Sunday, January 16, 2011

My take on birth

As time approaches for me to give labor in a few months I have been thinking about the experience I want to have. I decided that I should write down the birth stories of my three boys. I realized I had never written them down anywhere and I figured that by writing down what my previous experiences had been, it would help me have a more concrete idea of what I wanted to happen this time around.

A lot of you know that I was not happy with my last doctor (or the office for that matter) and my last experience there ended with me almost shouting at the receptionist, “No! I will not reschedule. You will never see me in this office again!” Take that. I almost turned around to the patrons waiting in the waiting room and said, “If you know what is best for you, you’ll run away from here right now.” I held my tongue but found another doctor that I was much happier with.

After this last experience I have been very distrustful of doctors and doubtful of their desire to do right by their patients and not just show forth their knowledge and ego as if their patients are nothing more than dumb animals that need to be controlled.

The year before I got pregnant, I thought long and hard about how I wanted this experience to be. I knew there was still another child to come to our family and I did not want to be pregnant before I had a better idea of how I could make this pregnancy a better experience.

I was nervous about choosing my bishop as my OB, for the very reason that some readers have stated, but after much thought and prayer, I decided that he was the doctor I needed to be seen by. So far, it has been the best choice for me. I have talked to him about the type of birth I would like to have (though, not in great detail yet as I am still ironing it all out) and he has been nothing but supportive and even acted a little excited when I told him I’d like to try a natural birth. He even suggested I try laboring in water or using a birth ball. I am confident that he will help me to have the experience that I want to have. My OB referred me to a really great neurologist and went out of his way to seek the neurologist out after my appointment to find out what the outcome was. He really has given me the most personal care of any OB I’ve ever had. It will be hard to go to someone else if we ever decide to have more children.

But, this isn’t about my OB. It’s about what type of birth I’ve chosen. I mention my OB though because I know that he will play a huge role in the kind of birth I end up having. So, let’s begin.

First, after writing the birth stories of all three boys, I’ve come to recognize some things that I really don’t want to happen again as well as some things that I feel have helped me solidify my decision.

So what is my take on natural birth vs. a medicated birth? Let’s start by me saying one thing that might infuriate some people: I think unassisted childbirth (giving birth without the assistance of a medical or professional birth attendant) is too risky. I’ve heard arguments that if a woman has educated herself she can have a perfectly safe birth. I find this a very bad argument. How is a woman who is in the middle of labor supposed to know that something is going wrong, let alone have the wherewithal to deal with it? Has she gone to medical school or been trained as a midwife? Has she delivered hundreds of babies before? Does she know what to do if a cord is wrapped around her baby’s neck? Chances are, no. Does that mean she can’t have a perfectly uncomplicated birth and deliver a perfectly healthy baby? No. But who in their right mind thinks that is a risk worth taking?

Ok, so unassisted childbirth is off the table for me. Obviously.

So next we discuss homebirth vs. a birth at the hospital. I actually really like the idea of a homebirth. I read on a blog about a woman’s experience with homebirth and why she chose it. She is Mormon as well and had the feeling that since our homes are thought to be the second most sacred place on earth (after the temple) that her home was the best place for her to welcome her new baby.

I think that’s beautiful. I love the idea of welcoming a new child sent from God in my sacred place—my home.

However, I feel there are just too many variables that come to play in labor and I don’t feel comfortable being away from a hospital where there is access to help if needed.

Mike read me a study recently that concluded that homebirths are better for the mother (a lower rate of infection, fewer invasive procedures, etc) but was worse for the baby (more likely to die). I’ll take the infection and less control over my experience over a dead baby any day. (Of course I know that this is a gross exaggeration. I don’t really believe that babies are dying all over the place from homebirths.) I guess the biggest problem I see with someone opting for a homebirth is that the woman can become so focused on the kind of birth she wants to have that when something begins to go wrong with the labor and her idea of what kind of birth she wants is threatened, it is hard for her let go and put her trust in an experienced doctor, thus increasing the risk of her baby dying.

I would not choose a homebirth for myself. I just don’t think it’s a very wise idea. But, while I wouldn’t choose it for myself, I understand why someone would choose it for themselves.

So that leaves a natural birth in the hospital setting (or a Birthing Center) vs. a medicated birth in a hospital setting.

I’ve had three epidurals, all a thankful relief. None of them came early in labor but after many hours of trying to cope with the pain of Pitocin without being allowed to move. The last epidural came without my asking for it and things were so dramatic, crazy, and confusing at that point that I barely had a chance to consider if I wanted the epidural or not. I was already an eight and by the time I got the epidural in, I was a ten. The epidural was the best one I’ve had. Because of the quickness of my dilating, there was not time to give me a lot of epidural so I was just given a very slight amount. It was just enough to take the pain away but little enough that when I needed to get on my hands and knees to try to turn Eli, I was able to get on all fours without assistance. After the birth, I was able to get out of bed and go to the bathroom on my own. It was wonderful.

After writing the birth stories of each of my sons, I’ve noticed things that occurred that made my experiences less than I had hoped for and many of them occurred because I had not educated myself enough. I recognize that many of the things that happened had to happen because of the intervention of the nurses and doctors. If left alone, I most likely would not have needed to endure much of what I endured. I would not say that any of my experiences were a horror story, just not as peaceful or as good as I would have liked.

So this time I’ve decided to do it differently. This time I’ve read a lot of books about birth. This time I’ve carefully chosen my care provider. This time I’ve talked to Mike about what I want to happen so that he will know better how to support me. This time I am going in prepared, knowing about my options.

In the process of reading these books I’ve decided to do a natural birth. I agree with the idea that our bodies were made to give birth and that interventions often create unnecessary problems. One intervention often leads to another. Being hooked up to Pitocin, almost inevitably leads to an epidural. Epidurals often slow labor down and create other problems and sometimes have side effects—none of which I’ve experienced except complete numbness from the waist down.

With all that said, I’ve read only a few books that I liked and a lot that I’ve disliked. First I read a book about a nurse turned midwife. I really enjoyed this book. She really presented birth in a way that empowered women and created a desire for me to experience birth naturally. I also felt that she did a good job of writing about the importance of having a good relationship with OB’s and being able to trust them when needed. Granted, most of her patients delivered at home and I have already discussed that I’m not looking for that kind of experience. But, she was honest in showing both the dangers of not trusting the staff at the hospital when a problem arises, and what happens when you give up some of your control to the staff hospital.

Next I read a few books I pretty much hated, a book called Pushed being one of them. These books were very statistics packed. That isn’t why I hated the books. If you want to believe that all epidurals lead to c-sections and all c-sections lead to death, then these books are for you. Holy cow can you say biased? I really felt the purpose behind these books were to make women scared to have any interventions whatsoever.

I also read a fair amount of blogs devoted to natural birth (mostly homebirths actually) and almost always came away feeling like a bad mom for allowing myself to be cared for in a hospital by a doctor. This response was interesting to me because I thought the whole point of was to feel empowered by being a woman and being able to bring a baby into the world by making choices that worked for us personally. But that is not the definition of empowerment I found being portrayed on these blogs. Their definition of empowerment pretty much is that if you don’t have a natural birth you can’t think for yourself and you are dumb.

So I hated these books and blogs.

Then I found a book I really love. I am reading it currently. It is called The Big Book of Birth. The author, Erica Lyon, is a childbirth educator and while she obviously favors natural birth, she favors a woman’s choice more. Her book really just educates women about childbirth. She discusses both medicated birth and natural birth and while she occasionally gives her opinion about one or the other, she mostly just writes to educate and encourage. This is exactly what I needed to make my decision. I needed to be educated but not to be left feeling guilty.

So, from my past experience and my current studying, I have decided to have a natural birth. Depending on the health of myself and the baby, I would not choose to be induced early (though, that probably won’t be a problem for me). I also would not choose a C-section if both myself and the baby are healthy. I do not want to have an epidural, though I won’t feel guilty if I end up having one. I would like to have a hep lock so that if I need an IV for some reason, I can get one quickly. I would like to try different positions (probably those that will relieve back pain as two of the three babies thus far have been posterior and this one might be as well), as well as use a birthing ball and perhaps get in a tub of water (I will not be pushing in the water, just doing the laboring part). I do not want to have the external fetal monitor attached to me but rather would like to have the handheld Doppler used, therefore allowing me to move. I do not have a real firm decision on episiotomies—I’ve had one with each of my children, very small ones and I have recovered very quickly each time. I would also like to explore my options for pushing positions. I plan to use Mike more this time, having him give massages and putting heat or ice on my back if I have back pain. I also plan on making Mike be a firm voice for me if I begin to feel pressured (though, with my current care provider I don’t see this happening).

I feel this is the right choice but I also recognize that there are a lot of things that can happen unexpectedly and I am not going to be so focused on the kind of birth experience I hope to have that I won’t listen to those that have expertise in delivering babies.

I feel the least amount of interventions possible is the right choice but I also am thankful for modern technology and doctors that are trained to provide care when needed. I also believe that while this is the right choice for me, it isn’t for everyone. I respect another woman’s choice even if I don’t agree with her choice and wouldn’t choose it for my own.

I think this quote by Erica Lyon sums up my feelings, “I would like to clarify that it is feminist to make your own choices based on what you understand and believe about your own body and your baby—not in reaction to another gender not experiencing something that you choose to experience. From the defensiveness I hear every day in women who use the epidural or who go through labor naturally, each woman feeling the need to justify her choice, I think she seems to miss the point. It is more important to make labor your own. Never mind what everyone else did or said or tried or how it when haywire or how euphoric it was. Just make it your own day, when you and your partner become parents together.”

16 comments:

Cherstin rocks said...

I've done natural birthing even though I didn't care to. It's not really my thing and that's okay for me. But more power to you for knowing what you want.

Having done the cloth diapering thing, I've been in a few situations where I can understand what you're writing about. A few interesting things I've taken away from it all, though, is that if you want to birth naturally, apparently Hypnobirthing is really effective.

Also, my OB gave me this website when Ellie was breech later than I would have liked. It's not just for breech babies, but posterior kids as well. www.spinningbabies.com

I hope you get the birth you want.

Megan said...

I am excited for you. I am only having my first but I also want many of the same things that you want for your birth. I am taking classes on hypnobirthing. I will be doing this in the hospital for many of the same reasons you stated. Good luck!

Megan Fife Taylor

Life as a Greenstreet said...

I'm excited for you too- with age comes wisdom! I think having a choice is such a powerful thing- and it looks like you're making yours wisely. So wonderful!

NavelgazingMidwife said...

I really love what you had to say. You're detailed description of your process of elimination was great and will, most certainly, help many women. Thank you for doing that!

And I know, because I've been there, natural birth *is* possible in the hospital. In fact, I've closed my homebirth practice to be a Monitrice/Doula exclusively.

(A monitrice goes to the laboring mom's home, monitoring her and the baby during early-mid labor and then going with mom to the hospital and becoming her doula. This way, women who want to go to the hospital late in labor are able to do so safely.)

I believe in being there for a mom, however she needs me. I'm totally not a radical that would frown or belittle a mom for wanting/having an epidural. No one is in her body but her (well, and the baby!), so who am I to tell her what to do? If she's my client, she certainly has the information she needs to make an informed choice.

I'm sorry all the books and websites were not helpful/validating to your choices, but that's one thing I aim to do, provide the middle ground... to do, exactly what you're planning... to support women in their desire for natural birth in the hospital.

(Oh, and don't tell anyone, but my daughter's pregnant [we haven't announced it yet] and I've helped her find a group of nurse midwives who work in a hospital. Now *that* will thrill the homebirth community! [not really].)

Your OB sounds *great*. I can't wait to read your birth story afterwards. You've certainly set the stage for a really great birth.

Natural Birth Goddess said...

Great blog! I do like how you are looking at your past births and using logical reasoning to get centered in what you want your next birth to look like. I think that is so important...you cannot change the past, but you can make different choices for the future!

I do love the Bradley Method for natural birth...and adding to that, I would suggest Hypnobabies (different from hypnobirthing).

I have had all my kids naturally. My first was a hospital birth, and I was so exhausted by all of the constant poking and prodding done by the medical staff, that I decided to go with a home birth for my future babies (I had 2 home births, now).

It is very possible to have a great natural birth experience in the hospital. Just as it is important to find the right OB, it is just as important to find the right hospital. My big mistake was going to the research hospital...great for high risk moms, but horrendous for low risk...they were bragging that their c-section rate was "only" 28% (and this was 8 years ago). You have to be sure that the hospital you are going to birth in is natural birth friendly...otherwise, you run the risk of "fighting for the right".

I wish you much success on your journey to have the birth you are desiring, and tons of kudos for researching everything...it's one thing moms these days do not do.

I look forward to hearing the birth story of your newest blessing.

Katrina said...

Yes- your hospital is sooooo important and the nurses that care for you during labor is vital in order to have a good natural birth experience. It is great to have a supportive doctor, but the nurses will be the ones caring for you during most of your labor! I hope that you will be doing your birth at Family Beginnings at MVH or Good Samaratin? The nurses there are sooo supportive, and will support you with whatever you decide to do, even if in the end you want an epidural, they are fine with whatever! I had a very difficult natural birth- but it was the most amazing experience of my life! ALL births are different, and I hope that your natural birth is a very positive experience for you! Just always keep a prayer in your heart, and in the end, all that matters is that you and the baby are alive and healthy!

Lokodi said...

Well, it sounds like you've made a very good, informed decision. I've had both my kids naturally but in the hospital. I used a birthing ball with both kids and I loved it. I also got in the tube to pre-labor with Eva and it reduced the immense back pain I was feeling. Having Mike push on your lower back really hard while you are on the ball up against something works for the pain too. I also think it's important to get into whatever position your body tells you to be in when you deliver. With Eva, they made me get on the bed to push because they had to turn her before I pushed and I hated it the entire time. It hurt my back so bad. However, with Gabe, they were wonderful at giving me suggestions as to different positions that would help me push and relive the pain. I ended up in a praying position when he was born. It was a lot better and came faster. I think a lot of nurses/doctors don't want you to be in those positions when you have the baby because it makes their job harder, but you are the boss! You need to decide what you're going to do and inform them. Be firm. Your body will tell you what it needs to do. When you're done, you'll feel empowered! Good luck honey. I wish I was there to help you. I think it's a beautiful experience and I would love to be there to support you in it.

Lindsey

Seth and Natalie said...

I really hope you didn't read my post about natural birth and come away feeling bad about yourself. (if you ever even read my blog, that is) It's amazing how we can have babies and be so uneducated. I learned more with the midwives I used in one visit than my previous 2 pregnancies. Who knew that having a baby could be such a great experience? My other 2 were natural as well, but not so much fun. Your Aunt Julie had all of her babies natural, and so did my mom, and so have billions of other women. If they can do it, so can you. Good luck!

Mike and Adrianne said...

Cherstin, thanks for the website. I'll check it out. My doctor said you usually can't tell if they are posterior until you are in labor but it will be nice to see what to do if that happens.

Megan, good luck with your little baby!

Brooke, I agree, choice is such a powerful thing.

Navelgazingmidwife, thank you for your comments. I really appreciate it. I think your practice sounds awesome. I really do think I would have done all of mine natural had I not been started on pitocin. I'd love to check out your blog.

Natural Birth Goddess, thank you for stopping by my blog and for leaving your comment. I appreciate your advice. I agree that many women do not take more of an effort to research what is happening to their bodies. That is why I had such a hard time with my previous OB--she was NOT cool with me doing research and coming in with questions.

Katrina, I agree that the nurses are such a huge factor. I have had some great nurses and some not so great--they didn't believe me when I said my water broke and it had!! I don't think nurses get enough credit for all they do. I will be giving birth at the hospital on base.

Lindsey, you are a trooper. I'm so glad you were able to get support from Hans the first time and the women in your ward the second time and I'm glad you were able to have such helpful nurses. I definately feel like I need to know before I go in what I want or I won't be able to be firm--hence, the research.

Natalie, I do read your blog and I did not in the least bit feel upset by your natural birth post. I appreciate when women write about their experiences and how wonderful they were. That's what I felt you did. I don't like when women write about their experiences in such a way that it is so final, so the only right way to do things, because even though I might agree that natural birth is the best way to do it for me, I know that there are so many variables in why someone chooses what they choose. And, I think that there is so much judgement of women and their choices that what I really appreciate it an unbiased look on things, that informs me to make the right decision for me wihtout making me feel it is the only way to do something.

Cali said...

Wow--that was a lot to take in! I'm glad that you've done the research that you wanted to, and I really hope that you have the birth that you want. You're smart to be open to options. I highly recommend water--makes a HUGE difference!

You are such an amazing woman, Adrianne. This baby is so lucky to be coming into your home. I really do hope that your birth experience is a wonderful one. Aidon's birth, for me, was the one that went how I hoped it would. It really is a different experience when there aren't so many medical interventions. You're in my prayers, my friend.

Papa Doc said...

I might be the only man commenting, but I have a right as your Dad.

You are amazing. This was a very good post and some very well thought out ideas. I like your decisions, and your improvisos. Only I would not worry about the use of pitocin. It is just the oxitocin used in humans. That is a natual chemical that your body has, too, and uses to cause the uterus to contract. I have given litterally thousands of shots of it to sows. It speeds the process up a little when things are slow and hurtful. I do not see that it has any direct connection to epiduals. Let you doctor use his discresion.

The epi thing is better than tearing. It heals quicker and I think many women would naturally tear without it.

I love you and your kids. They are loved and well cared for. This new little girl has a lot to look forward to. Just think, Jess was number four for us. You came later. So let the future happen and it will bless you beyond anything you can now imagine!

Dad Clark

Tracie said...

Hi, I stumbled upon your blog. I really liked your post and your thoughts about the process of how you came to make your own birthing decisions. I wish more women would stop and make informed birth decisions (regardless if they reflect my own chosen birth decisions.) Knowing really is half the battle. :) Best wishes to you and your upcoming birth. (And doing posterior birth naturally? Totally doable. I gave birth naturally last year to my first child. He was posterior and the labor was long and hard. But I did it. And no regrets. Two words: counter pressure. And also, doulas are totally worth it.)

I see you're undecided about an episiotomy. For a great place to start with resources, I recommend http://www.childbirthconnection.org/article.asp?ck=10203#pelvic

Also, http://www.childbirthconnection.org/article.asp?ck=10197&ClickedLink=281&area=27

Childbirth Connection is a great site that presents evidence-based research. (They cite everything and you can follow links and other research.)

Anonymous said...

I love that quote at the end! Each of my boys were very different births and I think they all went the way they were supposed to. Although Joshua ended being natural and I really was OK with and had asked for some meds. I wish that I had been able to have his birth not so quick that I never got to try the ball or the bar. I had really wanted to give it a go. But I guess it did happen naturally and that was really what I had wanted to try. Good luck with yours and I think you've made a great choice! I hope it goes really well. I know your OB is great! ~ Angela Orme

Jess and Jason said...

I tried to comment while we were away and the computer wouldn't work.

More power to you! I think every women has the right to choose what she wants to do.

Ryan was completely natural...I didn't even have an IV, but I was in the hospital. It was my favorite birth of the three children.

Good luck! I know it will be beautiful! (and even if it is not everything you want it to be, the end result will be beautiful!)

Michelle said...

Great and well thought out and researched post. I wish I would have tried other things for my deliveries. You are a great Mom!

Michelle said...
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