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Accepting Problem Pregnancies

I have to confess that for most of my life I have been a woman who believes pregnancy and birth are processes designed to work.  It isn’t even anything I’ve ever considered thinking otherwise about it. And while I know cognitively that bad things do happen during pregnancies, I tend to chalk it up to poor health or poor decisions or those pregnancies that are lost so early that most people, including me, just don’t think about them.

But with this next midwifery school test I am being challenged to deepen my understanding of pregnancy problems. What triggered this?  Rh incompatibilities and anemia. But wait, those are not really a big deal right?  I used to think so.  But like so much else in life, what seems simple when you know or understand a little becomes quite complex when you learn more.  There truly are no easy answers.

Starting with Rh incompatibility, I had “trained” myself (I’m gong to say trained because I really did pick the material I studied and learned how to think based upon it) to believe it was not a big deal because the problem only happens if some of baby’s blood gets into mother. See, natural birth theory is that if you leave birth alone this doesn’t happen.

And you know what, most of the time I still believe that.  Three things have to happen to cause a problem.  1) mom must be Rh- and baby be Rh+. 2) mom must be capable of creating antigens against the Rh factor. 3) enough of baby’s blood must get to mom for her to create an immune response to it.  But here is the thing, you don’t need modern meddling to get an immune reaction from mom. Other normal parts of life can cause this – such as a miscarriage, an ectopic pregnancy or a blunt abdominal trauma. So this isn’t a modern made-up problem.  In fact, the female doctor who started putting the pieces together to figure out the issue so many years ago, did so because she kept having problems in pregnancy.

But the issue isn’t just the Rh D we think of with negative and positive. There are other antigens that coat blood including the factors that make blood A, B or O.  And each of these can have an effect on mother and baby and not all of them are exclusive to blood so mom might have developed antibodies in another way.  Most of the time this works out right, but sometimes it doesn’t.  What do I do with those times?

Moving on to anemia, how can this be a big deal? I agree iron deficiency anemia is not such a big deal, improve the nutrition and the problem goes away.  But iron deficiency is not the only anemia, and there can be other issues with a woman’s blood that affect the baby. Genetic blood traits of a mother can put a baby in jeopardy. Traits like sickle cell anemia or a thalassemia. You cannot avoid these except by controlling genetics.

This brings me right back to infertility. It has been so easy to accept that it isn’t God’s plan for every woman to have children, that God has to get them ready, or any of the other things I tell myself to make me feel better about another woman’s pain. Yes, God is in control.  No, stories do not always have what I would call a happy ending.

And so this is where I am this week.  Facing for the first time real issues a small percentage of women have in pregnancy and wondering why. I know an easy answer is that we live in a fallen world so things are not perfect. But I’ve never been satisfied with that answer. Besides, it seems somewhat hypocritical to base my pregnancy theory on the fact that God created a perfect system if every time there is a problem my answer is that we live in a fallen world it doesn’t work the way God created it.

So this week, as I am faced with the very small number of unpreventable and undeniable problems in pregnancy, I am at a crisis of faith.  Does what I believe about birth and God really line up with each other?  Are they consistent with the truth? And if not, is it because what I believe about birth and God is wrong, or because I am calling truth that which is not true.

I’ve never had a birth crisis of faith before, but I’m actually excited about where God will take this. I’ve experienced enough of my life to know that when I am brought to a point of faith-crisis, I am on the cusp of a great growth.  I just don’t know how long the growth will take.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas and childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student in a nursing program learning to become a producer of knowledge.

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