Sunday, November 09, 2008

Natural childbirth redux

A pregnant reader stumbled upon my blog a while back and emailed me to ask for some feedback on my experience with natural childbirth in a hospital setting. And like a good blogger, I neglected that email inbox for a good month or so and didn't see her note until yesterday. I tried to respond but my email was bounced back. So, Sarah, if you're still out there and haven't given birth yet, I hope you'll find this post helpful. (and I'm sorry)

Standard cautionary statement: I AM NOT AN EXPERT ON NATURAL CHILDBIRTH. Or anything else.


I'm worried the hospital staff will mess up my plans [for natural childbirth]. I've written a birth plan, but other than that- how were you able to get around that?

Sorry, there isn't a short answer to this question. Get comfy!

I was under the care of a practice that included both midwives and doctors, and their philosophy is that natural childbirth is a natural (duh) and desireable way to give birth. If a patient decides that they want drugs, that's fine, too, but I knew in advance that they would support me. I didn't have a birth plan because everything I wanted was their standard approach to care (no drugs or episiotomies, baby goes to mom right away, any non-critical treatments for baby are delayed, etc.), but in general, I think a birth plan can be a good thing if it's not too lengthy.

Another important thing: the hospital didn't require continuous fetal monitoring. I don't know about other women, but being chained to the bed with a fetal monitor probably would have been the end of natural childbirth for me. Lying down isn't a good position for labor and birth anyway- standing and walking makes the most sense so that gravity is working in your favor. Aside from that, I really needed to be able to move around so I could manage the pain. Ask if you can be checked intermittently instead, preferably with a Doppler.

If the above doesn't apply to you, some of these other approaches might help:

We hired a doula who we liked and trusted, and she was a great resource to us before, during, and after the birth. Completely worth the money, if you can afford it and find someone you're comfortable with. She was there for us, and only us. While our midwife was also wonderful, she had lots of other patients to tend to that night. The doula stayed with us the entire time. It really gave me peace of mind.

My husband was on board with natural childbirth, and we'd done lots of preparation terms of understanding labor and how we could work together (and with the doula) to avoid interventions. We did perineal massage, practiced breathing and labor positions, etc. We had a "bag of tricks", if you will, or props. The doula had things like scarves and aromatherapy supplies and a birth ball. We also brought some items, like an ultrasound picture of the baby for me to focus on, a (washable) gardening knee pad for when I knelt on the floor, a small electric fan, a boom box and some meditation CDs, and lots of Gatorade, Jell-O, and breath mints. The bathroom had a shower where I could labor (but alas, no tub).

In addition, I'd invited my mom and Mike's mom to be there for the birth. I told them in advance that if they couldn't handle seeing me in pain, I couldn't have them in the room with me. People freaking out and saying, "Don't you want medication now?!" would have been completely awful, because I needed to feel confident and capable. Fortunately, the moms were great and I was so glad they were there.

So, in a nutshell: surround yourself with people who will support you and believe in you.

Also- labor at home for as long as you can before you go to the hospital. We spent all afternoon at home with the doula, and left for the hospital when my contractions were about 2 minutes apart. In retrospect, we could have stayed home even longer than we did, but we had no way of knowing for sure how far along I was. The more established your labor is when you arrive, the better, but you have to be comfortable with your decisions.

What worked for you?

Besides what I wrote above, I tried to prepare both physically and mentally. I exercised right up until the day I went into labor. I meditated a lot, and visualized myself having the experience I wanted. I sought out positive feedback and birth stories from other women (Roxanne, for one- thank you) and tried to ignore people who implied that I was crazy or a martyr or wouldn't be able to do it. The book Birthing from Within (by England and Horowitz) was really, really helpful. I also practiced self-hypnosis before the birth, using Hypnobirthing: The Mongan Method as a guide, but ultimately, I didn't end up using it much in labor. I don't know why- I just didn't. Before the birth I feared that I might lose control and feel unable to handle the pain, but that never happened. It wasn't as bad as I thought it would be. Honestly! And it was incredibly empowering.

Is there anything you were disappointed with, or would have done differently?

Yeah, I was disappointed that my baby decided to take a gigantic crap before he was born! The large amount of meconium in the amniotic fluid meant that we had to speed things along, and the pushing stage ended up being different from what I had visualized and wanted. It also meant that my husband couldn't help catch the baby as we'd planned, and I wasn't able to hold my son right away. I was sad about those things, but in the end, it didn't matter that much. In all, Lion was treated by the neonatologist for only about ten minutes post-birth, though it seemed like an eternity at the time. He could have ended up in the NICU, and we are thankful that didn't happen.

I wish there had been a tub in the room. I wished for one many, many times. The hot shower was enormously helpful, but a tub would have been even better. If we have another baby, I will seriously consider a birthing center or a home birth for that reason.

In all, the experience was pretty much what I wanted. It took preparation, support, and a little bit of luck.

Hope this was helpful. I hope you have (had?) the experience of your dreams.

(if anyone else has feedback on NCB in a hospital, feel free to chime in)

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