Tuesday, November 24

Why I’m choosing to “go natural”

As you may or may not know, I’m planning a non-hospital, drug-free waterbirth attended by a midwife. I get varied reactions from people when they find this out – mostly polite surprise, but also the occasional “Hoo boy, you’re brave” (Mark’s grandma) and, among the brutally honest (my father), overt initial skepticism. Curiosity is one consistent aspect of nearly everyone’s reaction.

And as a disclaimer, I’m not trying to convince anyone that they should do the same thing, but I am glad that I was exposed to this birth information when I was, so if I can increase exposure to this way of having a baby, then great. If I help someone else find a better birth for herself, then hey, pay it forward.

I always assumed I would give birth in a hospital, in a bed with a hospital gown, just like everyone else I knew. My exposure to birth was limited to postpartum visits to friends and family, one visit to a friend who was actually in labor in the hospital, and television portrayals (which, it turns out, are a wild misrepresentation). In other words, my exposure was (and still is) very limited. But I assumed I would go to the hospital like everyone else. I wanted to “see if I could do it” without an epidural – partly to see if I was “tough enough,” and partly because I wanted to connect with this rite of passage for women through history. But, if I couldn’t hash it, I thought, I’ll get an epidural.

This was my plan – or rather, this was the default option. Then I read the birth story of my friend Melanie. She talked about laboring in a tub, using a birth ball, walking around, and her doctor massaging the perineum as the baby crowned (!) – I thought it was all quite strange but thought hey, to each her own. Then, in a later post, she referenced an article called “The Purpose of Pain in Labor” (which unfortunately is no longer available on the website – Mel, if you have a copy would you email it to me?). The gist of the article (as I remember it) was that pain in labor, like in any aspect of life, is your body’s way of communicating with you, and that naturally responding to that pain allows your body to be most effective in getting the baby out with the least damage to everyone involved.

I had a major “Huh.” moment reading that article. It just made so much sense. One reference led to another, and by the end of the day I was researching birth centers and midwifery and waterbirths, and I was just about sold.

Coincidentally (actually, I don’t think it was a coincidence, I think it was divine providence), that same day Mark attended a presentation on various community service opportunities he would have this year, and one of them was at the only birth center in the Valley. He took the time to talk to the nurse afterward and get some additional information, thinking it sounded like something I would be interested in. When he came home that day, we both, independent of each other, had a lot to say about birth centers. This was the first of many little confirmations that this was the right direction for me to take.

I must pause to tell you why Mark thought this would appeal to me. My biggest fear about giving birth was not the pain, not that something would go wrong with me or my baby, nothing like that. My biggest fear was that I would have people telling me what I could and could not do. It was that I would be in a hospital where people would be telling me that I couldn’t even get a drink of water if I was thirsty. I had this vision of being so thirsty and being told all I could have was ice chips, and grabbing some medical individual by their white lapels in raging agony and yelling, “Get me a damn drink of water NOW!”

So, naturally, learning about a place where you’re “allowed” to labor as you want – eating and drinking as much or as little as you want, moving around, and just generally trusting your body and your own intuition – was very, very appealing to me. And the more I learned, the more it appealed to me on just about every level.

The more I’ve read, the more I’ve learned about some of the problems with the obstetrical model of maternity care, and how most women (like me) are just not familiar with the other options. I won’t try to regurgitate everything I’ve read over the last five months, but I’ll give a few examples of what I mean. And I mention these because they were huge wake-up calls to me.

Did you know, for example, that lying on your back – the standard hospital position – is probably the worst position to deliver a baby? You don’t have gravity working for you, it’s generally more painful, and you’re more likely to tear or end up with an episiotomy. Most women who choose their own position end up squatting, sitting slightly reclined, lying on their side, or even being on all fours.

To me this was a revelation. I thought women everywhere, throughout the ages, had given birth on their backs. Not so – the US is one of the few countries where this is standard procedure, and only since the last century.

I had always thought that giving birth in a tub was something that crazy hippie home birth people did. (I had even been known to make jokes along the lines of “Are you going to be one of those crazy people who give birth in a tub?” followed by a superior chuckle.) In fact, I have read that water is the best non-pharmaceutical pain killer for labor. Some women even describe it as relaxing. (I’m not holding out for that, by the way, but if it happens – woohoo!) You’re also less likely to tear under water.

Another thing I had never before considered was how a birth could be affected by a woman’s environment and her emotions. Being able to let go and surrender to the birth process is key, and tension, fear, and anxiety can impede and even halt labor. One article talked about how a doe in labor finds herself a dark, secluded spot to give birth. If anything happens where she feels threatened, the adrenaline rush will actually stop her labor so she can get up and run. The same is true for humans – how you’re feeling emotionally has a huge effect on labor.

If you have the same, trusted person with you for the duration of your labor (which is what a midwife or doula would do), if the lights are low, if you’re comfortable in your environment (if it’s as home-like as possible), that fight-or-flight reflex is much less likely to be triggered. It can be very hard to really relax with various nurses, students, residents, and so forth, coming in and out of the room, checking your cervix, changing shifts, etc. At the hospital, you don’t get to choose who ends up spending most of your labor with you, and you might get stuck with an ornery nurse (I know I’ve heard several of those stories).

Anyway, those are just a few of the things that I had never before considered, but once I started learning more about them it just made so much sense. And the list goes on, from the effects of various interventions (pitocin, pain medication, fetal monitoring, etc.) to the obstetrical philosophy (seeing birth as a potential emergency and over-treating for fear of litigation) to cesarean rates (way too high) to hospital policies (often not mom- or baby-friendly, and surprisingly often not evidence-based) to VBACs (unfortunately discouraged) and so forth.

So that’s a little bit of why I’ve chosen to go the way I have. And to follow up on my disclaimer at the beginning of this post, I’d just like to say that I don’t think that every woman should necessarily say adios to her OB and have her baby at home. Unfortunately, some natural birth advocates are a little too aggressively evangelical and they end up vilifying all doctors and hospitals and it can be a real turn-off.

But I do think that every woman should try to become as informed as possible and make her own decision, one that she’s happy with. Personality is a huge factor that I think rarely gets addressed. You may be like me and want to make all your own decisions regarding your care, or you may feel much more at ease knowing that you’re in the hands of a highly trained professional who is going to make the decisions for you. Your biggest fear may be similar to mine, or you may be afraid of something going wrong with your child. Either way, my hope is that everyone can at least know the truth about all her options. And OBs, as good as they may be, are likely to give a one-sided representation of reality. I’m a skeptic by nature and I don’t like to take any one person’s word for it, especially when it comes to something as important as my body and my child.

One more thing. Reading and hearing birth stories is very interesting (and often inspiring). When it comes to hospital births, I haven’t really read or heard a woman rave about how wonderful her experience was. Mostly they seem neutral, mediocre, or sometimes even really bad. And though there are certainly the rare scary birth center and home births, as a general rule women who have chosen to go that route tend to rave about their experience. Not that it was easy, but that it was empowering, beautiful, spiritual, and even life changing. I hope to have one like that.

If I don’t have one like that, if I end up in the hospital or with a c-section, that will certainly be disappointing, but I think I’ll be okay with it – because I know I won’t be railroaded into it and ultimately it will be my decision. I’m not holding out for any ideal birth because I know that labor is a poker hand and you get what you get – long or short, hard or easy, emergency or not. But I’m happy knowing that I’ve done everything I can to plan for the kind of experience I hope to have.

For some good, middle-of-the-road resources, I recommend Your Best Birth as a nice introduction to the various birth options (it does lean natural-birth but was neutral enough for me) and The Birth Partner as a great resource for preparing for birth no matter where or how you’re going to do it. And this is a blog mostly about birthing that I follow regularly now, because its author is educated, smart, and objective. (Her two birth stories, which are linked in the "About Dr. Freeze" sidebar, are amazing by the way.) There’s too much polemic and divisive stuff out there on both sides, from blogs and books that make you see every man with a stethoscope as a misogynist to simply false doctrine on the Today Show about the “Perils of Midwifery.” So I recommend steering clear of both extremes, and don't believe anyone who uses fear as a tactic to get you to believe their side (whether that's "Your doctor will disregard your wishes and cut you a huge episiotomy for his own convenience" or "If you don't do x, y, or z, procedure, your baby might die"), because unfortunately there's too much fear mongering out there. So these three resources, I think, are good objective places to start.

By the way, feel free to disagree with anything here. You may even extol the virtues of the epidural! You won't hurt my feelings. In fact I’ll respect you for voicing a contrary opinion. And soon I’ll have my own birth story to share (I was 38 weeks on Sunday), ready or not…


pintosbeans said...

Kudos for putting this all down in a convincing but not pushy-at-all way. You know where I stand from all our talks, but I just wanted to say "Rock on" for the blog post.

(Sorry, I'm in Writing office hours...and the only phrase going through my head is something like, "Well done! Such a wonderfully turned argument essay that accounts for opposing viewpoints and presents a clear thesis in a logical and well-supported way.") ...We're writing argument essays this week, maybe I'll copy paste this up on an overhead for discussion on how this has all the necessary components, etc. etc.

Amy said...

I can't wait to hear about your experience.

I agree about the whole concept of water birth and the natural approach. Our bodies were made to do this and I think it's silly to assume they can't without all that"help". The "delivery on the back" thing has always kinda blown my mind. It doesn't make sense to try to push a baby out like that....

However, with the cord wrapped around his neck, his heart rate dropping and consistently unstable, and his inability to breath once he was delivered, I'm REALLY glad we were in a hospital for this one. Maybe the hospital experience caused some of that, but I don't think being in the water would have unwrapped the cord (which caused the heart rate issues....) who knows. And if you want to hear somebody rave about their hospital experience, let me know - mine was truly fantastic. Through the whole process it was amazing.

Someday I hope to feel good about doing a natural birth - and I really hope to do it that way at least once....but with each birth I'll re-evaluate and see what comes.

Amy said...

Sorry for the novel in your comments....

Katie said...

That is very interesting. I have to admit, it's not something that I have thought about at all, but your thoughts and comments have made me think a little bit. Thanks for sharing.

Although, I do have to admit, my biggest fear is something going wrong with my baby, so I want to be as close as possible to the intensive care unit for babies where my Stake President is in charge. (something about knowing he's in charge there as well as at church brings me great comfort.)

Mariley Johnson said...

I'll admit. I've just gone the hospital route because that's what people do, right? But those ideas are all very interesting. Glad you made me think about it.

Ann-Marie said...

I loved reading your thoughts. It sounds like you're feeling prepared. 38 weeks--wahoo! I can't wait to hear ALL about it! :)

Charly said...

Good luck with your birth plan! I really do hope it works out for you. Me myself, I am grateful for hospitals and doctor care. I am one of those women that would have died in childbirth long ago before modern advances because my body does not do birthing prep (various details in which I won't go into...haha). So I am grateful for caesareans and the opportunity that procedure gives me to have children. I have researched, studied and conversed with many (docs, midwives, doulas, etc) and we've all reached the same conclusion for my "predicament". So here I am giving my shout out to hospitals and 'their help'...haha. But like I said, I do wish you the best of luck and can't wait to hear about it!

Melanie said...

I'm excited to hear about your story. Best of luck--stay positive.

And I'll look for the article. I do have the hard copy so I can scan it in if I can't find it.

Nicole said...

I hope it all goes well for you. I knew someone who did the birth bath and she absolutely loved it. I have a feeling you will feel the same way. I am more of a worrier about everything (I mean everything in LIFE).

Without a hospital, I think both of my babies would not be here, and me either probably. With Mary I was one of those eternal pushers and she had to be "helped" after a few hours. Bradley's placenta detached and we had to get him out before he suffocated - scary to think about now, but I was never worried at the time.

It will be fun to see your blog updated more once you have a little one - ha!

Scotty B said...

i'll be honest....I stopped reading about half way through your post (for some reason it doesn't hit me as close to home as it may for some others... :) ) but I've always respected your opinion and I wish you all the best....

Tim and Jennifer said...

Hey! I don't know if you remember me, I'm in the LV ward. Anyway, Ann-Marie told me I should check out your post. I loved it! Mainly because you were the first person to write about water births and mid-wives that I didn't label as "hippie" after a paragraph.
Good luck with your delivery! Babies are the best. I loved my hospital experience and am sad my dr. isn't here in San Antonio. It was the best part of my pregnancy! I hope you get the experience you want-- that's what every mother deserves, especially after 9 long months!

Jillian said...

Good for you Dani! Even though I'm not in the running as far as the whole birthing thing is concerned, I've watched some people very close to me go through the same thought process as you and Mel did. I'm definitely leaning in that direction too for when I have kids some day. Not something I've always planned on, but I definitely feeling it could be a good way to go.

Hope your birth goes (or went?... I guess you could have had your baby by now) well. If you're bored and want some more birth stories, there are bunch on my Mom's blog-- www dot graciousrain dot com--under the HypnoBirthing tab. Lots of good ones there.

Best wishes to you!