Monday, December 13, 2010

Just Do It.

I just read this fairly short blog post from a blog a good friend recommended to me, and it sums up this idea very well. GO read it, then come back.

I find it sad that so many of us women concede to medical authority so quickly and so often, especially when it comes to birthing our babies. I suppose since I have had more babies than the norm, I have had the experiences over the years that have given me sort of a time advantage. I NEVER would have given birth to my first baby at home and I probably would not have been interested in self hypnosis or cloth diapering. In fact I recall clearly telling Robert years ago that I could not imagine giving birth at home. Can you imagine having to do the clean up?! And, hey, I enjoy the idea of the nurses being room service and baby care both, while I rest in anticipation of bringing our bundle of joy home.

Well, the years have flown by, and my perspective has changed a bit.

It doesn't seem to me that it has changed THAT much, but I would say that in general I have gone with the medical model of birth more than anything else. All my births have been natural (no drugs), vaginally delivered, and totally healthy. We did have an elective induction done with Angel, but that was about the most intervention-y we've gotten. The stupid internal monitor was the WORST, given that it made me have to be in bed the entire labor (which admittedly was "short"), and laying in bed while laboring to bring your baby into this world is tedious and makes the time go so much sloooooooooower.

As I am in a retrospective mood waiting for this little man to make an appearance, let's see what I remember about my previous births and maybe I can analyze where I made changes and learned what I have. I have birthed 6 babies, so far. All healthy, all full term, 5 of which with my husband. I am proud to be known to the medical community as a Grand Multiparas, and even prouder of the fact that I did it. I mean, even if it was only one, there is something so supremely satisfying about knowing that Heavenly Father entrusted me to carry these babies for 9 months-ish, then actually help them get out of an area barely big enough for them anymore, without dying, going crazy, or severely damaging my body. Seriously, it seems like a pretty weird thing to do when you think about what really goes on during gestation and birth.

But I digress.

#1 baby. I saw an OB, who I guess my mom picked. I went into labor starting with an obvious mucous plug loss as the starting signal, in the wee hours of the morn on my due date. I knew the exact date of conception, so it was interesting to note that I had indeed gestated for the exact period of time estimated by doctors. Labor was uneventful. I remember being hot and laying on the floor with my head against the cold tiles to feel cooler. I recall something about a "muscle relaxer" being given to me (so that's the one instance where my sans drugs claim may be false). I remember that I felt it in my thighs, it was very painful and I couldn't relax at all. One of my sisters was to be my birth partner, went through all the classes with me, and then wasn't quite able to handle it, so she left and my mom stayed. I remember her rubbing my legs. I walked a lot in the halls. When it came time to push, it took less than half an hour I am sure, but I don't really know. I was a little more preoccupied with the emotional battle going on around me with both grandmothers wanting to be there for the birth. Let's say simply that they don't get along. I had a pretty long episiotomy, but didn't really feel as if I was in charge of any decisions in terms of the pregnancy and birth process. I didn't really learn much with that pregnancy except pure experience. If you had asked me then, I would tell you that birth is extremely painful, but overall not too long either. Pretty sure it was about 8 hours long. Baby was perfect, still is from what I know (at least in my eyes, who only see him from a distance).

#2 Robert & I are expecting our first, the one that will change us forever from a couple to a family. We were seeing an OB, who is nice, laid back, and doesn't worry about the fact that I only gained a gross total of 1 pound. Being a good 40 pounds overweight, I wasn't worried either. About 10 days before his due date, we went in for an elective induction. Again, we were pretty uninformed. I had no idea of any risks possibly associated with an induction. All we knew was that we were already at 3 cm. I had no idea what a Bishop's score was. I simply assumed that at 3cm, my body was pretty ready, and we wanted our baby out and in our arms. We went to the hospital, let them hook me up to the monitor, hook a cathode onto the baby's head (effectively restricting my movement to whatever I could do while laying down on my back in bed), and administer Pitocin (and probably IV fluids, too). Labor was shorter than my first (about 6 hours), though felt interminable being stuck in bed, painful, and pushing was pretty quick again. If I remember correctly, we did not have another episiotomy, but did tear enough for like one stitch, no biggie. He was 6 lbs 3 oz, and perfect. We stayed in the hospital for 2 days, letting the nurses take the baby to the nursery as often as they deemed necessary and allowed the staff to tell us what to do, from feeding schedules to drugs administered to changing the baby's diaper to fundal massage (UGH!). Oh, and the OB came in to catch the baby, he was never there for the labor process at all. In fact, the nurses were pretty much not there either, coming in only to fix monitors or help me go to the bathroom when needed.

#3 We decided, since the OB was not there during the whole birth and I wasn't wild about dealing with another male for something so womanly, we'd find a Midwife this time. In Utah, you pretty much get a CNM (Certified Nurse Midwife; who is an RN, trained in midwifery and certified by the American College of Nurse Midwives), as we wanted to deliver in the hospital still, and only CNMs have hospital privileges They also have to be "under" an OB to practice where we lived. We chose a fairly large practice of CNMs who deliver at the same hospital we delivered our first at. It was a great hospital. The only problem this time was that the practice had about 7 CNMs, meaning we saw a different one every time we had an appointment. This was disconcerting, to say the least. But overall, the prenatal care was fine, though being MWs they did really try to get me to gain the normal 15-20 pounds , which I was resistant to, but wasn't trying hard either way of course. We took the Hospital labor and delivery class again (we took a class with all of our pregnancies, to refresh ourselves on the process and prepare ourselves for each one), which didn't really give us tools to use except the vague shallow breathing techniques they teach, and the basics on the physiology of the birth. A couple of days after the baby's due date we let the MW sweep my membranes, and we were ready to head to the hospital within short amount of time. I don't remember how long exactly, but it was within a day or 2. We ended up with a MW we did not know at the birth, of course, the ONE we had yet to meet. But she turned out to be WONDERFUL. She was THERE! She stayed with me for the whole labor, helped me get into the tub, and when it came time to push encouraged me to NOT lay flat on my back, but on my side while she supported the upper leg. Pushing was short again and labor overall was shorter than the last. He was 7 lbs 15 oz, possibly would have been over 8 if he hadn't decided to christen the nurses as he came out. I figured by now that by the time I had a few more babies, they'd just pop out after less than an hour! Again, we took advantage of the 2 nights stay insurance would pay for, and let the nurses and hospital policy dictate what we did, though, as with all of our births, Robert stayed every night with me at the hospital.

#4 We decided to find a smaller practice this time, hoping for a little more personal treatment, even though our MW was amazing. We were slightly disappointed to find that the practice we chose delivered at a different hospital (I hate the unknown more than anything!), but went with them anyway. There were 3 of them, and we met them all. We felt a bit more prepared, but still felt like novices. And pregnancy brain always made me defer to Robert when answering or asking questions, as I can never seem to remember the details of the pregnancies for some reason. Strangely enough this one I remember the least about the pregnancy, though I remember right after she was born as clearly as if it was today. We finally had our first girl, a little princess (and, BOY, has she turned out to be so!), and holding her that day and looking into her eyes, it felt like our family had finally truly begun to blossom. She was only 6 lbs 1 oz but perfectly healthy (I guess we just make 'em small), and a smiler from day one. As far as I recall, we once again had an uneventful, fast birth, with a short pushing stage, but I still felt everything very painfully. And though I had done 4 natural births so far, I could not (and today, still cannot) explain why I adamantly refuse to have any drugs to birth my babies. Oh, there are plenty of risks to discuss: epidurals that don't work fully, epidural headaches for years afterwards, pushing for HOURS b/c the epidural DOES work, effects on the baby due to whatever cocktail of drugs they are using currently, Pitocin problems, like a ruptured uterus, etc. But truly, all of those things I've learned about over the years (and more, scarily enough!). I suppose it's always been an innate knowledge that I could do it. Heavenly Father made me, expressly to do this. I'm a woman, I'm strong, I'm pretty brave, and I want my babies to know I did it for them. It's not a scary thing, even when it is painful (I mean really painful, when you don't know how to prepare!). I guess that's the best explanation I can come up with.

#5 Another boy is on the way, and we decided on the same CNM practice as before. The hospital has proven itself to be a good one, and they haven't done anything to me that I would consider bad. In fact we always had good nurses and a nice room and provisions made for Robert to stay with us. I have a friend who I met in my water aerobics class before Isa was born who I found out some interesting things about. She gave birth at home and used Hypnobirthing techniques to make her labor easier. Pfft, I said, not gonna happen. I stink at relaxing, have already proven at a "hypnotist show" at Robert's work that I cannot be "hypnotized", and still imagine giving birth at home to be more work that it's worth. Besides, I like the idea of going to the Hospital Hotel and being waited on for a couple of days. It was the beginning of the end for me. I am constantly amazed at how Heavenly Father knows me. He knows how resistant I am to change, so He puts little hints in my path for a while (sometimes years), until I am curious, find out more on my own and eventually change my mind set. And so it had begun. Close to the end of this pregnancy, I heard somewhere about the Mongan method of Hypnobirthing. I was intrigued by claims that I could have a pain-free birth! Right! If that were true why doesn't everyone do it? What a crazy claim to make.

But...

My births were really, excruciatingly, amazingly, unimaginably painful. I would clutch the sides of the bed until my hands were white. I have never been a screamer (it only makes it hurt worse), but man, it hurt, and I have a high pain tolerance. Maybe, just maybe, it could help a little. I'm not expecting pain-free, but if I could just get it to ease up a bit... And, believe you me, it could NOT possibly get any worse. So, Robert and I were browsing the bookstore one day and I wandered purposefully over to the baby section and found Marie Mongan's book, "Hypnobirthing." And it clicked. It made actual, logical sense. For the first time in my life I learned about the muscles in my uterus. Did you know you have 2 sets of perpendicular muscles that make up the uterus? (If you are female of course) And that they work together, but each has a separate job to do? One pulls one way and the other pulls the other way, when it's time to get baby to come down, the muscles stretch alternately and help to open the cervix and get the birth canal ready while baby does his/her thing to get where they need to be. I don't explain it well, but I finally got it. I was in so much pain, b/c I would tense up! Think of your arm muscles, biceps and triceps, one helps to straighten your arm, the other to bend it, but in order to do either the opposite muscle must relax. Imagine trying to bend your arm while flexing your triceps. I can personally imagine this because I broke my arm and dislocated my elbow after Isa was born (she was about 7 months old, I think), and after the cast came off, I needed physical therapy b/c my muscles were so tight I could not bend my arm more than a couple of inches. Any more and it was extremely painful. In order to even start my exercises each visit to the therapist, I had to soak my arm for 20 minutes in warm water to loosen the muscles as much as I could. So the theory made sense, and I bought the book with high hopes, it came with a cd after all!

I was disappointed. The cd was just the background music, and I was supposed to do the scripts while relaxing, but how do you do that when you need to close your eyes and let all your muscles relax but hold a book at the same time and read a relaxation script to yourself...? I was disillusioned and wanted badly to be able to take a live class, but as we were still starving students, it was not an option. So we laid it aside, figuring I'd done it before and could do it again without Hypnobirthing. Then we got our (my) hopes up again when we found out one of the midwives actually did a class, at a steep discount to her patients, and we planned on taking it when it was later in the pregnancy. Unfortunately, that particular MW also had cancer and stopped giving classes with the last class before we were far enough along to take it. So we had another very fast (I didn't even have time to get into the tub by the time it was filled b/c it was time to push so soon), intense, and (I'm not afraid to say it) extremely painful birth. It's always worth it, but I wish I would have known then what I do now. Famous last words, right? H popped out quickly at 8 lbs 11 oz, proving that I could do it no matter what the size, right?

#6 I am officially a Grand Multiparas, and feel pretty confident in my birthing ability. I feel like I know more about the process and understand my body a bit more. Robert is really close to finally finishing his BS in Computer Engineering, and he got a job offered to him that was a dream to poor students such as ourselves, allows us to pay our bills and have money leftover(!) for like the first time in our married lives, and has amazing medical benefits. All this means we can possibly take a Hypnobirthing class and pay the pretty high price (when compared to the hospital classes, which were always like 20$ or something close to that). In retrospect, it makes sense that the hospital classes are so cheap, considering the amount you actually learn... We found a class on Hypnobirthing, but it was in SLC and we were not wanting to drive all the way there for the entire 7 weeks or so class, b/c it also meant finding a babysitter for the class time (minimum 2 hours), plus drive time (another 2 hours). That's a heavy commitment to ask anyone when most of our friends are in college, too. Then we found a class on Hypnobabies, and were not heartened at first, though it was very close to us (only about 15 minutes away), b/c it seemed to be a totally different method and I was so impressed with the Mongan ideas. I did some research and quickly found that Hpnobabies was considered by anyone who had done both to be the superior method and had much more "tools" and tracks to use, so I was hopeful. We went to the instructor's house (where she holds class), paid for the class, and got a cd to start listening to. It was awesome. Robert was politely interested, but stoically hopeful along the way. Being a lifelong insomniac who only gets worse at sleeping and falling back to sleep when pregnant, just the 2 tracks I had were a dream come true. It was so nice to be able to relax and get some sleep! The class was a lot of birthing info we already knew, as well as a lot of discussion on things done in the "medical model" of birthing, but we also practiced letting the birth partners or the instructor help us to enter a state of self hypnosis (read: deeeeeep relaxation). Let me explain it this way for those of you thinking of someone up on stage at a show clucking like a chicken. Have you ever been hypnotized? The answer I'll wager you give is no, however I daresay the truth is yes. Ever been driving home, letting your thoughts wander, then find you have gotten most if not all the way home with your body driving automatically? You look up and think, how did I get here and can't really remember the drive... Or you're reading a book and it takes someone multiple times calling your name for you to even register that you are hearing them. Both forms of self-hypnosis: sort of hyper focusing and relaxation rolled into one. Now I have NEVER been someone who can relax easily. You know how you've done that exercise wherein you lay down on your back, kind of spread-eagled and someone talks you through tensing and releasing each muscle in your body one at a time and it feels so nice when you come to the end. I suck at that. But as we did the scripts together at home and I listened to the cds (altogether it came to like 8 I think), my mindset was changing and I finally trained myself to be able to relax at will!

Now, don't start thinking that I only was able to do this b/c I had the experience of my other births or b/c I have a high pain tolerance or something. Many of the women I've heard from do this with their first birth, and many women do it without the benefit of specific training such as a class like we did. Really, there are women the world over who give birth pain-free naturally for some reason. Pretty sure it's the fear-tension-pain cycle. Look that one up. Fascinating stuff. It's also about the perceptions and preconceptions you have been raised with. Can you imagine being scared of going to Disneyland? Not usually if you live in the USA, b/c our society has generally ingrained us to believe that a giant friendly mouse will make all your dreams come true. Now can you imagine being excited to give birth, not the baby holding part and how cool that is, no, I mean the actual laboring and pushing baby out of a 10cm hole in your body part? Probably not, since everyone you know has spent your whole life telling you how painful and scary and bloody and even gross it is. And, hey, that's how it is on TV and in movies, so that must be true, right? (I'm rolling my eyes right now.) Point being, it was a LOT of work and practice for me to get to this point, not to mention a 300$ class, but worth every penny (especially if you ever looked at that bill for the epidural...)

Fast forward to the beginning of July 2007, I go into labor in the afternoon, Robert comes home quickly since it seems these contractions/pressure waves are only about 2 minutes apart. We get to the hospital with minutes to spare, the nurse finally checks me- after ignoring Robert telling her that I birth very quickly and am practicing Hypnobabies (you can just picture the poor nurse rolling HER eyes, right?)- to find I am at 9 cm, and EJ is born about 15 minutes later, the midwife having made it for the last 11 minutes. Oh, and it was completely pain free. Did I mention that I felt NO pain? 'Cause I didn't, seriously, none. Did I say it was easy? I did NOT say that at all; it took all my powers of concentration to focus my brain on the fact that what I felt was pressure and power coursing through my body. I almost lost it right before Robert came home, then he reminded my to put on my headphones so I could listen to my Hypnobabies tracks, and I was able to focus. Overall it was indescribable. The closest thing I can imagine is being transfigured to see a true Heavenly vision, there is no way to describe on Earth how powerful and transcendent that feeling is. I think many of the women in "Spiritual Midwifery" explain it best, seeing as they were all "Hippies." They tended to call it psychedelic and far out and use phrases with light and power in them.

and here we are at

#7 We've hit the official full term, assuming we go by the actual first day of my last period, which admittedly started slowly (and would put the due date at Jan 1st), so I have been dating the birth since a few days after my period started, putting us at Jan 4th. I have been having lots of practice waves, tightening of the uterus. Some of these have simply been this little man stretching out, b/c he is obviously NOT comfortable in there anymore, but a lot of them I have to stop and concentrate on. Now they say Braxton Hicks (or practice contractions) are painless and tight, and "real contractions" are painful and emanate from the back. Ha, this is funny, considering mine are not painful and they do emanate from the back sometimes... hmmm. And going with the Jan 1st due date, we are where I was when EJ was born. Considering all the practice I'm getting, I am surprised we haven't seen more action, but he'll know when the time is right. And I do still have a million things to do before Christmas, even though I am pretty antsy and wish he were here now (or at least when Robert gets home...). Having been nesting we have all of our birth supplies ready and I am reasonably confident he would be fine no matter what at this point, so I am ready, sort of. Well, I'll let you know.

So here's my evolution. Natural, vaginal births, all. One induction, no problem, but will never do that again, especially as we'll never go with a doctor again (knock on wood, assuming we never have a high risk pregnancy) and a CNM would never induce unless you were more than 2 weeks over your due date and we've never gone that far with any of ours. I am disillusioned by basic medical procedures with no point &/or real reasoning except doctor/hospital liability, including but not limited to: internal fetal monitoring, constant external fetal monitoring (which has actually been shown to increase your chances of a c-section with no better outcomes than not having the constant monitoring), stupid IVs simply b/c you walked into the hospital (just in case, they say), pitocin during and after the birth, insisting that your baby is too big to birth naturally or vaginally (they told us Isa was 7 1/2 pounds by ultrasound a couple of days before she was born and she was 6 lbs 1 oz., just ask the ultrasound tech what their margin of error is; also women have birthed 12 lb+ babies), fundal massage, circumcision, cutting the cord before it stops pulsing, pushing baby out on the bed in the doctor preferred (basically uphill!) position (do you have any idea how much easier mommas would be able to get the baby out if they could just squat or get on all fours or do any other myriad positions that their body is urging them to do?), hospital birth for a mom who is low-risk (it's only been like 60 years since hospital births started being popular and our c-section and maternal/infant mortality rates have not gone down in a long time), taking the baby away after birth (the only person who should have that baby, best case scenario of course, if the person who caught it-hopefully daddy!- who should then hand it to momma, duh), being stuck in bed, non-emergency c-sections, elective inductions (especially when momma has no idea what a Bishop's score is, much less what hers is!), and in general any thing momma does not understand, and anyone who acts as if momma could not possibly understand. Yes, I get that in unusual circumstances or emergencies there may not be time to explain everything to a layman, especially a laboring mom, but true emergencies are few and far between. Ever seen one of those birth story shows, where the doctor insists you need to be induced or have a c-section today, then they make the couple wait hours or schedule it for the next day even? How is that an emergency when it can wait?! And women are amazing, no matter what your background and schooling, women have an innate ability to understand their bodies and do what needs to be done, sometimes it just takes another woman letting them know they can do it.

Please note, none of the above actual procedures are bad in and of themselves, on the contrary they are life-saving in the cases that need them and are perfectly acceptable and a great blessing then, but doctors and hospitals seem to be leaning towards making sure they have less liability and moms and babies are simply alive. Mom and baby being alive is of course the point of the whole thing, but too many people are discounting the importance of the experience as a whole. What good is a living baby with a mom who is emotionally scarred for the rest of her life by an unnecessary c-section or other procedure, when she finds out later it was uneeded and she feels like a birthing failure? Or how is it a "good outcome" when they schedule a mom for an induction early due to the idea that baby may be big or just for scheduling purposes only to discover baby is too small to be born and must remain in the hospital long after mom is discharged and has lasting developmental problems? And what about the mom who is fine, and baby is fine, then she finds out later that her birth could have been magical, spiritual, even transcendent? I'd feel cheated. In fact, I do. I am mad at America in general for perpetuating this idea that birth must be painful, b/c I finally figured out that it doesn't have to be, and I am mad at America for teaching other women that so that they sneer when I try to explain what I've learned like I'm trying to be arrogant or judgmental or whatever they are thinking. Can't we just share our different birth experiences and learn from each other, taking what will help us both in our different situations? I guess I'm also mad at other moms who seem to be just flying by the seat of their pants and letting everyone else tell them what to do and how to do it, even though I KNOW that was me with my first couple of births. I guess for me I just felt like I was going to the sources I should (doctors and other moms, right?), but wasn't getting any new info each time, so I must have known what I needed to know. I hate feeling ignorant, especially when I feel like I should have/could have done more. Well, I refuse to do it anymore. I'm not going to trust every source on the internet, but neither will I trust everything that comes out of a doctor or nurse's mouth unless I have a real understanding of it and they have some sort of published information to give me besides vague "this will happen" or "you should do this." And I will read more non-fiction and learn for myself more of what I think I already know.

Whew, that was a lot, with no pictures, sorry. And I didn't explain many things very well, so please ask me more questions if you have them or I was unclear. Now I am tired of writing, and need to visit with my 1st grader who got home just a bit ago and help my 5th grader finish his school today. Hopefully my next post will be pictures of the latest addition to our family and not me ranting about how he is still closeted in my uterus...

4 comments:

M. Kristy said...

You are absolutely right! Well said!

Meg said...

What a wonderful post! You are so right. I'm excited for your new little one! What a great family he is getting.

Loni said...

Hey April! I just stumbled on your blog. How have you guys been? Congrats on the new addition!

Okay, so I don't mean to play devil's advocate here and I have only had three babies compared to your seven (right?) and maybe it's just because of Shane's in residency, but sometimes I feel like doctors and modern day medicine gets a bad rap. I have lots of friends who are huge proponents of natural birth and home deliveries so maybe I've just been in one too many conversations where I've felt put down for making, what I consider to be a safe choice, to have a baby in a hospital with a doctor. But sometimes I think that it's only because modern medical procedures have worked so well that we're even able to have these conversations. It was not many decades ago that childbirth was the biggest killer of women. And let's not forget all the babies who died too. My mom believes at least two of her kids would have died right after delivery from knots in cords and cords around necks had it not been for an emergency staff right on hand.

So anyway, to each their own and what you have it working for you and that's wonderful. And yes, it's sad that our medical system is the way it is that doctors feel like they have to work defensively and cover their back from law suits. I just felt I had to stand up for the good docs out there and say that just because you have an epidural or a c-section, you can still have a beautiful, incredible birth because after so many long hard months, you're bringing your child into the world and isn't that what matters the most?

Best wishes to your family!

Lewis Family said...

Loni, I totally agree with you. Being a natural birth advocate, what I say usually comes out sounding like I do not like the medical profession at all and unfortunately also tends to come out like I think non-natural/vaginal births are somehow failures or "worse" than doing it my way. I suppose it's the same with all of our parenting and other family choices we make, huh? I'm so glad you stopped by finally! And I am very glad to know that one more worthy Priesthood holder I know who listens to the Spirit has joined the medical profession. I am also unfathomably grateful we have never needed any emergency help in our cases; it has definitely taken the number of births we've been able to have to help me feel confident enough in myself and Heavenly Father to birth our latest at home. HUGS to you and all of yours!