Assignment- Childbirth In Your Life and Around the World

This week in Early Childhood studies we are looking at prenatal development, the many factors that can influence that earliest development, and the potential impacts on children as they continue to grow throughout life. I have never given much thought to the impacts my prenatal care or birthing experience has had on the development of my children; except to consider that I must have done things “right” as they are wonderful, healthy children. My studies are teaching me many details that could have been impacted in ways I never realized before. The following is the story of how I brought two children into the world.

I have had the pleasure of carrying two healthy children into this world. While pregnant the first time I turned to the well-known book, What to Expect When You’re Expecting. I enjoyed reading details about prenatal growth, and I took every bit of nutritional advice to heart. Already a non-smoker and non-drinker, I made sure to avoid soft cheeses, lunch meat, too much large fish, and more. Of course I craved those things like I never had before! Unlike those in poverty, we had the benefit of having health insurance to cover all the prenatal care necessary and the finances to afford well-rounded healthy foods as well as indulgent chocolatey pregnancy cravings!

Due to a health condition I have called Chiari I Malformation, we had to have an extra ultrasound with a specialist to determine if my children would inherit the condition. Mine is a very minor level, but the condition can be very serious. Thankfully, the ultrasound was clear. Also due to my condition it was determined that I could not risk the physical pressure of experiencing contractions and labor. I would require a cesarean. Not just any cesarean, a cesarean under full anesthesia. I was disappointed, but I quickly came to terms with the concept that it was more important for me to survive to raise my child than to be awake for their entrance into the world. My scheduled cesarean went well, my daughter was born at 38 ½ weeks, 6 lbs 7 oz., 19 ½ inches. The downside was that I was very disoriented, even incapacitated at times during the first 24 hours after her birth. Thankfully, my husband instantly became an amazing father. 

In the years before becoming pregnant with our son, I read an article explaining that cesareans under full anesthesia for Chiari patients is overly precautious and sometimes unnecessary. I approached my obstetrician with this information. They felt that I should see my neurologist for a check-up before proceeding. My neurologist said my MRI scans were out of date, and insisted on new ones before agreeing to a regular cesarean. Reluctantly, I booked an MRI. I had checked to see if this would harm my unborn child. I found nothing to suggest it would. Still, I cried throughout the lengthy scan, fearing I was doing harm to my son. My scans showed that my condition had not changed for the worse, and my neurologist agreed that a regular cesarean was a possibility. Then he retired. 

I went and picked up my file before my scheduled cesarean, pleased to hand it over to receive the opportunity to be awake as my son entered the world. You know what they say about the best laid plans. Apparently, the neurologist had made no note about his latest opinion and the obstetrician had to proceed as they planned with a cesarean under full anesthesia. I found this out while in surgery prep around 7am. Extremely hormonal, I cried, uncontrollable tears. I tried to calm down as it was time to go into surgery. But while lying spread out, naked and shivering on the surgery preparation table I could not contain my disappointment and I cried more. The surgeon even noted my crying in the surgery notes. With my first pregnancy I was the first of my friends to have a child, I was told anesthesia was the only option and accepted it rather blindly. I had not allowed myself to consider what I would be missing. But with my second child I knew more. I wanted to be there, and I could not believe that even after taking my unborn child into an MRI, that I had not done enough. Looking back I can see what could have been done differently, I can see how a busy mommy brain forgot details like checking the file for the notes before my cesarean. Yet, I remind myself that the point remains- It is more important that I am alive to raise my children. After all the stress, I came out of anesthesia (much better this time) to meet my sweet son; born at 38 ½ weeks, 6 lbs 9oz and 19 ½ inches. 

With both of my children I enjoyed holding them skin to skin, as did their father. They spent the nights in a bassinet in my hospital suite for the four day stay. My husband slept on the sofa chair and helped endlessly with their care. I began nursing them immediately, though that went much differently with each child. My first, I had no milk but insisted “breast was best,” but as she lost weight we compromised by taping a tube to my breast for my husband to push a syringe of formula through while our daughter “nursed.” Eventually I had some milk, but never enough to be a full diet so we continued by supplementing formula bottles. Looking back I think my lack of milk was due to my age, my first pregnancy, and my required early scheduled cesarean. Interestingly, with my second child, I had an overabundance of milk, which came with new issues to overcome. 

My sweet children were born to two parents in their twenties; two parents with well-paid full time jobs; two parents with complete health insurance, a home, safe vehicles, and family/friends/ and funds to buy every modern thing a child could need. Now 8 and 5 years old, they are bright, curious, creative children with their whole wonderful lives ahead of them. We have much to be grateful for.

After reflecting on my own birth experiences, I chose to look at birth practices of Japan in comparison. Japan has followed a similar progression to the US; from having historically mostly home births, to medical advances resulting in majority of hospital births, to a recent revival of interest in home births with midwives. The article Post Modern Mid-Wives in Japan: The Offspring of Modern Hospital Birth, detailed the history of Japan’s approach to birth in pre-modern, modern, and post-modern time periods. (Matsuoka, 2010) The points that struck me the most was the impact of Americans on Japan’s practices, and how new medical advances post WWII were twisted to make birth a more profitable and convenient business for obstetricians; further, how those practices resulted in extensive amount of infant deaths, and disabled infants. I was more pleased to see the post-modern resurgence of interest in home based mid-wives and natural births. Not because I feel that is the only best option, but because I feel it shows Japanese women are continuing to educate each other on the process of pregnancy, birth, and postpartum rather than accepting the “status-quo” doled out to them by dominant males as was the situation experienced by Brett Iimura, an American living in Japan. (Iimura, 2005) 

In another article I found that the Japanese government also seems to be recognizing the benefits of more natural birth on both mother and child, as it has funded programs to train medical personnel, execute studies, and implement practices for the “Humanizing of Child care” and “Humanizing of Maternity care.” Still, it is typical of the Japanese culture for the women to not take a leading role in the decision making process of their child birth experience, and to lean heavily on the word of their medical personnel. (Behruzi et all., 2010) It is unlikely in Japan that a woman would approach her doctors as I did in regards to a medical condition and birth procedure.

Despite, or maybe because of, a time period of many medical interventions during child birth, Japan seems to culturally have the perspective that less intervention or medications are best for prenatal care and child birth. This is probably in contrast with the opinion of the majority of Americans, where epidurals and cesareans are the norm. Additionally, in Japan after vaginal birth mother and child stay in the hospital/birthing center for one week receiving monitoring and breastfeeding support; much different from the quick discharge in the US after a vaginal delivery. Another difference however leans toward American’s having a step up in the humanizing approach, which is the participation of fathers and family members during birth. In Japan, the culture doesn’t yet encourage or allow for family participation to support the mother’s emotional wellbeing. (Behruzi et all., 2010)  Sometimes this is simply because it is not financially responsible for the father to participate. Overall, I think there are many similarities between American births and Japanese. Contexts such as education, and economic status, and services available will similarly impact pregnant women and new mothers in both countries.

References

Behruzi, R., Hatem, M., Fraser, W., Goulet, L., Ii, M., & Masago, C. (2010, May 27). Facilitators and barriers in the humanization of childbirth practice in Japan. BMC Pregnancy Childbirth, pp. doi:  10.1186/1471-2393-10-25.

Iimura, B. (2005). Birth In Japan. Midwifery Today, 60 (3).

Matsuoka, E. (2001). Postmodern midwives in Japan: The offspring of modern hospital birth. Medical Anthropology, 141 (45) dx.doi.org.ezp.waldenulibrary.org/10.1080/01459740.2001.9966193.