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The Business of Being Born - The Fucking Bluebird of Goddamn Happiness [entries|archive|friends|userinfo]
Zoethe

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The Business of Being Born [Jun. 6th, 2010|01:57 pm]
Zoethe
Watched this documentary last night while busily not sleeping until 6am - one of those nights. I have to say that anyone who is considering ever having children should watch it. It's very pro-home birth and natural birth, and has a lot of good information about the problems with hospital births. But one of the things that is great about it is that one of the women involved in it went into preterm labor and they didn't flinch away from showing her midwife making the call that they couldn't get it stopped and she needed to be in the hospital, nor did they flinch from showing her cesarean section. They made it clear that medical intervention is sometimes necessary, but that there are also times when medical intervention interferes with the natural birthing process and creates the emergency that leads to the c-section.

As a woman who had two natural childbirths in the hospital, I feel very fortunate to have been in Fairbanks, Alaska, where I was allowed to continue my difficult labor with my first daughter despite the fact that I was not progressing according to the charts. She was not engaged in the pelvis, but she was also not stressed. From 6pm until after 3am I was allowed to walk and move and change positions, and when she finally dropped in, she was out in about 35 minutes. If I had been less well-informed, less determined to have a natural birth, and not fortunate enough to have a personal friend who was a labor and delivery nurse come in on her off-duty night and serve as my midwife, I probably would have ended up with a section, because once they start the pitocin and stadol routine, the epidural, etc., there is a cascading effect of stressors on the baby, and if Erin had been distressed without me progressing, then it's surgery.

As it was, I didn't even have an IV with either of the girls. When I had my shoulder surgery and mentioned that it was my first IV, the nurses here were flabbergasted - running a line is completely routine, even though it's been shown that it's the first step toward intervention - "oh, we'll just hydrate you with an IV" = less mobility, and then adding drugs is that much simpler.

Adding to that the increase in scheduled routine c-sections (with optional on-the-table tummy tuck in NYC!) that make surgical delivery seem like the norm, and we have an insane system on our hands. For one thing, when Ferrett had his appendix out he was hospitalized for the better part of a week and told not to lift anything over 5 pounds for the next two weeks. On the other hand, we're booting women out of hospitals two days after major abdominal surgery and handing them 7-9 pounds of squirming infant - how are these two scenarios reconciled???

For another, why are we teaching people that anything that causes discomfort is automatically bad and scary and we should avoid it at all costs. Epidurals should not be routinely offered; they are shown to increase the risk of an emergency c-section, and yet many hospitals treat them like step two of the admitting process. You know what? Getting back into shape can make a person sore as hell for a while, but that's part of the process - no pain, no gain, as they say. Sometimes there are things in life that hurt, but not all pain is a sign of something wrong that requires dramatic medical intervention. But we're teaching medical students to treat birth as a crisis event, rather than a natural event that has a risk of turning into a crisis.

(Yes, I'm a little passionate about this topic....)
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[User Picture]From: k425
2010-06-06 06:09 pm (UTC)
It's not as if it's hard to stay hydrated during labour.

In fact, when I had to transfer from home to hospital (after 3 hours of pushing I agreed with my midwives that I needed help they couldn't giver at home) the first thing they did in hospital was to, er, catheterise me because my bladder was huge and I had no urge to wee.

I was offered a spinal by the obstetrician, mainly because I accused him of not using enough local anaesthetic when he was sewing me up afterwards. But I got by perfectly well on N2O - something that seems to be sorely underused in the US! (It doesn't take away the pain but you don't really care about it.)
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[User Picture]From: zoethe
2010-06-06 06:34 pm (UTC)
Birth is so much saner in your country.
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[User Picture]From: zoethe
2010-06-06 06:37 pm (UTC)
Medicine is excellent - used judiciously. It's just not being used that way.
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[User Picture]From: mamculuna
2010-06-06 06:13 pm (UTC)
iin 1972, when I was having my first baby with no drugs, and fortunately a relatively easy labor, it was so unusual, even in San Francisco, that they called in some interns to watch it happen.

My roommate was having a C-section because she'd had one before--and had the first one because she didn't want to go through labor, even with drugs. She could barely get to the bathroom, the next day, while I was up and bouncing around.

I was lucky, I know--I've had friends who had no choice about the C-section, and others who had long and miserable labors.

On the other hand, since I had such an easy delivery, I really wished I had a home birth. What I really hated was my husband having to leave and the baby taken off to the nursery. If the mom is fine, no need for the separation. And I had to fight with the nurses about bringing the baby to nurse a lot and not giving him sugar water.

By the time I had the second one in 1973, I was in SC, and the doctor (who had to sub at the last minute for the OBGYN I'd chosen) had never done a natural delivery before and didn't believe me when I said this baby's coming NOW! The nurse pretty much did the catchings.

Having babies--what a great thing to get to do. I would have had more if my body had cooperated.
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[User Picture]From: zoethe
2010-06-06 06:46 pm (UTC)
I was really lucky because Fairbanks OB nurses were completely awesome both times around. I had Erin with me all day for the one day I was there. (I left early because my roommate was out of it from her c-section, but her husband was a complete dick - showed up at 8:30am after I'd given birth at 4:30am and turned on NASCAR on the TV REALLY LOUD, then when my husband arrived told him to go out drinking tonight because it was his last night of freedom. John came around the curtain with wide, shocked eyes and I mouthed get me out of here!!) With Amy I had a private room and had her there with me all of the two nights I stayed (I was dizzy and had extremely low BP, so they kept me an extra night). There wasn't even a sugar water bottle in their bassinets, and the nurses checked in to see if I needed any help getting them latched on. When I was having problems with Erin, they were just very calm about it and said that it wasn't tragic if I just held her and let her sleep a little longer - no pressure for water or bottles of any kind.

I think the pioneer spirit made these things easier.
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[User Picture]From: finding_helena
2010-06-06 06:16 pm (UTC)
No kids yet, but am looking at the subject seriously, and I am completely on board with this. I want a natural vaginal birth if at all possible and honestly my greatest fear about labor is not pain or risk but being medically muddled into a birth with more interventions than were really necessary. I wouldn't shy away from a C section if it really were necessary but I am very, very wary of the cascade of interventions. I'm going to start to interview providers soon and want one who is on the same page as I am. I live in a big city, and have a little money saved up. I have options on providers, even if they don't take my insurance.
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[User Picture]From: zoethe
2010-06-06 06:53 pm (UTC)
If you have not read Ina May Gaskin's Spiritual Midwifery, I highly recommend it. You will feel much more educated when you finish it.

My recommendations: write up a birth plan and have your provider sign off on it, then take about 10 copies of it with you and hand them out to everyone who comes into your room. They may not all read them, and they may just identify you as the crazy natural birth woman, but they will be aware of how serious you are about this.

Also, I can't tell you how important it was for me to have a second support person with me. Recruit a good friend, preferably one who has given birth, even if it's not naturally, who is on-board with your plan. My friend Camille had an awful birth experience ending in an emergency c-section, but she was a rock of support (and as it turned out, she felt like attending Erin's birth was a healing experience and helped her process her own birth experience). It was great having another person there to listen, ask questions, and let John go get a cup of coffee and something to eat!
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[User Picture]From: dana3
2010-06-06 06:20 pm (UTC)
After 67 hours of hard labor -- failed home birth -- I was transported to hospital. 30 minutes after hitting hospital doors I was delivered of a not-quite-healthy almost 9# baby who spent the next week in NICU (and is now a fine adult). No IV, no epidural, none of what they would now consider textbook normal. Pain is part of the experience -- and if Nature didn't give us amnesia about it, there would never be more than one child per woman. ;) Fortunately she does, because Nature is a Mother too ...
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[User Picture]From: cubes
2010-06-06 06:35 pm (UTC)
And what's with the judgmental crap piled on the women who do opt for pain meds or epidurals?

They used to do surgery without anesthesia; today even the most minor procedures generally involve some form of sedation -- even though there are some extra risks involved.

Why are women who, for whatever reason, choose to have some form of pain relief somehow less strong/worthy/whatever than those who manage labor and delivery without?

Pain was part of my experience, and when it got to the point where I was in a screaming panic -- no amnesia here -- despite all of the preparation I'd done and all of the techniques my husband and doula tried, I got the damned epidural (by my own choice, thank you) and had a perfectly healthy, wonderful baby girl just a few hours later. I'm glad that option was available to me, because I might have been able to deliver the baby without it, or I might have exhausted myself to the point of needing a c-section by the time she was ready. And with the pain mostly out of the way, I was able to be there 100%, mentally and emotionally, when my daughter was born. But I still got the tut-tut from my Bradley instructor and several classmates because I went down the evil medical intervention road (which road made my baby possible in the first place, and may well have saved her and myself from severe complications toward the end of my pregnancy).
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[User Picture]From: cubes
2010-06-06 06:21 pm (UTC)
And we need to teach women (hell, PEOPLE) that they are in charge of their own health and well being. We also have to be honest enough to admit that a part of the large numbers of epidurals and c-sections is because the mothers in question want those things. They want (what they perceive as) comfort and convenience. They are, in all likelihood, incapable of and/or uninterested in analyzing the risks and benefits. When you have a woman who is uninformed and really doesn't care to do the hard work -- either before or during the birth -- there's a good chance she and her baby will be better off with that IV and epidural, and maybe even the c-section.

Anyone who walks into a doctor's office, any doctor's office, and just goes along for the ride without some self-education, an advocate by one's side if at all possible, and the willingness to shop around for a good health care provider as you would for any other service takes on at least half of the responsibility for the outcome. Yes, the doc is the professional, but I proofread my attorney's and accountant's work, and I make sure the lights still turn on before I sign the electrician's check. Why would I do any less when my own health is at stake?

And from here I start thinking about the way-too-many cases where whether the baby is born by c-section or not is the very least of that child's problems in life, and how high the correlation probably is...
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[User Picture]From: zoethe
2010-06-06 06:58 pm (UTC)
Definitely there is an attitude of avoid any pain or work, but it's hard to say where that's originating. Scheduled C's are great for docs - no getting out of bed in the middle of the night, no waiting around. Why wouldn't they want to make that the norm?

That women buy into the message is sad, but that message is coming from an industry - why be sweaty and miserable when you can be done in 10 minutes? It's crazy, but we are sold convenience continually.
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[User Picture]From: phillipalden
2010-06-06 06:22 pm (UTC)
My sister-in-law just gave birth to their first child, (in San Francisco.) The staff at the hospital were very supportive, eager to answer questions, and made both her and the husband feel, (as confident as they could being first-time parents.)

I got the impression the hospital wanted to make sure they were comfortable with taking the baby home before they released them. Maybe it was just that UCSF is a great hospital, (system and medical school,) but I feel they really did a great job, especially with new parents.

I'm sure that health care, like so many other things, can vary greatly from place to place.
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[User Picture]From: zoethe
2010-06-06 06:59 pm (UTC)
Oh, decidedly. I'd love to see stats on UCSF versus national norms.
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[User Picture]From: creentmerveille
2010-06-06 06:54 pm (UTC)
I'm glad to read this. I was never intending to be a mum and therefore had not researched much about the topic, and was not well informed about LDR practices when I had my child; I simply did/believed what the doctors told me.

If I had it to do again, I would not have had an IV, and would have tried to do things naturally. I would not have had the baby induced- I thought I had to instead of letting her decide when to be born. Wrong- it was just more convenient for the doctor to schedule the birth.

I thought I had to have pain meds which sent me on a VERY bad trip (hallucinating, calling my nurse Nurse Ratchet, etc). I was then denied 'more drugs' and was given an epidural - for those of you who have not had one, especially while in transition, this is not a medical procedure but rather some strange form of torture. Touch my WHAT at the peak of a contraction? Toes? THE HELL YOU SAY.

If I had studied up a bit, I would have made sure my doctor knew I would have liked to have 'cut the cord' instead of doing it for me as there was no Husband there to take care of such things. In short, I wish I had been proactive and taken charge of the event instead of letting 'them' tell me how it was supposed to go. I forgive myself; I was 23, plenty scared and alone, so I just accepted what I was told to do. But I hope more women read your post and consider the idea that it's up to them how the birth happens.
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[User Picture]From: merle_
2010-06-06 07:18 pm (UTC)
Adding to that the increase in scheduled routine c-sections (with optional on-the-table tummy tuck in NYC!)

Good grief. That's just.. wow.

"Here's your kid (hands it off to the nurse), and now let's do some surgery rather than let you bond!"
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[User Picture]From: zoethe
2010-06-07 12:22 am (UTC)
I know. I was stunned at the notion of the cosmetic surgery c-section.
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[User Picture]From: kythsharrie
2010-06-06 07:29 pm (UTC)
Oh I plan to be prepared for the day of birth. I keep telling my guy (the baby's daddy) that I will NOT have an epidural. He's all "Oh yes you will! You don't have a choice!" all because he's watched those shows on Discovery Health (about births and such). I think it's unnecessary. Yes, I'll be in pain, but that's fine. Unless there are issues galore, I'd rather have the baby as natural as possible.

And gods help the doctors and nurses if they try to take my baby away to the nursery before I'm ready to let him/her go.

What I consider shocking though is the fact that my youngest step-sister was due to give birth in January. I was talking to my uncle and he said her doctor scheduled a c-section for this date and I was all "What? Why? What's wrong?" And he said it was because the doctor didn't want the baby to be born late. It was already a week past the due date and all that crap.

I dunno about that. It was bizarre. Okay. So the baby MIGHT be a bit late. As long as there are no issues and complications give it a little more time before ripping the baby out of momma. I swear, doctors and their frequent use of c-sections. If my doctor tries without giving me time with the baby I'll sue the damn hospital.

I even know the approximate date of conception so I know more or less when the baby's due.
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[User Picture]From: ba1126
2010-06-06 08:02 pm (UTC)
Mine were all (all seven!) between 10 days and two weeks late! Every body's body is different!
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[User Picture]From: ba1126
2010-06-06 07:45 pm (UTC)
In my experience (seven births), it depends on the hospital, the doctor and the patient. I used three different hospitals, and three different doctors.

With the first birth, I was given sodium pentathol while in mild labor and came to eight hours later as they wheeled me into the delivery room for a normal (but groggy) delivery.

My second was in a different hospital, different doctor. I had many hours of mild labor, then two 'really good' pains, and the head started crowning!! No time for anything but catching the baby!!

The next two were in a third hospital with a third doctor. They were much the same as number two, long hours of little progress, then rapid crowning and delivery.

Fast forward 13 years!

Number 5 was the same doctor and hospital, but a VERY different experience! The baby was three pounds bigger, and "sunny side up". Again with long hours of little progress, and then with a few pushes, he entered the birth canal, but got STUCK! At this point, I insisted I would have him vaginally, and it really was too late to do otherwise. With several young 20-something nurses saying "push harder!" (I have done this four times before, and I am pushing my GUTS out!!), I delivered a beautiful baby with a very swollen face, but otherwise perfect!

Number 6 and 7 were the same doctor, small babies and the old story of "no progress, no progress ...The head is crowning! (they didn't want to believe me and I said "I know what I'm talking about! Check and see!" They just about managed to catch the last one!!
I made it clear that I was
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[User Picture]From: zoethe
2010-06-07 12:36 am (UTC)
Yes, listen to the mother!
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[User Picture]From: zoethe
2010-06-07 12:41 am (UTC)
Many young doctors are terrified of twins and breech births because they've never seen one. They have no clue what to look for, what's within the realm of normal, because no medical school in the US is teaching it.

In the UK and Europe these cases are regularly delivered vaginally. But no one here knows how to do it.
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[User Picture]From: kisekinotenshi
2010-06-06 08:16 pm (UTC)
Totally with you on this. I was an emergency c-section baby, but the entire birthing process was made much worse by a horrible doctor. My mother had my two older brothers at home with no problem (except my middle brother, my oldest brother kept trying to sit on her lap and ask what was wrong while she was pushing), but something went wrong with me and the midwife agreed that it was time to go to the hospital. The doctor there wouldn't let the midwife or my father (who was IN MED SCHOOL) into the room, treated my mother like a complete idiot for attempting a home birth, then drugged her up right away and then wouldn't tell her what was going on. She said she was terrified that I was going to die, because she was so woozy and kept hearing things about how I couldn't breathe and they had to go in before I had brain damage and so on. She still likes to remind me on my birthday what a horrible experience it was (tongue firmly in cheek, of course). But that story, along with all the things I've learned about medicine through listening to and talking with my father, has made me damn sure I wouldn't go to a hospital to have a baby unless there was real danger there (although I don't intend to have a baby anyway, but hypothetically).
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[User Picture]From: kythsharrie
2010-06-06 11:37 pm (UTC)
I'm sorry, but the mental image of the little kid crawling onto your mom's lap and asking what was wrong while she was pushing made me giggle.

And good gods, that sounds like one heck of a hospital horror story!
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[User Picture]From: blaze_villain
2010-06-06 08:22 pm (UTC)
My hospital birth was really crazy. My water broke at around 7 a.m.
I headed to the hospital, labored there until I was dialated to 6, got an epidural, was flying high until 9 1/2 cm, and stopped progressing. This was about 10 p.m.
Pitocin to speed up the labor, and it started to hurt like a bitch around my vaginal area. We eventually figured out that I was one of 30% of women whom an epidural DOESN'T WORK FOR in the vaginal area. Hmmm.. they certainly didn't tell me it might not work for me. Damn.
What was the point??? I pushed for 3 1/2 hours of very rigid "Count to ten, do it again", no rest, screaming the whole time, because I was lying on my back and totally not pushing the way I've seen women do more effectively in natural birth videos since then. I felt everything, so I would have rather been moving around the room instead of stuck in that bed with drugs that didn't work anyway.
Finally, the doctor came in, and I had Lizzy at 1:56 a.m.
A beautiful 7 lb, 14 oz. little girl. I had torn my anal area so bad the doctor had to stitch me up for 45 minutes after I had her.
Perhaps that wouldn't have happened had I not had to be so still after getting the epidural I didn't need.
Anyway, I watched the documentary too. It was really great.
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[User Picture]From: zoethe
2010-06-07 12:49 am (UTC)
Epidurals are generally evil. But not completely. My sister's BP was going through the roof, then she had the epidural and it came back down and she gave birth within the hour.

For her it was an excellent and possibly lifesaving tool. But how can you tell that you are using the tool right if you use it almost universally?
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[User Picture]From: zoethe
2010-06-07 12:51 am (UTC)
Yup. Lay midwifery is dwindling because it's harder and harder to find the kind of backup needed for emergencies. And that's sad.
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