Every Wise Woman

Real Food, Real Health, Real Birth

When to Be Thankful for Medical Intervention

[The following will be the most personal and emotional post I have ever shared, and may contain some cathartic rambling. I need to work things out in my head and it helps me to write...in a sense, this is my personal “de-briefing” brain dump. I apologize in advance for its length, scope and potential circumlocutions. Thank you for being my “sounding board.”]

It is no secret that I am concerned about the broken modern medical system that can create problems rather than heal disorders/malfunctions/ailments and promote lifelong wellness. Yes, there are doctors who break out of the mold of their conventional training; they question the establishment’s paradigm and pursue holistic education, learn Real Medicine, and adopt skills and a knowledge base that can be of genuine value to ailing people.

But these practitioners seem to be the exception, not the rule. The medical industry is dominated by drug companies and “little gods in white coats.” Corruption, ego, profit-seeking, as well as protocols and treatments driven by limited paradigms and legal pressures conspire to create a bloated system that is impotent to effectively treat ailing health, systemic malfunctions, chronic illness, autoimmune disorders, and more. Truly, the system needs more groundbreaking doctors like the late Dr. Mendelsohn, a self-confessed medical heretic who upheld holistic principles of wellness and healing, and who encouraged parents to eject from the system, taking direct control of their children’s health.

[Here is the cliff notes version of a planned post that will likely not see the light of day: In my opinion, well child checks are a waste of your time and money. You can and should learn to be your child’s own pediatrician, you just need some study and basic tools (books, otoscope, stethoscope, blood pressure cuff, basic herbal and homeopathic kits, etc). Maternal instincts are divine...hone them, trust them. Save yourself the headaches of fighting the fear-based, drug-driven system and protect your child from unnecessary treatments and vaccines. Learn to follow your gut; should you feel you need to do so, seek help for your child if he is seriously ill/suffering beyond what you can diagnose and remedy at home. This line will vary for people depending on knowledge base, acquired skills and confidence. But keep learning and practicing and you’ll feel the need to seek help less and less.]

I have long vocalized my vexation with the modern medical system’s limited paradigm of the human body’s functions, responses and healing powers; its approach to wellness and illness; its eagerness to categorize as “idiopathic” whatever malfunctions do not fit into its paradigm or cannot be solved by its limited tools (“WE don’t know what causes X, ergo there IS no cause…”). I am concerned with harms caused by an overblown, malpractice-driven, sometimes fraudulent system. Some elements of the system are downright dishonorable, others simply misguided. There exists a tendency to apply extreme unnecessary interventions or “one-size-fits-all” protocols to every situation. The error of the allopathic technocratic approach is to apply toxic bandaids of drugs and surgeries rather than to achieve healing through effective cures, such as botanical and homeopathic medicines, nutritional healing, and noninvasive physical therapy modalities (acupuncture, reflexology, chiropractic, hydrotherapy, craniosacral and massage, etc.). For as much as the “system” thinks it corners the market on medical knowledge, there are vast mysteries still to be uncovered. The more we know about the workings of the human body, the more we realize we have so much more to learn.

Rather than taking personal responsibility for wellness, people rush to obtain treatments and procedures they don’t really need that won’t truly help. This is not healing, it is not establishing wellness. Unfortunately, such behavior contributes to the perpetuation of a faulty system. People should eject from the regular use of the medical establishment and should studiously take their health into their own hands, establishing and maintaining wellness through a non-toxic lifestyle, genuine nutrition, and botanical medicine.

But within the afflicted conventional medical system exists caring individuals, well-meaning practitioners, and certain emergency procedures and technologies for which we can be thankful. It has always been my opinion that emergency medicine is a necessary and legitimate arm of the modern medical system. While I don’t agree with all its practices and treatments, I find lifesaving medical technologies overall to occupy worthwhile space on the spectrum of healing arts.

The specialized skills and modern technology involved in lifesaving procedures and trauma treatment are often quite advantageous. They can mean the difference between life and premature death. It would be wonderful to see our system enlightened to incorporating nontoxic, natural medicine and modalities into its emergency care system. A multitude of potent, fast-acting herbal and homeopathic medicines exist. Herbal antibiotics can be just as effective, and are certainly safer, than their synthetic pharmaceutical counterparts (which contribute to toxic load and flora disruption); bugs don't easily develop antibiotic resistance to botanical medicines as they do to drugs. But conventionally trained doctors don’t know how to use these herbal medicines. And as long as the medical industry is deeply profit driven (i.e: pharmaceutical companies), these beneficial botanical medicines will not be employed as they should be.

Not all traumas require conventional medical care. Herbal first aid is incredibly potent. When you become intimate with botanical medicine, build a knowledge base of anatomy and physiology, and become confident with healing and triage skills, you can treat most accidents and illnesses at home without suffering the negative side effects of conventional medical treatments. We can often successfully remedy minor breaks and dislocations, wounds and poisonings, infections, even cardiovascular and respiratory malfunctions and much more.

But sometimes the nature of accidents and ailments require emergency medical treatment, the legitimate protocols and technologies of the modern medical system. This is when modern medicine can serve a valuable purpose. I have long said that if my husband were to cut off his arm in a chainsaw accident, I would take him to the ER and pray for a competent surgeon. But I would perform post-op wound and infection care at home (you would be astounded to see the power of certain plants, like plantain, comfrey, shepherd’s purse, cayenne, garlic and usnea).

A particular pet peeve of mine is the fear-based birth industry, whose standard protocols...driven both by a flawed technocratic paradigm and inflated legal concerns...suppress and subvert the normal physiological processes of labor and birth. The perpetual medicalization and technological intervention of normal birth violates women and babies. The system treats all births as potential traumas and subjects laboring mothers to practices and interventions that hinder the natural physiological process of birth, which can lead to negative birth outcomes. But within this system are valuable skills and technologies that are appropriate for the minority (approx. 5%) of at-risk women and unforeseen pregnancy and birth complications.

The current system is backwards and needs an overhaul so that our medical culture expects, upholds and encourages the power and beauty of normal birth. As in some European models, our birth system should be one where midwives are the primary caregivers and women are expected to birth normally and naturally, supported by midwife (“with woman”) attendants. But OBs, as complication, trauma and surgical specialists, play an important role in serious emergent conditions of both pregnancy and birth. The OB would be an assisting member of the midwife-led team, prepared to attend to the minority of women who require more invasive medical care. This would be a valuable system that provides appropriate care for all unique women; when the rare occurs, and what is ordinarily a natural, risk-free physiological event becomes a life-threatening trauma, a solution exists.

Professional midwives are pregnancy and “birth as a natural physiological process” experts. While we embrace a holistic paradigm of natural physiological birth that requires little interference and often only support and assistance, well-educated and well-trained midwives can competently manage and treat many difficulties that arise during pregnancy and birth, even traumas to mother or baby (such as hemorrhage or neonatal resuscitation). Typically a holistic midwife sees herself as an assistant to the birthing mother, an emotional encourager and physical attendant responding to the mother’s needs, and as a lifeguard sitting by and carefully observing. But a well-trained midwife has tremendous technical abilities and instincts, with her hands, her observational skills, and her intimate knowledge of her client serving as her most important tools.

Rather than relying on sometimes unreliable and potentially harmful diagnostic devices, a midwife uses her hands to assess a woman’s pelvic capacity to birth, the size and position of baby during the stages of pregnancy, and more. A homebirth midwife can manually perform procedures for birth complications that in a hospital setting would often result in a surgical delivery, such as assisting a woman to birth her breech baby, or resolving a shoulder dystocia during birth. Midwives have the skills to assist prolonged and difficult labors, helping to shift malpositioned babies and encouraging the laboring woman to choose a position that facilitates the birth process and preserves the perineum (hint: the typical hospital position for pushing, semi-reclined with knees drawn to chest, feet to buttocks, is detrimental to the perineum and can slow baby’s birth progress). As opposed to the industrial protocol episiotomy, a violation of a woman’s body and natural birth processes, the midwife performs perineal support when needed to allow those resilient tissues to stretch and accommodate baby’s descent. And when a perineal/vaginal tissue tear occurs (which is far less common with proper birth position and perineal support), the midwife has the tools and skills to repair it. If faced with a difficult birth, a skilled and knowledgable midwife can stop hemorrhages, perform bimanual uterine compressions if necessary, treat shock, and even resuscitate a nonresponsive newborn. I could go on, but I think you get the picture. If unanticipated complications occur, the midwife is prepared. And this preparation includes the wisdom to know when to seek outside assistance.

For a healthy woman assisted by a skilled midwife who has provided intimate, continuous, hands-on prenatal care, the home is the optimal birthplace: safe, comfortable, risk-free (from both foreign pathogens and the cascade of unnecessary interventions). The majority of women can pursue birth as as the beautiful, natural, empowering event for which our bodies were designed.

But there are times when complications can occur beyond a midwife’s toolbox of skills and equipment. There will be potential clients who should be screened out as homebirth candidates because of health risk factors. There may arise complications during a pregnancy that require medical treatment, such as pre-eclampsia. As disappointing as it is, there are times when a technocratic setting may be the safest birth route for the at-risk woman and baby. There will be times when nothing but an emergency technology will do. OBs are trauma and surgical experts. If you are a member of the 5%, the technical obstetrical approach can be helpful, even necessary.

I have a “passionate” personality. I become easily indignant at injustice. In large part, portions of the modern medical system and the modern birth system are unjust, even harmful. But despite my frustration with this system, I have given intellectual assent and neutral respect to the careful use of lifesaving emergency medical procedures. But now, I am personally thankful for the appropriate use of medical technology because on February 12-13, 2013, it saved my life.

On February 12, I suffered my fourth miscarriage. This one was shockingly fast. I had no major impending signs, only a few spots of brown (which means “old”) and pink-brown blood throughout the day...nothing more, no cramping, no increase in bleeding. So, I was devastated when my water unexpectedly broke early Tuesday evening and I instantly birthed my lifeless 14-week-old baby boy. Immediately, I began bleeding like a slow faucet and soon after started slipping into shock.

This was unlike my other miscarriages. It was violent and traumatic. I felt myself losing consciousness as I bled and passed clots...this was all within five minutes. If I had been treating “the client,” I would have immediately dosed with aconite, cayenne and shepherd’s purse (anti-shock and anti-hemorrhagic remedies). Maybe it would have worked...it has done before, in other situations. But I was not in a position to treat myself…I was unable to direct my husband. The situation was traumatic. I was hemorrhaging too quickly beyond what I could control...it was clear that I needed help. As someone who does not use the medical system, I do not take this lightly. But I know enough from my midwifery studies to know that losing consciousness while hemorrhaging is highly undesirable and potentially fatal. This was the only reason I would consent to a transport to the hospital...I felt my life was seriously at risk, and my husband was unwilling to allow me to bleed to death on the bathroom floor. My husband got me down on the bathroom floor and called an ambulance. The rest of the event is a bit of a blur.

The average woman has eight to ten pints of blood in her body. A blood loss of 40% can cause death. A massive hemorrhage is defined as a loss of total EBV (estimated blood volume) in 24 hours, or a loss of half of EBV in three hours. Blood transfusion is necessary to avoid death. “Obstetrical hemorrhage is often acute, dramatic, and underestimated. Postpartum hemorrhage is a significant cause of maternal death.” (Society of OB/GYNs of Canada, Hemorrhagic Shock document)

Medical professionals agree that blood loss, something difficult to visually assess, is regularly underestimated. We estimate that I lost two pints of blood before the ambulance arrived. At the hospital, between the time I arrived hooked up to the saline IV and the time I quickly began crashing, the blood loss was approximately another two pints. Between those events, sensing my husband's concern at the possibility of inappropriate interventions (such as hysterectomy), the OB did not push us into immediate surgery. However, the ER team erred initially by not administering what should be standard protocol for a woman who arrives in a state of hemorrhage...anti-hemorrhagic uterine clamping drugs, such as methergine, pitocin, cytotec.  Most medical professionals would agree that this error did contribute to the crash that followed.  (Such is the risk of living in a small town with a small hospital.)

Our bad situation turned worse quickly as my bleeding increased and I went from mild to moderate hemorrhagic shock; my husband knew that despite the “vitals” looking semi-reasonable (BP, pulse, etc), I was slipping away. Diagnostics are limited. Machines and tests can tell us only so much about what is going on inside the body. In diagnosing any ailment, labs can look “normal,” stats can appear acceptable, and you can still be very ill. These tools are imperfect, limited indicators of what is going on physiologically; they are not flawless representations of reality, they have neither God-like knowledge nor x-ray vision. My body rapidly degraded from a Class 3 to a Class 4 hemorrhage, but because my husband’s instincts made him insistent, I was not lost.

The man who knows me best observed me and knew I was dying. I knew it, but was not lucid enough to participate, and I believe that the OB saw it as well. (They told me later that my pallor was alarming...that I was “whiter than a sheet,” that I looked like a body in a casket. The OB told me she was instantly concerned when she observed my blanched lips.) The OB seemed relieved that my husband insisted upon whatever emergency lifesaving measures were necessary (of course wanting to avoid hysterectomy), and that he did not bat an eye at the course of blood transfusion.

The Bible says that the “life is in the blood.” I have never before understood that fact so intimately. As I lay in the ER, my body suffering the shock of a major hemorrhage, I felt myself dying. It was a physically painful and emotionally horrific experience. In addition to the physical experience (extreme coldness, shaking, loss of sight and sound, gushing blood), I felt my life leaving my body with all that blood. It is an experience I am unable to adequately express with words, the feeling of my life force ebbing away.

I remember at one point that my husband was leaning over me, speaking urgently to me, telling me to stay awake. I was losing consciousness, and I knew that if I closed my eyes, I would never again open them. I have never been so scared, despite my trust in God. I was not ready to die. I struggled to remain...and then I was taken to surgery, of which I gratefully remember nothing due to the anesthesia. My body continued to bleed aggressively.  The OB worked with difficulty for two hours to stop my uterine hemorrhage while they began my blood transfusion (my husband says the young OB seemed shaken but relieved after the surgery; she later expressed how intense the situation had been). In addition to the difficulty in halting the hemorrhage, during the surgery, my heart suffered arrhythmias. No doubt!

The OB told me later that despite making multiple passes through my uterus and removing all its contents, despite giving me every drug she could to stop the hemorrhage and get the uterus to contract; despite performing bimanual compressions...the bleeding simply would not stop.  She had the ER doctor come in to do ultrasound while she went through the uterus again, hoping to find something she had missed, to no avail.  She said she was mentally preparing to begin a hysterectomy (which she knew we did not want) to save my life when the bleeding finally just slowed and stopped.  What an answer to the prayers of my husband, pacing alone in a waiting room!  It was a miracle that saved us from the limitations of "rural medicine," as our local hospital does not have the expertise or the equipment to perform procedures that can arrest uterine hemorrhaging far less detrimental, invasive and permanent than hysterectomy, such as B-Lynch suturing, uterine arterial ligation, or uterine arterial embolization. 

Before being released from the ICU two days later, I had received six pints of blood along with additional platelets and plasma; even after that, my hemoglobin and hematocrit levels were lower than normal and I still feel weak. Under normal circumstances, it takes 90 days for the human body to replenish its red blood cell levels. After traumatic blood loss, it takes the body longer to return to "normal."  I should be “renewed” in four to six months. The life is absolutely in the blood.

The medical technology of a blood transfusion restored my life. Risks? Side effects? Sure...of course...risk of allergy to the blood during transfusion. Fatal risks of overuse of the fluid resuscitation (saline IV). Risk of future infection from the blood transfusion (yes, blood products can be dangerous...at this point, I cannot read anymore articles about the risks I endured on that front; it was our only choice to avoid death). Risks of iatrogenic death simply due to my being subject to all those procedures. Risk of contracting an illness or infection from spending time in the hospital. Side effects of having my body subject to numerous chemicals and drugs. But I was dying. And now I’m alive. I survived the risks thus far and cannot allow myself to fear any others.

Yes, I’m radical about natural living. But I wasn’t ready to die, so compromises were made. Lifesaving emergency procedures were taken and then I awoke and spent observation and acute recovery time in the hospital. The situation demanded that I be subject to particular protocols. Would I have chosen therapeutic doses of usnea and garlic, vitamins D and C, rather than the pharmaceutical antibiotic insisted upon to “ward off” potential infection after the procedure? You bet your bottom dollar. But that wasn’t a protocol fight I could fight at that time. (I immediately began dosing myself upon returning home.) Acceptable compromise. At least no one tried to give me a vaccination. That would have been a fight I would refuse to lose.

Sure, now I need to add an intense couple weeks of GAPS Intro into my recovery scheme, to combat the pathogenic overgrowth I’m already feeling. But I know the drill. The anesthesia drugs that were given to me to put me out for the two to three hour desperate, multiple pass D&C procedure? I’m not going to regret that; I’m glad to some degree that I wasn’t awake and aware (though I do feel the need to understand everything that happened to me while I was “out”). I’ll happily add some extra liver detox boosts and juicing during my GAPS Intro recovery boot camp. I need to consider it a small price to pay for defying death. I will take time now to heal, to detox my body, to re-establish flora and gut health, to use nutrients and anti-infectious herbs to support my immunity. I would prefer to see the emergency medical system rely less on pharmaceuticals and more on healing botanical medicines for certain aspects of treatment, but that is not their way. With the good (but not without its risks) lifesaving technology comes some bad… But I’m here to talk about it, and that’s what matters to me today. The appropriate use of medical skill and technology can save lives.

I will continue my studies and training to become a knowledgeable, skilled, professional midwife, acquiring the techniques and instincts to assist and empower women to birth their babies naturally at home, and to attend to any complications and traumas that I can. But I have a renewed understanding about the importance of carefully screening homebirth candidates and providing intimate continuity of care during the prenatal year (watching diligently for anemia, malnutrition, and other underlying health complications). I understand in a very personal way that some women might suffer complications that cannot be treated without medical intervention.

In future, when I encounter a genuinely high-risk client or acute life-threatening trauma that only specialized technology can treat, I will be thankful to have a working relationship with a respectful and skilled (and hopefully holistically minded) OB. Words cannot express how saddened I am to think that I may never become pregnant again.  Of course, this is not something that I or anyone can know with certainty.  The unusually aggressive D&C procedure likely scarred the interior of my uterus, which can make it extremely difficult for the embryo to implant.  This is the devastating reality of my survival.

Life has a way of educating us, and I pray that my experiences will become valuable to others; my pattern of hyperemesis (extreme nausea and vomiting) during pregnancy no doubt lead to anemia, increasing risk of hemorrhage. I experienced this with my third birth, but we were able to control the hemorrhage at home and all was well after my recovery. My miscarriage this September left me weak, likely anemic, and the hyperemesis of this (quite unexpected) pregnancy undoubtedly contributed to further anemia, spurring the hemorrhage, which seemed out of my control. Might I have stopped the hemorrhage with aggressive use of herbs and manual compression? Possibly, if I had been in a state of mind and body to tend to my own care. But that didn't happen, and without the blood transfusion, I would have died. 

Can I safely become pregnant again? Possibly.  Will my uterus be able to accept and support another baby?  I don't know...  Will this traumatic event throw my hormones into havoc and possibly bring on early menopause?  Quite possible, even probably.  But I still hope to have another child.  If my body can get past the hurdles and conceive again, the greatest risk is of another miscarriage while anemic.  As opposed to a full term pregnancy, the body's blood volume is not great enough in the midst of a pregnancy to compensate for traumatic blood loss during a second term miscarriage.  The uterus is fuller and the placenta does not birth directly after the baby; the process is much more drawn out, which means significant and constant bleeding from the uterus.  The uterus cannot clamp down/contract closed while products of pregnancy are yet retained.  The extreme bleeding, coupled with anemia, set the scenario for deadly hemorrhage.

I don’t know if I can heal the underlying malfunctions causing my pregnancy difficulties. I am hopeful but not prognosticating.  I am praying for wisdom and healing.  But I am so thankful that I have three live children, my miracles, whom I love beyond telling.

Now, I recover. It’s strange, but I’m feeling like I’ll never be normal again. I’m sure that will pass in time. I can’t quite put it into words, though, but I feel like I’m not all here...that some part of me didn’t come back with the rest of me. I have no doubt that the emotional and physical losses will take time to heal. I just feel...different. I don’t think I ever before fully comprehended how fragile life can be. Things look and feel different to me now. Perhaps I have a new lease on life, as they say...a renewed sense of purpose. It is time for me to seriously assess how I should live the remainder of this life. In the last six months, I turned 40, lost two babies to miscarriage, and almost died. Needless to say, I’m entering an intense life re-evaluation mode. I believe that means more undistracted time with my children and husband, and a simplification of my pursuits. I don’t know when I might write again, but I thank you all for your support and I pray that God blesses you!

EWWHerbals                                                                              "Every wise woman builds her house..."  Proverbs 14:1

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