Tuesday, July 19, 2011

My Changing Views on Birth

Just a warning, this is going to get long :)

When I got pregnant with C I had just celebrated my one year wedding anniversary and my husband had just completed the police academy.  We were young and trying to get the hang of things and still starting our life together.  I had been in the room for the birth of my sister's second baby, but beyond that I had almost no knowledge of childbirth, interventions, risks, etc.  I blame myself for not taking the initiative to research everything, but I wasn't worried because nowadays you go to the hospital, you get some drugs so nothing hurts, the baby comes out, and you're good to go!  Right?  Well, that was my thinking, anyways.  I didn't ask too many questions or challenge my doctor because he was the doctor and knew what was best.  Right?  And there was no reason not to get an epidural (I mean, that's what they're there for!), it didn't have any negative side effects because if it did they wouldn't be handing them out like candy to women in labor, Right? (oh wait, women in labor don't get candy.  only ice chips.)

One thing that I had been adamant about was my desire for a vaginal birth.  Of course in an emergency I wouldn't say no to a c-section, but as long as baby and I were safe I wanted to push him out myself.  When I went into my doctor's appointment at 39 weeks and 3 days, a growth ultrasound showed a "big" baby at 8 lbs 9 oz.  I'm not blaming this entirely on my doctor because I knew better and should've said no, but I was tired being pregnant and my doctor essentially made me believe that if I let my baby get much bigger I wouldn't be able to push him out and would end up with a c-section.  So I said yes to the induction.  If you're interested in reading my full birth story, here it is.  Turns out my "big" baby was a totally average (small, even) 7 lbs 12 oz at birth.  Then, I find out that my doctor was going out of town the next week, so I guess he was just fitting me into his schedule?

Bonus throwback picture of C:

The first few months of C's life were stressful.  I was in pain, we were dealing with C's allergies and trying to get him to gain weight and be healthy, and we spent a lot of time driving back and forth to doctor's appointments.  I wasn't resentful or angry about my birth, I just felt, "well, it happened and it's over and I can't change it, let's move on and focus on the baby."  When we fast forward a few more months when my baby fever kicked in and I started thinking about future second baby, I looked back at my birth and postpartum experience and thought, "I really don't want to go through that again."  For the first time I viewed my birth as a life experience and not just a way to get my baby out. As I started to look at complications I had and research when and why those complications happen, the same thing kept popping up: INTERVENTIONS.  I had almost every intervention offered short of surgery, and I had a pile of post-birth complications (both for me and my baby) to show for it.

I knew 100% that I would not get another induction unless it was essential to my health or my baby's, and that I would like a more present, supportive birth staff than my doctor who walked into the room to catch my baby and stitch me up, only to leave again and the nurses who I had just met and changed shift every 12 hours.  I felt like I wanted someone who I had known during my pregnancy and who could be there with me through my labor as a person of support and encouragement outside my family.  The more research I did, the more I leaned toward a natural birth, then an out-of-hospital birth, and settled on a home birth with a midwife as my ideal experience this time around.  Unfortunately, we have no birth centers in NV, so in order to avoid the hospital setting, I have to be at home.  I really like the idea of a home birth and pray that it works out for me, but it would be nice to have an in-between option.

If you had mentioned a drug-free birth, much less a home birth to me the last time I was pregnant, I would've looked at you like you had 3 heads.  I used all the lines: "I don't need a medal, I just want a baby!"  "Why would you stay at home?  What if something went wrong?  That's dangerous."  "I don't want to feel any more pain than I have to."  "No epidural?  That's what it's there for!" and so on.  Since I was the one saying all of those things, I want to list my reasons why, this time around, I feel that a natural home birth is the best option for me and my family.  Here we go:
  1. I am not sick.  Pregnancy and birth are natural human processes, not diseases that need to be taken care of by a doctor.  Even though I did not have a c-section,  I went into the hospital to have a procedure done to me to get my baby out.  My body was built for this; I want to let it do its job, not have the job done for me.  Plus, why go to a place full of germs and sick people to welcome a brand new, vulnerable baby?  My home germs are much less scary.
  2. In my home, nobody will take my baby away from me. C was put on my chest for all of ten seconds before he was whisked away to the nursery, and I didn't see him again for 3-4 hours.  Even then, it was after multiple calls to the nurse's station and I finally had to demand someone bring me a wheelchair and take me to se my son.  I don't need to know how big my baby is the second they're born, that can wait for me to get some snuggles and get properly acquainted.
  3. In my home, I will not be confined to a bed.  Yes, I can be in bed (my own, big, comfortable bed) if I wish.  Or I can be in the tub, or on a birthing ball, or walking around, or leaning over the counter, or sitting on a toilet, or anything else that feels good at the moment.  Lying on my back in a narrow, hard, hospital bed does not feel good, even with an epidural.
  4. In my home, I will not be hooked up to machines.  Hospitals use External Fetal Monitoring (EFM) which is basically a belt around your belly that records baby's heartbeat continuously.  Sometimes they do internal monitoring, where they screw a monitor into baby's scalp (C had scabs for a couple weeks after he was born from this).  This confines you to the hospital bed, and has shown to have false-positive results, where it shows that baby is in distress even when he/she isn't.  The American Academy of Family Physicians states that "Meta-analysis of all published randomized trials has shown that EFM is associated with increased rates of surgical intervention resulting in increased costs.8These results show that 38 extra cesarean deliveries and 30 extra forceps operations are performed per 1,000 births with continuous EFM versus intermittent auscultation. "; if you wish to read the full journal, you can find it here.  Also in that publication, it states that "The American College of Obstetricians and Gynecologists (ACOG) states that with specific intervals, intermittent auscultation of the FHR is equivalent to continuous EFM in detecting fetal compromise." meaning that periodic checks on baby with a doppler is just as accurate.
  5. In my home, I will push when, where, and how I want.  In the hospital, you are on your back, legs in the air, working against gravity, and you have nurses telling you "ok push... NOW!  One... two... three..." up to ten.  First off, you're expected to hold your breath during pushing (apparently full lungs help push the baby down?  And what does the lack of oxygen do?), and let me tell you, those nurses are the slowest. counters. ever.  I want my body to tell me what to do when, not the other way around.  Here's an article about pushing positions and the benefits of spontaneous pushing.  Also, here, here, and here.
  6. In my home, my husband will be involved.  Don't get me wrong, he was there and he was wonderful for the birth of C, but his duties involved holding my hand, getting me ice chips, and putting a cool washcloth on my head.  In a home birth he will be my coach and my support, an active, educated participant in labor instead of merely an observer.
  7. In my home, I will not be starved.  From the time we started my induction until C was born was 23 hours.  It never made sense to me how I was supposed to eat nothing but ice chips for a full day and then find the energy and strength to push a human out of me.  New research has shown fasting during labor is not necessary or beneficial to mother or baby.
  8. In my home, I will not be modest.  Everyone says when it's time to push, you aren't going to care how many strangers are in the room staring at your bare lady bits.  While I will say that you aren't going to stop in the middle of pushing to say, "excuse me kind sir, would you mind averting your eyes at this present moment?" it's not fun or comfortable to be that exposed to that many people (most of whom you have never met), and when you're trying to get the hang of breastfeeding, it's a pain to scramble to cover up because the dang nurse left the door to your room wide open when she walked in.  In my home, where I will surround myself with those I love and am most comfortable with, I won't have to worry about how I look, what is showing, whether or not I pooped during pushing, if I vomit on somebody, or who is watching my baby enter the world.  
  9. In my home, I can be as vocal as I want.  A common tool for working through contractions is vocalizing; moaning, yelling, screaming, whatever.  In the hospital, you don't want to disturb other women in labor, or be that crazy lady being tortured down the hall, so a lot more gets internalized (I don't think I made a peep during the 50 minutes of pushing).  At home, I can be as loud as I want without feeling insecure about it.
  10. In my home, I will not be rushed.  I won't have doctors pushing Pitocin because I'm not progressing as fast as they'd like to see, I won't have nurses charging at me with giant crochet hooks to break my water, I won't be on a timer for surgery once my water does break, my child won't be vacuumed out of me because I'm not pushing effectively enough, I could go on and on.  I want to have this baby on MY schedule (well, technically on HER schedule, lol), not a doctor's.  There also won't be anybody rushing to cut the umbilical cord and sever my child from me at the earliest possible moment.
  11. In my home, siblings are welcome 24/7.  C is going to be a big brother, but he's still my child and still needs his mom.  I don't like the idea of being gone for 2 or 3 days and showing up at home with a new sister.  This is already a big change for him, and I want him to be as involved and as comfortable as I can manage.  That doesn't mean I necessarily want him running around while I'm pushing the baby out, but I do want him to meet her as soon as possible, and be at home in his own bed, with Mommy and Daddy nearby.  Having my mom across the street means that he can spend some time at Grandma's house while I'm in the difficult stages of labor, but he is still close and in a familiar environment.  He doesn't have to show up to visit Mommy in a hospital, hooked up to machines, and then leave without her.
  12. In my home, I will not be pressured.  Being in the hospital, I felt that all my decisions were being made for me.  It wasn't that I was presented with all of my options and asked what I would be most comfortable with, I was told what needed to happen, and then they did it.
  13. In my home, I will not have an IV.  I will stay hydrated by drinking water (what a novel idea!), and I won't have to wheel a cumbersome machine back and forth, negotiating wires and tubes every time I have to pee.
  14. In my home, I will sleep when the baby sleeps.  So here's how it goes down in the hospital: Ahh, the baby fell asleep.  Time to get some rest.  In prances chipper nurse, turning on the freakishly bright lights while she's at it, "HI HI!  I need to check your stitches!"  Ok, let me just lift my gown and expose myself to you for a minute, nurse I've never met.  Oh good, she's gone.  Turn the lights out.  I'm tired.  20 minutes later, a different nurse comes in.  Blinded once again by hospital lights.  "Hey there!  I have to stab your sleeping baby in the heel to get a blood sample and then take his temperature.  I'll be super quick!"  Well great, now the baby's pissed.  let's try nursing again.  No go?  How about a new diaper?  That's better.  Shhh, he's drifting off.  Ahh, sleep.  Wait, why is my arm wet?  His band-aid came off his heel and he's bleeding everywhere!  Go to the nurse's station and get a new band-aid!  No, don't turn the light on, he just fell asleep!  BE QUIET!!  Why did you have to trip on the loudest thing in the room?  Now he's awake and crying AND bleeding.  And so it continues.  (Yes, the band-aid falling off and blood getting everywhere in the middle of the night did actually happen during my hospital stay).
  15. In my home, my husband will be able to sleep next to me.  He won't be struggling to get comfortable in a little pull-out chair next to the hospital bed, unable to even hold my hand because of the height difference and maze of wires and tubes connected to my arms.  He will be in our bed, with his wife and baby, able to cuddle and rest as a family.
  16. In my home, I will be comfortable and relaxed.  Hospitals are stressful places, there's no way around it.  The smell of disinfectant, sickness, and medications, the bright lights, the beeps and clicks of machines, the scurrying of nurses and doctors, the presence of charts and needles, none of it says, "hey, chill out, you're totally safe here"  It says something closer to, "be careful, don't move, you might die!  Good thing we're here to handle the inevitable emergency you're heading towards."
  17. In my home, I will be one minute away from a hospital with a level 3 NICU.  I'm aware that even though I am a low risk, healthy mom, sometimes things happen.  If a problem or danger arises, we are literally a minute away from the nearest hospital.
  18. In my home, I will not have to bring in a ton of luggage.  All of my toiletries, books, favorite pillow, baby's outfits and cloth diapers, etc., it's already there!!
  19. In my home, there are no visiting hours or restrictions.  If I want to have friends over to meet my new little miracle, we can sit comfortably on the couch, enjoy some baked goods, and pass the baby around, oohing and aahing over her perfection.  In a hospital, you can only have so many people at once and there's nowhere for them to sit, so they're standing awkwardly at the foot of the bed, only to be kicked out ten minutes after they arrive because a nurse has to check something on me or baby.
  20. In my home, my birth can be beautiful.  When I see pictures like these, I am amazed at what an amazing, peaceful, beautiful experience birth can be.  All you can see is an excited mom meeting her new baby, no needles, wires, tubes, masks, or chemicals in sight.  Just perfect.
So there you have it!  I know that not everyone in my life will agree with my decision or be comfortable with it, but I hope that they can accept it as a well-researched, thoroughly thought out decision that I've made in the best interest of myself and my baby.  

1 comment:

  1. I'm glad that you're going to get your home birth. Many of these reasons are the same same ones I had for choosing a home birth.


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