Thursday, December 22, 2011

So this is not at all Christmas-y but it's been on my mind. Talkin' bout birthin' bebbies.

Ok let me start by saying I have no personal experience in this area...yet. But then again, many OB/GYNs don't have any personal experience in it either, and they are still trusted and respected.

So hear me out (if you want)...

FYI many of you may think this is coming out of left field, but one of my "hidden talents" is that I took the course to become a doula, but never finished my certification. I only attended one birth and three are required. I was in nursing school at the time and pretty busy, and I'm terrible at marketing, so I just let it go. But I've been fascinated with pregnancy and birth practically my whole life. My high school research paper was on Midwifery. I entered nursing school with the intention of becoming a Certified Nurse-Midwife (but decided the time commitment and crazy schedule and great responsibility was too much). I did a research paper for my bachelor's on Kangaroo Care in the NICU. About half of my nursing career was working with mothers and babies, although in pre-delivery and recovery, not labor and delivery. Anyway, let's just say I do have more than an average knowledge.

I'm certainly at the age where a lot of my friends are having children. And I mean A LOT! Or so it feels. And I've been silently (mostly) troubled by how some of their births have turned out. By births in America in general really. And no, I do not know all the details of every situation. But I am informed on statistics and reports of the INSANE C-section rate in our country and the complete breakdown of natural birth. It's really sad to me that women are not more informed about birth. I can understand that most of us think what our doctors tell is what is best. And I think most of them are doing what they think is best. I think the problem is that they themselves have been misinformed in their training, and they are all worried about being sued. And rightfully so in this highly litigious society we dwell in.

But let me tell you, just because you are told a c-section is the safest route, does not mean it is not without risks. Lest we forget, it is major abdominal surgery. Yes, it is more controlled (if planned and not done emergently) than natural birth and much more predictable. That alone is enough to make some women choose it. But, is that how birth is really meant to be? Are we really meant to circumvent the natural process in this area? Birth is not a sickness. It is not a disease that needs treatment.

I wish that more women could trust in the ability of their own bodies to function as God intended. I am more than aware there are circumstances where natural birth would truly be unsafe. Such as a placenta covering the cervix, an active STD, a congenital defect that could be traumatized during birth, multiples (although natural birth with twins can be safe), a severely pre-term infant, need for emergent delivery to save the life of baby or mother. But most of the c-sections in my circle have not been for these reasons. They've been more like:
"I'm overdue, the baby is too big, the baby is breech (who tries for a version anymore these days?), I was not dilating, I had a c-section before."
Or in medical terms "Post dates, Cephalo-Pelvic Disproportion (CPD), breech, failure to progress, repeat C/S."

Let me tell you that for each of these reasons there's a plethora of research on why they do not necessarily require a c-section. Unfortunately in our "fast-food" society, we want what we want and we want it now! Doctors should inform their patients that a "due date" is actually an EDD (estimated delivery date). Your baby is not aware they should arrive within a certain 24-hr period. Most midwives agree that going 2 weeks past your due date, as long as your checkups are good, is perfectly acceptable.

On CPD- research has shown that all measurements and markers used to determine head circumference to pelvic outlet size are grossly inaccurate. This is because our bodies stretch, conform and move in ways we never thought possible when giving birth! Ladies, if you've been told your baby is likely "too big", especially if it's your first, please, at least try! I've seen and heard of very tiny women successfully giving birth to very large babies.

On breech- Most women have a c-section for this and it most cases that is perfectly acceptable. However, if you and your doctor are willing and your pregnancy is healthy- they can actually attempt to "turn" the baby from the outside, called a version. This is usually done in the hospital and labor may be induced directly after to ensure the baby doesn't turn back before it can be born.

On failure to progress- many times it is not a failure rather than an impatience. TV births (which I love to watch) make us think that birth happens in 2 hours and pushing lasts 5 minutes. This is SO not the case for most women, especially if it's your first baby! But hospitals often have time limits for births, especially if your water has broken. Especially if your doctor is missing his golf game. Especially if he/she would rather deliver you at 3pm then 3am. Oops, did I just say that? I know not all doctors think this way, but I've heard reports of those who surely do.
And let's face it, birth is hard! No woman wants to think that laboring for 24 hours or more could be normal! But I urge you to trust in the time-honored process. To at least give your body and your baby the chance!

Repeat C/S- Did you know that now even the American Congress of Obstetricians and Gynecologists (ACOG) now agrees that vaginal birth after cesarean (VBAC) is safe for women with one or even two previous c-sections with a low horizontal scar? See here. The reason for most surgeons doing a repeat c-section was the risk of uterine rupture, a life threatening emergency situation. The risk of this is between 0.5-0.9%. Well, that's about the same risk rate of life-threatening complications for mother or baby in a c-section.

Ok so I understand that I probably sound like some birth-Nazi. But what I really want is for women to inform themselves. To make an educated decision beyond "My doctor said". To explore options. To renew their faith in the ability of our bodies to function as God designed.

And let me tell you that personally, I am considering a home birth, when the day comes. The problem is getting insurance to pay for it, and deciding if the very minor risk of  major complications (should my pregnancy be healthy) is a reason to be in the hospital for birth.

There's probably more to come on this later, but I realize I've made this post insanely long as it is.

I welcome your comments and questions. Even disagreements :)

11 comments:

  1. Very interesting and informative from an educated nurse's perspective. I suspected a lot of what you said. My first was posterior, but I eventually delivered her... My twins, Baby B (a/k/a Jacob) was breech, but I delivered both of them, w/in 15 minutes of each other (that seems to validate what you are saying!?)

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  2. Cori has much to say about educating yourself as a prospective mother. When she was interviewing doctors and midwives prior to her first birth (she was 38), one midwife told her right up front that she would be considered an "at risk" pregnancy & most likely a candidate for a c-section. Made Cori mad! She LOVES the midwife who delivers her babies. She also did Bradley classes & did TONS of independent research and studying. :-)

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  3. Cori has much to say about educating yourself as a prospective mother. When she was interviewing doctors and midwives prior to her first birth (she was 38), one midwife told her right up front that she would be considered an "at risk" pregnancy & most likely a candidate for a c-section. Made Cori mad! She LOVES the midwife who delivers her babies. She also did Bradley classes & did TONS of independent research and studying. :-)

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  4. I have done lots of reading and research on the subject of birthin' babies (even though I have no experience) and there are several several mandates I will have when I get pregnant. I also know that I am not going to be using my current ob/gyn as she induces 99% of her mommies and than tons of them end up with c-sections. Not going to be me.

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  5. I always told you to get your CNM so you could deliver all the Jones grandbabies!!!! You woudl make a totally awesome midwife ...I thought so when you were only a highschooler and I still do! :) and totally agree here and actually am a little more "left field" than even you are when it comes to Csecs...they are not safe at all and carry so many long term risks for the mother and baby that they should only be used if every other measure has been taken...including some measures that even local midwifes won't use. You see I grew up where midwifery was rebirthed in America...the hills of TN. Ina Mae Gaskin is the mother of our midwifery today and blazed the trail for it to come back...I do not recommend reading modern books on people's experiences in general but this book fully prepared me as a mother to fight for my freedom of natural birthing. your greatest foe is FEAR and secondly the hospital staff (regardless if you have a certified nurse midwife.) Next is YOUR HUSBAND! yes, really....if he is not on board with you 110% then you have already lost the battle against a csec b/c if he caves, you will cave when the pressure is on and you are exhausted.

    This week someone I know just had her baby ...first sign she was headed towards a Csec was her complaining on facebook and wanting that baby out ASAP. Second was having a baby induced....thirdly, 90% of first time deliveries go to the hospital way too early and thus end up with Csecs b/c they are there "too long." and yes, she had a csection after a 29 hour labor...HELLO!!! for a first baby that isn't unusual and these first time mamas need to learn to spend 80-90% of their labor AT HOME! And it's called "labor" for a reason...after all the hours of contractions (my first was 24 hours) then I spent more than two hours of Bradley-Lamaze pushing, and I got her out!!! If your baby doesn't crack open the egg and fight it's way out, it will be sickly and weak and YOU and IT will pay for it...Csections are like helping a baby chick hatch aritifically. Human babies need the entire birth experience to be healthy and strong.

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  6. I loved the Bradley classes we went through and am grateful to the doula who taught them...sadly though, all the way through the course the HUSBANDS kept giving excuses for why they wanted hospital births (most were military guys...wusses!?!) My husband told me that they were gonna cave in and get epidurals and have csecs...and he was right!!! In the end, Brian and I were the only couple to have a natural birth of all the couples in our class. Just watching birthing movies and shows will not prepare you...you must be educated to rebuff the crap (parden my French but that is what is is!?!) that medical professionals ...including some midwives will try to shove at you as truth.


    Another important point is to interview midwives; don't just pick one b/c they are popular with your friends...YOU have to agree with her and "click." And don't rely on them to remember to tell you everything you need to know and do. Do your research and read and ask questions. They are like preachers who preach multiple services every Sunday morning...they say the same things over and over so much, they forget when and to whom they last told something and might forget some important points to tell you. My favorite book to pace me through my pregnancies and remind me of herbs and supplements and foods to take and eat is " Pregnancy the Natural Way" by Zita West. I think it's out of print but you can buy used copies online at Amazon.com. My first interview was shocking (like Mary Beth mentioned)....and I moved on quickly to find another even if it meant to travel; thankfully I didn't have to. :)

    Another thing I HIGLY recommend is taking several Natural Parenting classes at Evermans (WITH YOUR HUSBAND!). And don't wait until your prego and sick and miserable. If you plan on having babies, start your education and indoctrination now along with your honey. Erin Hinds is a Bradley instructor and has the resources to pull in professionals regarding baby wearing, pediatric chiropractic, vaccinations, birthing options, and much more. It is worth the $10 every class and each are different!

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  7. I cannot tell you how many thousands of hours my husband and I read and educated ourselves before we had our first. In fact, my husband could actually deliver babies at this point! The only reason we don't is that the midwife who would do it has let her certification go and has no doctor backups in town. So if anything did go wrong, she backs out and leaves you on your own subject to the worst of all: Emergency Room Csection!?! No one wants one of them, because they are the most unprofessional and unsafe deliveries you can possibly have...because Edoctors are not professional OBGyn's and only perform a few a year and those are done poorly and leave the mother suffering side effects for years and in some cases unable to carry a baby without medical intervention in future pregnancies.

    And water birthing...hahahaha! I saw all those youtube movies and videos and wanted it b/c I love to swim. So every time I get into the tub, my contractions SLOW DOWN...which is NOT what you want to happen at all!?! Afterwards I studied it further and that IS what happens...and if you have the time for a 30+ hour delivery then float away!?! I certainly do not want to be having a baby for three days! LOL

    If I seem intense about my comments, I am. Before I had my first, it was all idealism; but reality will bring out the best or worst in you. You WILL capitulate if you are not educated almost as much as the nurse or midwife herself b/c of fear, lack of support and medical pressures. My journey in motherhood began nearly three years ago and I am happy to say that I am learning to be that MAMA TIGER and if need be FIGHT for my rights to protect my babies and my own health. :)

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  8. forget insurance, Hon! Don't ever let funds or money be the measure of what is right and wrong for you. Think of it this way, you are investing the the most important TREASURES of your life...you will be old and gray before someone finally gets insurance to pay for a home birth!?! Well, unless you are a movie star...and even then, I think they have paid out of pocket most of the time. :P We live on very minimal income because of being in the ministry and my being a WAHM and GOD HAS PROVIDED for every child and we paid out of pocket cash for each of them. God is prolife and will pay for your babies...you might have to cut living expenses drastically and eat in every night and drive one car, but it will be worth it all!!! :)

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  9. there are a lot of ways to turn a baby from breech by the way...the book I listed above lists many ways and in most cases inversions do work nicely however, the downside is that they do require epidurals which have a lot of risks in themselves. I have a number of friends who had them and ended up with epidurals when delivery time came b/c they were so exhausted and in pain from the inversion...but it is STILL worth doing to avoid a Csection. I had a late turner my last baby and discussed in full detail with my midwife possible options.

    First is certain yoga poses and pelvic rocks on a birthing/yoga ball. Which by the way is the one most valuable piece of pre-delivery help that I invested in!!! I do 80% of my prelabor on this thing at my HOME! This includes the pelvic tilt: sleep or lay on an inversion board...an ironing board works if you are low on extra funds.

    Secondly...increasing your water intake thus the amniotic fluid making the baby easier to turn on it's own.

    Thirdly...massage. there are techniques and certain oils to use that help "convince" a baby to cooperate with the direction of your hubby's gentle massaging of your tummy.

    Next to last...and this seems weird, but acupuncture works for many breech babies. I have researched it and it is not demonic, but a natural medical practice used by many people prior to our modern medicine procedures.

    Inversion was my last option b/c of the side effects of epidurals. Do your research on these...epidurals can be deadly. Someone I went to college with recently died giving birth to her fifth baby b/c the epidural was given too high and it put her in cardiac arrest. They couldn't save her...a close friend who had an inversion for her first baby, said after that epidural she felt like she had delivered a baby she was so exhausted and caved into a second epidural when the baby came; her recovery took months.

    Don't want to end on a negative note; but I do understand the intensity of your feelings, Sarah. And to some you may sound like a birth "Nazi" LOL but in reality we need professionals just like you who crossover to embrace what was meant to be a natural life process! I loved your "insanely long blog!" :)

    Just one word of caution when it comes to a first baby aka home birth. And I noticed there are few who have commented on your blog. :) Most mothers gradually work towards that birth and have it after they have had their first in a hospital. Your first labor is very long typically and after that they get shorter and shorter with subsequent babies. If you do not have a midwife who has a connection with a local hospital and/or doctor, it is not advisable to gamble with a possible emergency room delivery. The first midwife I interviewed, I discovered that 25% of her babies end up in the emergency room and she does not accompany the mother. Furthermore, she did not refund your money if she didn't deliver the baby either. And if one's hubby is not over 100% on board with you, it's best to compromise a wee bit the first time around to convince him that natural is best and use a midwife in a birthing center or hospital. All the couples I know that have had homebirths including my mother, it was NOT their first baby. :) There is something to being under your husband's authority and protection. And if he is even a little afraid, then you don't have the necessary support you need or the spiritual right to demand a home birth even though you are desperately wanting it.

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  10. Sarah, thank you for writing this post. I've had two daughters, both via C-section. It was not my intent, though. I had planned with my doctor my birthing wishes and she was totally on board. She knew of my intense desire to give birth naturally--no drugs, no C-sec. etc. However, being almost two weeks over due and having gestational diabetes, and knowing that we were having a big baby, when the time came, I had to go with what was the safest for me and baby. Baby's heart rate was dropping and I was not progressing after several hours of my water breaking. An emergency C-sec resulted, and I was thankful to have a healthy baby girl. It didn't happen the way I planned, but God was with me and baby and everything turned out great. I had my fair share of nay-sayers up here that said this and that about what I could've done differently, but I do trust my doctor and I am blessed to have a good relationship with her and all of the staff I've had the privilege of working with. Suffice it to say, after all the doubters got to me after the baby was born, I did question my doctor to make sure that the C-section was indeed the best plan of action. We went over every little detail, even some that I didn't know were happening at the time, and I am convinced that she made the right decision to insure my well-being and the baby's health. I chose a second c-section. I guess I could've gone with a VBAC, but I read the consent forms for that and researched so that I was informed, but again, for me, I feel that a scheduled C-sec was the best choice. I would've had to have gone three hours away to a much larger city, with a dr. I didn't know delivering, and without my baby girl and hubby being there if I would've had a VBAC. I liked having hubby there, with baby girl to see the new baby sister, my dr.. doing the surgery, and being able to go home three days later. There are pros and cons to everything. You are right. Be informed. Write your birthing wishes. Do everything you can to have a natural birth. And then put it in God's hands. And if you have a natural birth, great. If you don't, that's ok too. You are still a Mommy either way and one doesn't make you a better or worse mother because of how you gave birth. And don't let anyone tell you otherwise. I had to learn that lesson myself. People can be cruel and hurtful when they disagree with something you do that doesn't line up with their ideas. I had to remember, they weren't there in the hospital room with me and they had no idea what I went through prior to the emergency C-sec. Anyway, for what it's worth, those are my thoughts. I've been blessed with two amazing little girls and I thank God everyday that they are healthy and that I can have more children, should He bless us again.

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  11. Sarah, I was thinkin'.....some women get so hung up on how the baby is born and don't really give much thought to how they raise the child afterwards. I think instead of the "natural" vs. C-section debate, there are any myriad of other things mommy can argue over. Say, for example, working moms vs. SAHM. Do you really want someone else or a daycare raising your child? That's a big one. I can say I am THANKFUL that I can stay home and that Aaron wants me to be home with our girls. Other women, some choosing and some with no other choice, have to utilize daycare. I think we should all just get along. Another topic of debate is breastfeeding. For some people it works great, for others, not so much, for whatever their reasons. But should mommies really judge each other over the subject? I never thought I would like breastfeeding prior to getting pregnant, but here I am, two kids later, having nursed both of them to well after a year. And some mommies like the "green"ness of cloth diapers while others like the convenience of disposables. Another hot topic is sleeping arrangements....to co-sleep or not to co-sleep. So you see, there is a LOT of things out there for people, especially women, to be argumentative about when it comes to having a baby. Bottom line? You and your husband pray about how to best raise the child God gives you and don't worry about everybody else's comments and opinions. God will give you wisdom on how to birth and take care of your baby. There, I'm glad to get that off my chest. Now I can get down off my soapbox and go referee my children! :)

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