I've got a friend who is pregnant with her second child and fighting her way towards a VBAC after an unnecessary c-section the first time around. She wrote a great post with some links to information about VBACs that I wanted to share, as I know I have a few readers who are wanting VBACs in the future.
See the post here on Operation Housewife.
Showing posts with label choice. Show all posts
Showing posts with label choice. Show all posts
Saturday, January 15, 2011
Saturday, December 18, 2010
What are you interested in?
So, part of my goal for this blog is to be a sort of "entry-level" blog into natural birth. Once you dive into researching birth, it is amazing the complexity that you'll find. But, I don't necessarily want to dive into complex areas of pregnancy and birth...after all, I'm not a birth professional (yet) so I technically don't have all of the scientific knowledge, etc. I mostly want to educate women on the choices they have. We have a choice in everything we do...everything!
Doctors and midwives have so much knowledge, thankfully, but ultimately, our care rests in our hands. It is so important to be educated and to work with your care provider so that you attain the best care possible. Many care providers are very busy and unfortunately, that may mean that you are not always in their best interest. That doesn't mean they don't care about you, or that you aren't important to them, but it may mean that often times, things are done simply as a routine. This is where choices come in. Research things and educate yourself so that you know when you have a choice about something and when you don't. For example, you might discuss IV placement (if birthing in a hospital) with your doctor or midwife. IV's are not medically necessary for birth, but they are routine. If you do not wish to have an IV, you do not have to have one (based on the discussion with your doctor). Obviously, if you are planning to have an epidural or other pain medication, you will need that IV. If you are desiring a natural, intervention free birth, you don't need that IV. Many doctors say you need at least a Hep Lock, in case of an emergency situation, but to that I say: if there is an emergency situation, I think you could put an IV in my arm fast enough that everything would be just fine (after all, if an EMT can place an IV in someone injured in a car wreck in the dark, one will most likely be able to be placed in me in a brightly lit room). That is one area where you do have a choice. Again, you research it, you weigh the pros and cons, and then you make a choice. If you feel more comfortable having an IV in your arm, by all means, have that IV. If you feel it would interfere with your ability to cope with the intensity of a natural birth, then decline the IV placement. Doctors and midwives vary on this practice. My second OB (before I switched to a home birth midwife) told me that I did not have to have an IV, but that she would prefer that I have a Hep Lock. When I told her I'd rather not have either, she was supportive of that. She is a great doctor who is understanding of how natural birth differs from medicalized births, so for me, she was a great choice as a care provider. The most important thing to remember is that you do have a choice in care providers, so if you are not happy with the way your doctor or midwife handles things or if you do not agree with the way they view birth, then you are free to make the choice to switch. You are the one paying them, so you are free to find someone who is a good fit for you. If you are not satisfied with their care, by all means, switch! It is your health, your birth, and you need to be with someone who will work with you, support you, and include you as part of your care. Informed consent...means you are educated, you work with your care provider to make decisions, and you make choices based on the information you have been given and learned.
So my question is, what things are you interested in learning about on this blog? What things would you like to know more about? Is there any particular aspect of pregnancy and/or birth that you would like to broaden your knowledge on?
Doctors and midwives have so much knowledge, thankfully, but ultimately, our care rests in our hands. It is so important to be educated and to work with your care provider so that you attain the best care possible. Many care providers are very busy and unfortunately, that may mean that you are not always in their best interest. That doesn't mean they don't care about you, or that you aren't important to them, but it may mean that often times, things are done simply as a routine. This is where choices come in. Research things and educate yourself so that you know when you have a choice about something and when you don't. For example, you might discuss IV placement (if birthing in a hospital) with your doctor or midwife. IV's are not medically necessary for birth, but they are routine. If you do not wish to have an IV, you do not have to have one (based on the discussion with your doctor). Obviously, if you are planning to have an epidural or other pain medication, you will need that IV. If you are desiring a natural, intervention free birth, you don't need that IV. Many doctors say you need at least a Hep Lock, in case of an emergency situation, but to that I say: if there is an emergency situation, I think you could put an IV in my arm fast enough that everything would be just fine (after all, if an EMT can place an IV in someone injured in a car wreck in the dark, one will most likely be able to be placed in me in a brightly lit room). That is one area where you do have a choice. Again, you research it, you weigh the pros and cons, and then you make a choice. If you feel more comfortable having an IV in your arm, by all means, have that IV. If you feel it would interfere with your ability to cope with the intensity of a natural birth, then decline the IV placement. Doctors and midwives vary on this practice. My second OB (before I switched to a home birth midwife) told me that I did not have to have an IV, but that she would prefer that I have a Hep Lock. When I told her I'd rather not have either, she was supportive of that. She is a great doctor who is understanding of how natural birth differs from medicalized births, so for me, she was a great choice as a care provider. The most important thing to remember is that you do have a choice in care providers, so if you are not happy with the way your doctor or midwife handles things or if you do not agree with the way they view birth, then you are free to make the choice to switch. You are the one paying them, so you are free to find someone who is a good fit for you. If you are not satisfied with their care, by all means, switch! It is your health, your birth, and you need to be with someone who will work with you, support you, and include you as part of your care. Informed consent...means you are educated, you work with your care provider to make decisions, and you make choices based on the information you have been given and learned.
So my question is, what things are you interested in learning about on this blog? What things would you like to know more about? Is there any particular aspect of pregnancy and/or birth that you would like to broaden your knowledge on?
Monday, June 14, 2010
How to have a natural birth in a hospital
I asked my friend, Rachel, who blogs at The Beginning of Motherhood, to share some thoughts about how to achieve a natural birth in a hospital setting. Rachel has a lot of experience with this, as she has had five children naturally and works as a nurse in Labor and Delivery. Thank you so much for sharing your wonderful tips!
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I have seen all sorts of births and all sorts of birth plans. I have seen women do fabulous going natural on pitocin, laying in bed, and in all sorts of other situations. I have also seen some women who have been doing great soaking in a tub, but ask for an epidural. I have seen some who I would have thought regretted not getting an epidural, but when asked, said they appreciated the experience. Any way it happens, a natural birth(going without pain medication) is something that you need to have a reason for wanting. To me, that has been the key ingredient. Also, your desire may change further down the road through labor, and that's OK. So, I would say the first step in having a natural birth in the hospital, is to decide if you really want to and why. These are not questions that anyone can really give you an answer too, but yourself, but I'll attempt to start you on your path.
First off, you can do a natural birth. Women have been doing them forever. So the real question is do you want to. The main reason for getting an epidural is the obvious: pain relief. Labor is hard work, and can be very painful. But, pain tolerance is not really an indicator of whether or not you will want an epidural. What you need to decide is if your reason for wanting one is greater than your reason for not wanting one. A few case examples. Many women are afraid of the needle in an epidural, or the pain of the epidural itself. I have had one woman tell me that when her contractions are so intense that she no longer is afraid of the needle then she gets the epidural. She always gets them. Therefore, for her, the labor is worse than the epidural. On the other hand, another woman I took care of felt like her fear of the epidural was greater than her fear of labor. Therefore, she always went natural. Some other factors to think about when it comes to reasons for/against getting epidurals: 1)you ability to move is greatly reduced when you have an epidural. Once you have one you are in bed, with a tube to drain your urine, and the nurses have to help with movement of the legs. This may be OK with you, and may be worth it, but again, it's just something to think about. Many people are worried about drugs being introduced. From what I have researched, the drugs given in epidurals will not cross into your babies body, but it does effect immediate breastfeeding(though not long term). It does tend to slow down labor, and there is an increased use of forceps or vacuums with them. For those who are experiencing exhaustion or can not relax, though, it may be useful. These are just some of the factors involved, and I would suggest thoroughly researching them.
So onto how to work through a natural labor in the hospital.
Request a hep-lock(where the iv is in you, but not connected to any tubing), or no iv at all if you feel comfortable with that. If you are not receiving iv fluids, make sure you are eating and drinking. If your hospital only allows ice chips, eat as many ice chips as possible and add sugar:) I would even bring some Gatorade pre frozen just for you to suck on. As long as it's ice, it fits in the policy. Some research I have read suggests that a woman needs at least 125-250 ml of water and hour. That's 1L of fluids every 4-8 hours. If you have to have an iv, you are still capable of moving. Request that you have an iv pole for the fluids to hang on so that you can walk around with it. If you do have any fluids running in, keep in mind that you can also get too much. Especially if you are on pitocin as that tends to increase water retention. One bag of iv fluid equals a liter, so keep that in mind when gaging how much you are drinking. Make sure you are going to the bathroom often, at least every one or two hours. An empty bladder will facilitate labor. Sitting on the toilet is also a comfortable position:) An iv pole can actually be very useful to hold onto during contractions. When you are feeling weaker, but still want to stand, an iv pole makes a good brace to pull down on. It is also useful during pushing. If you are wanting to squat, the pole can be used to hold onto.
Request intermittent monitoring. Keep in mind that this may only be possible if the nurses aren't busy, and your babies heart rate is looking OK. Intermittent monitoring has been shown to be safe and effective in monitoring the heart beat of the baby. ACOG guidelines suggest listening to the babies heart beat every 15-30 m while in active labor. This also needs to be done during a contraction and immediately after. This allows the nurse to check the heart rate while you are in different positions or different places. If you have to be connected to the monitors, you can still sit up and move around. You can stand, squat and walk. The difficulty in this comes from making sure that the heart rate stays on the monitor. It is helpful to have someone hold it on tighter during contractions, while sitting up, or squatting. Anyone can do this, it doesn't have to be a nurse. If you notice that the babies heart rate isn't picking up at different times during your labor, try having someone hand hold it. While I normally, don't like internal monitors, for someone who is going natural and having to be on the monitor, they can be useful. With internal monitors, the babies heart rate is picked up much easier and movement is not restricted as much. This would be something that I personally would like at on a case by case basis, and only if the mothers bag of water is already broken.
Which leads me to the bag of water. I would suggest not getting it broken as a matter of policy. Research shows that it does tend to decrease labor time, but only by about 20m. Once your water is broken, contractions tend to be stronger and harder. If you want to shave off time in labor, I would suggest having your water broken during transition or after(around8-10cm). At this point, your labor is already pretty intense, and shaving off time at this point is usually very welcomed. This really is just my opinion. Also, once the water is broken, it allows for germs to be introduced. So often the water is just broken, without a thought as to the individuals preference. Just make sure you at least think about it.
The bed in the hospital can actually be very useful. There are a lot of different positions that it can help you obtain. If you want to kneel, you can kneel over the top, bring the bottom down and kneel on that, or just be on your hands and knees on something soft. During pushing, you can bring the head all the way up and the feet all the way down to simulate a squat or birthing chair. I would play around with it and see how you might find it the most useful. It is also useful to use to kneel on, or put a birthing ball on and lean on.
Water....this has been shown to be one of the most effective pain relief measures for those who are going natural. If you find yourself getting tired, afraid you can't go on, or just needing to try something different, try a hot bath. Some hospitals do not allow this. If this is the case, bring a heating pad that you can use to sit on on the birthing ball, use with counter pressure, or just relax muscles and tension.
If you need to have pitocin, don't sell your selves short and feel like it's impossible to have a natural birht. I have seen many women do fantastic with pitocin. Some key things to remember...you can do it. You have to have a reason for wanting to do it, but it's OK if you don't want to. Ask your provider if you can do low dose pitocin. This will add the pitocin more gradually. You can also request that your pitocin be turned off once you have reached active labor. At this point, your body will sometimes take over and you will no longer need pitocin.
For some it is useful to try not to think about the contractions in terms of pain, but just intensity. If you prefer this, make sure you ask your nurse not to ask you your what level your pain is at. But let her know whether or not it is getting more intense. This is an important indicator of how your labor is progressing and how well a woman is coping.
One last point, when you first arrive at the hospital there is a whole admittance procedure. If you are not in too much pain, it's not that big of a deal. But if you are having to work hard through contractions, appoint someone else to answer the questions that are needed.
----------
I have seen all sorts of births and all sorts of birth plans. I have seen women do fabulous going natural on pitocin, laying in bed, and in all sorts of other situations. I have also seen some women who have been doing great soaking in a tub, but ask for an epidural. I have seen some who I would have thought regretted not getting an epidural, but when asked, said they appreciated the experience. Any way it happens, a natural birth(going without pain medication) is something that you need to have a reason for wanting. To me, that has been the key ingredient. Also, your desire may change further down the road through labor, and that's OK. So, I would say the first step in having a natural birth in the hospital, is to decide if you really want to and why. These are not questions that anyone can really give you an answer too, but yourself, but I'll attempt to start you on your path.
First off, you can do a natural birth. Women have been doing them forever. So the real question is do you want to. The main reason for getting an epidural is the obvious: pain relief. Labor is hard work, and can be very painful. But, pain tolerance is not really an indicator of whether or not you will want an epidural. What you need to decide is if your reason for wanting one is greater than your reason for not wanting one. A few case examples. Many women are afraid of the needle in an epidural, or the pain of the epidural itself. I have had one woman tell me that when her contractions are so intense that she no longer is afraid of the needle then she gets the epidural. She always gets them. Therefore, for her, the labor is worse than the epidural. On the other hand, another woman I took care of felt like her fear of the epidural was greater than her fear of labor. Therefore, she always went natural. Some other factors to think about when it comes to reasons for/against getting epidurals: 1)you ability to move is greatly reduced when you have an epidural. Once you have one you are in bed, with a tube to drain your urine, and the nurses have to help with movement of the legs. This may be OK with you, and may be worth it, but again, it's just something to think about. Many people are worried about drugs being introduced. From what I have researched, the drugs given in epidurals will not cross into your babies body, but it does effect immediate breastfeeding(though not long term). It does tend to slow down labor, and there is an increased use of forceps or vacuums with them. For those who are experiencing exhaustion or can not relax, though, it may be useful. These are just some of the factors involved, and I would suggest thoroughly researching them.
So onto how to work through a natural labor in the hospital.
Request a hep-lock(where the iv is in you, but not connected to any tubing), or no iv at all if you feel comfortable with that. If you are not receiving iv fluids, make sure you are eating and drinking. If your hospital only allows ice chips, eat as many ice chips as possible and add sugar:) I would even bring some Gatorade pre frozen just for you to suck on. As long as it's ice, it fits in the policy. Some research I have read suggests that a woman needs at least 125-250 ml of water and hour. That's 1L of fluids every 4-8 hours. If you have to have an iv, you are still capable of moving. Request that you have an iv pole for the fluids to hang on so that you can walk around with it. If you do have any fluids running in, keep in mind that you can also get too much. Especially if you are on pitocin as that tends to increase water retention. One bag of iv fluid equals a liter, so keep that in mind when gaging how much you are drinking. Make sure you are going to the bathroom often, at least every one or two hours. An empty bladder will facilitate labor. Sitting on the toilet is also a comfortable position:) An iv pole can actually be very useful to hold onto during contractions. When you are feeling weaker, but still want to stand, an iv pole makes a good brace to pull down on. It is also useful during pushing. If you are wanting to squat, the pole can be used to hold onto.
Request intermittent monitoring. Keep in mind that this may only be possible if the nurses aren't busy, and your babies heart rate is looking OK. Intermittent monitoring has been shown to be safe and effective in monitoring the heart beat of the baby. ACOG guidelines suggest listening to the babies heart beat every 15-30 m while in active labor. This also needs to be done during a contraction and immediately after. This allows the nurse to check the heart rate while you are in different positions or different places. If you have to be connected to the monitors, you can still sit up and move around. You can stand, squat and walk. The difficulty in this comes from making sure that the heart rate stays on the monitor. It is helpful to have someone hold it on tighter during contractions, while sitting up, or squatting. Anyone can do this, it doesn't have to be a nurse. If you notice that the babies heart rate isn't picking up at different times during your labor, try having someone hand hold it. While I normally, don't like internal monitors, for someone who is going natural and having to be on the monitor, they can be useful. With internal monitors, the babies heart rate is picked up much easier and movement is not restricted as much. This would be something that I personally would like at on a case by case basis, and only if the mothers bag of water is already broken.
Which leads me to the bag of water. I would suggest not getting it broken as a matter of policy. Research shows that it does tend to decrease labor time, but only by about 20m. Once your water is broken, contractions tend to be stronger and harder. If you want to shave off time in labor, I would suggest having your water broken during transition or after(around8-10cm). At this point, your labor is already pretty intense, and shaving off time at this point is usually very welcomed. This really is just my opinion. Also, once the water is broken, it allows for germs to be introduced. So often the water is just broken, without a thought as to the individuals preference. Just make sure you at least think about it.
The bed in the hospital can actually be very useful. There are a lot of different positions that it can help you obtain. If you want to kneel, you can kneel over the top, bring the bottom down and kneel on that, or just be on your hands and knees on something soft. During pushing, you can bring the head all the way up and the feet all the way down to simulate a squat or birthing chair. I would play around with it and see how you might find it the most useful. It is also useful to use to kneel on, or put a birthing ball on and lean on.
Water....this has been shown to be one of the most effective pain relief measures for those who are going natural. If you find yourself getting tired, afraid you can't go on, or just needing to try something different, try a hot bath. Some hospitals do not allow this. If this is the case, bring a heating pad that you can use to sit on on the birthing ball, use with counter pressure, or just relax muscles and tension.
If you need to have pitocin, don't sell your selves short and feel like it's impossible to have a natural birht. I have seen many women do fantastic with pitocin. Some key things to remember...you can do it. You have to have a reason for wanting to do it, but it's OK if you don't want to. Ask your provider if you can do low dose pitocin. This will add the pitocin more gradually. You can also request that your pitocin be turned off once you have reached active labor. At this point, your body will sometimes take over and you will no longer need pitocin.
For some it is useful to try not to think about the contractions in terms of pain, but just intensity. If you prefer this, make sure you ask your nurse not to ask you your what level your pain is at. But let her know whether or not it is getting more intense. This is an important indicator of how your labor is progressing and how well a woman is coping.
One last point, when you first arrive at the hospital there is a whole admittance procedure. If you are not in too much pain, it's not that big of a deal. But if you are having to work hard through contractions, appoint someone else to answer the questions that are needed.
Thursday, June 3, 2010
Home birth, part 1
I have been wanting to do some posts about home birth, because while it is not the right decision for every one, with my last pregnancy, it was the right decision for me. It is near and dear to my heart and was one of the most empowering, transformative experiences I've ever had.
I thought to start out my posts on home birth, I would begin with my personal experience - how I was guided to choosing a home birth. I mostly want to record this for my own sake, and I don't mind sharing the journey with others.
When I found out I was pregnant with my second daughter, I was so excited. I knew that I wanted to have a natural birth, without medication. This is because I had had an epidural with my son, and was not too impressed by it. I desired a natural birth with him, but I was not prepared enough and decided to get an epidural when I was dilated to 6 cm. I felt let down after his birth and told myself I would go naturally the next time.
So, the next time came, and I was determined. When I was pregnant with my son, I had so many people tell me I couldn't have a natural birth, especially members of my family. They said, "Oh, you have no idea how hard it is. Just wait, you'll want the drugs." I wanted to have a natural birth for myself, but it didn't hurt to have someone in mind I wanted to prove wrong.
I called my insurance to see if midwives were covered. They weren't. So next, I researched and found a doctor who was very supportive of natural birth. I enjoyed going to this doctor, but it still felt like just a doctor. Nothing special about the relationship. I felt very confident, however, that I would be able to have a natural birth and knew that this doctor would be supportive.
My next step was finding a doula. I talked to a few doulas, and settled on one, who happened to be apprenticing with a local home birth midwife. I hadn't really considered home birth before. And, I didn't consider it at first either. Not for any particular reason, I just didn't really think about it. I was very happy to have a doula and knew that I would have the support I needed to birth naturally in a hospital.
As my pregnancy progressed, I researched and read all I could about pregnancy, labor, and birth. I wanted to be prepared. I talked to people who birthed naturally. I read birth blogs. Incidentally, I read a lot about home birth. My mind was opened to that possibility, little by little. I had known a few people who had had home births right around the time my first was born but other than that, I hadn't had any experience with home birth.
I was due right in the midst of the whole "Swine Flu/H1N1" thing (I would call it an epidemic...but, well...it didn't turn out to be an epidemic at all). Because of this, the hospitals became very, very strict regarding visitors in the Mother/Baby unit. I found out when I was around 26 weeks pregnant that the hospital I was delivering at would not allow children under 12 in to visit their mother's or sibilings. This made me so sad. I couldn't imagine being away from my little boy (who would be only 20 months old when I delivered) for two whole days, let alone not being able to show him his sweet little sister. I wanted him to be a part of the experience. I didn't know what to do about it. I knew it sounded stupid to people, but it hurt me to the core. I just couldn't imagine it.
Then, I found out that if a mother was suspected of having H1N1, that in some cases, the baby would be taken away so as to not become infected. This enraged me and I felt it was wrong. I do not want newborns to get sick, but I didn't believe it was the hospital's right to separate the mother and baby, against a mother's will. If it were me (and it very well could have been me) - I would want the choice. Choices. Those are important. And, we as mother's should have a choice. I wanted a choice. And, if I wasn't able to have that choice in a hospital, then I would find a way to have that choice.
I also felt that the hospital was a very germy place, with the whole H1N1 thing, and I didn't feel comfortable with that. I felt that our home was a much safer place for my baby to enter this world.
Incidentally, like I mentioned before, my doula was an apprentice midwife. I called her up one day, just to see how much a home birth would cost. Finances were my main concern. If it wouldn't be expensive, I was almost positive I needed to talk to my husband about doing a home birth. She told me that they were just starting a program for low-income families to be able to do home birth. By having part of the appointments occur in group settings, with a moment for individual check-ups, they could charge less, but still let women have the birth experience they wanted. It also provided a great system of support for pregnant women and new mothers. What an amazing blessing for us.
I spoke to my husband about having a home birth. I had already done all my research and I had felt that it was very safe and that it was something we should consider. At first, he didn't really see the need for a home birth. He thought I could have the birth I wanted in a hospital. I knew that would be his reaction, and definitely understood it. I felt the same way - "Why can't I just be satisfied with a hospital birth?" I couldn't understand why I felt so driven to have a home birth. I was being led and guided...and even pulled at times. But why? I didn't really know, but I knew I had to do what I was being guided to do.
I continued to research, and of course, pray and think about the decision. I educated my husband, and as he researched and learned, he saw that it would be a good thing too. He supported me and told me that we would birth wherever I felt it would be best. I knew he was behind me 100%. I had a lot of negativity from my family surrounding my decision. I had decided on birthing at home, but with all of the negativity, I had lots of thoughts inside about not doing it. I thought to myself, "It'd be so much easier just to give birth in the hospital...nobody would ask me questions...nobody would be saying bad things about me." But, again, that would be going against what I felt so driven to do. It would be going against something inside telling me it was the right decision.
It was not an easy decision to decide to have a home birth. It was not hard because I felt it was unsafe - through research and prayer, I felt totally confident that it would be safe. I knew God was in control and I knew that the outcome depended on His plans for me. I knew my midwife had the knowledge and experience needed to have a good outcome. I knew I was healthy and low-risk. It was hard because it was going against the grain. Home birth is not common, although it is becoming increasingly more well-known. It was hard because I had such little support, outside God, my husband, my midwife, a friend, and the natural birthing community online. It was hard because I was making an uncommon choice.
I ultimately decided to have a home birth when I was 32 weeks pregnant. From the moment I made my decision, I felt so excited. That told me it was the right decision to make. I couldn't stop thinking about it and planning for it. I felt sad that I didn't have many people to share that excitement with. I kept it to myself because I had opened up to my family about wanting a home birth and had had such negativity, that I decided it was best to just keep it to ourselves so I wouldn't have to deal with what other people think. I decided I would let people know about Maude's home birth after she was born. It was easier that way for me because the negativity put a damper on my excitement.
I firmly believe that the harder the choices are that we make, the more rewarding they are. That doesn't mean that we should make choices that are wrong. That is not what I am saying at all. What I am saying is that we should make choices that are right, even if they are HARD. Even if they are the hardest thing you'll ever do. If it is right and your heart is telling you to do it, you have to do it, no matter what. Having a home birth took so much courage. But it is a decision I will never regret. I came away from that experience with so much growth. I grew spiritually as I made the decision and I grew spiritually as I birthed. My testimony of God grew. I knew He was aware of me and I knew He was guiding my life. I also knew that He knows all things. He knew when Maude would come. My labor lasted a long while and I felt so hopeless. The apprentice midwife said to me, "Kami, God knows when Maude will be born. You just have to trust in Him. He already knows how this will end! Have faith!" I realized that I was not in control - God was. He already knew when she'd be born and I had to trust in him. I did trust in Him and I turned my will over to His.
In the end, I know why I was led and guided to this choice. No experience has changed me the way my home birth changed me. I felt empowered. I felt transformed. I learned how to listen to God's voice guiding my life. I came closer to my husband. I learned to trust in my body. My confidence grew. I also gained two wonderful friends - my midwife and apprentice midwife. I'm forever changed by them. If I would have taken the "easy" route (in this case, for me, it would have been the easy way out, but I do not mean that if you choose to birth in the hospital, that you are taking the easy way out), I would not have become the person I am today. My decision, although very difficult, changed my life for the better and I am so thankful I did something hard. Now I know "I can do hard things."
I thought to start out my posts on home birth, I would begin with my personal experience - how I was guided to choosing a home birth. I mostly want to record this for my own sake, and I don't mind sharing the journey with others.
When I found out I was pregnant with my second daughter, I was so excited. I knew that I wanted to have a natural birth, without medication. This is because I had had an epidural with my son, and was not too impressed by it. I desired a natural birth with him, but I was not prepared enough and decided to get an epidural when I was dilated to 6 cm. I felt let down after his birth and told myself I would go naturally the next time.
So, the next time came, and I was determined. When I was pregnant with my son, I had so many people tell me I couldn't have a natural birth, especially members of my family. They said, "Oh, you have no idea how hard it is. Just wait, you'll want the drugs." I wanted to have a natural birth for myself, but it didn't hurt to have someone in mind I wanted to prove wrong.
I called my insurance to see if midwives were covered. They weren't. So next, I researched and found a doctor who was very supportive of natural birth. I enjoyed going to this doctor, but it still felt like just a doctor. Nothing special about the relationship. I felt very confident, however, that I would be able to have a natural birth and knew that this doctor would be supportive.
My next step was finding a doula. I talked to a few doulas, and settled on one, who happened to be apprenticing with a local home birth midwife. I hadn't really considered home birth before. And, I didn't consider it at first either. Not for any particular reason, I just didn't really think about it. I was very happy to have a doula and knew that I would have the support I needed to birth naturally in a hospital.
As my pregnancy progressed, I researched and read all I could about pregnancy, labor, and birth. I wanted to be prepared. I talked to people who birthed naturally. I read birth blogs. Incidentally, I read a lot about home birth. My mind was opened to that possibility, little by little. I had known a few people who had had home births right around the time my first was born but other than that, I hadn't had any experience with home birth.
I was due right in the midst of the whole "Swine Flu/H1N1" thing (I would call it an epidemic...but, well...it didn't turn out to be an epidemic at all). Because of this, the hospitals became very, very strict regarding visitors in the Mother/Baby unit. I found out when I was around 26 weeks pregnant that the hospital I was delivering at would not allow children under 12 in to visit their mother's or sibilings. This made me so sad. I couldn't imagine being away from my little boy (who would be only 20 months old when I delivered) for two whole days, let alone not being able to show him his sweet little sister. I wanted him to be a part of the experience. I didn't know what to do about it. I knew it sounded stupid to people, but it hurt me to the core. I just couldn't imagine it.
Then, I found out that if a mother was suspected of having H1N1, that in some cases, the baby would be taken away so as to not become infected. This enraged me and I felt it was wrong. I do not want newborns to get sick, but I didn't believe it was the hospital's right to separate the mother and baby, against a mother's will. If it were me (and it very well could have been me) - I would want the choice. Choices. Those are important. And, we as mother's should have a choice. I wanted a choice. And, if I wasn't able to have that choice in a hospital, then I would find a way to have that choice.
I also felt that the hospital was a very germy place, with the whole H1N1 thing, and I didn't feel comfortable with that. I felt that our home was a much safer place for my baby to enter this world.
Incidentally, like I mentioned before, my doula was an apprentice midwife. I called her up one day, just to see how much a home birth would cost. Finances were my main concern. If it wouldn't be expensive, I was almost positive I needed to talk to my husband about doing a home birth. She told me that they were just starting a program for low-income families to be able to do home birth. By having part of the appointments occur in group settings, with a moment for individual check-ups, they could charge less, but still let women have the birth experience they wanted. It also provided a great system of support for pregnant women and new mothers. What an amazing blessing for us.
I spoke to my husband about having a home birth. I had already done all my research and I had felt that it was very safe and that it was something we should consider. At first, he didn't really see the need for a home birth. He thought I could have the birth I wanted in a hospital. I knew that would be his reaction, and definitely understood it. I felt the same way - "Why can't I just be satisfied with a hospital birth?" I couldn't understand why I felt so driven to have a home birth. I was being led and guided...and even pulled at times. But why? I didn't really know, but I knew I had to do what I was being guided to do.
I continued to research, and of course, pray and think about the decision. I educated my husband, and as he researched and learned, he saw that it would be a good thing too. He supported me and told me that we would birth wherever I felt it would be best. I knew he was behind me 100%. I had a lot of negativity from my family surrounding my decision. I had decided on birthing at home, but with all of the negativity, I had lots of thoughts inside about not doing it. I thought to myself, "It'd be so much easier just to give birth in the hospital...nobody would ask me questions...nobody would be saying bad things about me." But, again, that would be going against what I felt so driven to do. It would be going against something inside telling me it was the right decision.
It was not an easy decision to decide to have a home birth. It was not hard because I felt it was unsafe - through research and prayer, I felt totally confident that it would be safe. I knew God was in control and I knew that the outcome depended on His plans for me. I knew my midwife had the knowledge and experience needed to have a good outcome. I knew I was healthy and low-risk. It was hard because it was going against the grain. Home birth is not common, although it is becoming increasingly more well-known. It was hard because I had such little support, outside God, my husband, my midwife, a friend, and the natural birthing community online. It was hard because I was making an uncommon choice.
I ultimately decided to have a home birth when I was 32 weeks pregnant. From the moment I made my decision, I felt so excited. That told me it was the right decision to make. I couldn't stop thinking about it and planning for it. I felt sad that I didn't have many people to share that excitement with. I kept it to myself because I had opened up to my family about wanting a home birth and had had such negativity, that I decided it was best to just keep it to ourselves so I wouldn't have to deal with what other people think. I decided I would let people know about Maude's home birth after she was born. It was easier that way for me because the negativity put a damper on my excitement.
I firmly believe that the harder the choices are that we make, the more rewarding they are. That doesn't mean that we should make choices that are wrong. That is not what I am saying at all. What I am saying is that we should make choices that are right, even if they are HARD. Even if they are the hardest thing you'll ever do. If it is right and your heart is telling you to do it, you have to do it, no matter what. Having a home birth took so much courage. But it is a decision I will never regret. I came away from that experience with so much growth. I grew spiritually as I made the decision and I grew spiritually as I birthed. My testimony of God grew. I knew He was aware of me and I knew He was guiding my life. I also knew that He knows all things. He knew when Maude would come. My labor lasted a long while and I felt so hopeless. The apprentice midwife said to me, "Kami, God knows when Maude will be born. You just have to trust in Him. He already knows how this will end! Have faith!" I realized that I was not in control - God was. He already knew when she'd be born and I had to trust in him. I did trust in Him and I turned my will over to His.
In the end, I know why I was led and guided to this choice. No experience has changed me the way my home birth changed me. I felt empowered. I felt transformed. I learned how to listen to God's voice guiding my life. I came closer to my husband. I learned to trust in my body. My confidence grew. I also gained two wonderful friends - my midwife and apprentice midwife. I'm forever changed by them. If I would have taken the "easy" route (in this case, for me, it would have been the easy way out, but I do not mean that if you choose to birth in the hospital, that you are taking the easy way out), I would not have become the person I am today. My decision, although very difficult, changed my life for the better and I am so thankful I did something hard. Now I know "I can do hard things."
Friday, May 14, 2010
what i wish i would have known
i found out recently that a friend of mine is pregnant with her first child. i am so excited for her! it got me thinking about the things i wish i would have known before i had my first baby...so i thought i'd brainstorm a little list just for fun. this is by no means all inclusive, but it's a start.
1. i wish i would have taken the time or known how valuable it is to select a care provider who honored my feelings about birth. i chose a doctor based on other people's recommendations and unfortunately, that practice was a very typical OB practice who had about 95% of their patients getting epidurals...which was not conducive to my desire to go naturally.
2. i wish i would have known that i had choices. any of the routine tests, etc...i had a choice. i blindly "obeyed" and did exactly as my doctor said. that is not necessarily a bad thing, but i just wish i would have been more informed and made decisions based on knowledge rather than just blind faith (i know we need to trust doctors because they do have knowledge and expertise, but i also feel it is very important to be knowledgeable as a patient - you have a right to informed consent).
3. i wish i would have known that i could have made it through labor without an epidural. i wanted to go naturally but i did not have enough confidence in myself to follow through with that desire - hence the title of this blog.
4. i wish i would have known how important it was to practice my breathing techniques!! hehe.
5. i wish i would have known the value of delayed cord clamping.
i could probably think up more "i wishes..." but the important thing is that i took what i wished i would have known/or done the first time around, and i applied those "wishes" as best i could to the second time around. i already have more "wishes" for next time. i think that is the beauty in having children...you really do learn as you go, and hopefully because of your increased knowledge, you make improvements!
what do YOU wish you would have known before giving birth to your first child?
1. i wish i would have taken the time or known how valuable it is to select a care provider who honored my feelings about birth. i chose a doctor based on other people's recommendations and unfortunately, that practice was a very typical OB practice who had about 95% of their patients getting epidurals...which was not conducive to my desire to go naturally.
2. i wish i would have known that i had choices. any of the routine tests, etc...i had a choice. i blindly "obeyed" and did exactly as my doctor said. that is not necessarily a bad thing, but i just wish i would have been more informed and made decisions based on knowledge rather than just blind faith (i know we need to trust doctors because they do have knowledge and expertise, but i also feel it is very important to be knowledgeable as a patient - you have a right to informed consent).
3. i wish i would have known that i could have made it through labor without an epidural. i wanted to go naturally but i did not have enough confidence in myself to follow through with that desire - hence the title of this blog.
4. i wish i would have known how important it was to practice my breathing techniques!! hehe.
5. i wish i would have known the value of delayed cord clamping.
i could probably think up more "i wishes..." but the important thing is that i took what i wished i would have known/or done the first time around, and i applied those "wishes" as best i could to the second time around. i already have more "wishes" for next time. i think that is the beauty in having children...you really do learn as you go, and hopefully because of your increased knowledge, you make improvements!
what do YOU wish you would have known before giving birth to your first child?
Wednesday, February 24, 2010
delayed cord clamping
what is delayed cord clamping?
delayed cord clamping is the process of waiting until the umbilical cord stops pulsating (approximately 5 minutes) and/or waiting until the placenta is delivered (approximately 30 minutes) before the cord is cut after the baby is born.
in today's hospitals, most OB's and some midwives routinely clamp and cut the umbilical cord almost immediately after delivery (about 30 seconds). why? what are the benefits?
after researching, the biggest benefit i can see is that it is convenient and a routine. it is not necessarily harmful, but why not wait to cut the cord?
“The cord is often cut immediately, but a recent scientific analysis has found benefit to waiting for at least two minutes or until it stops pulsating—in five minutes or so. Less likelihood of anemia for as much as six months exists in babies whose cords are cut late. Until the cord is clamped or stops pulsating, blood passes back and forth between the baby and the placenta. It goes from placenta to baby when ever the uterus contracts, squeezing blood from the placenta through the umbilical cord to the baby. Between these contractions, with each beat of the baby’s heart, blood is pumped from the baby through the umbilical cord and back to the placenta. This transfer stops when the cord is clamped or stops pulsating, which occurs when the blood vessels close down. The best way to make sure that the baby has the right amount may be to place the baby on the mother’s belly and wait for the cord to stop pulsating. Exceptions to this are when the baby needs immediate medical attention, when the cord is tightly wrapped around the baby’s neck, preventing delivery, and when you have decided on cord blood removal and storage.”
- Penny Simkin, author of The Birth Partner
there are some risks associated with clamping the cord early:
"Newborn anemia, respiratory distress leading to brain damage and/or death (rare, yes, but it happens), inadequate blood supply resulting in a need for transfusion, possible heart defects resulting from problems closing off the hole in the heart valves following birth. There are a few doctors now theorizing that the rise in autism is due to brain damage caused by early cord clamping.
"Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one’s life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns."
info from here.
these risks may not be extremely common (other than newborn anemia) but through researching, i feel that delaying clamping the cord is an extremely smart option because it allows the baby to receive so much more blood and oxygen. and really, if there is no danger to the baby or the mother, why not just wait 5 minutes to cut the cord? of course, this is something you need to discuss with your care provider and if you truly feel that delaying cord clamping is what you want to do, advocate for that to happen because i can guarantee you, if you are birthing in a hospital, the cord will most likely be cut quickly after birth. so, make it happen if that is what you feel is best!
i believe delaying clamping the cord also allows extra time to have that special bond. the baby was inside of you for 9 months, it is probably such a shock to come out and all of the sudden be quite literally cut off from you, the mother. perhaps it is gentler to take things slowly. just a thought.
this is just a very short overview of delayed cord clamping. if this is something that interests you, please educate yourself about it. here are some great resources to get you started:
http://nursingbirth.com/2009/05/17/the-deal-with-delayed-cord-cutting-or-%E2%80%9Chey-doctor-leave-that-cord-alone%E2%80%9D/
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/
http://www.whale.to/a/butler7.html
delayed cord clamping is the process of waiting until the umbilical cord stops pulsating (approximately 5 minutes) and/or waiting until the placenta is delivered (approximately 30 minutes) before the cord is cut after the baby is born.
in today's hospitals, most OB's and some midwives routinely clamp and cut the umbilical cord almost immediately after delivery (about 30 seconds). why? what are the benefits?
after researching, the biggest benefit i can see is that it is convenient and a routine. it is not necessarily harmful, but why not wait to cut the cord?
“The cord is often cut immediately, but a recent scientific analysis has found benefit to waiting for at least two minutes or until it stops pulsating—in five minutes or so. Less likelihood of anemia for as much as six months exists in babies whose cords are cut late. Until the cord is clamped or stops pulsating, blood passes back and forth between the baby and the placenta. It goes from placenta to baby when ever the uterus contracts, squeezing blood from the placenta through the umbilical cord to the baby. Between these contractions, with each beat of the baby’s heart, blood is pumped from the baby through the umbilical cord and back to the placenta. This transfer stops when the cord is clamped or stops pulsating, which occurs when the blood vessels close down. The best way to make sure that the baby has the right amount may be to place the baby on the mother’s belly and wait for the cord to stop pulsating. Exceptions to this are when the baby needs immediate medical attention, when the cord is tightly wrapped around the baby’s neck, preventing delivery, and when you have decided on cord blood removal and storage.”
- Penny Simkin, author of The Birth Partner
there are some risks associated with clamping the cord early:
"Newborn anemia, respiratory distress leading to brain damage and/or death (rare, yes, but it happens), inadequate blood supply resulting in a need for transfusion, possible heart defects resulting from problems closing off the hole in the heart valves following birth. There are a few doctors now theorizing that the rise in autism is due to brain damage caused by early cord clamping.
"Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one’s life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns."
info from here.
these risks may not be extremely common (other than newborn anemia) but through researching, i feel that delaying clamping the cord is an extremely smart option because it allows the baby to receive so much more blood and oxygen. and really, if there is no danger to the baby or the mother, why not just wait 5 minutes to cut the cord? of course, this is something you need to discuss with your care provider and if you truly feel that delaying cord clamping is what you want to do, advocate for that to happen because i can guarantee you, if you are birthing in a hospital, the cord will most likely be cut quickly after birth. so, make it happen if that is what you feel is best!
i believe delaying clamping the cord also allows extra time to have that special bond. the baby was inside of you for 9 months, it is probably such a shock to come out and all of the sudden be quite literally cut off from you, the mother. perhaps it is gentler to take things slowly. just a thought.
this is just a very short overview of delayed cord clamping. if this is something that interests you, please educate yourself about it. here are some great resources to get you started:
http://nursingbirth.com/2009/05/17/the-deal-with-delayed-cord-cutting-or-%E2%80%9Chey-doctor-leave-that-cord-alone%E2%80%9D/
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/
http://www.whale.to/a/butler7.html
Thursday, January 28, 2010
a mother's thoughts on birth today
i just came across this post and thought i would share it. i liked what this mother had to say, and found it interesting to hear her perspective since her first birth was very different than mine. it is interesting to see the battles she is having to fight and i appreciate her passion for birth. she had a c-section with her first and now would like to have a VBAC (vaginal birth after cesarean). she's having a tough time finding doctors who support her wishes, though. i liked these passages:
"So, where do women go when they are refused to be treated by all? What options are we left with with when our only option is to have major abdominal surgery performed for unnecessary reasons? Most women are left with more healing to do and more pain because they have been cornered into having a repeat cesarean. Our women have been given false information about what is the safest options for them and their baby. The only way to get our rights given to us and taken out of the hands of the hospitals and doctors is to become educated and to stand up for ourselves. We need to push the fear of labor and natural birth aside and become more afraid of the epidurals, the lack of choices and the high rates of cesareans.
"So, where do women go when they are refused to be treated by all? What options are we left with with when our only option is to have major abdominal surgery performed for unnecessary reasons? Most women are left with more healing to do and more pain because they have been cornered into having a repeat cesarean. Our women have been given false information about what is the safest options for them and their baby. The only way to get our rights given to us and taken out of the hands of the hospitals and doctors is to become educated and to stand up for ourselves. We need to push the fear of labor and natural birth aside and become more afraid of the epidurals, the lack of choices and the high rates of cesareans.
In a day when so many women believe they are free and equal we are blindly having our choices stripped when it comes to birthing our children. We have been buying into the fear and the ignorance that has been seeded into American women. It’s time to to stand up for ourselves and refuse to be cut. It’s time to stand up and let the doctors know that our bodies are made and structured to be able to labor and birth babies. It’s time to have a choice."
(emphasis added)
go here to read her full post.
i came across this quote yesterday and loved it...so i thought i'd end with it...
as roberta scaer says, “if you don’t know your options, you don’t have any.”
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