Sunday, March 30

When in Doubt

Much is made of the character of Thomas, the Twin. "Doubting Thomas" is a name he's commonly known by today. The disciple who didn't believe Jesus was alive until he saw him with his own eyes. A lot of Sunday school lessons have been taught, painting Thomas as one to be pitied or reviled; certainly not a shining example of faith.

But, I totally get where Thomas was coming from. He thought he knew how Jesus had come to save the people of Israel and lead them back to the land of promise. For three years or so, he walked with Him and worked with Him, but he never could quite get past his preconceptions of what Messiah was there to do. Until suddenly, everything went wrong. His faith was shattered. The One he thought he believed in was gone. Surely Jesus couldn’t be the Messiah! He was killed by the Roman authorities--hung like a common criminal. But a week later, he ran into some friends. They were all excited because of this wonderful news that would turn his world upside-down, or right-side-up, if he believed. But he had believed; he thought he had.

He'd believed so much that right up until the last moment on that awful Friday, he thought Jesus would amaze everyone. When they led Him away in the garden, Thomas thought He would escape, just as He had from that crowd in the Temple. As He was marched through the parody of judicial process, he thought Jesus would speak up, clear up the misunderstanding, make everyone understand who He really was. Even while Thomas gathered toward the back of the crowd, watching Him hang there, not understanding, but still hoping against hope, still knowing that He could come down, Jesus could save Himself ... couldn’t He?

But He didn’t.

Thomas was crushed. He was embarrassed and ashamed. Why did he believe such nonsense for so long? But still, it had seemed so true. He wanted to believe again, to trust what his friends were telling him, but he just couldn’t risk it. It hurt too much.

So, Thomas told his friends that he couldn't believe, wouldn’t believe until he saw the Christ for himself--until he touched His hands and His side.

Jesus had compassion on him. He arrived, right through the locked door of the room where His disciples had gathered. He invited him to see, to touch, to know for himself that Jesus was for real. Finding himself once again in the presence of his Friend, his Lord, Thomas knew. He believed. He rejoiced.

I don't believe this story is so much a warning against doubt as a celebration of grace. Thomas wasn't left in his doubt. Jesus gave him just what he needed, the chance to see for himself, and to believe. To meet with the risen Savior personally, not just through others who had seen Him. We are offered this same invitation: Taste and see that the Lord is good. Find security in Him and enjoy His blessings. Worship in the presence of almighty God; for those who belong to Him, stand in awe of Him and lack nothing (Psalm 34:8-9).

Have a wonderful Sunday.

Sunday, March 23

Easter Morning

When I was a kid, I used to go camping with my family pretty regularly every summer. I don't remember if we ever camped as early as Easter Sunday, but we may have some year when it was late in April.

We would visit one particular campground near our house several times a season. On Sunday mornings, the owners hosted an outdoor worship service next to the shuffleboard courts, complete with an out-of-tune piano and warbly soprano retirees. At least once a year, my dad, an ordained minister, was asked to preach the Sunday sermon.

I picture this scene in my head and it always comes with a soundtrack. The warbly sopranos are joined by booming bass echos in the chorus of Robert Lowry's "Christ Arose" (alternately titled "Up From the Grave He Arose"):

Up from the grave He arose
(He arose)
With a mighty triumph o'er His foes
(He arose)
He arose a victor from the dark domain
And He lives forever with His saints to reign
He arose (He arose) He arose (He arose)
Hallelujah Christ arose

Have a happy Easter, everybody!

Bonus eschatological funny
I woke up this morning just about sunrise, tired after a late and emotionally exhausting Easter Vigil service at our church. I rolled out of bed and a single thought popped into my head, "Well, it's Easter. Either Christ is not returning this morning or else the rapture is happening post-trib."

Friday, March 21

Good Friday

Soldiers led Jesus and the man carrying His cross to the hill of Golgotha, which means Place of the Skull. Jesus was offered wine and myrrh (a mild painkiller), but when He'd tasted it, He refused the drink.

The soldiers nailed Jesus to a cross. Next to Him, they hung two thieves. A sign above His head denoted His crime, "This is Jesus, the King of the Jews."

As they sat down to guard the men, the soldiers gambled against one another to see who would take home Jesus's clothes.

The crowds passing by mocked the men being executed. They called to Jesus, "You claimed you could rebuild the temple in three days. If you really are the Son of God, show us! Come down from your cross and save yourself."

Jewish leaders and rabbis made fun as well, "He saved other people from death, but he can't save himself. If he really were king of Israel, he'd come down from the cross! Then we could believe him. He said he was God's Son, let God save him, if He wants to."

Even one of the criminals beside Him spat out, "Aren't you the Christ? Why don't you save yourself and save us!"

At noontime, the sun became dark. Light did not return for three hours. In that time, Jesus shouted, "Eli, Eli, lema sabachthani?" which means "My God, my God, why have You abandoned me?"

Some of the people standing nearby heard His cry and thought He was calling for Elijah. One of them ran to bring wine vinegar to revive Him; others said to wait, "Let's see if Elijah will come to save him."

Jesus called out, again, as He died, "It is finished!"

Immediately, the curtain in the temple was torn in two from top to bottom. An earthquake shook the land and rocks broke apart.

An officer and some soldiers guarding Jesus felt the ground shake and saw everything that happened. They trembled in fear, saying to one another, "This man really was God's Son!"

Wednesday, March 12

Works for Me: Kid Safety

I can't remember whether I read or heard this idea somewhere or I actually thought it up on my own. Adam and I started doing this with our daughter when she was old enough to be out of her stroller during our visits to the local aquarium (where we used to have a membership, so we went quite a bit).

Before heading out of the house, take a couple of digital photos of each child. Make sure one shows the whole outfit (or two if coat/hat/etc. will be worn--one with and one without) and another is a close up showing facial features. If you get separated from your child(ren), you not only have a recent photo available, but one which actually shows the clothing they are wearing.

For more tips, tricks, and ideas, visit Rocks in My Dryer.

**Edited to note: The instant I published this, I heard a crash from my daughter's bedroom. She'd fallen out of bed. Apparently she was calling my bluff on this safety business!

Tuesday, March 11

Childbirth in America: Homebirth

When I was pregnant with my daughter, Adam and I took a Bradley Method® childbirth class. I have mixed feelings about how well our class prepared us for the birth experience, but one thing the AAHCC folks do quite well is to encourage informed consumerism--asking questions, seeking second opinions, basically all the things we would expect to do when encountering any other procedure.

Just so there is no doubt where I'm coming from, I am 100% in favor of natural childbirth. There is great debate over just what "natural" entails when it comes to birth, but for me, a natural birth is one that is not interfered with unless necessity demands it. That means, barring medical complications which might require greater constraints, mothers should labor as they are most comfortable: in whatever location, in whichever position, with whomever they choose, eating and drinking as they desire, and not kept on a predetermined time schedule of when they "should" be delivering the baby. I am not against medical interventions, including pain medications. I do believe, however that medical procedures are overused in pregnancy and childbirth. In many cases, interventions into the natural process have become standard practice, rather than an appropriate response to medical need.

As I began to research my own birthing options, and as I continue researching now with an eye to expanding our family, I have become increasingly appalled at the current climate for childbirth in this country. My two biggest concerns are the lack of evidence-based practice in obstetrical medicine and the lack of information available from these same professionals. Not being a physician or educator myself, there is not much I can do to change modern obstetrical practice, but I can offer some easily accessible research.

Here is the first installment in a planned series of posts comparing popular beliefs about childbirth to what the research actually shows.

The Belief: Most women are safer giving birth in a hospital.

The Reality: Despite the recent ACOG statement against homebirth (which, among other things, dismisses homebirthers as women who put their own desire for a particular experience in childbirth over the safety of their babies), birthing at home is not any more dangerous in most cases. Multiple studies have compared birth outcomes of low-risk mothers and babies who birthed at home or in hospital. In nearly all cases mortality rates and overall measures of health were virtually the same, while intervention rates, including episiotomy, delivery by forceps or vacuum, and cesarean section, were considerably higher for hospital birthers.

The Research: For reasons of brevity, I did not include all the studies I reviewed, however below you will find a representative sampling of the research that has been published on the safety of homebirth.

Outcomes of planned home births with certified professional midwives: large prospective study in North America
Study of 98% of planned homebirths with a direct-entry midwife (as opposed to CNMs--certified nurse midwives--who must also be RNs) in the US and Canada for one year. Medical intervention rates for this group included 4.7% of women receiving an epidural (compared to the nationwide US rate of 59% and Canadian rate of 45% [source]) and only 3.7% requiring a cesarean section (considerably lower than the national average of 23% in both the US [source (PDF)] and Canada [source] for the same time period). Conclusion: "Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States."

Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia (PDF)
Comparison of planned homebirths with a regulated midwife and hospital births with either a midwife or physician. Researchers noted, "Women who gave birth at home attended by a midwife had fewer procedures during labour compared with women who gave birth in hospital attended by a physician .... Comparison of home births with hospital births attended by a midwife showed very similar ... differences." They concluded, "There was no increased maternal or neonatal risk associated with planned home birth under the care of a regulated midwife."

Home versus hospital birth (abstract)
Meta-analysis of studies comparing planned hospital births and planned homebirths with an experienced homebirth practitioner, backed up by a modern hospital system. The study authors concluded, "There is no strong evidence to favour either planned hospital birth or planned home birth for low risk pregnant women."

Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands
This study compared perinatal outcomes, based on an index “incorporating 22 items on childbirth, 9 on the condition of the newborn, and 5 on the mother after the birth.” The researchers found no relationship between birthplace and outcome for first-time mothers, but among women who had given birth before "perinatal outcome was significantly better for planned home births than for planned hospital births".

Simulated home delivery in hospital: a randomised controlled trial (abstract)
A study of women randomly assigned to either midwife-led care, birthing in hospital "rooms similar to those in one's own home to simulate home confinement" or standard obstetrical care and birth in "delivery suite rooms with resuscitation equipment for both mother and baby in evidence, monitors present and a delivery bed on which both anesthetic and obstetric procedures could be easily and safely carried out." Authors noted, "There was no difference in the percentage of mothers and babies discharged home alive and well. Generally higher levels of satisfaction with care antenatally and during labour and delivery were shown in those women allocated to midwife care."

The Safety of Home Birth: The Farm Study (PDF)
A study comparing outcomes of births from 1971-1989 attended by lay midwives at The Farm in Tennessee to those in the 1980 US National Natality/National Fetal Mortality Survey. There were no significant differences between the two groups in labor-related complications or deaths. The Farm group had a much lower intervention rate, including cesarean delivery. The author suggested that some differences in births may be attributable to lifestyle choices (such as a high percentage of vegetarians birthing at The Farm) or observer bias, however, he concedes, "the results regarding perinatal deaths, in particular, are hard to ascribe to observer bias." He also mentions that births taking place in the hospital "have a safety advantage in cases in which life-saving technology is immediately required. There is some evidence, however, that elective interventions, which are used more frequently in-hospital, may increase the risk of various adverse outcomes in low-risk women." The study concludes "for relatively low-risk pregnancies, home birth with attendance by lay midwives is not necessarily less safe than conventional (hospital-physician) delivery. Support by the medical and legal communities for those electing, and those attending, home birth should not be withheld on the grounds that this option is inherently unsafe."

The influence of the high-risk care environment on the practice of low-risk obstetrics (abstract)
A chart review of three urban hospital OB units, two set up to receive high-risk moms, the third mostly offering services for low-risk birth. Researchers found "physicians at the perinatal referral centers performed significantly more artificial rupture of membranes, epidural blocks, augmentations of labor, and episiotomies on their low-risk patients than did those at the low-risk hospital." They concluded "[C]aring for low-risk patients in a high-risk care environment is associated with a higher intervention rate." Or, as my friend who referred this article put it: Simply taking a low-risk normal pregnancy INTO a hospital increases the likelihood of intervention (and therefore raises risk).

When Research is Flawed: The Safety of Home Birth
Critique of the well-publicized but poorly executed study by Pang, et al. which "alarmingly concludes that planned home birth confers twice the neonatal death rate of planned hospital birth."

For Further Reading: Additional studies and information.

Monday, March 10

Because I Promised

At church today, I saw a friend who reads my blog. I promised her I'd start writing again, so she wouldn't have to read my quote about logic yet again.

We're fully healed here, finally. I was sick with the flu for a good two weeks, though the rest of the family managed to get done in 4-5 days. After my second relapse, I finally figured out that my jump back into activity the moment I was feeling better wasn't really helping me. After giving myself permission to recover slowly, I started feeling considerable progress over just a few days.

Our little 3-year-old finally was able to have her birthday party, four weeks late. Our theme this year was a Teddy Bear Picnic. I spread a checkered tablecloth in the center of the living room and served snacks out of an old picnic basket I inherited from my grandfather many moons ago. Instead of a single birthday cake, we served individual mini cupcakes, decorated to look like Teddy bear faces.

Didn't Adam do a great job decorating?

I'll be posting a better description on By Hook or By Cook, along with the ducky cake info I promised last summer. I haven't forgotten! I'm just running behind (as usual).