Childbirth Choices

(This is mostly a rant.)

"Women have a right to give birth how they choose, without drugs if they don't want them, without a cesarean section if it's not necessary, and, if it's safe, in their own homes. "

I have a friend who is 41 weeks, 3 days pregnant with her first baby.

I am going to lay a nickel down the on the table right now and bet she's going to have a c-section. (Raise eyebrow).

I can smell it.

They decided to induce her day before yesterday, 24 hours of pitocin and she dilated to a 1. They wanted to continue to intervene, but they also gave her the option of going home, which she decided to take, and is now back at the hospital again I think.

I have been spending WAY too much time on the "Unassisted Childbirth" messageboards on IVillage the last 6 months or so, and the year or two before that, reading stories on the "Negative Birth Experiences Board."

It's turning me into a hippie.

What I get out of all of the information I have gathered, through scholarly articles, midwives, nurses, moms, homebirth advocates, etc., is that the hospital community is sort of working on a deadline with each laboring woman in the hospital. You sort of have only so much time to produce the "goods" (ie, the child) before they are going to start intervening. After a couple of hours of sloooow dilation, you're going to get shot up with pitocin. Everybody gets pitocin.

My question is... WHY?

It speeds things up.

Ok... so WHY do we need to do that?

Unless there is some sort of legitimate medical necessitation to speed up the labor (which I am not seeing), a typical labor where a woman begins on her own, should probably, mostly, maybe, not really need pitocin administered during labor.

Pitocin causes harder contractions, more contractions, and contractions that last looooonger than natural contractions. All of this speeds labor up. But it also makes labor MUCH more uncomfortable for mom. There is no natural progression in pain. It is one minute of my body doing it's thing, and the next of OWWW! Granted, its totally effective. But what's the point, really? (Generally speaking, of course.) Because all that pitocin does, the residual affects should be considered too... The baby is being squeezed, longer, harder and more frequently due to the pitocin than it would in a pit-free labor. This can cause fetal distress. This can cause fetal heart decelerations. In turn, this can make a normal labor go from "normal" to "emergency c-section" with virtually no effort at all. Why would we want to do that?

And c-sections. Now, even before I got on this whole "natural birth" kick (which is really more like a piqued interest because I will likely still have my babies in hospitals, with doctors, and probably drugs), I had these bad feelings about c-sections and how people got talked into them. Another friend had her daughter 3.5 years ago. First baby. She had a c-section. The doctors freaked her out by telling her the cord was wrapped around the baby's neck. I forget what else was going on, but I remember listening to everything over the phone and going... wait a minute... that doesn't sound right... I don't recall the overall circumstances, but I do recall feeling very uneasy about the decisions that were made. Luckily, all is well.

Remember THIS: A fetus, a baby in utero is not breathing. They do not breathe. Their lungs are not pushing air in and out. The oxygen is being delivered through the umbilical cord. A cord around the neck is many cases (not ALL, of course) is comparable to wearing a scarf. The most important piece of information about umbilical cords is whether the flow of blood and oxygen is being disrupted. A prolapsed cord, where the cord falls out of the uterus before the baby, and the baby then pinches the cord as it tries to exit the body- well every second you're in that position is another second your baby is suffocating. That would be VERY BAD. Anything that involves a pinched, torn, knotted, etc. cord is very very bad. But the simple fact of the cord being around the neck is not necessarily a cause for concern. It CAN be, don't get me wrong, it CAN be a serious cause for concern, but it is NOT an automatic conclusion. It's not an instant, no questions asked cause for a c-section either.

What really is the need for medical intervention during a regular labor with no red flags? Why do I need an IV? Why can't I wear a bra and my own underwear? Why on earth am I giving birth laying on a table with my legs in the air instead of working with gravity and being upright? Why do you want to rush my labor along with pitocin for the simple fact I'm not dilating particularly fast?

I love doctors. I am so grateful for doctors. I don't really think I'm interested in having a midwife when my turn comes. It's a little too hippie for me. I think I'd actually feel more comfortable in a hospital, than sitting in my bathtub and moaning, personally. HOWEVER... all of this has been very enlightening in the fact that "Women have the right to give birth how they choose" is a revolutionary concept to me. I have never before thought about the loss of control you experience when you enter a hospital, particularly in a birth setting. The hospital has a specific protocol as to how everything is done and they just do it, like a well oiled machine.

But I don't like that. I'm not comfortable with that and I don't want to do that.

There are SO many preparations for "what if's" in the hospital. Let's give you an IV just in case we need to give you medication. Let's have you remove all of your undergarments just in case we need to do an emergency c-section so it doesn't have to be cut off and so there is no additional presence of bacteria. Let's do a cath just in case... blah blah blah.

If and/or when I have a child... I am going to be wearing a bra in that hospital gown. I can't stand not wearing one, and going through something so intense and having to have the additional experience of having my sweaty skin touching more sweaty skin... UGH. I will wear my bra. I will wear some comfy, giant underwear that doesn't get in the way of exams. (Bang fist on table!) I will refuse to remove them. REFUSE! I also don't want an IV. Or constant fetal monitoring. I'm also NOT going to be induced unless there are health risks- like meconium- just because I am overdue. Just let me do my thing. It's my choice isn't it... Isn't it the doctor's job to educate the patient on their options, pointing them in the right direction but ultimately leaving non-life threatening decisions up to the patient?

I do not like submitting unquestioningly to authority and have no idea what's going on. That sounds scary to me. I am very much a blind-trust person... but after all of this... when it comes to childbirth, I think I am WAY too wary of the medical communities thoughts on "normal" and am not comfortable with their definition.

The c-section rate in the United States is around 30%. I believe it is around 2% in other developed nations. We also have one of the highest fetal mortality rates. Why is that?
For the record... I am political conservative, as tree-huggerish as this posts sounds. I am very annoyed by some comments made on said laboring friend's Facebook page which are incredibly ignorant and pretty much attacking anyone telling my friend to be cautious in her decisions. it is extremely frustrating. The best weapon you have, in any circumstance is always knowledge and education. So educate yourself.

This movie is VERY left-wing, conspiracy theory centered, very hippish, etc., but it is also very interesting, and although I can challenge many things said in this film, I also think it's enlightening and enjoyable. Be aware that there is a significant amount of female nudity because the film shows actual laboring women and actual births. (That's certainly not the WHOLE film, not by any means, but there's no way you could miss it, so I didn't want you to not know. So don't click if that's an issue.)

I came up with a link to a free copy of the movie online. Scroll down to the little movie screen, and at the bottom of the advertisement it will say "Click to Play" click that, and then on the lower right hand side of the screen you will be able to expand the video to full screen. it's around an hour and 20 minutes long and compares hospital births vs home births, discuss the history of birth in the 20th century and interviews alot of health professionals in the OB/GYN community as well as the Midwifery community. It was done by Rikki Lake... she's very into the whole touchy feely birth "experience" which I am not into, it hurts, let's get it over with already... but the documentary is still interesting, informative and I highly recommend watching it!

It's called, "The Business of Being Born."
http://www.zshare.net/video/62983863bf35922e/