Jan 13 2009

Thoughts on natural childbirth

After getting through one semi-unmedicated birth at a hospital assisted by a midwife, I can totally see why people choose to have home births. I can also appreciate why some women opt for that epidural.

I made it through one birth without pain medication, but that doesn’t mean my next birth will be the same. Each birth is different, and we’re all better off to prepare ourselves for a variety of scenarios.

If you’re pregnant or would like to be some day, it’s a good idea to learn all you can about labor and delivery. If you know what to expect, you’ll be much more at peace with the whole thing. You’ll know what is normal and what is not.

Normal: Vomiting during active labor. Unpleasant, but your body is clearing itself out.

Abnormal: High blood pressure.

Shane and I wanted to have a natural, unmedicated childbirth. After researching birth and medications, I learned that certain interventions, such as using an epidural for pain, or Pitocin to speed along labor, could actually cause problems. The epidural might not work. In rare cases, it could cause damage to your spine or make you sick. The drugs have been shown to reach the baby, and you can see the difference in babies born with epidurals than ones born without. An epidural can lengthen your labor. It can make your pushes not as effective. It can cause distress in your baby. The epidural blocks the good hormones and chemicals your uterus is sending to your brain. After delivery, you might not be able to walk for awhile or use the bathroom on your own.

There was a point in my labor when I started talking about epidurals. I was in transition, which is intense. Asking for pain meds and wanting to give up are extremely common in this stage, which only lasts maybe 30 minutes. I didn’t really want an epi, but it certainly did hurt during the contractions! Because of our childbirth class, Shane and I knew how to get through this period.

In many cases, a woman who has an epidural might also receive Pitocin to increase her contractions, since the epi might slow her down. Pitocin is synthetic oxytocin. Your body also produces oxytocin, but the natural version has different effects than the Pit. These contractions are said to be stronger than natural ones, and can cause considerably more pain in a mom. In addition, the contractions can be too strong for your baby and can cause him distress. Long-term effects of this drug are not known.

First-time mothers who have these interventions are thought to be much more likely to have a last-minute c-section.

I knew that I absolutely didn’t want a c-section. It’s major surgery and recovering from it would be difficult. It can also cause problems down the road. But, I know there are times when c-sections are absolutely necessary, and if I was in that situation, I’d want one.

Ideally, I wanted to go into labor on my own and proceed without any intervention. I wanted to avoid c-sections and artificial complications. I also wanted my baby to be born without any drugs in his system. A dose of medicine for me, an adult, would be way too much for my little six-pounder. I didn’t want anything to get in the way of those natural hormones surging through our bodies during labor and in the time after. And, the thought of an epidural — a needle in my spine — terrified me. I didn’t want to lose the feeling in much of my body. I wanted to keep what control I could.

Shane and I prepared for our birth by taking Bradley childbirth classes, reading books, and practicing our relaxation techniques. Our class allowed us to talk about birth each week. We discussed aspects of it as a couple, and also with other expectant couples. Our trained instructor had a wealth of information to share.

We both learned about what we could expect and how to best prepare. Taking the class (ours was 10 weeks long, about 2.5 hours each meeting) was absolutely worth our time. True, we could have gotten through birth without the class. But, I think the knowledge gained made it much easier on both of us.

If you’ve read my lengthy birth story, you know that I didn’t have a totally unmedicated delivery. I had cervidil to augment my labor, and I also had an IV of magnesium sulfate to prevent seizures, as I had developed preeclampsia.

The whole preeclampsia thing makes me wary of ever having a home birth, personally.

In early labor at the hospital, I thought to myself, “I get why people want home births.” You avoid all the nurses taking blood samples from your arm, hooking you up to a (possibly unnecessary) hep lock, restricting your movement by hooking you up to fetal monitors, etc. You have to wear an uncomfortable hospital gown and do your thing in an unfamiliar environment.

I can see the appeal of being in your home, not being bothered by anyone.

However. My preeclampsia came on fast. It wasn’t confirmed until 1 a.m., and I had been in active labor since about 4 p.m. the day prior.

I can’t say for certain what would have happened if the preeclampsia went undetected, or if I didn’t have the magnesium sulfate. Maybe I would have seized. Maybe my baby would have gotten into trouble. Maybe nothing would have happened at all. My pre-e case was on the mild side, and my son was born 3.5 hours after the pre-e was discovered (delivery is the cure for pre-e), so there really is a good chance that nothing would have happened. We just can’t know, though.

I think the pre-e startled me enough to rule out any future home births. I hadn’t really considered going for it, though I hadn’t ruled it out. Now, I’m ruling it out. In the future, I want to continue to deliver at a hospital so that I can have immediate access to potentially life-saving medications. And, I can have a rapid c-section if it becomes critical. But, I do want to keep under the care of a midwife, as I had this time. I appreciate the midwifery model of care, and I know midwives are more likely to let me do things naturally.

If you’re pregnant, please prepare yourself for your delivery. Read all you can (I like the Thinking Woman’s Guide to a Better Birth, Ina May’s Guide to Childbirth, Natural Childbirth the Bradley Way, and Husband-Coached Childbirth). Scour the internet. Read birth stories. Talk to your friends. Take a childbirth class. The Bradley method is all about doing things naturally, understanding what’s going on, relaxing through the pain to let your body work, and having your husband coach you all the way through. I like it, but it might not be for everyone. Find a way to prepare that will work for you and your husband.

Just know that if you don’t actively prepare for your birth and just show up at the hospital in labor thinking, “Maybe I’ll try it without pain meds,” you’ll probably fail. Sorry. If you (and your partner!!) don’t understand what will happen and what various interventions can do, you just might be taking on more than you can handle. Maybe.

And if you know yourself and know that your pain tolerence isn’t high and you hope to have an epidural (after understanding all the benefits and risks, of course), you have to realize that hey, there is a chance that it won’t work. Maybe half of your body will be numb, but not the other side. Maybe it’ll give you a horrible spinal headache. Maybe you won’t have enough time to get one. Maybe the anesthesiologist will be MIA. It would be a reasonable idea to at least prepare for the possibility that you won’t have access to pain relief.

If you do get an epidural or some other form of meds, do not feel like a failure. Don’t let anyone make you feel bad. Your circumstances will be different from anyone else’s, and any of your previous births, likely. Your family and friends cannot understand the level of pain you’re experiencing. Maybe you’re having an exceptionally long labor, and you’re simply too exhausted to keep going. Getting an epidural to allow you some time to rest could be a great thing! Or maybe, your labor is extra short (which means it’s really intense!) and your pain is simply too much to handle. Maybe your baby is facing your front and causing you excruciating back labor.

You can’t know what will happen beforehand. Prepare for all possibilities (even a c-section), and you can’t go wrong.

After getting through one mostly natural birth, I can definitely say that it was worth it. I felt amazing immediately afterwards. My baby was alert from the get-go. My recovery was undoubtedly easier. The recovery nurses, our pediatrician, and even our midwife were impressed with how we all looked in the hours and days that followed. After achieving that, I felt as if I could do anything!

Posted under Preggo | 7 Comments »

7 Responses to “Thoughts on natural childbirth”

  1. I would highly recommend Dr. Sears’ The Birth Book to anyone, but especially if you are considering unmedicated.

    I am one who wanted to go natural, but did have an extremely long labor and I was worried that I would not have the strength to push if I didn’t rest some. I got an epi at 7 cm. I do think it slowed my labor down. They did give me pitocin (without even telling me), which I found aggravating and I might have resisted if they had told me what they were doing.

    I think taking control of your labor and making your own decisions in the most important thing in having a fulfilling birth experience, no matter what those decisions are.


    Vanderbilt Wifes last blog post..Souvenirs

  2. Congrats on your new baby! Your birth story was fun to read! I have three babies…first one was delivered vaginally, though I did have an epidural. I, too, developed pre-e…also VERY quickly…I was not in labor in any way, had a later dr appt (5is) and was being induced by 7pm! I also started to get another problem called HELPP syndrome, which is scarier than pre-e. Anyway, I was on the mag-sulf as well – ick! And didn’t really have a choice about the epi, since my body was under so much stress. My second two babies were both c-sec. Baby 2 was footling breach and she was not coming out naturally! :) Baby 3 was less then 2 years after #2, and it was no recommended to try a v-bac due to the possibility of my uterus not being fully healed from the previous birth.

    Anyway…one thing you should check in to regarding pre-e is that in a lot of cases, it doesn’t re-occur in later pregnancies! I didn’t have any symptoms with my later two pregnancies.


  3. A midwife can tell if you’re pre-eclamptic and get you to the hospital in plenty of time.

  4. Interesting thoughts. Taking the classes and reading up on natural childbirth really helped me.
    It surprised me how nervous I felt at home laboring and then how at ease I was at the hospital. I’m not sure if I would want a homebirth after that but a birthing center is a definite option. I was also surprised how effective the shower was for me, I would love to have the option of a tub next time.
    Good post!!

    Stacys last blog post..The Birth Story of Liberty Ann

  5. Your very right about the epidural. With my first child, I gave up trying to go without. As soon as the epidural was in place both my daughter and I’s heart rates dropped and did not come back. We were put in for an emergency c-section. Recovering was not easy the first time. With our second daughter, we had to have a scheduled c-section and had one even though we were 3 weeks early. Ever since my second c-section and epidural I have had problems with my spine since. However recovery the second time was easier, probably because I knew what to expect.

    If I could go back and change things, I would of never opted for the epidural with our first delivery, a lot of the problems I have now probably wouldn’t exist. If only I knew then what I know now.

  6. We are going with a home birth this time, because, for us, it’s a day and night difference. The hospital sucks here. They don’t employ midwives at all, and actually speak out against them quite rudely. As I was reading through your birth story, I couldn’t help thinking how wonderful your birth team was, because at the hospital here you would’ve had a c-section sooo fast. There is one doctor in particular who plays on women’s insecurities and talks many of them into c-sections just because “your baby will be too big for you to push out” or some junk like that. The sad thing? That OB is a woman and a mom. You never know who will be on call when you go into labor, and if she’d been on call the night I had my daughter there is no doubt in my mind I would’ve been sectioned. So nope, I can’t go there.

    I am about to leave for an appointment with my midwives, and I am going to ask them about the pre-eclampsia. I know they keep a check on the baby with a doppler (which is waterproof if you’re in a tub), and I guess they would take your blood pressure too if they suspected anything. One of the most interesting birth stories I’ve heard was of a woman who went to a birth center and started seizing, and then was taken to the hospital and had a C-section and a healthy baby.

    But I can totally understand why you would go back to the hospital, having had such a great team. If the OB’s here were like that, I would too.

    Jennys last blog post..Now that’s what I call a responsible dog owner

  7. I had four unmedicated, midwife-attended births! And my boys weighed 9 pounds and 9.11 pounds, respectively. I wouldn’t have had it any other way.

    Congratulations! It’s a BIG accomplishment and one you should be very proud of—for you and your baby! I, too, considered an epidural every single time but am so glad that I was able to get through without one.

    Good for you–for having a plan and sticking to it! Enjoy that sweet baby!

    Jens last blog post..Make Wise Choices……..

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