I could use this post to rant about how women have no idea that their bodies are made for childbirth and how to use it, and how they blindly do whatever their OB tells them to do (sometimes to their peril), and how frustrating it is for ME to hear all that after all the research I have done on the topic. Instead, I want to just plant a seed of self-education (utilizing my own bias, of course! After all, this IS an opinion blog… MY opinion) 😉
Here are some things you should consider when planning your birth:
(this post expresses my bias quite shamelessly, so just use these as a jumping off point in your own research either way you decide to go)
- One intervention may lead to another intervention: Fine, I’m a biased woman, but this is a matter of fact and you ask any OB, midwife, nurse, even medical and nursing students about this one: being the subject of a medical intervention (such as anesthesia, aka epidural) increases your chances of being subject to additional intervention. Things could go wrong: puncture your spine through the injection process, overmedication, undermedication, slow-down of baby’s heart beat, etc. Or even when things go right: the slow-down of labor functions and the mother’s inability to feel the “right time” to push may drag the process on to a point when the labor is “not progressing,” which makes uneasy health professionals think of ways to accelerate the process, such as providing pitocin (an induction agent). Pitocin increases the strength of contractions, which, coupled with the anesthesia, may create an unfavorable environment for the baby, which may cause distress to the baby. Once the baby is in distress, the goal becomes to get the baby out at all cost. Hence, a c-section. Therefore, if you don’t want a c-section, the best way to avoid it is to avoid medical intervention altogether.
- Pushing time is longer under medication: anesthesia numbs your limbs from the waist down (and, fyi, it also gets passed onto the baby), making it harder to sense when it is the right time to push. Some have described the feeling as being told to do number 2, when you don’t actually have the urge to go. The decrease in feeling slows down the process, and the pushing stage of labor may easily take 2-4 hours. The effects of the anesthesia make it impossible for the mother to stand up, walk around, or squat, which means the only possible position for pushing is laying on her back. Considering that gravity is working against you, delivery is simply more difficult to accomplish, opening up the opportunity for other types of intervention (such as an episiotomy).
- “I can’t handle a headache, let alone the pains of labor!”: This is the biggest fear of future mothers out there: the pains of labor will be so intense that they will not be able to handle it. Where are new mothers hearing that labor is painful? Maybe from every other mother who went through it and got the anesthesia because “they couldn’t handle it.” I will not say that labor is not painful, but I will say that most mothers are expecting it to be painful, which creates a sense of fear around the day of labor. When you are expecting something to be deadly painful, fear will intensify that pain (this is a fact, don’t shoot the messenger!). This is why mothers who are TRULY preparing for a natural birth attend classes that go on for 9 weeks at a time (as opposed to mothers who say “I tried to go natural” but really they had come to that decision on the day of labor without serious previous preparation). In these sessions, future mothers are trained in (1) pain management exercises, (2) creating a support system that will check fear at the door, (3) preparing mentally for a mind-over-body approach, (4) avoiding negative thoughts that may create fear or negative anticipation for that day, (5) to convince themselves and their partners that they CAN do this. Imagine a woman who did not get this type of training trying to go all natural on the day of labor: it’s as if you showed up on the day of the Boston Marathon without any training at all, and expected to run the full race. The chances of success are slim. However, armed with the proper training, the right support group, and the avoidance of negative thoughts, chances of success dramatically increase. Can a woman who has trouble with her headaches handle the pains of labor? Yes! They just don’t know it yet, and other mothers are not being very encouraging in convincing them otherwise.
- Your experience will be different from other mothers’: Obvious, right? Wrong. Many women assume that their path will be the same as that of other mothers who have been nice enough to share their stories: “I will get to the hospital, get my IV for fluids, get my epidural when the time comes, and pitocin only if it’s needed. If I need to get a C-section, then so be it. All for the sake of my child!” Ladies ladies, it doesn’t have to be this way! OWN your experience! Do your research. Interview places to deliver: different hospitals and birthing centers. Once you have all the information you need, make the decision that is best for YOU. Oh, and don’t you dare making that decision without watching the documentary The Business of Being Born first! This is a well-known documentary about births in America, and will give you a completely different perspective than that of your OB or your sister who went through the most painful labor in history. I’ve even talked to mothers who watched the movie AFTER giving birth, and they wished they had seen it BEFORE the birth. They tend to believe the process would have been a lot easier and smoother.
- You DO have options of care: OBs are Surgeons, Midwives are Certified Nurses: Educate yourself on the difference between the two. OBs are not the only choice you have for care during your pregnancy, and they are SURGEONS. They will use all available medical equipment, tests and knowledge they possess to help you. However, in most European countries OBs are only consulted when the pregnancy is considered high risk (as any specialist should be). Otherwise, a Certified Nurse Midwife can provide the same pre-natal care, tests and support as an OB; with the exception that they will not jump to medical interventions as a default (midwives think horses, OBs think zebras). Most major hospitals have midwifery groups you can sign up for your care, while leaving the heavy lifting to an OB only if your pregnancy has certain risks associated with it. Would you go to a G.I. specialist if you had simple constipation? No, just like you shouldn’t immediately think “surgeon specialist” when you think of such a natural process as birthing is.
- Remember that the OB’s goal is the same as yours (healthy mom and baby), but their motivations for the methods are far different from yours: when an OB decides to do a c-section instead of doing vaginal birth, they are minimizing the risk to the baby (mission accomplished) while allowing the mother to carry all the risk that comes with a major surgery (such as infection, reaction to the anesthesia, and recovery). C-sections also work quite conveniently for OBs: they are scheduled, which means they don’t have to be available for up to 60 hours that labor could last near your bedside checking on how you’re doing and increasing risks and uncertainty. C-sections are also much more expensive (and therefore they get paid more by insurance companies) than allowing a mother to deliver vaginally. All these things considered, it is no wonder that major hospital’s C-section rates are 30-40%. It’s not that 30-40% of women are unable to deliver babies vaginally (that would mean an immense biological flaw in humans), it’s that there is a whole system working in favor of C-sections.
- C-sections are not just major surgery, they also take away from the birthing experience: when a baby is born, it needs its mother nearby right away. That moment of bonding is so important and so worthwhile for all birthing mothers. When you think of what kind of birth you want to have, remember that you are not going to get the “baby out of you” but you are working together with the baby to find its way out. A scientific study showed that when a chimpanzee gave birth vaginally, it would forever take care of that baby; while chimps who delivered through c-section were more detached and did not acknowledge the babies as their own. Now, we are not chimps and we know that it is the same baby, but the biological process of giving birth is universal among mammals, and it marks a significant point in the start of the relationship that mothers should not miss out on. Also, consider that recovery for c-sections is 4 days (versus 8 hours for natural birth), plus time afterwards when you won’t be able to lift heavy things or engage in physical exercise as the wound heals.
- You cannot do this alone: Independent women of the world, I know this is very hard to hear. Even if you are about to be a single mother, you WILL need the support of those who love you to get through labor day. Not only do you need them to be physically there for moral support, but you need them to be in tune with your wishes and to refrain from telling their own horror birth stories on that day. Let them know that you need them to stay positive, to just be there for you, and to check their opinions at the door (in a way, they need training, too!). Only happiness and smiles on that day! It doesn’t have to be the most horrible experience of your life: you can turn it into the happiest and most wonderful time to share with family and welcome a tiny new member.
In short: I wish I lived in a place that was more open to the natural process of labor, and I didn’t feel like I was going against the grain everywhere I go and everyone I talk to. So the best I can do is to pass on the knowledge (biased as it may be), and hope that women out there learn how to make this decision for themselves.
Good luck!
ina