women’s heart health / cardiovascular illness is appalling. We’ve known for decades that heart-attacks in women present differently than men. However far too many are still misdiagnosed or not taken seriously. After a heart attack, women’s survival rates are considerably lower, especially if they are married and/or have children. (Married men who have heart-attacks often go home to be cared for during recovery. Married women who have heart attacks often go home and resume their role as primary caretaker of family and home.)
- Women’s symptoms are more likely to be dismissed and their voices not taken as seriously during medical appointments and in the emergency room. They are less likely to be referred to specialists, and receive fewer diagnostic tests and prescription medications. This issue is amplified for BIPOC women and plus sized women.
- Menopause negatively affects over 80% of women globally, yet there are very few medical treatment options. Research is vastly underfunded for an event that affects almost 50% of Earth’s population.
There are so many other examples of frightening outcomes, disparity and lack of resources for women’s health; too many to list here. We can do better.
One of the benefits of a planned caesarean is that there’s time to consider options, ask questions and make choices beforehand.
Many hospitals are willing to take extra steps to make a caesarean birth more gentle and family friendly. The following is a list of practises that are being requested as part of a “Gentle Caesarean”. Yes I’m aware that the very nature of a caesarean and the postpartum recovery do not seem gentle to most people. However I appreciate that there are medical staff working hard to make the experience as positive, healthy and family-friendly as possible.
- Watching your baby being born. Clear surgical drapes, surgical drapes with a panel that can be lowered to a clear panel, or having the drapes lowered entirely.
- Cord cutting. Most hospitals don’t allow anyone other than staff to cut the cord in the surgical field. But they can leave a longer cord and have the partner trim it – like a ceremonial cutting of the cord – at the baby warmer.
- Skin-to-skin contact with the birthing parent, from the chest up.
- Maternal heart monitors on their side or back, leaving the chest available for holding baby skin-to-skin.
- Music of your choice – played on the sound system or your headphones.
- Support through the entire procedure, from the moment of entering the O.R. until heading to the recovery room. Most hospitals allow one support person in the O.R. and recovery room. Some allow doulas to come in as well.
- Healthy baby stays with the parent(s); family stays together in O.R. and recovery room. (In some hospitals, healthy babies born by caesarean are automatically taken to NICU or a medical nursery for observation. This has to stop!)
- Photos / videos – always bring your device. There’s often a nurse who is waiting for the baby to be born and will take some photos of the birth, the first time parents hold the baby, etc. There are many beautiful moments to celebrate at any birth, including caesareans.
- Flora for the baby – vaginal seeding. You might ask for a GBS test a week before the surgery before going ahead with this. Note that this is still new enough that most medical staff will not participate. Plan to DIY.
- Covid o rother illness testing options – find out if this is something that will affect your birth. What happens if you take the test or don’t take the test?
- Any cultural / spiritual aspects you might wish to include. I’ve seen an obstetrician lead a prayer before starting the surgery and have joined the surgical team in singing happy birthday to a newborn.
- Obstetrician of your choice. Certainly a perk of scheduling your birth.
- Volume of monitoring machines – ask for the volume to be turned up or down if it’s reassuring for you, or not, to hear things like fetal heartbeat, maternal heart beat.
- Delayed cord clamping – up to 1 min is considered safe with caesareans. (I’ve heard of a hospital that keeps the placenta and baby attached after the placenta is removed – definitely not standard of care in most places. Never hurts to ask.)
In some facilities the things on this list may already be standard care. In others, requesting these things will provide an opportunity for staff to gain a new perspective. Patient safety is the primary concern. Some of these practices may be considered safe or not, possible or not, depending on patient health, the facility and/or the staff working in the O.R.
Speak with your doctor well ahead of time about the things that interest you from this list.
If you get a sea of “no ways,” then ask why not. There could be valid reasons or it could be one unbending person. If it’s the latter then you might wish to explore working with another doctor or giving birth in a different facility, if that’s an option.
Oh, the days are hot and even more so when we’re growing a baby or holding a newborn. If you don’t already know, profuse sweating is a normal part of postpartum recovery even during winter.
Here are some tips for summer survival with a baby-bump that go beyond the obvious, typical lists – wear loose clothing, do things early in the day, stay hydrated, find AC. I think we all know that by now.
Summer Pregnancy-Safe Drinks
Growing and/or feeding a baby both take a lot of energy and we burn through more electrolytes and minerals in the hot summer. Sugar drinks are not helpful. Pregnant and breastfeeding bodies are more susceptible to blood sugar shifts and the yeast / thrush infections that result from high sugar intake. I have 2 articles for you for healthy, refreshing and cooling drinks (other than plain old water which is of course, important every day). They’re all nutritive during pregnancy and postpartum recovery – actually any time. Kids and adults can consume these.
Cooling Essential Oil Body Sprays / Mists
Even though every bottle says “don’t use during pregnancy”, there are a lot of oils that are safe. Consult a certified aromatherapist – that’s me, from way before it was cool (pun intended) to be into essential oils. You can make a spritzer with:
- lemon – actually any citrus oil.
Add any combination of those to aloe, witch-hazel or a flower water such as rosewater.
If you prefer to buy a spray, check out the perineum sprays such as that made by Earth Mama Organics. They can be used all over, not just your bottom!
Caution #1: Citrus oils can make your skin more sensitive to sun-burn; only use for an indoor spray.
Caution #2: Many commercial refreshers and cooling sprays contain Eucalyptus, which should never be used near babies and pets. Best to avoid it through pregnancy too. Some types are safe but the most commonly used ones are too strong.
Angie’s Tips for a Cooler Birth:
- Put a small wireless fan in your birth bag and/or birth place. Some of my clients use handheld fans and others use ones with a big clip.
- If you’re having a hospital birth, i.e. in a scent-free environment, then bring an empty squirt bottle and fill it with cold water for misting.
- Ice chips! They’re amazing during labour & birth. Suck on them, put them in a washcloth and use as a cold-pack all over the body, put them in a bowl of water and dip a washcloth in to apply on foreheads and necks, add them to juice and water. I rarely attend a birth without using at least a couple of cups of ice-chips.
- Temperature fluctuations are amplified during the birth process. This video has tips to regulate temperature during birth and what the partner / birth companions can do.
Some people compare labour pain to that of breaking bones. Besides scaring pregnant people, that’s not an accurate comparison. On the other hand, some women share stories of pain-free birth. Here are 5 ways the sensations felt in labour are different than “broken-bone pain”.
- Broken-bone pain is unrelenting and doesn’t go away without strong pain meds; labour pain comes and goes in a rhythmical manner. In fact, throughout labour, much more time is spent in the rest between contractions. Even in advanced labour, most contractions last between 60-75 seconds but can sometimes get to 90 seconds. Then there’s a rest before the next once. In active labour that rest will generally be between 1-3 minutes. In earlier labour that rest will be up to 10 minutes. There is no rest with broken-bone pain. It’s constant.
- Broken-bone pain is all encompassing, resulting in the release of stress hormones and injury responses in our body. Labour pain is accompanied by powerful pain-killing hormones such as endorphins. The female body is equipped for labour with strong, naturally occurring hormones that are released as labour progresses. The effect of these hormones has been compared to morphine by physiologists. (However those hormones are not as concentrated and isolated like morphine. Still, that’s a powerful comparison!) Stress makes pain worse.
- Broken bones are a terrible injury; labour is a normal human process.
- Broken bones are due to an accident; labour is a known and sometimes planned event. Therefore we can prepare for the intensity of labour. There are many helpful tools and strategies for comfort measures that can be done by the labouring person or their birth companions. We teach many of these in our How to Ease Labour Pain Class.
- Doulas! Birth doulas can make a significant difference in how labour is experienced and felt. There’s ample research showing the benefits of doula support through birth, including shorter labours, half the rate of Caesareans, significantly fewer requests for epidurals. To my knowledge, there’s no such thing as “broken-bone doulas”. Everyone around someone with broken bones is providing medical care – good thing too. Ideally, labouring people will have someone knowledgeable with them whose only job is to provide comfort and support.
- Broken bone pain is measured in weeks and months; labour is measured in hours.
* It’s interesting to note that I’ve only heard men make this comparison. Many pregnant women fear this will be the case but I’ve never heard anyone who’s gone through labour and had a past experience of broken bones say they were the same thing. I’m one of them. A couple of years before being pregnant, I broke my pelvis. There is absolutely no comparison between the two events.