CHDs and Homebirth

Baby G

On a balmy March night back in 2014 I attended what I then thought was going to be a normal birth. This was the mother's seventh child, and the sixth one that my mom would help her with. The birth its self was amazing! The baby was a surprise OP, and the mamma pushed him out in TWO pushes!! It wasn't until after he was delivered that we realized something was wrong. Even though he started breathing right away he never cried, and after his first breath he went limp. He never stopped breathing, but we had to get him stimulated to use his muscles again. After he was flexing and moving, we continued with the normal checkup, and cleanup, and the whole time he never cried. I can only describe it as a laziness, he seemed fine other than the fact that he refused to cry, and he never opened his eyes. ( he also had some signs that he might have downs syndrome, but I never heard if they got a conclusive diagnosis) Since he was breathing fine, nursing, and his heart sounded fine, mom decided that we would let the family rest that night and discuss taking him to the doctor the next day. The next day while talking to another midwife mom found out that sometimes that laziness that we had seen is the only indication that there might be something wrong with the baby's heart! Of course after that mom recommended that the parents take the baby to the doctor right away, so they did, but the doctor couldn't find anything wrong either! Fast forward a week or so, and a few more doctors, finally the fourth doctor they saw heard a murmur. It turns out that he had been born with a hole in his heart so small that a stethoscope couldn't pick it up at all. It was only after the blood had been pumping through it for a few weeks that it was big enough for the stethoscope to detect it. Fortunately they caught it before it got too big, and they did surgery on it, and now he is doing fine.


The next time I would encounter a CHD baby would be just over a month later.

Baby W

Early on a Saturday in May my mom woke me up to tell me that we needed to head to our client's house that was about two hours away because she was in labor. After we had only been on the road for about 30 minutes the Doula called and said she saw the head!! Needless to say, I floored it! I know for a fact that I got up to 110mph, and I might have been going faster. While I drove like a maniac, mom got ready to walk the dad through delivering the baby if it came to that, and we all prayed like crazy that we would make it in time for the birth. When we finally arrived we flew into the house, (we even forgot to close the car doors!) and found the mom lying down on the floor of her bathroom, thankfully without a baby. This mom had really wanted a water birth, but my mom had advised that she stay out of the water if her husband was going to end up catching the baby, so when we got there she went ahead and got in the birth pool. Not even five minuets later, we had a baby!! Let me tell you that was the calmest baby I have ever seen! She came up out of the water and gave one little cry, and then settled on her mom's chest and just looked at everyone! After we cut the cord and got mamma and baby out of the water we proceeded with her newborn check and everything looked and sounded normal. Two days later the mom called to ask us to pray as they were headed to the ER with the baby after she had had a really big cry and then her responses had slowed . When they got to the hospital the doctors found that the left side of her heart hadn't developed!! They quickly life flighted her to a heart specialist hospital and she had the first of her life saving heart surgeries. She is now doing well. 


Unfortunately Baby W's story isn't as rare as you would think. Every year 1 in 100 babies is born with a Congenital Heart Defect (CHD) and many of them have no outward symptoms, and prenatal ultrasounds don't always detect them. The CDC even addresses that fact, "Some babies born with a critical CHD appear healthy at first, and they may be sent home before their heart defect is detected. These babies are at risk of having serious complications within the first few days or weeks of life, and often require emergency care."1 


So what are we supposed to do to prevent these normal appearing, but critically ill, newborns from slipping through the cracks until it is too late? 


The answer is a simple test that can be incorporated into the normal newborn exam. The CDC's website explains, "Newborn screening for critical CHDs involves a simple bedside test called pulse oximetry. This test estimates the amount of oxygen in a baby’s blood. Low levels of oxygen in the blood can be a sign of a critical CHD. The test is done using a machine called a pulse oximeter, with sensors placed on the baby's skin. The test is painless and takes only a few minutes.
Pulse oximetry screening does not replace a complete history and physical examination, which sometimes can detect a critical CHD before oxygen levels in the blood become low. Pulse oximetry screening, therefore, should be used along with the physical examination"2


Now that we know how to check for CHDs it is critical that we get that information out there! I really didn't know much about CHDs before these births. I have a cousin who was born with a CHD, but his was caught on a prenatal ultrasound, so I didn't really pay a lot of attention to how easily they are missed until it happened to me. You can ask your midwife, or doctor, how they check for CHDs, and if they don't, refer them to pulse oximiters. It could be a matter of life and death, and it is too simple to justify skipping it. 

Baby W

Baby G

1&2 lhttp://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html

We Are Made To Give Birth

Recently I have been re-reading "Ina May's Guide To Childbirth" by Ina May Gaskin so that I can write a book critique on it. While reading I have come to realize that she has such great success with her midwifery career because she has discovered some basic, but unfortunately forgotten, principles of birth. However sometimes she attributes these things to the right source, God, and sometimes to the wrong source, evolution. At one place in the book she says that, " Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic." I agree whole heartedly with that statement.  A little later though she refers to "old" and "new" parts of the brain, and how we have "evolved" to not know how to give birth, and that if we let our primitive "old" brain work we would be much better off. Her conclusion that letting the brain stem work uninhibited to produce the hormones needed for a successful labor and delivery is correct, as is her conclusion that stimulating the neocortex inhibits labor. However I know that when God created us we had all of our brain.

Further on in the book she recalls the history of how we got to the modern idea of birth, and says that if we forget all of those ideas and just "let our monkey do it" we will be better off. I agree that we need to come to birth with the assumption that birth is a normal process, but we aren't descended from monkeys, so I would say that you just need to trust that God made your body just fine, and you need to let your body work the way it was created to work.  Another thing she says is that "imagining yourself as a powerful mammal can help you feel empowered". I think it is helpful to look at animals and see that they give birth just fine, usually without any help at all, and say to yourself  "if God designed animals to have babies just fine, then I know I can have a baby without unnecessary intervention." But to imagine that you, who are created in the image of God, is just an animal is, in my opinion, wrong.

I would recommend that instead of trying to let your monkey do it, or imagining you are an animal, you should memorize Isaiah 66:9 "Shall I bring to the birth, and not cause to bring forth? saith the LORD: Shall I cause to bring forth and shut the womb? saith thy God." I found that verse completely by accident one day, but I wrote it down because it is a great promise to remember when you are pregnant, or in labor. I remembered it earlier as I was trying to critically read through and find what I disagreed with, and why.

I realized then, that while she was right in stating that we need to get our thinking brain out of the way of our acting brain, attributing natural birth to a primitive evolutionary instinct that we need to tap into is wrong. What we need to tap into is the fact that God designed us to give birth and that we need to not try and "play god" with our unnecessary medical interventions.

This post is not to say that all medical advancements are bad. I've never said that, and I never will. It was simply an intriguing thought to me that you could have the correct knowledge and attribute it to the wrong source.

Life? Choice? Baby? Pregnancy?

Have you ever read a pregnancy book? I'm currently working my way through 21 of them as part of my midwifery course. And as I've read I've been amazed at the dichotomy and duplicity of every author's vocabulary when it comes to the baby. On one page they will tell you that it is so wonderful to do a sonogram and see the heartbeat, or to see how the baby is definitely a tiny human, and then turn right around and say that if such and such is wrong (downs syndrome, or other defects) the "pregnancy" can be terminated! It is mind blowing to think that in our country right now you can have an abortion up to 24 weeks of gestation! Most people have already felt the baby move by that time, and yet it's legal to "terminate" the "pregnancy" if you so chose? They can't even say that it's just tissue then, they cant even use that argument for a 12 abortion! Babies look distinctly human by the 12th week and if you do an ultra sound you will see a heartbeat and get to see the baby moving around even though you can't feel it yet.

And the thought of killing a baby just because there is "something wrong" sickens me. How would it be if went around killing all of the born people that we thought had something wrong with them? Oh that right that already happened in Germany under Hitler and the whole world thought it was WRONG!! But it's just fine to kill that unborn, though no less alive, baby because it has and extra chromosome or isn't formed just the way you want it? And woman's choice? That woman made a choice to sleep with that guy and now you can face the consequences like a woman! In the case of rape you didn't make that choice but it's not that baby's fault either and you shouldn't kill it just because it's daddy is a worthless piece of slime sucking scum. Even if you can't raise the baby there are hundreds of couples who can't have children and would LOVE to adopt that little baby. It is a new life. Not a "choice"

Building on that, I think our society's definition of life is way off. I believe that life starts at conception, others believe that it starts at birth, however let's define life with death. Clinical death occurs when the heart stops beating and the person is then pronounced dead. By law of opposites life should be defined by when there is a heartbeat. That happens at 6 weeks! So you can argue that life doesn't start at conception, but it sure as heck starts long before birth, and it is legal to take that life until the 24th week.

 It saddens me to see people kidding themselves and others by referring to that life, that baby, as just a "pregnancy" when you want to "terminate", a.k.a. kill, it.

Thus ends my rant for the day.