Monday, April 25, 2011

You have choices in childbirth...

I'm on a journey... I'm a former Art Teacher who hung up my 'smock' to stay home to raise two beautiful boys. Two boys who arrived so differently and by doing so, altered my future career path. As a big reader, I read a fair amount about pregnancy and childbirth before the arrival of our first son. A few weeks before delivery I arrived at my prenatal check-up with a birth plan in hand. My husband and I discussed what interventions we wanted to avoid and what our expectations were. Most wishes were hesitantly accepted. It was a 26 hour labor with no epidural, no pitocin and the feeling of winning the longest race I'd ever run and it was... EXHILARATING! The repercussions of having an OB assisted hospital birth were: I was limited to the lithotomy position in bed, which resulted in a minor perineum tear (the worst recovery pain EVER!), I lacked the support/encouragement/knowledge of another experienced labor coach/assistant, and lacked food needed for energy during the long hours of labor.

Fast forward 2 years being pregnant for the 2nd time. I knew I wanted more support and encouragement from my provider. I wanted to enter a hospital feeling like I wasn't 'at risk' for something to go wrong but rather that I was capable and was designed to do this birthing thing. I sought the care of the one and only certified nurse midwife in town. She was wonderful. She explained each test, procedure and possible interventions in labor. I was informed of the risks and benefits of each. She taught and demonstrated various techniques for managing labor pains (use of a birthing ball, side lying, back massage, etc.) During labor she spent more time helping me to recognize what stage of labor I was in. She also helped ward off other unnecessary, but commonly given interventions (constant fetal monitoring, intra-uterine pressure catheter and an epidural). I freely ate, which she encouraged and shared that their was no scientific evidence to prove it unsafe. She was not only my advocate, but she empowered me to trust what I wanted and what my body could do. With this birth, I changed positions often, used a birthing ball and ended up delivering our second son in a hands and knees position. The result: a healthy baby boy with no evidence of tearing. My postpartum recovery was a snap! I went shopping 3 days later.

We have choices in childbirth and we should be questioning protocol and giving ourselves permission to say "No", because present day practices truly aren't all evidence based (meaning it's not what's best for you or baby). Maternity decisions are driven by monetary and legal reasons. Obstetricians are paid more when you arrive and deliver during their shift. On top of that, obstetricians and medical residents want to get home to their families and this means... intervening to speed up your labor process. Have you ever heard of the phrase "intervention cascade"? One intervention leads to another that leads to another. If you're considered low risk, does it make sense that you need to be poked, prodded and limited to bed? Generally speaking, obstetricians want to be in control, they want us (as one nurse summed it up) 'numb and dumb'. It's the only area I've witnessed doctors, medical residents, and nurses enter a room and state what they're going to do often without explaining risks/benefits to a patient so that she can give informed consent. You should be asking what the risks and benefits are to each and every treatment/intervention and stating that you'd like a few minutes to process the information (given it's not an emergency). You have the right to say no and to call the shots. Here's a link to 'The Rights of Childbearing Women'. It matters how our babies arrive and we'll remember their arrival forever...

1 comment:

Jamie Kaufmann said...

I think you are on a great mission! I wish I had done childbirth much differently. Two C-sections has taken such a toll on my body. I knew after the first that it just didn't seem right to have no advocate on my side, helping me. A mid-wife was exactly what I was needing. I did have one nurse who really cared, and that made all the difference...for her 12 hour shift. I so wished it had been like that the whole time, for both kids.

Now my boys have a mom having gallbladder surgeries, bad back, maybe not able to ride bikes or rollercoasters anymore, it just makes me so sad. :(

The only time I wanted to be a nurse was during childbirth because I knew how much women needed someone on their side! Kuddos to you for actually doing something about that. You'll do great!