Friday, April 30, 2010

Should You Switch Doctors/Hospitals?

If you are asking yourself this question, whether it is at the end of your pregnancy or the night before a surgery, the answer is probably yes. At the very least, you owe it to yourself to explore your options and the the issues that are making you uncomfortable. Intuition is a powerful tool. If something doesn't feel right, it probably isn't.

Sheridan of the Enjoy Birth Blog, just had a series of posts about comparing two births that were similar, but had two very different results based on the hospital's policies and the OB's approaches: one had a vaginal birth and the other a cesarean. Fortunately, the doctors were kind and inclusive during the cesarean so the mom still feels good about it, but she probably could have avoided the surgery had she followed her intuition and switched providers. We all do the best we can with the information we have at the time. There are things that I wish I would have done differently during my first pregnancy like try an ECV or research vaginal breech birth and look harder for a provider who would let me try or at least wait until I went into labor before having the c-section. I felt like I didn't have any realistic choices at the time so I focused on having a good c-section experience. I did have a good experience, but it was still major surgery which will effect every pregnancy after and have future consequences that I can't predict.

Sheridan's post is timely, because this topic has come up on the forum recently. I made a long response which I thought,"Hey, this would make a good blog post!" So here it is with personal details removed:

If the doctors won't answer your questions at appointments, you can bet more of the same during your birthing time. Docs like this do not want patients to be involved in their own care. It is a sign to change doctors/hospitals.

If you leave the appointments crying, it is a sign to change doctors/hospitals.

If they flat out tell you that you cannot have what you want, despite scientific evidence that what you want: movement in labor, no iv, no continuous EFM and skin-to-skin bonding with baby immediately after birth, is best for baby, it is a sign to change doctors/hospitals.

The best case scenarios in these cases, do not have you getting what you want. It may seem like an overwhelming prospect to travel to give birth, but if you can't get what you want locally, it is well worth it. I flew halfway around the world and then drive two hours to have the birth my baby and I deserved. It was worth it. All that effort just to let nature take its course. Nature's course is pretty awesome. I just let my body do it and I knew I didn't have to fight. Fighting/stress interfere with your natural processes.

Sometimes women worry about their husbands missing the birth, but if your birth goes so fast that your husband can't get there (as mine did) you won't care. I am so glad that I had a fast, easy, doula and midwife-supported birth that my husband missed by 1.5 hours (because he was driving and his phone didn't work in the US, otherwise, he would have made it) than a traumatic experience where I was bullied, disempowered and separated from my baby, or in my case, forced to have a repeat c-section that I did not want.

If you settle for a hospital/doctor that is less than what you want and you have a bad experience, your husband will pay the price for that. He will be the one that will have to deal with your trauma and possibly resentment towards him.

Why is feeling good about the experience important? Because feeling bad about it can be haunting and traumatizing. It can trigger or make worse post-partum depression and interfere with bonding. Not everyone is negatively affected by being bullied or not even bullied, but simply excluded from the decision-making process, but if you think you might be (I know I would) then refuse to accept it.

Also, ALL doctors say they only do c-section when they are medically necessary, but the rates at which some doctors find it necessary are very high. Being flat on your back and restricted from eating and drinking and getting fluid overload from an iv are all ways to increase problems that may cause your doctor to find a c-section necessary.

As foreigners, it is hard to find an ideal situation where location, language-ability and care practices are exactly what we would want. However, if you are calm, firm and persistent in interviewing doctors and stating your wishes both before birth and during birth, you can get what you want.

This message might sound harsh, but I just want to stress the importance of choosing a care provider. It is one of the most important choices you can make. You need someone you can communicate with and who will include you in the decisions. No matter what the result, if you are informed and participate in the decision-making, you can feel good about the experience.

At the very least, you owe it to yourself to explore your options. You have choices. Explore your options, both near and far and then make a decision. Listen to yourself and your intuition. Details such as where you will stay can be worked out. Sometimes payment can be worked out.

Thursday, April 22, 2010

Childbirth Education Course Development

My friend Rachel and I are in the process of developing some childbirth education courses to serve the English-speaking expat community here in Seoul. I believe that different programs work better or appeal to different women and we want to expand the range of options available.

Rachel and I are reading a lot of books and looking at programs to figure out how and what we want to teach. There are some philosophies of birth that say that women will find their own ways of coping in labor and technique-based classes are not necessary and even counter-productive. I know one thing for sure, I do not agree with this. (I do understand that there are women who this philosophy would really work for, though. I think they would have to be extremely committed to it and very well supported to get through if things did not go smoothly). This philosophy came about in response to the failure of the old Lamaze method on the part of many women who were told in the classes that they should be able to relax their way to avoid pain. When they felt pain, they grew anxious that they were "doing it wrong" and felt a lot of disappointment. I understand where the reaction against the method comes from, but I do not agree that method-free is the best way for most women to go. Since most women go into their births without prior experience of birth and very little body awareness or relaxation training, their natural ways of coping are often inefficient and counterproductive leading to longer, more painful labors and higher rates of intervention. If we were giving birth in a rural area without access to interventions, most women would eventually find their way through, but I think it would be rougher than it needs to be. I believe that birth can be enjoyable! I do think that the real point is not to be a slave to a particular method, to have a range of tools to use.

Currently, Lisa Fincaryk teaches a wonderful general childbirth education course that focuses on the differences you encounter in Korea such as the standard procedures in most Korean hospitals, how to negotiate with your Korean doctor and writing a birth plan. One of the strengths of this class is role-playing negotiating with the Korean doctors and staff. It is a great class with lots of good information, but it is not a method. While I think that the information in general childbirth education courses is essential preparation, I think that they give you enough information to HAVE birth preferences, but not enough to prepare you to carry out your preferences. Many women are prepared intellectually (through childbirth education classes), but not physically and emotionally. In the Passion for Birth Childbirth Education Lamaze seminar we learned lots of great and engaging ways to teach general childbirth information, but since most people lack time or resources to take both a childbirth education course and a labor preparation/method course, I would rather teach a method course.

Lisa also teaches Hypnobirthing classes here in Seoul as well. We are so fortunate to be able to have that option here as well. Hypnobirthing (I finally read the book) says that birth can be painless and enjoyable. The philosophy is that pain is caused by tension in response to fear. By eliminating the fear and training yourself to relax completely, you can work with your body instead of against it and have a pain-free, or very manageable birth. Having experienced a near pain-free and very manageable birth using Hypnobabies, I believe that it is possible. Where I disagree with Hypnobirthing is in their coverage of interventions and problems in labor. The coverage is minimal because the practitioners believe that covering undesirable topics will plant strong suggestions that will manifest themselves because they will override all the positive work you are doing by entertaining those thoughts.

I disagree. The culture through family horror stories, horror stories from strangers, fearful images from movies and television and lack of confidence in the body's ability to birth have already put the fear in us. Also, most women give birth in intervention-friendly hospitals and if you do not have a good understanding of when interventions are necessary or helpful and how to evaluate that, your whole plan can be derailed if you have something unexpected come up in your birthing. I think that by teaching women about the range of options between a zen, pain-free natural birth and an emergency c-section, you will actually reduce their fear and improve their satisfaction about their births because they will have a greater ability to make choices about their care. I believe that education, support and choice are keys to a women having satisfying birth experiences.

I do think also that Hypnobirthing kind of makes it seem like if you have a problem in your birthing time, it is your fault. Breeches are explained as being caused by fear. Having had two breech babies, this is really hard for me to hear. I did not feel afraid, but I had breeches. With Eva, I did fear release hypnosis sessions and the Hypnobabies breech track and nothing worked. An External Cephalic Version finally did work and I went on to have a very easy Hypnobabies birth, but I don't think that being told it is your fault is really helpful. I think I have the same reaction that Gayle Peterson and others had in response to the old Lamaze method. However, I do think that there is a lot of good information and technique in Hypnobirthing and for some people, it would be a very good fit.

I would like to become a Hypnobabiesinstructor because Hypnobabies does cover interventions and changes in labor. Unfortunately, they are not holding teacher training until 2011. So, I will continue to encourage women to look into Lisa's Hypnobirthing class or order the Hypnobabies Home Study Kit, but I realize that not all women find the hypnosis method appealing.

So, what are we going to teach? Well, Rachel used The Pink Kit for her birthing. The philosophy behind The Pink Kit is that women need to do the work to develop skills to use in their birthing time. Birth can be easy or difficult. If you follow your natural instincts, you may have a very quick and easy birthing time. However, sometimes our instincts lead us to positions and breathing that works against our bodies instead of with our bodies. By developing body awareness and an understanding of the potential impacts of our own anatomy, we can work with our bodies to get the baby out. The Pink Kit does talk about the impact of fear, but gives women (and partners) confidence by helping them build skills to use no matter how your labor progresses.

Yes! This philosophy really speaks to me. It is proactive and not fear-based. It is good preparation for the birth partner as well because there are things that the birth partner can practice. You can do The Pink Kit as a home study as Rachel did, but many people, especially first-time parents or those with previous birth trauma, prefer a live class. We know we want to use The Pink Kit as a basis for our class called Birth Skills. We want to include information on birth in Korea as well as the best elements of other books and philosophies to round out the class. We are in the early stages of trying to decide what to put in the class and how to present the information.

Here is where I need your help. If you can answer the following questions that would be great. If you don't want to answer in the comments, you can send me an e-mail mamaseoul at gmail dot com.

1. What childbirth education/ labor preparation classes did you take?

2. What other resources (books, films, groups, etc) did you use to prepare in addition to or instead of the classes?

3. What did you learn in your classes or other preparation that you feel helped you the most during your birthing time?

4. What did you feel unprepared for? What do you wish you would have known, but didn't?

5. If your partner attended classes, what did your partner learn in classes (or other preparation) that helped the most during your birthing time?

6. What do you think would have better prepared your partner to help you?

7. General impression of your classes/additional comments/anything else that you think will be helpful to us as we put together our classes:


Friday, April 16, 2010

Sewing Lessons in Seoul: I Made It and It's Beautiful!

In my sewing class, I made a dress:

Now that Eva is walking it is almost impossible to get her to stand still, but her she is wearing it. I made it in size 2T so it should fit better next summer. She is size 12-18 months right now.

I am taking sewing lessons in a friend's house. There are three of us that set up our machines at the dining table and Mrs. Ahn, the teacher, assists us with our projects. She helps us make our own patterns and helps us through step by step. It is amazing how much I can accomplish in 2.5 hours! I leave Eva with a babysitter.

Mrs. Ahn can eyeball measurements and free-hand amazingly well. I struggle to cut or sew in a straight line! I showed her this dress and she made a pattern. I decided to make the neckline without the accent because I thought I would like it better and I do.

Now, the dress isn't perfect and I need to do some ironing and thread trimming to finish it off, but I actually finished something!

Mrs. Ahn speaks English very well. She teaches lessons in your home and also takes custom orders. If you want to learn to sew, I highly recommend getting a small group together and setting up some lessons!

Mrs Ahn: 018-369 3023

Thursday, April 15, 2010

Happy Birthday J!

Another birthday! J turned 2 and the party was held at the Yongsan Fire Station, perfect for the fire fighter theme. His mother, unlike me, figured out her theme months ago and had super cute fire fighter themed party favors and had everything ready in advance! Maybe I should start planning Ian's next party right now..

Cupcakes with simple fire truck decorations and REALLY, REALLY RED frosting:

Ian looking like an angst-ridden fire fighting circus clown after eating one of the really, really red cupcakes:

The kids were able to sit in the fire truck. Very cool!

Friday, April 9, 2010

Vote for the Kanzius Radio Wave Cancer Treatment

Erie-Native, John Kanzius developed a theory of using radio waves to target cancer at the cellular level to avoid the awful side effects of the current treatments. Unfortunately, he died before his idea could enter human trials, but the Foundation continues his work. You can help by voting every day in April for the $250,000 Pepsi Refresh Everything Grant.

From the Pepsi site:
Current treatment methods of chemotherapy and radiation therapy are both physically debilitating and expensive. John Kanzius’ theory of using radio waves to stop cancer offers a better way.

Early research has focused on pancreatic, liver, breast, prostate, colon, lung and leukemic cancers. The preliminary findings indicate that the Kanzius Radio Wave Cancer Treatment is non-invasive – that is, no surgery is needed and 100 percent of the cancer cells are destroyed without damage to neighboring “good” cells or tissues!

In 2010, upon receiving approval from the FDA to build a larger, human-sized device, pre-clinical testing will begin. The Kanzius Cancer Research Foundation’s goal is to begin Phase I Human Clinical Trials by 2012.

For everyone you know who had had cancer, please vote!

G. Alec Stewart, Dean of the University of Pittsburgh Honors College Dies

The news has reached the far corners of the earth. On one e-mail that a friend wrote from Pittsburgh, recipients were in Montreal, Doha, Berlin and Seoul among other locations. My small group of friends from the UHC is scattered across the Earth and are just a small representation of the lives he touched.

The UHC is located near the top of the Cathedral of Learning. It is an amazing place. It was amazing even then, when my friends and I were there a few years before the renovation that added a second floor and designer touches. I remember late nights looking out across the city of Pittsburgh. I did a lot at the UHC, as did every person on that e-mail and those that came before and after. We are his legacy.

"Doc" was always accessible. He spent a lot of time talking to students about anything and everything. He was open to different ideas and different types of students. The Honors College was open to every student. There was no "admission". Some students had UHC scholarships, but any student could participate in UHC classes. There was no standard curriculum. You could take 1 UHC class or many. Doc said that many times he had seen kids who barely made it into Pitt catch fire for quantum physics or Shakespeare and that passion had to be nurtured. A teenager's high school boredom or immaturity shouldn't limit his opportunities for college growth. If you get into Pitt, you are already "in" the UHC because of Doc's philosophy. He wanted the UHC to be an intellectual community, not a cut-throat competitive environment. He succeeded. It was one of my homes away from home during my time at Pitt.

He had a great sense of humor. I remember that he said that Hugh Henry Brakenridge (Pitt's founder) was rumored to ride horses naked in the rain and he wanted some students to pull a prank for April Fool's Day or Founder's Day. That kind of thing was right up my alley with my theatre involvement but I never got around to it. I wonder if someone ever did. I hope if any of his current students remember that someone will make a ride through Pitt campus, in memoriam.

I wish I had the time to write a worthy tribute, but I am afraid if I wait for that, I'll never write anything. So, I will just say that G. Alec Stewart was a great man and educator. He will be missed. And, if anyone reading is in Pittsburgh with access to a horse...

Wednesday, April 7, 2010

Happy Birthday A!

April is crazy for us as for as birthday parties go. We are already on birthday #2 with birthday #3 and #4 scheduled. Two parties in May already as well!

Another mom-made cake:

The border around the cake is made with fancy marshmallows. I think that it is a great and easy way to add some decoration.

They had a clown who did face-painting and balloons:

A child using her balloon sword to cut down the decorations! Hey, what else was the sword for?

The party was in the building's playroom.

They had a pinata as well. I was a bit scared for the dad because there was no place to hang it from. He held it on the end of a hockey stick and the kids weren't blindfolded so there were no injuries.

Happy 4th birthday, A!

Baby Unders

I ordered a pair of babyMISHA infant underwear from Diaper-Free Baby to try with Eva. They come in plain and prints in sizes S (0-6 months), M (3-12 months) and L (6-18 months). They are just small underwear without any absorbent layers.

I ordered size L because this summer I think I may put her in dresses and let her go diaper-free as a continuation of our EC journey. I compared them to Baby Gap underwear size 2T-3T (Ian's) and they are a bit smaller and definitely have smaller leg openings. The size L fits her now and should fit her through the summer. I also have Hanna Andersson size XS (also Ian's) and those are much bigger. Most of what is available in EC wear seems to be made by small companies, so you need to custom order or wait for stock to come in. I may ask my sewing teacher to help me make some myself.

She was very comfortable in them. In fact, she took off running. I had her diaper free (not in the underwear) for a long time time evening and she did pee on the floor but it shocked her and she cried. I took her to the potty immediately. It was too late of course, but I am hoping to strengthen the association.

Tuesday, April 6, 2010

Bounce Back Fast (Or Slowly)!

I bought the Be Fit Mom: Bounce Back Fast workout dvd after Ian was born. I did it a few times, but not enough to make a judgement on it. I thought about using it after Eva was born, but a crazy summer full of moving and traveling tanked those plans. Well, now that Eva is a year old, I really want to workout regularly to close the abdominal separation from pregnancy and increase my energy.

I just finished my doing the Bounce Back Fast Abdominal Separation workout for the 4th time since March 31st. I was attempting to do it everyday, but I haven't made it so far. I am going to try using a mantra to workout regularly,"I am making a choice. I choose to workout." That dvd workout is only 34 minutes long. I should be able to manage it. I also need to be practicing asanas and meditation every day, but truthfully, that hasn't been happening.

Now, I am not going to lie, this workout is boring. It is boring because it has to be, because the movements are subtle. It is easy to do the exercises incorrectly, but for them to be effective you have to pay attention. Helene Byrne sets you up for every exercise, every time to help you do it correctly. I will report back when I have done the workout 30 times. Only 26 more to go!

Sunday, April 4, 2010

Saturday, April 3, 2010

Flowers in the Afternoon

Happy Birthday K and Grandma

After the Easter Egg Hunt, we went to K's 2nd birthday. Her mother made the cake herself and did an awesome job. Her hands were stained red from working with the fondant, totally something that would happen to me, but the cake looked great and was moist and delicious.
Ian spent the party like this:

And sometimes like this:

Eva loved the Malay pancake and curry:

Today (well tomorrow for her) is also my mom's birthday. Happy birthday, Mom!

Friday, April 2, 2010

Easter Egg Hunt with Lady Gaga

Lady Gaga's Paparazzi, The Black Eyed Peas' Boom Boom Pow were among the songs setting the atmosphere for the Easter Egg Hunt at Yongsan today. It was like a continuation of last night's Girls' Night Out. Not appropriate and yet, a lot more enjoyable than some cheesy kids' music.

They put empty plastic eggs on the field and the kids, grouped by age, filled their baskets. I, of course, forgot to bring a basket, so my kids had to use a bag, but, hey, we made it on time. The plastic eggs were empty, but the kids could turn them in for candy. There were a few special eggs that got prizes. They were giving out very generous portions of non-chocolate candy so I told Ian he could have some M&Ms at home and we skipped out.

Eva actually got the idea and put eggs in her bag. Then she started taking the eggs out later, but she did really well and enjoyed it.

Ian was a lot more interested before it started. It is nice because he is still at the age where he isn't aware of the prize eggs and that only a few kids will find them and win. So he didn't even look for it and was happy to turn his eggs in and leave without candy.

Baby Likes Tofu

Curt passed a test and wanted to go to the Fish Market to celebrate. It was rainy and cold and Ian was a bit cranky so I needed someplace closer with valet parking so we went to a nearby barbeque place. Eva ate half of the big lump of soft tofu we got as one of our side dishes. She also ate some rice, rice cakes and squash from the soup.

Thursday, April 1, 2010

Dr. Fish Pedicure

That is Chalica making the squealing sound in the video. I was much cooler than that as I approached the tub and stuck my feet right in, only to withdraw them quickly with the same ridiculous squeal! It is a freaky sensation. I had to really relax and focus to get used to it. This place is primarily a coffee shop. You have to buy a coffee and then the Dr. Fish soak is 2,000 won for 20 minutes. It is a lot of fun and definitely a must-do for any visitors to Korea.

Gangnam Station, Exit 6 walk a few minutes. The cafe is on the second floor across the street from the Skin Food and Adidas stores. It doesn't say Dr. Fish on the outside, it says something like "Book and Coffee".