A midwife and "Birthing From Within" mentor, I am passionate about informed decision making and helping moms and partners birth in awareness. My blog chronicles my journey from cesarean to vaginal birth after cesarean and my quest for information to help families have EMPOWERING births.
Last week I received an email from a mom that attended my prenatal yoga class, her baby boy had arrived, born without drugs, just a lot of breathing and pushing.
To tell the truth I had been waiting for this email. His mom and I spent a lot of time together preparing for the birth. The mom practiced yoga and breathing exercises faithfully throughout her pregnancy, often watched with half amusement, half apprehension, by her two children. She had had an epidural for her first two pregnancies (though they didn't do much good she had exclaimed!) and was about fifty fifty split on whether or not she would have a third epidural. I was very curious on how things would turn out.
"It's a boy!" she wrote. "No drugs, just lots of breathing and pushing. All the yoga and exercises made a huge difference, but I think the one thing that you said a few times more in passing was how much birth actually hurts. It somehow made it better knowing it was supposed to hurt. (I realize that may sound dumb, but I think it gets glossed over a lot)."
Her email got me thinking. I remember the one thing that really surprised me with my first birth was the pain. It was over the top, and encouraged me to go to the hospital sooner rather than later. And later, the prospect of being saved from the pain certainly crossed my mind as a benefit to the cesarean. Growing up my mom always talked about labor as something that was pretty easy. The story went something along the lines of we were out to dinner, it was our wedding anniversary, we had some champagne, we went home, your dad made tea, we went to the hospital and you were born shortly afterwards. It all sounded so easy and pain-free. One moment my mom was drinking champagne, the next moment she was pushing me out, nothing to it, right? When I wasn't easily able to manage my pain, it was scary.
And many of us have friends who talk up pain-free birth. Something along the lines of "Get the epidural! I went to sleep and the next thing you know, I was ten centimeters!" Sadly few of us grow up with the message, child birth hurts like heck, but that is ok. The euphoria, the "I can do ANYTHING since I just did that" feeling after the birth makes going through the pain worth it. When you know the pain is normal, and you've prepared your body and mind to handle it, it isn't so scary and you realize that you too can birth a baby with "a lot of breathing and pushing" (and MOVING) and without the drugs. So do I tell my almost six year old that childbirth hurts like heck? You bet I do!!!!
FALSE! "Studies show that the 8 percent to 9 percent of U.S. women who use midwives and the 6 to 7 percent who choose family physicians generally experienced just-as-good results as those who go to obstetricians. Those who used midwives also ended up with fewer technological interventions. For example, women who received midwifery care were less likely to experience induced labor, have their water broken for them, episiotomies, pain medications, intravenous fluids, and electronic fetal monitoring, and were more likely to give birth vaginally with no vacuum extraction or forceps, than similar women receiving medical care. Note that an obstetric specialist is best for the small proportion of women with serious health concerns."1
Check out this fantastic Maternity Care quiz from Consumer Reports (and share it with your friends and family!). And while you are on their site, read this very accessible article on the importance of evidence-based care "Back to Basics for Safer Childbirth."
1. Consumer Reports Maternity Care quiz, http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/maternity-care-quiz/maternity-care-quiz.htm, accessed 2/13/09
I met a mom in the park the other day who was planning her third cesarean. With both her first and second babies she was declared to be 41 weeks with no sign of labor. Since she "failed" to go into labor twice, her OB is of course recommending a scheduled cesarean. I've heard more then one mom state the reason for their cesarean as failure to go into labor by 41 weeks. My friend Ginny, who helped me find the way to home birth with my second baby (a VBAC) has her babies around 42 weeks and, you guessed it, no sign of labor at 41 weeks.
So I suggested the mom mention the new study, "Timing of Elective Repeat Cesarean Delivery at Term and Neonatal Outcomes" when she asks her OB to schedule the cesarean at 39 and 1/2 weeks (her request) rather than earlier (her OB's plan).
And if you need some more food for thought, check out this OpEd by Michael McGuire, the CEO of United Health, one of the largest managed care organizations (MCO) in the country, about the link between elective c-section and other elective pre-term delivery and NICU admissions.
McGuire writes: "It turns out that in an audit of all UnitedHealthcare-insured ba bies admitted to the NICU in one market, 48 percent of all newborns admitted to NICU were delivered by elective admission for delivery including scheduled C-sections (cesareans), many taking place before 39 weeks of pregnancy, or full term."
Think about it. If a mom with a 42 week gestation has a scheduled cesarean at 38 weeks, her baby is denied four extra weeks in the womb. And yet I regularly hear of moms who have their first cesarean because of a failed induction at 40 and a half or 41 weeks and then in their second pregnancy, their cesarean is scheduled at 38 weeks!