Thursday, June 4, 2009

Natural Birth

With Nicholas and Sophie, we found a Bradley instructor to prepare us for natural childbirth, but, due to their early entrances into the world, we never made the first class. Nicholas was born naturally by circumstance; after a mere 5 minutes of what I described to Peter as "severe gas pains", he was born seconds after my water broke. Sophia's labor began Saturday after dinner with back pain. It continued into the morning and at 2:30 in the afternoon my water broke, spiraling a backache into painful back labor, which continued until she was born at 6:08pm. I was starting to hyperventilate, not from the pain but from the knowledge that my daughter was being born into this world only to die... The pain of that was worse than any physical pain I was in. Labor was, well, labor. That knowledge, however, was agony. I couldn't breathe. I was a mass of sobs. And, as a result, the kind on-call OB, who I truly believe thought he was doing the right thing and couldn't think of any other way to calm me down, hooked up a morphine drip. I did calm slightly down although I don't remember it really doing much to the pain. In retrospect, I know that it most likely slowed Sophia's breathing down, since morphine has that effect on babies, which shortened her already short life. As I was holding her afterwards, I had to give her to Peter as I puked up the nonexistent food in my stomach in response to the morphine. I had read about the side effects of drugs on babies and it influenced our decision to "try" natural birthing. After reading about morphine's effect, I made a decision that, unless our lives were in danger, I wouldn't knowingly accept drugs to birth any future children. Immediately after conceiving Alexander, I contacted our Bradley instructor and she, graciously, agreed to one-on-one classes. In the sessions we completed prior to Alex's birth, we covered pain and natural ways to relieve it, meditations, and different massage techniques, in addition to discussing drugs and their possible impacts, as well as reasons (other than convenience of either parent or doctor) to consider a c-section. I loved those classes. When Alexander's water broke, Peter says that I was more calm than he's ever seen me. That he knew I was afraid and that we both knew the outcome of his labor prior to that much-hoped for 24w. But, in that, was peace. I slept after contractions and when his labor hit full force, breathed, talked to him, and labored naturally until he was born into this world for those beautiful moments. It was the labor that I had hoped for- for all of our babies. His older siblings had taught me more than a book or a class, and he gave us the dream of a drug free, peaceful labor.

Why such a rambling? In addition to having pulled out my natural childbirth books and reviewing them, I've occasionally (much to Peter's dismay) flipped on a baby show. Not often, mind you. I can't take it. The teenagers. The comments. The innocence. The watching it all work out. Sometimes, I'll watch the ones which the preview marks as pregnancy after loss or natural birth or Bradley birth. Those are really the only ones that I feel like I can attempt. I rarely make the full half hour. But today, feeling a little confident as I countdown the moments until our 4pm appointment with Dr. Bailey, I thought, I'd check out the info button. Sure enough, "2 women have natural births". I flip it on. The intro began with screaming women, flat on their backs, legs up, crying and saying "I cant do this." I turned it off. Went to Cold Case Files on A&E instead. From life to death. But at least in this, I know what I'm going to see before I see it.

One of the first things that we discussed in our classes were advantageous labor positions. I've witnessed births live and on video, as well as being there. And at no time were positive, natural labors done laying flat on their backs with legs in stirrups. (Not that you cant labor this way naturally. I'm sure plenty of people do it successfully.) But anyone who has taken a class knows that it compresses the birth canal and makes the baby's descent more difficult. Yes, it's more convenient for the doctor. But who is really delivering the baby? The mother! Shouldnt the question be "What is more convenient for the mother?"?

I realize that I am blessed with an "enlightened" OB who has no issue with birthing in odd (read: comfortable) positions and who told me with Nick and Sophie that he'd sit on the floor if that is what got us through it. From what I've heard from friends who have birthed in a hospital (which isnt my first choice but at this point I'm too high risk for a home birth and I adore Dr. Bailey and can't imagine not working with him at this point), most docs are not like Dr. B. One friend told me that her doctor said "We'll be doing a C-section at 36w. Schedule it on your way out." No ifs, ands, or buts about it. Why? "Well, they'll be okay. 36w is just about full term for twins anyway." (Dr. Bailey's comment was that, if an amnio showed lung development, he has no issue taking the stitch out and letting labor start at 36w, but his ideal for twins is 38w, when most research shows complete lung development. If the amnio doesnt come back the way he'd like to see, then the stitch wont come out until 37w, with the hope that I wont go into labor right away.) Another friend, pregnant with a single, was told by her doctor, "Everyone gets an epidural, even the so-called natural people, so go ahead and sign the form when you are admitted." When pushed as to whether he would do a natural birth, he said, outright, no. His births are epi's and forceps or vacuum births. That's if you can avoid the much pushed for C-section. (By contrast, Dr. B. brought up a C-section once with Alexander, because he was implanted low and said that, if the previa continued, it was not safe to labor vaginally, which is supported with studies and evidence. He brought up once this pregnancy in the context of "if you want to keep the stitch for a subsequent pregnancy, it would hold up, but you would have to have a C-section." No pushing. No "do this". Nothing.)

Am I the only one this pisses off? While I'm not one to pre-plan a medicated birth, I have plenty of pals who have no desire to labor naturally, and that is fine. If that is their birth dream, then so be it, and with my blessing. But why does it seem like people are pushed in that direction? Yes, C-sections are more lucrative. And drugs could mean a longer hospital stay in addition to the pharmacy billing. But is that really where we are? That we moved from birth being a rite of passage, a true gift from God, a moment of bonding with your child to being a mere medical procedure? It makes me sad... Women should have choices. The choices to choose drug-free or medicated births. A choice that isn't influenced by their doctor's desire to control the labor process. The choice to labor naturally, no matter how long it takes or hurts, without the fear of being forced to have drugs or a C-section when the baby is absolutely fine. A choice that isn't influenced by the convenience of the medical staff. Where are those choices?

I have a big mouth (I know- you are all shocked) and dont have an issue standing up for what I think (and letting everyone else know, too...) Peter is strong willed (could read: hard headed) and I've never known him to be walked all over. We are both intelligent people. Neither of us would put our children at risk and, God knows, if there was a problem and we needed drugs and a C-section, I'd be the first to say "wheel me in". We trust our doctor, who has never once failed to give us two sides to every story and asked what we thought, before giving us his opinion. A doctor who has followed our wishes, even when he thought that they were least likely scenario. And never once said "but I'm busy. Just induce. It's not like your baby will live anyway." Most people, I think, can make themselves informed when it comes to labor and delivery, yet many women I've talked to, who were unhappy with their births, talk about how their doctors talked down to them, made them feel inferior, and ultimately behaved as though they didnt have a choice. It's not fair! It's not right!

Okay... I'm on my soap box. I'd better get off of it. I dont want to trip and fall, or worse yet, work my blood pressure up before my doctor's appointment.

DISCLAIMER: Whether you've chosen to medicate or not, your decision is yours and I think we all have to make the choices that make the most sense for us in our situations. Don't let my rant offend you if you chose medicated births; I dont think you are a bad person. The opinions I have on natural birth are those Peter and I have come to. But everyone is entitled to their own opinion and feelings, and to do what is best for their family.


Anne said...

I am anxious to hear what your dr says today. Am praying for you, Peter, and the babies and checking your blog daily. Please God let this pregnacy have viable babies. I love you have pics of Nick, Sophie and Alex. They are beautiful babies and your love for them shows so much. You honor God by this love.

Mon said...

omg your post totally hits me, its like if I wrote it myself ! THats exactly what I keep saying. I hate when they make a woman to lie down on her back so the doctor can sit comfortably. And I dont like when they automatically assign twins pg high risk without any other reason, just becuase there are two. My doula told me in the classes that twins births are actually even easier cuase they are smaller and the way is already prepared after teh first one, for the second one. If you dont mind, can I link my blog to your post? Im also totally planning a natural birth, no drugs, no epidural (unless absolutely necessary), no c-section (again unless something goes wrong) and definitely im not planning lying down on my back with my legs up !!! I am also not planning to stop pushing if the doctor is not there yet (thats another issue i have a problem with, they tell women tostop pushing and wait for the doctor whos at home getting ready to drive to the hospital, for example, if he's on call, not in the hospital directly !!!)

Anonymous said...

It sounds like you have really educated yourself on this and that you have a supportive doctor. Really that's the most important thing. Whatever your plan, whatever eventuates, all I want is for you to bring precious, healthy babies home with you. Lots of love xxx
(ps I say all this as someone whose first birth plan went all to hell, so I totally understand where you are coming from)

Baby Smiling In Back Seat said...

Aside from being more lucrative, part of the c-section pressure comes from avoiding litigation. If anything goes wrong, the doc can defend against malpractice by saying, "I did everything I could."

I have very strong feelings about the overmedicalization of birth, but now that I have my own high-risk pregnancy, I've become a fan of any intervention that keeps my babies safe.

It's great that Dr. B is open to your input! I hope that you get the birth you want -- at 38 weeks. :)

Donna said...

Well said! I'm glad you found the right choice for you and that your Dr supports you!

ashleyjnc said...

You are on there for prayer... scroll down, she didn't add your blog address for some reason. I asked to have you included because I just felt like you need extra prayer.

Barefoot said...

Yay for an understanding and supportive doctor! And I am impressed that you are able to watch even a few minutes of the baby shows....I am going to continue along my path of denial as long as I possibly can. :)

Reba said...

it's so true that once you get to the hospital, there's often no time to discuss your "plan" for how you want the birth to be. i'm really glad you and your doctor worked out a plan that you're both comfortable with, and peter too.

with my twins, i was planning to have a c-section (that obviously ended up not happening). with the ham, my "birth plan" was to get the baby out alive, by any means necessary. i explained to my doctor beforehand that i wanted my epidural immediately upon entering the hospital (i am a big baby about pain), and if there were any slight worries, concernes, etc. that i wanted them to cut me open, get her out, and let me know later what happened. ;)

as it turned out, i had my epidural but it wasn't placed correctly so it had started to wear off by the time i was pushing her out. so i ended up feeling everything from the waist down. i'm sure the meds had dulled the pain significantly but to me, this is as much a "natural" childbirth as it will ever get.

and you know what? yes, i screamed my throat raw as she came out. but i am so glad that once again, i got to feel my baby entering this world. it is truly the most amazing feeling.

Anonymous said...

The other reason they all push on their backs is that the epidurals keep them there.

I admit that I feel incredibly lucky to be (able to be) treated by a midwife at an excellent hospital for my twins. I feel like I have the best of both worlds. When I asked whether they'd start getting nervous if I went over 36 weeks, she looked at me like I had 3 heads and said No, of course not!

It is, however, generally advised to have an epidural line placed for twin births, though, even if no medication is used - I still haven't thought about that a whole lot yet!

Very nice post, though! Keep on your soap box, I like what you're selling.

Gabby said...

I'm so glad someone else writes long blog posts.

I love your spirit, Michele, and I am right there with you with the natural childbirth.

I don't think you need any more ammunition with what you believe, but have you seen The Business of Being Born? it's a movie that was made about why medication and c-sections are so common (all the reasons you know.

the other thing you might be interested is this YouTube video.

If you are ready, it's a photo montage of beautiful women who have given birth to twins (and triplets!) naturally. ALL SUCCESS stories!

Praying for you and your sweet babies.