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 »
Dec 18 2008

One problem solved by drinking

Remember how my amniotic fluid was low on Monday? Well, I had another ultrasound this morning. A 7:45 a.m. appointment. How nice.

Anyway, my fluid is up to 9.4 whatever units which is awesome. I had suspected that I was dehydrated on Monday, and that can sometimes cause fluid levels to be lower. I’ve been drinking even more water lately and woke up at 6 a.m. to get plenty of fluids in me before my appointment. I think this definitely helped. If there truly was a problem, I wouldn’t have been able to drink my way out of it.

Everything else on the ultrasound looked good. Baby has been practicing his breathing muscles, which we’ve been able to observe on the past two ultrasounds. He’s getting ready!

My fundal height has decreased to 31 cm. Whaaaat? How bizarre is this? It should be 38 cm now (+ or – 2). It’s possible that it has decreased from the 33 whatever it was on Monday because maybe the baby has moved even lower down. Or maybe his position has shifted slightly and that’s affecting the count. The same midwife has measured me the past few times, so who knows what’s going on?

All I know is, fundal height is not an exact science. Since we know that the baby is in fact measuring just fine and that there is plenty of fluid, we can only assume that my guts have been smooshed into oblivion.

Posted under Preggo | 3 Comments »
Dec 16 2008

38 weeks

How in the world did I get to be 38 weeks pregnant already? This last trimester has flown by. I’m still feeling good and I’m still not in any hurry to meet my baby. Shane is starting to get a little antsy though. He’s so excited and just wants to rock him all day long. :) Won’t be tooo much longer. Four weeks, tops.

I had my last meeting with our Bradley childbirth teacher. She’s been absolutely fabulous. I had a one-on-one meeting since I missed a class. Shane couldn’t come — he was at work.

We talked about delivery complications, including inductions and c-sections.

She made me feel more at ease about circumstances that would warrant an induction or c-section. I really don’t want either, but if I have one or the other, I want to be absolutely certain that it was the right decision to make. I do trust in my midwives to help us make those decisions if necessary.

From the moment I found out I was pregnant, I’ve been praying for the baby’s health and for God to give me what I needed so I could have a healthy delivery and also be a good parent. I’m praying for peace during the birth — that Shane and I are at peace with whatever happens and that we feel God’s presence. I’m also going to pray for my midwives and nurses, for them to have clarity of mind. Oh, and traffic. I’m praying for good traffic and road conditions for the ride to the hospital :).

I feel totally at ease about giving birth. And, I’m going to do my absolute best in giving my baby the gift of being born without medical interference. I’ll write more about my thoughts on unmedicated deliveries once he’s born. I know it’s a controversial topic, and I don’t want to debate it or talk about birthing drugs right now. *Thinking happy labor thoughts*

Here’s what’s happening according to BabyCenter:

Your baby has really plumped up. He weighs about 6.8 pounds and he’s over 19 1/2 inches long (like a leek). He has a firm grasp, which you’ll soon be able to test when you hold his hand for the first time! His organs have matured and are ready for life outside the womb.

Wondering what color your baby’s eyes will be? You may not be able to tell right away. If he’s born with brown eyes, they’ll likely stay brown. If he’s born with steel gray or dark blue eyes, they may stay gray or blue or turn green, hazel, or brown by the time he’s 9 months old. That’s because a child’s irises (the colored part of the eye) may gain more pigment in the months after he’s born, but they usually won’t get “lighter” or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

See what your baby looks like this week.

Posted under Preggo | 2 Comments »
Dec 15 2008

Appointment update

EVERYBODY PANIC!!! The pregnant lady’s belly isn’t as big as other bellies! Oh noes!

Good gravy, here we go again.

At my appointment last week, I was measuring small. 33 cm at 37 weeks. I guess the ballpark figure I should have been at was somewhere around 35 to 39 cm. So, I had yet another ultrasound today (my 5th one!) so they could measure the baby’s size.

Just as I had suspected, my baby is totally fine. He’s measuring right on target and is in the 46th percentile for size. The 50th percentile is right smack in the middle, so I guess you could say he’s barely on the smaller end of that spectrum, but whatever! He’s fine.

The ultrasound tech was amazed at how he was taking up every last bit of available space. She couldn’t see my right ovary (and I definitely have one) because he smooshed it clear out of the way. Where? Idk. I hope it finds its way back.

The midwife (the same one who ordered my first growth ultrasound back at 28 or 29 weeks) consulted with one of the doctors in the practice just to confirm that my results were fine. I guess she’s just trying to be safe. The doc wanted to know how I looked.

“Very tall and slim,” the midwife said.

“Well, there ya go,” said the OB. “More room for the baby to hide.”

Only what I’ve been saying all along. Also, the baby’s head has dropped pretty low, so obviously that’s going to make me measure a tad smaller.

I had an internal exam and there’s nothing really interesting going on. That’s ok with me. I also had a non-stress test, where they hook you up to the monitors for 20 minutes and keep track of the baby’s movements and any contractions that might be going on. He had hiccups and was making quite a racket! The results of the test were good.

One super minor thing: My amniotic fluid was on the low side. Not low enough to be a problem, but on the lower end of the “good” spectrum. I’m thinking it was just because I was a bit dehydrated, what with the early appointment and not having much to drink this morning and all. So, “just to be safe,” I have my 6th ultrasound on Thursday to check my fluids again. I’ll drink lotsa water beforehand and show them that, hey, whaddya know? Things are fine!

I guess I should be thankful that the midwives just want to make sure everything is ok. And yeah, it is better to be safe than sorry. But good grief, I am so tired of all of these appointments and tests. Thankfully, I don’t have too many more to go!

Posted under Preggo | 2 Comments »
Dec 10 2008

37 week belly pic

I whipped out my camera and took a picture of me and my 37w1d belly. Definitely bigger than I was the last time I took my picture at 34 weeks!

Posted under Preggo | 2 Comments »