I guess since I'm pregnant right now I've been thinking a lot about giving birth lately. And I tend to read up on birthing methods and such because I'm a dork. Anyway, here are a few thoughts I have about the matter:
Birth
I've
always known I'd give birth naturally. I suppose it became a
conscious decision once I became pregnant with our first child; and
this too might have been spurred by my mother having birthed all
three of us naturally (and two at home); so I didn't find the idea so
hard to digest. Not until my pregnancy and the prodding of friends
and acquaintances for birth/labor details did I discover what a taboo
subject natural childbirth is. I usually don't even discuss the
subject (unless someone brings it up and asks my opinion) because I
know it's offensive to some and they get defensive in turn.
But it's actually something I'm very passionate about and proud of
having accomplished. I also find it silly that so many are opposed to
hearing about natural birth, because it's the way it was intended to
be from the beginning and like it's name, a natural process. So I
thought I'd share some medical facts, not opinions, from what I've
read over the years so that those who don't understand where I'm
coming from might have a clearer picture of my objectives.
Number
One: Induction
Early
induction rates in the U.S., without medical necessity, are between
5% and 40%. Most studies show that the leading cause of early
induction is that the mother is “just ready for the pregnancy to be
over with”. The only medically backed reason for inducing would be
because of a preexisting health condition for mother or baby. This
would include but is not limited to heart disease, seizure, cancer,
hypertension, diabetes or a congenital defect in the baby that the
doctor has become aware of. Having said that, it's still possible to
give birth without being induced even with one of these conditions.
Another
common reason for induction is that the baby is “too
big”(Macrosomia) or the mother is “too small to deliver” (a
rare condition called Cephalo-pelvic Disproportion). Macrosomia only
affects 1-10% of all babies. But the most common reason for
early induction is an “overdue pregnancy”. A 40 week gestational
period is thought to be how long most women carry a child, but the
national average for a first time mother is 41 weeks and 1 day. 37
weeks is becoming the new average to many obstetricians because it's
considered full term but those last weeks of development are crucial
for liver, lung and brain growth. The American Congress of
Obstetricians and Gynecologists (ACOG) recommends an early induction
no earlier than 39 weeks to ensure proper fetal development. Sadly,
doctors often trade size for development based on guess work and
ultrasounds that can give a rough estimate of how big they think the
baby is towards the end of pregnancy. This measurement is commonly
incorrect.
Number
Two: Epidurals
Epidurals
are an analgesia, used to target a specific area to block pain but
not sedate a patient. The use of an epidural during labor is for pain
relief so the mother doesn't feel anything. There are advantages and
disadvantages to this.
The
only real advantage to an epidural is that you can't feel the pain
that comes with giving birth.
Disadvantages
to having an epidural:
- Drop in blood pressure
- Headache from spinal fluid leak (this is very rare)
- Soreness from being unable to change positions easily
- Nausea
- Numbness after the epidural is supposed to have worn off
- Surgical intervention for delivery
- It can cause labor to slow down or stop altogether
Most
women overlook these possible side effects in exchange for comfort
during labor. However, sometimes epidurals aren't as strong as they
should be and the mother ends up feeling labor anyway. Catheters are
necessary as well since the mother can't move about on her own.
Patients also rely on nurses and doctors to tell them when they need
to push when under epidural anesthesia whereas in natural birth, the
mother feels the urge to push on her own. There's less chance of
tearing this way. This leads us to our next topic.
Number
Three: Episiotomies
An
episiotomy is an incision to widen the opening of your vagina to
assist in birth. Many doctors feel it's better to administer an
episiotomy instead of risking a vaginal tear. However, tearing is not
guaranteed and recovery is after an incision has been made. Patients
must be stitched up after this procedure and given additional pain
medication.
There
are ways of avoiding an episiotomy like perineal massages before and
during labor, not lying flat on your back while pushing and Kegel
exercises to name a few.
Number
Four: Narcotics during and after birth
Lortab-
Classified as a Category C (Category A being the safest) drug by the
FDA for pregnant and/or nursing mothers. This means it is not safe to
take. Studies have shown respiratory distress in infants who’s
mothers used this drug during pregnancy.
Ibuprofen-
Category C drug and Category D after 30 weeks of pregnancy. This
means it is not safe to take while pregnant or breastfeeding.
Pitocin-
A synthetic version of Oxytocin; a natural hormone found in the body
that starts labor. This drug is used for inductions. Pitocin is
listed as a Category X drug by the FDA. I will give their definition:
Category X
Studies
in animals or humans have demonstrated fetal abnormalities and/or
there is positive evidence of human fetal risk based on adverse
reaction data from investigational or marketing experience, and the
risks involved in use of the drug in pregnant women clearly outweigh
potential benefits.
I
mention these three drugs specifically because they're the most
commonly used with laboring women.
Warning!
Opinion Section
I've
had so many conversations with individuals who are pro-medicated
births that have called me stupid or crazy that I can't even count
them. They don't understand why someone wouldn't take advantage of
medical advancements or pain killers when they're offered to you
freely in a hospital. But I don't agree with a lot of them and think
most are totally unnecessary. Medicine is something you take when
you're sick. Being pregnant isn't like having cancer; you don't need
treatments. One constant with most obstetricians, midwives and nurses
for pregnancy is to be very cautious about what goes into your body
as far as drugs are concerned so you don't endanger your baby while
it's developing. But then all these really strong drugs are
administered during the birth! They still reach your placenta and
ultimately your baby. I don't say those things to chastise women who
have used or are planning to use drugs during labor. It's deeply
unsettling to me that women are unaware of the risks of the
procedures and medications associated with many hospital births. And
I understand why they aren't worried. Their doctor tells them it's
fine to take and why shouldn't you trust a doctor? They're highly
skilled and trained in their practice. I'm not at all saying doctors
are bad or can't deliver babies or anything of that nature, I'm just
stressing the importance of doing research for yourself so that you
know what's best and can form your own opinions. I'm SO thankful for
medicine and technological advancements. My first birth was at a
midwifery inside a hospital and my son came a whole month early. We
had no idea what was going on and it was very reassuring knowing that
if there were an issue, people and medicine would be there to help
out. Thank God nothing was needed, Clive was just fine and I was able
to have the natural, non-medicated birth experience that I wanted for
us.
We're
about to have our second child and we're doing it in the quiet and
comfort of our own home. I'm not a nature quack that's anti hospital,
it's just what we wanted. I can't even tell you how excited I am
about it either! No staff, no beeping or other hospital noises, no
disruptions...just me, my family and my midwives. I believe giving
birth is intuitive; I believe a woman's body is perfectly equipped
for everything it needs during labor. That's how we were made. I
personally like to feel contractions, not because they feel good but
because they're an indication of how my labor's going and a warning
sign that baby is on it's way out. I always hate when people tell me,
“You don't win any awards for doing it without medicine.” That's
not the point. It's not about personal glory or showing off; even
though I think it's something to be admired for and a great sense of
personal achievement, just as running a marathon is an awesome
accomplishment.
So
bottom line, women have babies every day. It's your decision how you
birth, where you birth and who's present and assisting you. As a
true, totally engrossed geek and lover of births and all the
processes that go with it, I just ask that you do your homework and
know why your care provider is recommending what they're recommending
and what's in the medicine they're prescribing and how that can
affect you and your baby. Happy birthing!
www.acog.org
