Thursday, July 19, 2012

Natural Childbirth

So Bonnie Jean and I had been looking more seriously at natural childbirth.  Our first child had a very long wait between induction and the epidural being given because labor was progressing too slowly for the epidural to be given.  We had little training for the labor process and didn't know what we were doing.  It ended up being a lot of pain until they gave up and decided that even if she wasn't dialated to a 3 she should still get the epidural.  As soon as she had the epidural the pain went down, she relaxed, and the labor proceeded quickly.  She couldn't walk around or really do anything about the pain because they felt strongly that the moniters should be attached at all times unless she was going to the bathroom, she had an IV, and as a result was essentially tethered to the bed.

So we really wanted to know some options to allow us to work around the stuck phase before an epidural would be possible.  We did do some self study on the bradley method.  The basic concepts he talks about seemed nice, but the nicest parts of them seemed to have been incorporated into the other methods that are widely promoted.  The stats supporting the method seemed encouraging but lacking scientific rigor (like giving a high percentage success rate when only measuring the people who decided not to change and get an epidural half way through the process).  The supposed bad practices being railed against, as far as we could tell, had more to do with the past than the present.

Labor woke my wife up at somewhere between 3-4 AM.  She woke me up around 4:23 when contractions were about 8 minutes apart.  Before we could finish gathering up to go they were coming at 4 minutes apart.

When we got to the hospital they insisted on keeping her hooked up to the monitors during most of the intake and medical questionnaire process.  She wasn't feeling so great at that point.  Once they were done they let her walk around, which felt much better, but she still was feeling like she might probably want an epidural.  We thought we'd try the hospital hot tub next.  That was marvelous, the water helped take the pressure off her back, the heat relaxed her, and things went along swimmingly.  They insisted on checking her again with the monitors since no one had bothered hooking up the portable monitors they had available.  Then, frankly I think they forgot about us.  It was only supposed to be a quick stop for a short monitoring and then back to the tub.  Bonnie Jean was feeling so miserable I went and asked someone if they couldn't hurry up and let us back to the tub.  They checked her again and discovered the hot tub and worked so nicely that she had gone to an 8.  The OB/GYN had another surgery waiting on her so she wanted to break the water in hopes of causing the labor to finish up rapidly.  They moved her into a classic birthing table posture, and being stuck on the table on her back being unable to move around made things miserable, hard to relax, and progress kind of ground to a halt.  Because the anesthesiologist was in surgery, the epidural wasn't an option and narcotic painkillers have a history of making Bonnie Jean feel nauseated and loopy.  So with the exception of some local painkillers injected in anticipation of stitches etc we were pretty much a drug free childbirth.

She started to feel like she needed to push very badly, but was still only between an 8 and a 9, not really ready to give birth.  Eventually it got to a point where there was only one edge of the cervix on the side that hadn't gone anywhere.  They kept telling her to bear down a little bit so they could watch what happened to see how likely it was the baby could get past that little bit of swollen cervix that was left, which left neither Bonnie Jean or I certain whether we should be working on relaxing or pushing because we were being asked to do both more or less at once.  That part of labor was extremely painful because we essentially lost control of the relaxation.  Eventually, the doctor felt that she could just hold that part out of the way and the baby could come past it.  The final part of labor was again very painful, none of the "if you push hard enough you won't feel a thing except a mini orgasm as the baby's head clears" the natural birth promoters were promising.  The doctor injected a painkiller on the part of the cervix that was refusing to retract, which helped some, but it was still some of the worst pain I'd heard my wife go through.  Perhaps if she had been given a more realistic option to stand or move around during the final part of the labor process she wouldn't have been in so much pain, but who knows.  Encouraging her to bear down a little bit to see what would happen when they weren't really wanting her to bear down was NOT a good idea from a making sure the contractions actually accomplish something perspective.  They only stopped telling her to do that when they decided that keeping up their little experiment was going to tear her cervix.  If she had an epidural perhaps that method would have been fine because she would have been in less pain and better able to relax or bear down at will.  But when the relaxing has to happen against an extreme backdrop of pain the whole thing was making it harder for us to do anything useful.  And breaking the water might have been ok if Bonnie Jean could have moved around.  They were just hoping that labor would become so rapid at that point that they wanted to be ready to catch the baby.  Perhaps in most cases that would have worked.  In this case, because it involved having to hold still on the labor table it kind of backfired.

In general I'd say if you are considering natural birth go for it, but be ready to be forceful about not being forgotten about stuck to the monitors for any longer than necessary.  If you have a hot tub at your hospital definitely try it out, it was amazing for us.  Don't let anyone promise you a painless paradise of the baby gliding into sight.  If the pain is managed right and there aren't complications forcing you to do things that interfere with the techniques it can be much more comfortable than it might be.  But don't be surprised by or disappointed by a painful labor.

Since the contractions became less productive as soon as we were out it made us wonder about water birth.  We don't care at all about the theories that supposedly since a baby is in a water type environment before birth exiting into a water environment will be better.  We did like how being in a hot tub allowed Bonnie Jean to profoundly relax in a way that she wasn't achieving elsewhere.  The contractions were so effective in this state of relaxation that she moved from a 4 to an 8 in something around three and a half hours.  We don't know if this would be the case at any typical center offering water birth.  But that hot tub, combined with vigorous massage, verbal support, walking, and moving around was a good ticket to effective labor.

Tuesday, July 17, 2012

Contractions

They were 15 minutes apart she said, but gone now.  We hope they stay gone for another few days.  Work won't reimburse me for my classes if I take off work for my son being born.  Granted, given that we are about to add another human being to our household that almost seems like the least of the worries.  I try hard at work, but sometimes I worry about making it another month without being fired.  Getting sales involves a lot of person skills on the emotional level that I simply don't have, the product isn't really all that unique, the market is saying just about anything I'm touching is borderline obsolete, and they just doubled the official sales requirement.  After we stashed away the last tax return this is the first time since we've been married when the emergency savings fund was fully funded.  Would be nice to keep it that way, for a while at least.  Now we're about to have a baby with a HSA account making sure we pay up through the nose for anything they do.  Granted, the math seemed to say that once the coverage actually kicked in it would be so much better that we'd be better off in the long run.  Meantime, I guess I can kiss the emergency savings fund being fully funded goodbye for a while.  Maybe next year's tax return will fill it up again.  The government seems to think that if we are this poor we don't deserve to pay many taxes.  Maybe in a year or so I will have completed enough classes to get some kind of job that uses the skills I'm building with all these classes, and I can get away from customer service work.  Not that I mind helping customers, but sometimes I feel like I'm less helping them and more giving them a guided tour to a house of horrors.  Yes Mr. Customer I know you think its nothing to do with me personally but you hate our collective guts.  And if you could please hang up soon I'd appreciate it because whether I can put food on the table another day is partially dependent on being able to get you to go away quickly before my average call length goes through the roof.  Occasionally I simply know the answer to their problem off the tip of my tongue  and I can bask in the admiration of callers who enjoy having their problem solved fast.  But its equally likely that the solution is one that goes beyond their technical skill to implement and somehow that is our fault.  From a service perspective I can see why they'd feel that way when they don't have anyone else they can think of to turn to, but there is sometimes nothing I can do about that.  If only solving my life problems were as easy as claiming that it was all the fault or responsibility of the first group that came to mind.

Saturday, July 14, 2012

How we do things

With the recent hullabaloo over how the finances of the LDS church are reported and dealt with, I thought it would be interesting to point out how much of this is a question of attitude, not actual behavior.

In the early history of the LDS church, there were problems with finances.  Elder's were assigned to collect money from church members for church projects, but there were rampant problems dealing with these Elder's not being reliable to get the money home where it belonged.  Sometimes they'd use it themselves or sometimes an associate would 'borrow' it from them.  Regardless of how or with how much intention of malice, the money was getting tangled in transactions it wasn't authorized for all along the supply chain to the church leadership.  So they had to change the rules and make certain all the church knew that only certain persons (I think it was the twelve) were authorized to receive money for these church projects.  There wasn't a good communication method so the message got repeated a lot at different church meetings as they were trying to get the message out so that unauthorized elder's couldn't collect from the faithful.

There was a scandal regarding the temple building committee in Nauvoo as well if I recall.  If my memory serves from when I read through that section in the history of the church, it was early on it was announced that since the members of the temple building committee were already designated as devout and good men that little effort needed to be spared to keep them honest.  Unfortunately there is a difference between honest and smart.  Eventually, some remaining member or members of this committee were called up before a public church court.  Strangely, a lot of early church court meetings were held during general conferences so we get a record of it from the history of the church. The good brother in question admitted to not knowing terribly much about book keeping and that he hadn't had the time to pay attention to it, so that there were most definitely mistakes in his record keeping that he wasn't afraid to admit.  More viperous steps were taken to protect the trustworthiness of the church funds in the temple building fund.

The essential point is that good men who were in their financially responsible roles as a result of church callings were capable of making mistakes, having their mistakes questioned, and submitting to public correction.  There was a degree of community participation in how this took place without anyone trying to necessarily question of whether Joseph Smith was a prophet.

Today the finances of the LDS church are pretty much hidden from public view.  A bishop might know what is in ward finances, but much beyond that everything is hidden.  The only glimpse of what is really happening is when the church gives its Conference auditing report, which in all honesty, is remarkably boring.  Or there are the glimpses from when a reporter tries to dig into the subject only to make a point.  Today, there appears to be a standard reaction that if we have a testimony of the Book of Mormon and there for of Joseph Smith all all his successors that there is a level of apostacy in calling for the church's money to be dealt with in any other way.  There is little functional difference between the members back in the early church triggered investigations and for a preference for  transparent book keeping today.  What is changed is the assumption of what attitude goes with the request.  There is nothing inherently doctrinally wrong with preferring that the church manage its finances in any particular way.  With little to no real information to work with Church members are left with a bad dichotomy of choices of supporting the bretheren and not questioning the finances or of questioning the finances and the bretheren together.  The history of bad financial skills and decisions being made by officially called individuals makes it clear these cultural behaviours don't have to match together, we just have made them do so in our minds.

Its kind of like women and the care of the physical needs of the family.  In the standard works there are plenty of references to women who participated in home projection.  I think in the Book of Mormon there are specific statements about gendered production of goods.  Women kept them from all being naked by spinning and making cloth I think is a typical example.  There is nothing questioned about how they might have been taking time away from their families to do so, it just exists.  Across many traditional world culture's women have participated in some degree in home production.  They may even arguably take time away from their families by arranging for communal child care or by aggressively swaddling the baby to make it so that they don't have to pay it any particular attention.  The roles are traditional and very gendered, so we don't jump to question it.  For explicit doctrine all we really have to go off of is a few scriptural versus where God gives Adam and Eve their gendered assignments and later quotes from Paul talking about how men who refuse to provide financial support are worse than infidels.  But that's it.

In our diversified economy, production has moved largely out of the home and into factories of varying types.  Women still participate in home labor and production, but the range upon which it might express itself is restrained by our specialization of labor.  Instead of having two producers who deal in non monetary commodities as part of farm life, we have the ideal family where the husband produces monetary value by exchange of labor and his wife... well... spends it and... ummmh... finds more and more creative ways of being creative within the confines of family needs.  Scrap booking as a highly developed social art form here we come and watch how cooking and cleaning can be made to take up as little or as much of our time as possible depending on resources available.  A meaningful female role in production in traditionally gendered relationships has declined.  But, since the two producer family arrangement has been undermined by our cultural application of the specialization of labor, two producer families can't exist without breaking down the highly gendered social roles we have carved for ourselves.  Not that there aren't social costs to women being out of the home.  Just like there are social costs to men being out of the home (although our traditional gendered interpretations of labor division only allow one of these to be voiced).

The point being, LDS culture has produced a grouping of assumptions that if women participate in production outside of the home they must be attacking the traditional gendered roles.  Even though the traditional gendered practice is for there to be two producers with limited child care devotion given, we can't acknowledge that tradition without appearing to attack the the grouping of social definitions we have in our mind.  Women in the work place=evil feminism and break down of society  blah blah blah.  The history of what kinds of production women participated in as part of agricultural home centered lifestyle shows that these groupings are in our minds, not inherent in reality.

We'd be better off flexibly allowing ourselves to examine what we really believe and what we really have simply practiced on accident.  They aren't always the same, but our desire to practice what we believe I think ends up with us believing what we practice.  We make doctrine out of accidents of history.  Not that you can easily take history apart and put society back together again.  They aren't the same things by that point.  But at least critical examination of the past can help us figure out what justifications should apply to our present.  The church would still be true with transparent financial records and women can still be nurturing and wonderful without being restricted to only social positions based entirely upon directing home consumption and raising children.  Presumably there's some good reasons you couldn't change it to be like that in either case without a lot of trouble, but that's not the same as black and white truth.

I wonder if the church's financial secrecy has been a way of avoid a Kirtland bank scenario where church leaders encouraged investments that turned out not to be sound and shook people's belief because they wanted to see God's hand in everything church leaders did.  Not that Joseph Smith adveritizing the bank with scripture quotes helped.  But by keeping the financial dealings more secret people can associate different kinds of impulsive belief with church expenditures.  It might not be any more true, but it will be less dangerous to their church membership.  Not that such scenarios couldn't be partially dealt with by selling off many business affairs that may only be tangentially related to church purposes.  Lots of other solutions could be found certainly.  But trying to make dogma out of practice will make it difficult to adapt to anything without someone mistaking a change in practice as a change in doctrine.  And that creates problems that shouldn't have existed in the first place.