Wednesday, February 26, 2014

Epidurals: Numbing Us To More Than Just Pain

Our first son, Trigg, was born after a very long 33 hours of labor and when he was given to me, the first thing out of my mouth was, “If I had to do it all over again, I would do it the exact same way”. We were so blessed to have brought him into the world surrounded by support for a natural birth but there were women who told me that I was “crazy” for enduring the pain of labor and if given the option, they would have taken an epidural. When it comes to laboring our babies, are we ignorantly loosening ourselves to the concept of natural birth simply because we believe the pain is too great? What if I told you that the ripple effect of interventions like epidurals are more than just temporary and are numbing us to more than just the pain?

In a survey published in 2006, Listening to Mothers II reported that more than three-quarters of all women surveyed were administered an epidural. In 2008, the CDC reported that over 60 percent of women in the U.S. were administered an epidural, with states like South Carolina having rates as high as 75 percent. And, even though the American College of Obstetricians and Gynecologists say that no woman should be deprived of pain management during her labor, are doctors doing a poor job of informing women that epidurals have the potential to numb us to more than we think?

An epidural is an injection of an anesthetic into the epidural space around the spine. The drug, which by the way, is typically derived from cocaine, blocks pain signals from nerves and temporarily paralyze the mother from the waist down. Epidurals come with an increased risk of fever, postpartum hemorrhage, breathing difficulties, permanent nerve damage, transient headaches and vertigo and death (among many other side effects, both temporary and permanent). When an epidural is administered, the drug enters the mother’s AND baby’s blood stream within minutes. This synthetic chemical not only puts the mother and baby at greater and more numerous risks but also obliterates the cascade of natural and beneficial hormones the body produces naturally that help ensure a successful labor.

Epidurals significantly lower the mother’s production of oxytocin, which in turn inhibits the mother’s natural response to strongly bond with her infant, successfully breastfeed and be alert post-birth. This bodily chemical is often referred to as the “hormone of love” because of its well-documented ability to promote social and maternal bonding through awareness and attachment. It has a remarkable effect on memory and passage of information through the brain, showing researchers the validity of how this hormone plays a vital role in how women form a strong bond to their young. Furthermore, mothers who were intending to breastfeed pre-birth and were administered epidurals were two times less likely to breastfed and weaned their children far earlier than mothers who had their babies naturally. Researchers have also found that epidurals contribute to maternal-infant effects, including neurobehavioral effects, immunity, and drug toxicity. Studies has suggested that there may be a correlation between women who give birth under the stress and toxicity of interventions like epidurals and the long-term relationship they hold with their child and how that particular child develops socially.

Now, let’s get back to the “crazy” comment that gets torpedoed at the mother who has actively made the choice to not have a cocaine-derived synthetic chemical stabbed in her spine and trust that her body is going to do what is necessary. How is it that when she gets asked about her pregnancy and she shares her plans to have a natural labor she gets weird looks and people get quiet? What kind of message are we sending to mothers who are making natural health care decisions for themselves and their child - choices that are not only a strong personal preference (which a woman is entitled to) but are also backed up by evidence-based practices and research - and we disregard her as a lunatic because our medicalized society believes she should be at the mercy of drugs and surgery.

Modern obstetrics and society continues to undermine our bodies and under support the notion of wholeness out of complete ignorance and disrespect. Today women are being unknowingly cornered into pivotal decisions that are being made for them by medicine at rates so frequent that emergency procedures and interventions with incredible risks have now become the norm. Even more disturbing is the growing inclination that we are more safe and efficient because of modern medicine! WAKE-UP CALL, FOLKS: WE ARE SICKER, FATTER, MORE MEDICATED AND DYING AT RATES HIGER THAN NEARLY ANY INDUSTRIALIZED COUTRY IN THE WORLD. If that statement doesn’t get you thinking outside of your tiny box or get you to take the blinders off, than you better check your pulse.

Before I was even fully aware of the implications of epidurals, I knew I didn’t want one. I’m the type of person who’s been known to wipe off the antiseptic the nurse puts on right before she jabs you with the needle. I’ve learned that people in the hospital are downright terrified of two things: germs and malpractice lawsuits. Because I’m privy to this, I know that as long as I can be quick enough to wipe off the brown liquid, I’ve prolong my chances of getting the needle. With that being said, how in the hell do you think you are going to convince me to put a line in my epidural space. Yeah, no. So, here’s my encouragement to all you beautiful mommies and support teams: PAIN IS GAIN. Let me share with you why this is innately true and how epidurals are for the birds.

Labor is this amazing process of ebb and flow. Your contractions are 3 minutes apart, then they are 10 minutes. You progress from 1 to 7 centimeters in a short amount of time and then you’re stuck at 8. You want to be massaged through contractions, then you threaten someone’s life if they touch you the next time. If you’ve been there, you know what I’m talking about. Labor is meant to be this way because your body is designed to release hormones in increments to specifically combat things like anxiety and pain. Remember our friend oxytocin? This hormone is the superstar in your birth. Not only is it being released through your entire labor as a natural pain killer, but it is the lifeline that gives you the extra oomph you need to push your baby out, allows you optimal bonding time post-birth, is responsible for milk let down and helps the uterus contract back down to size after labor. In other words, the more “pain” the mother perceives and interprets through her labor, the more oxytocin gets released as an aid to her. And oxytocin isn’t the only hormone released during a birth (but we don’t have time or space to discuss in detail the specifics today). How amazing…but some of us are turning off the switch on purpose because of the fear of pain but wait, there‘s more!

It has become increasingly routine that hospitals are administering pitocin to women who aren’t progressing to their standards. Pitocin is another synthetic chemical that tries to take the place of naturally occurring hormones in a laboring woman’s body. However, pitocin makes the contractions of labor not only more frequent, but more intense. Typically, pitocin is administered before an epidural, but by the time pitocin kicks in, mom is climbing the walls asking for relief. Here’s the kicker, ladies. Although our very intelligent doctor is “speeding up” the process by giving you pitocin, the administration of an epidural has been conclusively found to SLOW DOWN LABOR! What the what?!

Seriously. Let’s all take a quick minute and process this scenerio: A mother goes into labor, she is administered pitocin because the natural and healthy ebb and flow of her labor isn’t good enough for Dr. Smith. She is completely beside herself because her contractions are on top of one another, an epidural is administered, which ultimately counterproductive to the first drug that was intravenously injected, her baby is born with the help of her nurse telling her when to push. Then, when it comes time to nurse her child, the hormone that’s responsible for her milk let down has been obliterated and the baby is taken to the nursery to be feed synthetic milk, robbing both the mother and child of vital bonding time and reaping the incredible benefits of being breast fed (you better believe I will be blogging on breast feeding). The next day when she’s discharged, she’s got vertigo and a massive headache which again disrupts her ability to comfortably bond with her infant and … all because we were too ignorant and oblivious to support her desire to have a natural birth. What a crock.

If you are pregnant, let me say to you this: You are in control of the outcome and satisfaction of your birth. If ANYONE is telling you otherwise, you need to switch doctors, midwives, etc (and if I were you, give them a piece of your mind). Statistically speaking, pathological issues that prevent women from having a natural birth happen in less than 10 percent of pregnancies. If we continue to be fed the lie that our bodies aren’t smart enough, strong enough or simply not drugged-up enough to deliver a baby, we are apart of the problem. Be your own advocate, find resources and measure your willingness to obey the process. The greatest source of encouragement in your 28 hour of labor will be YOURSELF, not an epidural - take my word for it. So, make sure you’re prepared, supported and well cared for. Labor is a natural process, let’s learn to trust it, not be numb to it.

Wednesday, February 12, 2014

Designed to Know

The Centers for Disease Control and Prevention reported that Americans made over 1 billion office visits to their physician in 2010. Most of us have faith that these trips will ensure unbiased health care advice that is based on knowledge, experience and best practices. But, what happens when we allow professional recommendations to undermine the potential of the human body, dictate how we heal and recover and ultimately, how we view health as an entity? When it comes to making an informed choice about your health, is somebody else making the decision for us?

There are a great deal of Americans who are reliant on being fed diagnoses, and because of it, our standard of care is based on symptoms and how to treat them rather than how we can allow the body to function properly. The polarity that exists between medicine and obeying natural function has become so extreme that we are now encountering historic rates of over-prescribed drugs to adults and children alike and epidemic instances of people with antibiotic resistant issues.

In 2013, a study published in JAMA International Medicine found "a large discrepancy between numbers of outpatient visits requiring antibiotics and the national prescribing rates for the drugs". Senior author and contributor to this study, Dr. Jeffrey Linder, reported that the prescribing rate for the correct antibiotic [for bronchitis] should be near 0%, yet their research found that the national antibiotic prescribing rate was 73%. Contributing author to this study, Dr. Michael Barnett of Harvard Medical School, says that their findings show that while only 10% of adults with sore throat have strep, the only common cause of sore throat that needs antibiotics, the U.S. national prescribing rate for adults with sore throat has stayed at 60%. Both authors note that the unnecessary prescribing and overuse of antibiotics has led to a surge in super bugs, which is a growing concern not just in America, but internationally. Unfortunately, drugs aren't the only growing issue.

The amount of surgeries preformed in our country is on a sharp rise and has been for nearly two decades. Today, one out of every three women gives birth via cesarean section, although the World Health Organization recommends that the best outcomes for women and babies occur at a rate of around 5%. According to government data, approximately 465,000 spinal fusion surgeries were performed in the U. S. in 2011 and experts reported that a portion as high as 50% were unwarranted. Obstetrics and Gynecology published in 2000 that nearly 70% of hysterectomies are inappropriately performed due to lack of adequate diagnostic evaluation and failure to try alternative treatments before surgery.

In 2011, a study conducted by Healthcare Consumerism and Hospital Quality in America Report reviewed more than 350,000 malpractice claims, of which nearly 29 percent involved a missed, wrong or delayed diagnosis. The study reported that such errors may account for the permanent injury or death of up to 160,000 patients each year, with researchers saying, "it is probably a lot higher than that". Breaking this information down, medical errors (not just wrong diagnoses) are occurring at a rate of 40,000 permanent and/or causes of wrongful death EVERY DAY.

As a doctor with a strong stance on natural health and healing, it has become increasingly easy for me to have visceral reactions to the way I see my patients, family and friends make decisions about care for themselves and their families. This isn’t because my knowledge is infinite and my ideas are superior but because most are making the choice to TREAT INSTEAD OF HEAL. We have been taught to view sickness as a disease and not a natural function of the human body. We bring fevers down with Tylenol when a fever is the body’s natural defense to being invaded by bacteria. We administer epidurals to nearly seven out of ten women in labor although literature has concluded that it is counterproductive to the birthing process. Why are people opting to take an intervention in any form when their bodies don‘t necessitate it in the first place? How enabled has our perception of health become that we are willing to risk our own lives for a “cure”? How diluted have our country’s doctors become that some believe that their years of education outweighs the intelligence our bodies have possessed for eons?

The best advice I can offer to any one person or patient when it comes to making a choice about their (or their family’s) health is this: HEALTH IS A CHOICE. How you decide to treat or heal is almost completely and entirely up to you. When individuals are serious about listening and trusting in their body, the route in which they chose to recover is almost always one that involves succinct and adequate options as well as faithful dedication to their decision. People who believe that health is a choice aren’t unraveled by the fear of a prognosis, they are empowered by the notion that their bodies are smarter than pills and devices. The individual who has made up their mind that it makes more sense to be conservative is not persuaded by the time it takes to recover because they know healing will occur in due time. Sickness is a not a lack of things from the outside, it is a powerful internal process that is necessary to the way we functionally sustain a higher quality of life. 

If you are a woman, you have capabilities that are so astounding that in some cases, we are defying science. Is it too difficult for you to believe that you were designed for health and not engineered to be sick? My encouragement to you for the week is this: consider making health care choices based on healing and not on treatment. Be more concerned with your approach to health than the convenience or the time frame it takes you to get there. When we own the right to make clear and informed decisions, The Extraordinary Machine wavers for no one. She is a monument to intelligence on levels we are still trying to understand. The female body is a comprehensive entity that doesn’t need to be told or directed on how and in what fashion it should heal. It knows because it was designed to know. Health is a choice and the time to make a decision on your own starts today.

Wednesday, February 5, 2014

Pregnancy is NOT a Disease

When I think of The Extraordinary Machine in its reference to the female body, pregnancy and labor is the ultimate showcase of how truly awesome our bodies are. Unfortunately, there are a lot of people, with women possibly (and ironically) being the largest demographic, who think and act otherwise.

A majority of women in our country go into labor at a hospital which is typically the place where she will find herself attached to monitors and intravenous fluids alike, be administered synthetic chemicals because her labor isn’t progressing as her doctor sees fit, ultimately has an epidural shoved into her spine and is then instructed when to push because she cannot figure it out for herself. When the baby is born, the cord is clamped haphazardly, the baby is taken from his mother prematurely, weighed and measured, washed and prodded, poked with a Vitamin K shot and is then temporarily blinded by erythromycin in the eyes. After numerous interventions, the infant, who has been subsequently drugged via the epidural, is given back to his mother who barely knows up from down. This is the standard for pregnancy and labor in our hospitals and the fact that it doesn’t disturb more women is puzzling to me. But who’s fault is it really?

Currently, there are at least 169 OB/GYN, postpartum and newborn diagnostic codes. These numbers label “issues” like breech presentation, false labor and failure to progress. In other words, these codes are examples of the “problems” the medical field gets to slap on you for insurance purposes when you don’t fit inside their standard of care. Frighteningly enough, there are 101 diagnostic codes to distinguish the location of neoplasms (cancer) and 71 for cardiovascular disease. When it comes to having babies, why has allopathic medicine duped us into believing that pregnancy and labor is more of a disease than a natural process?

According to the CDC, in 2008, women who’s births were attended by a medical doctor in the U.S. were administered epidurals as a form of intervention at a staggering rate of nearly 65%. Additionally, in a 2006 survey of nearly 1,600 women, 86% used pain-killing drugs and nearly 45% of the practitioners present at the time of labor were reported to have tried to induce labor. Recently, the American College of Obstetricians and Gynecologists reported that interventions like induction via oxytocin (pitocin) aren’t as safe for the neonate as we originally thought. The study revealed that the use of pitocin to induce or progress labor has been found to be an independent risk factor for unexpected admission to the NICU lasting more than 24 hours for full-term infants. [Pitocin] also correlated with Apgar scores of fewer than seven at five minutes. But hey, can’t we just assume that with all this monitoring, drugs and surgery we are performing, we can be assured that this is the healthier way to deliver babies?

Even though the United States spends more on health care than any other country in the world, its infant mortality rate ranks equivalent to Poland and worse than Hungary. We are twenty-six among thirty countries ranked by The National Center for Health Statistics. IF YOU MISSED THAT, WE SUCK. If we had a report card and were graded by a percent in relation to the other 30 industrialized countries we are ranked with, we would receive a 13%. That’s like, an F-----. Why is it that we are seemingly convinced that our bodies, with all their infinite wisdom, have the capacity to conceive, develop and carry another being inside of us successfully, but when it comes time to labor, our bodies are stupid, completely insufficient and require interventions?

When was the last time your obstetrician told you that your body is smart enough to actually enlarge its own heart and lungs due to its increased work load, or that your uterus produces upwards of a pint of extra fluid to help protect your baby? Did you know that you produce almost 40% more blood volume to help circulate more red blood cells to carry oxygen around the body during pregnancy? Were you ever reassured that during an undisturbed birth, the hormone oxytocin (the body’s natural pain-killer) is released at astronomical rates, helping make labor sustainable and pain more manageable? How about the fact that beta-endorphins are secreted during labor to help increase your alertness and can actually shift your consciousness to increase your focus if you allow your body the chance at a natural birth? All of these things happen naturally because we are designed to be an Extraordinary Machine, but we continue to rely and electively opt for multiple interventions to make the birthing process quick and painless. In the end, aren’t we really just shorting ourselves?

I could spend a great deal of time discussing statistics and how dangerous interventions completely obliterate the normal and healthy physiologic process of pregnancy and labor but I intend to write future posts on specific interventions like cesarean sections, epidurals and erythromycin. I, however, want to offer to you a few avenues on how to perform like THE EXTRAORDINARY MACHINE:

1. GET A MIDWIFE. This is my number one piece of advice to any and all expecting mothers. Midwives, depending on proper certification, have hospital rights in every state in America. They are trained to do nearly everything an OB/GYN can, including prescribe medications and perform minor surgeries. They statistically spend more time with their patients, personally coach women through their labors and offer safer alternatives to pain management and birthing difficulties. They also have a dramatically higher satisfaction rates with their patients than do obstetricians and osteopaths. I will definitely be dedicating a blog to these wonderful men and women.

2. QUIT UNDERMINING THE PROCESS. I have heard so many women say that they are “trying” for a natural birth. What other kind is there, really? I was in labor for over 33 hours, for which of four I pushed. I was exhausted and disheartened but never was the answer to our situation drugs or surgery. The difference between women who are “trying” for a natural birth and the ones who succeed is this: they have MADE UP THEIR MINDS that their baby is coming naturally, hell or high water (besides for pathological emergencies), because they TRUST and KNOW that BIRTH IS A NATURAL PROCESS.

3. GET EDUCATED. The best place to start is by seeking out women who have had successful natural births and practitioners who support these women. Listen to their stories and allow them to take precedent and high priority on how it is you view birth. In addition, find out what these women are doing differently. It is very typical that this demographic of individuals is cultivating habits that are suppressed by the medical world. Things like avoiding ultrasounds, flu shots and medications during pregnancy, being under the constant care of a chiropractor and keeping a strict exercise regimen. Read books published by midwives and chiropractors instead of osteopaths and medical doctors. They will give you a much better insight into natural child birth and health care options and they rarely utilize fear as leverage to manipulate decisions. I personally recommend "Gentle Birth, Gentle Mothering" by Sarah J Buckley and "Birth Matters: A Midwife's Manifesta" by Ina May Gaskin. These books will ROCK. YOUR. WORLD.

Ultimately, the birth you have is almost completely up to you and I would hope you would be fully informed and comfortable with the decision(s) you make. At a later date, I would be honored to share with you the birth story of our first son, Trigg, because it is an awesome testament of The Extraordinary Machine. I would also like to encourage you that having a heightened awareness of the potential of the female body during your pregnancy is powerful and can ultimately give to you the birth that you are entitled to and designed for.

*** Any statistical data I have published can be produced if asked for.