Urbandad’s Weblog

Bella Belly
September 26, 2008, 11:26 am
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Tara’s belly is growing.  She feels the baby a lot now, although I have to say I have yet to really feel anything substantial.  The baby is always to one side too.  



She bought a bunch of maternity clothes finally, being unable to wear anything but her yoga pants any longer.


Best for the Group or Best for the Individual?
September 24, 2008, 12:09 pm
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The medical establishment wants it’s cake and eat it to.

On the one hand, they advocate immunizations.  The argument for mass immunization, and the data clearly bears this out, is that population-level health outcomes improve when there is a policy of immunizations against diseases that are highly infectious and very malicious.    Now, you do have a prisoner’s dilemma in the sense that it is in each individual’s best interests not to get immunized and let the rest of the population carry the burden of pain, monetary costs, and possible side-effects of the injections while enjoying the benefits of living in a population that where diseases have few vectors.  If everyone did this, epidemics would occur.  Hence the tragedy of the commons.

At the same time, they argue against home birth by ignoring population-level health benefits and by arguing that the health benefits of the individual are more important then the benefits to the population. The American College of Obstetricians and Gynecologists (ACOG) released a statement given the buzz with Ricki Lakes film The Business of Being Born stating:

The American College of Obstetricians and Gynecologists (ACOG) reiterates its long-standing opposition to home births. While childbirth is a normal physiologic process that most women experience without problems, monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center is essential because complications can arise with little or no warning even among women with low-risk pregnancies.

So what does the clinical data tell us?

Here is an article on clinical outcomes:

Outcomes of planned home births with certified professional midwives: large prospective study in North America.
655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated.

The rates of intervention are much lower than for comparable low-risk hospital births and no increased risk of infant mortality.

Here is another article with similar results, a study of over 24,000 births:

The WHO says that c-sections should be expected to be between 10-15% as acceptable due to necessary medical intervention.  In the US the c-section rate hovers around 30%, between 200-300% higher them medically necessary.  C-Sections are dangerous.  They can result in life-threatening infections and other complications. The risk of death from cesarean sections is 26 times greater than from vaginal birth (Cohen, Nancy Wainer and Lois J. Estner. Silent Knife: Cesarean Prevention and Vaginal Birth After Cesarean. New York: Bergin and Garvey, 1983.)

Other studies demonstrate a much higher risk in hospital births:
A study in the UK shows that planned home birth with an attending experienced midwife has a perinatal death rate of 3-4 babies per 1,000 births. Hospital births have 2 to 3 times the mortality rate at 9-10 deaths per 1,000. (Kitzinger, Sheila. Home Birth. London: Dorling Kindersley, 1991.)

Stepping away from the birth data and looking at the broader picture, industrialized countries like those in Western Europe who practice home birth with midwives have much much lower infant mortality rates, even controlling for similar populations within the countries.

So, one the one hand, the medical establishment is saying that you should immunize because population outcomes are better despite the fact that as an individual you are better off not immunizing against many diseases.  At the same time, they are advocating hospital births when on a population level they are more dangerous, because of what could happen to you as an individual.  Yet even here, the data suggests a home birth is at least as safe, and has much fewer interventions – which translates into better health.

Vente Visit With Our Midwife
September 14, 2008, 10:48 pm
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Today we met with the midwife in Starbucks, just before she taught a childbirth education class on anatomy and physiology to those studying to become childbirth educators.  We listened again to the heartbeat with the doppler – 158 beats per minute.

September 14, 2008, 1:09 pm
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Tara and I received our first gift for the baby.  It came from my friend Ashley who used to work with me at Grey SF as a planner.  She is preparing for law school now.

They are a pair of Tom’s Shoes.

They are canvas and they rock!

When you buy a pair of Tom’s they donate a pair to kids in need.  They work in S Africa and Argentina.  They are very bobo.

September 10, 2008, 12:10 am
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On Saturday night Tara and I had dinner at her friend’s house  — another doula, who recently had a baby.  She had a very long birth.  On the one hand, it is encouraging because it shows that you can be pushing for hours and hours and still have a perfectly normal birth of a healthy child – no distress.  But it is also an instigator of fear – listening to how challenging the birth was.

Her husband Kevin dried out the placenta in the oven and ground it into powder which was then put into capsules. I know it sounds gross, but it is supposed to be quite nutritious.  There does not seem to be any reason not to…  Here is an article on the subject in USA Today.

He told us there was a website, Placenta Benefits, where you can go to that has a mail-order kit for making these capsules. When I get them I will post pictures of Kevin making the pills.

Hudson Valley Farm
September 10, 2008, 12:00 am
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I have gained about 8 lbs since I moved to NY 2 years ago.  Today on the subway on the way to Penn Station to catch a train to Delaware for a meeting, feeling bloated from my dinner last night at Blue Hill, I had this glimpse of an image of myself as the out-of-shape dad who is too busy with work and the kids to take care of himself.

I never could understand those guys who would let themselves get fat – yet here I am and the child is not even on the way and already I have put on the pounds.  My diet has not changed significantly, I think, but my activity level is lower – even if I am walking the dog twice a day and riding a bike to work many days of the week.  Taiko and the gym and landscaping were all really physically demanding—and no longer a daily part of my life.

I am afraid of falling into that lifestyle that is so dominated by the clock, so pathologically over-whelmed by work, that you miss life.  I always envisioned myself being able to shape a lifestyle that was flexible and intensely experiential.

Yesterday Tara and I spent the day with her good friends who are moving from Nantucket to Rhinebeck, maybe.  They have experience in both cooking and landscaping and have a much more bohemian lifestyle then we do.  By keeping expenses down and working in industries that are less concentrated, they are able to move around.  There is a part of me that is jealous of their flexibility but I can see also how that can be equally stressful.  My cousins in London make it seem so easy.

We fantasize about moving to the Hudson River Valley, buying land and creating a compound of cottage industries with her friends – opening up a B&B, starting a cooking school, growing and raising organic varietals for the NY gastronomical market.  I wonder in this picture if I can gain the clients I need to sustain an income.   I wonder how much this is fantasy and how much a potential avenue and how far off…

Belly Button
September 9, 2008, 11:59 pm
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Tara’s belly is now substantial.  Someone on the subway actually gave up their seat for her.  Her bellybutton is getting bigger too!

So she had to go clothing shopping.  Nothing fits, and she needs bras since she has never worn them before.

We are going to LA in October for a baby-shower of sorts – for friends and family.  It it so weird for me that there are many folks in my family who have never met Tara.  It is amazing how fast the time goes by.  So we are flying out for a party that we will have at my brother’s house.