Tips and advice for epidural-free childbirth

[Blenheim]

Hi, Charbie! I had a med-free birth last time and plan to do the same this time. Some things that I'm doing or have done, that I hope will help-

-- Hire a doula.

-- Make sure that your support person/people know what natural birth looks like, what typical emotional reactions would be like on your part (i.e. getting to the point where you think that you can't do it may mean that you're at transition and just need encouragement), and how to help you through various stages. I think the only thing that got me through my last labor was DH knowing how to apply counter-pressure to my hips. Ah, heaven. I'd really recommend getting a copy of the Birth Partner for this one. Or, have the doula present to help guide your hubby.

-- Stay home as long as possible.

-- Move and be able to be upright. Lying down was so dang painful in transition last time and I felt like I was trying to escape my body when I tried. Squatting was, well, painful still, but it was tolerable pain.

-- Stability ball, walking, water.

-- I wrote a birth plan that my OB signed and added to my file, and so if he's not there when I get there, we can point out that he already signed off on it if the nurses or resident or whoever wants to do differently. I tried to keep it to the things that were most important to me, and it includes things like freedom of movement, hydration via fluids (no IV unless medically indicated), do not offer epidural or medicinal pain relief (will ask if I want it), no augmentation unless indicated, intermittent fetal monitoring, pushing in a gravity-assisted position according to my body's cues. My OB also suggested that if he thinks something may be helpful to me but if he knows it's something that I don't necessarily want (artificial augmentation of labor, etc) then he will suggest it and his logic for it, and then leave us for a while to discuss it so that I don't feel pressured.

-- Ina May's books are great for positive birth stories. The Hypnobirthing book has some huge positives and can help take away any lingering fear about labor (I read it last week), although having been through labor before, there were some parts of it that I had a hard time swallowing.

Good luck!!

 

[MonkeyPie]

I'm noticing a bit of a trend here, and something to consider is this - unless you have a doctor/hospital that is batshit crazy, a c-section IS NOT EASIER FOR THEM. It requires more paperwork, more manpower, and more finagling to get a mother/baby ready for. Liability issues go WAY up with any surgery as well. It is a very involved process, and no doctor in their right mind would prefer it if you went into a c-section just to get you out of the labor room. Something that several people have mentioned here is that a c-section and pitocin are often forced upon you to hurry the process along, when in fact it is better for the hospital to keep you in labor as long as your body needs to be (as long as both mom and baby are healthy and tolerating it well, of course). It cuts down on liability issues if they go with what mom is asking for.

I'm not saying it doesn't happen, that there are not doctors and nurses out there that are stupid and they try to speed up the process by pushing mothers to do things that aren't medically necessary. I agree that this happens. But pitocin and c-sections are not the devil, they sometimes cannot be avoided, and going into the birthing room with the mindset that even if you are dying you will not consent to anything that might actually help labor move along is just asking for trouble. Your body is meant to do this, but sometimes it gets confused and it needs some help. These interventions exist because they are needed for a lot of people, otherwise they would not exist at all.

 

[lliang_chi]

Monkey, I totally agree with you that interventions are not evil and sometimes completely necessary. There's a reason why child birth was such a dangerous thing way back in the day, and still is today in some parts of the world.

Charbie, and to everyone else pro-unmedicated birth: That's great, I have not advice and it sounds like you're getting a lot of advice here on this thread. I sincerely hope you get the birth experience you're aiming for.

That being said, I'm sure all the ladies here are 100% on board with interventions if it's medically necessary. It sounds like that's the case. To me, the main message is "Advocate for yourself in the hospital." But perhaps it's not coming across so well in some posts.

My friend was recounting a story about when his daughter was delivered (via c-section, breached baby). His wife **insisted** with him that he needs to watch the nurses when they were taking his daughter anywhere, lest they give her formula. So after the baby was born he told the nurse in a very joke-y humrous way, "So... I was told I'm supposed to keep an eye on you when you're with my baby, in case you trick her into taking formula..." (He has a great sense of humor). His wife was mortified because her L&D nurse was the sweetest lady ever. She quickly said, "No not her! She's great!" But I guess his wife was drilled by her sources that this was something you had fight tooth and nail, when it really wasn't the case.

Good luck, mamas!

~LC

 

[Blenheim]

MP, agreed that both certainly have their place. I may not have explained my position well, but there's a lot of gray area when it comes to "medically indicated" and there are multiple approaches for dealing with labor when it deviates from the normal, and I think that it's helpful to be on the same page with a provider regarding preferences and your personal threshold for wanting certain types of interventions, knowing that the actual course of labor may call for different measures than from what you had hoped going into it. Using the example of pitocin, I would prefer to avoid pitocin and would like to explore other options for speeding up labor if it's dragging on and I'm not progressing, but if I stall out and the other options aren't working, then that's when I'd like to talk pitocin. Knowing that I'd prefer to avoid it, and that it's not really the kind of thing where a few minutes here or there matters, my OB wants me to have the opportunity to think it over to make sure that I'm happy with that course of action. On the other hand, some women may prefer pitocin to nipple stimulation or whatever, and so he may suggest pitocin sooner for them.

 

[Jennifer W]

LV I understand and appreciate what you are saying. However, I do get turned off when someone says they want a med free brith for whatever reason and the posts are usually about how wonderful an epi is not only on PS, but other birth sites and IRL. It's a shame, IMO, that more people don't encourage or at least try to support someone's decision to go natural. I guess that will be my unpopular opinion.

Anyway, healthy mama and baby are #1 no matter what.

Absolutely agree, but (and it's a big but) as with any birth plan, a med free birth plan can go off-track in, quite literally, a heartbeat. While it's important to help women to exercise their right to choose and to arm them with all the info about their choice, it's also helpful (IMO) to share our experiences of when things did not go to plan, and to emphasise that this can result in a positive experience too.

My own plan for a med/ epi free waterbirth, which was worked out in a lot of detail, and about which I was adamant was abandoned minutes after my waters broke and contained meconuium. While I knew this was a possibility, no one really told me what would happen, what it would mean, and I had blanked my mind to the possibility of induction, surgery and epidurals. They were therefore a huge, huge and horrifically distressing shock, right at the moment when no one wants to be shocked, distressed and unprepared. So, plan for the birth you want, and know the possibilities (not just in a vague and abstract it will never happen sort of way).

With that said, my beautiful cousin had her second baby yesterday, and both times she had a med free labour using hypnobirthing techniques. This is a UK link, but it gives some basic info.
http://www.hypnobirthing.co.uk/

 

[Pandora II]

I'm noticing a bit of a trend here, and something to consider is this - unless you have a doctor/hospital that is batshit crazy, a c-section IS NOT EASIER FOR THEM. It requires more paperwork, more manpower, and more finagling to get a mother/baby ready for. Liability issues go WAY up with any surgery as well. It is a very involved process, and no doctor in their right mind would prefer it if you went into a c-section just to get you out of the labor room. Something that several people have mentioned here is that a c-section and pitocin are often forced upon you to hurry the process along, when in fact it is better for the hospital to keep you in labor as long as your body needs to be (as long as both mom and baby are healthy and tolerating it well, of course). It cuts down on liability issues if they go with what mom is asking for.

I'm not saying it doesn't happen, that there are not doctors and nurses out there that are stupid and they try to speed up the process by pushing mothers to do things that aren't medically necessary. I agree that this happens. But pitocin and c-sections are not the devil, they sometimes cannot be avoided, and going into the birthing room with the mindset that even if you are dying you will not consent to anything that might actually help labor move along is just asking for trouble. Your body is meant to do this, but sometimes it gets confused and it needs some help. These interventions exist because they are needed for a lot of people, otherwise they would not exist at all.

I'd agree with all this. It's also worth bearing in mind that whilst women have been doing this for millions of years there are now women giving birth whose mothers or grandmothers gave birth with medical intervention and who might well not have survived in the past. Due to this some issues such as a strangely shaped pelvis are now becoming more common and could mean that a woman really has no option over the kind of birth she has. Medical skills and knowledge are now ahead of survival of the fittest and natural selection.

 

[MonkeyPie]

MP, agreed that both certainly have their place. I may not have explained my position well, but there's a lot of gray area when it comes to "medically indicated" and there are multiple approaches for dealing with labor when it deviates from the normal, and I think that it's helpful to be on the same page with a provider regarding preferences and your personal threshold for wanting certain types of interventions, knowing that the actual course of labor may call for different measures than from what you had hoped going into it. Using the example of pitocin, I would prefer to avoid pitocin and would like to explore other options for speeding up labor if it's dragging on and I'm not progressing, but if I stall out and the other options aren't working, then that's when I'd like to talk pitocin. Knowing that I'd prefer to avoid it, and that it's not really the kind of thing where a few minutes here or there matters, my OB wants me to have the opportunity to think it over to make sure that I'm happy with that course of action. On the other hand, some women may prefer pitocin to nipple stimulation or whatever, and so he may suggest pitocin sooner for them.

I cannot tell you how much I wish I could have avoided pitocin, lol. It was not pleasant! I had no idea that there were even any other options though that would achieve the same thing - I knew nipple stimulation could help, but I didn't think it was on the same level as pitocin, and by the time I was finally admitted, I just wanted something to happen. It would be nice if other options were suggested, but usually pitocin works most effectively.

 

[Hudson_Hawk]

MP, do you wish now that you'd been more informed overall about the process and your options? If memory serves me you didn't do any childbirth classes or read books, right?

My birth experience was so messed up I don't think I can really participate in the conversation right now. But I will say that the epidural and the catheters were two of my biggest fears going into the event (and the episiotomy). However, I had to have a spinal with my c/s and it wasn't nearly as bad as I thought it would be. I also had no side effects or complications from it.

 

[MonkeyPie]

MP, do you wish now that you'd been more informed overall about the process and your options? If memory serves me you didn't do any childbirth classes or read books, right?

My birth experience was so messed up I don't think I can really participate in the conversation right now. But I will say that the epidural and the catheters were two of my biggest fears going into the event (and the episiotomy). However, I had to have a spinal with my c/s and it wasn't nearly as bad as I thought it would be. I also had no side effects or complications from it.

Yes and no. I read up online but didn't do any books, mostly because I wanted to go in without any expectations. I didn't have a birth plan and I wanted to be realistic about what my body could do without trying to force it to do something it couldn't. That ended up being good for me, since my body did not want to do labor properly, lol. I think that even if I had known of other options, I would have gone with the pitocin anyway, because it worked so much faster than anything else and by the time they started me on it, I just wanted to get progress of some kind. Too bad it failed!

The epi was my biggest fear by far, because only a couple years before I had watched as my husband had to suffer through a lumbar puncture that was absolutely traumatic because he couldn't bend his lower spine enough for the needle to fit through. Turns out my fears were founded, at least for me - they had to fight to get the needle in all three times they tried on me, and then it was all for nothing.

I know that my case was not the norm, but it makes me sensitive towards this topic a bit. Going in with a birth plan that you refuse to sway from, and then feeling cheated when you have to veer from it, makes me feel upset for people.

 

[charbie]

Ill be back to reply more later, but wanted to thank everyone for the info you've given so far. I appreciate everyones input!

 

[Puppmom]

-- I wrote a birth plan that my OB signed and added to my file, and so if he's not there when I get there, we can point out that he already signed off on it if the nurses or resident or whoever wants to do differently. I tried to keep it to the things that were most important to me, and it includes things like freedom of movement, hydration via fluids (no IV unless medically indicated), do not offer epidural or medicinal pain relief (will ask if I want it), no augmentation unless indicated, intermittent fetal monitoring, pushing in a gravity-assisted position according to my body's cues. My OB also suggested that if he thinks something may be helpful to me but if he knows it's something that I don't necessarily want (artificial augmentation of labor, etc) then he will suggest it and his logic for it, and then leave us for a while to discuss it so that I don't feel pressured.

-- Ina May's books are great for positive birth stories. The Hypnobirthing book has some huge positives and can help take away any lingering fear about labor (I read it last week), although having been through labor before, there were some parts of it that I had a hard time swallowing.

Good luck!!

This is key. My plan was no epidural. The nurse asked me a zillion times if I wanted one. Hubby kept fending her off. The last time she asked me (She said I was progressing quickly and this was my "last call") I was in the middle of transitioning and the pain was at it's worst. I was lying on my back getting a cervix check and DS was doing a number on my hips. I caved and said yes but felt the urge to push while getting the epidural and it didn't work. In hindsight, I wish I hadn't gotten it at all.

 

[nfowife]

I would also make a birth plan...discuss this with your doctor. I would be happy to post mine if you want to get some ideas for wording. One thing would be that you do NOT wish to be offered an epidural or pain medication- that way you have to request it if you want it.

 

[fieryred33143]

-- I wrote a birth plan that my OB signed and added to my file, and so if he's not there when I get there, we can point out that he already signed off on it if the nurses or resident or whoever wants to do differently. I tried to keep it to the things that were most important to me, and it includes things like freedom of movement, hydration via fluids (no IV unless medically indicated), do not offer epidural or medicinal pain relief (will ask if I want it), no augmentation unless indicated, intermittent fetal monitoring, pushing in a gravity-assisted position according to my body's cues. My OB also suggested that if he thinks something may be helpful to me but if he knows it's something that I don't necessarily want (artificial augmentation of labor, etc) then he will suggest it and his logic for it, and then leave us for a while to discuss it so that I don't feel pressured.

-- Ina May's books are great for positive birth stories. The Hypnobirthing book has some huge positives and can help take away any lingering fear about labor (I read it last week), although having been through labor before, there were some parts of it that I had a hard time swallowing.

Good luck!!

This is key. My plan was no epidural. The nurse asked me a zillion times if I wanted one. Hubby kept fending her off. The last time she asked me (She said I was progressing quickly and this was my "last call") I was in the middle of transitioning and the pain was at it's worst. I was lying on my back getting a cervix check and DS was doing a number on my hips. I caved and said yes but felt the urge to push while getting the epidural and it didn't work. In hindsight, I wish I hadn't gotten it at all.

Mine too! My nurse was so amazing I wants to take her home with me but man did she push the epi. The minute I got to the room she asked if she should call for an epi. When I said no, she told me that I don't need to be a hero and she had 3 kids all with epis. Then the whole time she kept pushing it, telling me I need it to relax so that I can progress and not end up with a csection. In hindsight that was
ridiculous but I hadnt slept and her plan sounded better.

 

[jstarfireb]

I'm noticing a bit of a trend here, and something to consider is this - unless you have a doctor/hospital that is batshit crazy, a c-section IS NOT EASIER FOR THEM. It requires more paperwork, more manpower, and more finagling to get a mother/baby ready for. Liability issues go WAY up with any surgery as well. It is a very involved process, and no doctor in their right mind would prefer it if you went into a c-section just to get you out of the labor room. Something that several people have mentioned here is that a c-section and pitocin are often forced upon you to hurry the process along, when in fact it is better for the hospital to keep you in labor as long as your body needs to be (as long as both mom and baby are healthy and tolerating it well, of course). It cuts down on liability issues if they go with what mom is asking for.

I'm not saying it doesn't happen, that there are not doctors and nurses out there that are stupid and they try to speed up the process by pushing mothers to do things that aren't medically necessary. I agree that this happens. But pitocin and c-sections are not the devil, they sometimes cannot be avoided, and going into the birthing room with the mindset that even if you are dying you will not consent to anything that might actually help labor move along is just asking for trouble. Your body is meant to do this, but sometimes it gets confused and it needs some help. These interventions exist because they are needed for a lot of people, otherwise they would not exist at all.

Big +1 to all of this. After spending several months on L&D rotations, I'm convinced that the idea that doctors are pushing for unnecessary C-sections just for the sake of convenience is completely false, at least where I've worked. I've seen some women laboring for 2-3 days before they finally concede that a C-section is necessary. From what I've seen, the OBs clearly have the best interests of both the mother and the baby at heart, but sometimes it's not communicated very well. The important thing is to keep an open mind and not feel like you've failed if an intervention is necessary, because it's not your fault!

 

[charbie]

Im trying to do my research now so that when we are in the thick of things, if things aren't going to plan, I can work together with my doctor and nurses to come up with the next best plan. But I would rather have done my research and come up with a plan A to hopefully stick to. And I wont be upset if interventions are medically required. But the point of this thread was more about how can I try and manage my pain to best experience an epidural-free birth.

MP and HH, I remember both of your birth stories since they both were a bit crazy, and MP I can understand why you'd be sensitive to the subject since it was a crazy situation. But its proof you do have to roll with the punches a bit as well, which I fully intend on doing.

I also do see that multiple people did advise to labor at home as long as possible, in an effort to avoid a longer labor in the hospital, which is actually advice given to us at the Lamaze class, so I appreciate that being reiterated.

In regards to unnecessary c/s, well, I have to admit im a bit skeptical myself since two of my friends who recently gave birth had scheduled c/s's due to the size of the baby. Both girls gave birth to babies a full pound under what the estimated birth weight was. Both say they wish they had been given an option in retrospect. So statistically among the friends recently giving birth, the odds point to big baby=scheduled c/s, and so im just more skeptical and nervous about it than probably your average person.

Again, I reeeeeeeeally appreciate all of the words of advice and encouragement! I have the mindset of being able to do it, which I think it half the battle!

 

[megumic]

Good for you Charbie! I think it's awesome you've done your research and decided what is right for you, your family and your birth. I thritto the mention of Ina May Gaskin's books. Very informative and inspiring. I also think that Mothering.com serves as a great resource if you want to read up some more. All other advice I've got has been the same as PP. Here's to hoping all goes well! Good luck!

 

[megumic]

I'm noticing a bit of a trend here, and something to consider is this - unless you have a doctor/hospital that is batshit crazy, a c-section IS NOT EASIER FOR THEM. It requires more paperwork, more manpower, and more finagling to get a mother/baby ready for. Liability issues go WAY up with any surgery as well. It is a very involved process, and no doctor in their right mind would prefer it if you went into a c-section just to get you out of the labor room. Something that several people have mentioned here is that a c-section and pitocin are often forced upon you to hurry the process along, when in fact it is better for the hospital to keep you in labor as long as your body needs to be (as long as both mom and baby are healthy and tolerating it well, of course). It cuts down on liability issues if they go with what mom is asking for.

I'm not saying it doesn't happen, that there are not doctors and nurses out there that are stupid and they try to speed up the process by pushing mothers to do things that aren't medically necessary. I agree that this happens. But pitocin and c-sections are not the devil, they sometimes cannot be avoided, and going into the birthing room with the mindset that even if you are dying you will not consent to anything that might actually help labor move along is just asking for trouble. Your body is meant to do this, but sometimes it gets confused and it needs some help. These interventions exist because they are needed for a lot of people, otherwise they would not exist at all.

I just need to respond to this because I don't think the first paragraph is entirely accurate, as I've done a fair bit of research on the medico-legal arena of labor and delivery. Doctors and hospitals often do c-sections as a CYA approach to medicine. In front of a jury, any doctor who does a c-section can say "I did everything I could..." in the event something goes awry. In fact, many of the malpractice insurance policies that cover ob-gyns set the policy of what a physician can and cannot do (i.e. whether the physician can attend a VBAC - vaginal birth after cesarean.) To me, that is the batshit crazy stuff -- I certainly do not want a malpractice insurer calling the shots on what is or is not medically indicated for my birth. So while c-sections aren't necessarily easier, I do think c-sections are often performed for non-medical reasons. Plus, at the end of the day the hospitals and physicians are the richer for a c-section...

If you look at the data, babies are predominately born Monday through Friday, with significant dips on the weekends. There is no rational explanation for this but physicians scheduling their inductions and deliveries to free up their weekends. With the c-section rate continuing to be on the rise, at an all time high of 34% in the US (up from 27% in 2002), it scares me that far too many ob-gyns are performing c-sections when they are not medically indicated.

That said, certainly, there is a place for medicine and surgery in labor and delivery. There are absolutely instances where it saves lives and is sincerely important to childbirth. I harbor no negative feelings towards c-sections, medical interventions, or the like. Rather, my frustration comes from physicians acting out of any motivation but the health of the child or the mother and I think the only way to control that is to be well-educated and self-informed about your options during childbirth.

PS - Monkey this is not a personal attack at all! Just wanting to share my research. If it weren't 2:45am I'd post the links to data -- tomorrow I can put them up if anyone's interested.

 

[stephbolt]

I'm noticing a bit of a trend here, and something to consider is this - unless you have a doctor/hospital that is batshit crazy, a c-section IS NOT EASIER FOR THEM. It requires more paperwork, more manpower, and more finagling to get a mother/baby ready for. Liability issues go WAY up with any surgery as well. It is a very involved process, and no doctor in their right mind would prefer it if you went into a c-section just to get you out of the labor room. Something that several people have mentioned here is that a c-section and pitocin are often forced upon you to hurry the process along, when in fact it is better for the hospital to keep you in labor as long as your body needs to be (as long as both mom and baby are healthy and tolerating it well, of course). It cuts down on liability issues if they go with what mom is asking for.

I'm not saying it doesn't happen, that there are not doctors and nurses out there that are stupid and they try to speed up the process by pushing mothers to do things that aren't medically necessary. I agree that this happens. But pitocin and c-sections are not the devil, they sometimes cannot be avoided, and going into the birthing room with the mindset that even if you are dying you will not consent to anything that might actually help labor move along is just asking for trouble. Your body is meant to do this, but sometimes it gets confused and it needs some help. These interventions exist because they are needed for a lot of people, otherwise they would not exist at all.

I just need to respond to this because I don't think the first paragraph is entirely accurate, as I've done a fair bit of research on the medico-legal arena of labor and delivery. Doctors and hospitals often do c-sections as a CYA approach to medicine. In front of a jury, any doctor who does a c-section can say "I did everything I could..." in the event something goes awry. In fact, many of the malpractice insurance policies that cover ob-gyns set the policy of what a physician can and cannot do (i.e. whether the physician can attend a VBAC - vaginal birth after cesarean.) To me, that is the batshit crazy stuff -- I certainly do not want a malpractice insurer calling the shots on what is or is not medically indicated for my birth. So while c-sections aren't necessarily easier, I do think c-sections are often performed for non-medical reasons. Plus, at the end of the day the hospitals and physicians are the richer for a c-section...

If you look at the data, babies are predominately born Monday through Friday, with significant dips on the weekends. There is no rational explanation for this but physicians scheduling their inductions and deliveries to free up their weekends. With the c-section rate continuing to be on the rise, at an all time high of 34% in the US (up from 27% in 2002), it scares me that far too many ob-gyns are performing c-sections when they are not medically indicated.

That said, certainly, there is a place for medicine and surgery in labor and delivery. There are absolutely instances where it saves lives and is sincerely important to childbirth. I harbor no negative feelings towards c-sections, medical interventions, or the like. Rather, my frustration comes from physicians acting out of any motivation but the health of the child or the mother and I think the only way to control that is to be well-educated and self-informed about your options during childbirth.

PS - Monkey this is not a personal attack at all! Just wanting to share my research. If it weren't 2:45am I'd post the links to data -- tomorrow I can put them up if anyone's interested.

Meg, you posted what I wanted to but couldn't find the time to pull together coherently! Although I'm not currently pregnant, we are thinking about it and I'm very interested in the culture of childbirth in the US. The stats I've read (mainly from the book Born in the USA by Marsden Wagner) do show that the c-section rate and maternal/fetal mortality rates in the US are higher than in other developed countries where birth is less medicinalized. The ideal c-section rate cited in that book, if I remember correctly, is somewhere around 10%.

I know there are a lot of factors dictated by insurance and CYA policies of the hospital that push women away from a low-intervention birth. And I certainly don't think women who want pain relief during labor should be forced to give birth without it. But I think the best way to be prepared for your labor, however you want to experience it, is to be aware of what options/interventions may be offered to you during your labor, what the pros and cons of those interventions are, and what complications might cause you to need those interventions.

Charbie, good luck to you, I hope you get to have the birth you want!

 

[MonkeyPie]

If you look at the data, babies are predominately born Monday through Friday, with significant dips on the weekends. There is no rational explanation for this but physicians scheduling their inductions and deliveries to free up their weekends.

I'm not offended, I think you make some good points, but this made me laugh because even doctors deserve to have a weekend off Of course they schedule during a weekday - that is when almost ANY surgery would be scheduled. Weekends are generally for emergencies for a reason.

I'd love to see where your info came from, though. That's interesting that those of us that actually work in the healthcare industry disagree with your conclusion. Like I said, I know it happens - there are crazies everywhere! - but the majority would not in their right minds want to do such a thing.

 

[MonkeyPie]

Meg, you posted what I wanted to but couldn't find the time to pull together coherently! Although I'm not currently pregnant, we are thinking about it and I'm very interested in the culture of childbirth in the US. The stats I've read (mainly from the book Born in the USA by Marsden Wagner) do show that the c-section rate and maternal/fetal mortality rates in the US are higher than in other developed countries where birth is less medicinalized. The ideal c-section rate cited in that book, if I remember correctly, is somewhere around 10%.

I don't think that is very accurate. This guy wants us to believe that maternal/fetal death is more common in a part of the world where we have more possibilities to SAVE lives, than say, the middle of Africa where if you have a complication there is likely no way for them to help you?

This topic has veered off from where Charbie wanted to be, but I would love to start a new topic with those of you that want to discuss it. This is interesting.

 

[stephbolt]

Meg, you posted what I wanted to but couldn't find the time to pull together coherently! Although I'm not currently pregnant, we are thinking about it and I'm very interested in the culture of childbirth in the US. The stats I've read (mainly from the book Born in the USA by Marsden Wagner) do show that the c-section rate and maternal/fetal mortality rates in the US are higher than in other developed countries where birth is less medicinalized. The ideal c-section rate cited in that book, if I remember correctly, is somewhere around 10%.

I don't think that is very accurate. This guy wants us to believe that maternal/fetal death is more common in a part of the world where we have more possibilities to SAVE lives, than say, the middle of Africa where if you have a complication there is likely no way for them to help you?

This topic has veered off from where Charbie wanted to be, but I would love to start a new topic with those of you that want to discuss it. This is interesting.

Sorry, should have bolded that initially, the comparison was to other developed countries (I believe the Netherlands was the main example they used in the book, I can't check because I don't have the book out from the library any longer). These countries treat birth as a more natural process (i.e. my phrasing "less medicinalized") and often the standard is giving birth at home or in a stand alone birth center vs. treating labor as a disease. You are correct that in some less developed areas of the world the MFM rate is much higher because there is no way to get the necessary interventions in the cases where they are required.

Anyway I won't take up any more of Charbie's thread with this, but I'd certainly be interested in a spin-off, as I said this is a topic that I am very interested in.

 

[Loves Vintage]

Charbie - I have another tip for you. In our hypnobirthing class, we talked about setting the room, both for your comfort and also to send a message to the medical professionals (in addition to telling them, verbally and in writing, if you wish) what your intentions are. Suggestions were to keep lights dim, bring in your own music, etc. We played meditative/chanting type music throughout my labor. I loved it! And, I have to say, at my hospital, everyone was VERY AWARE that I wanted a natural birth. No one offered me an epidural. Instead, when a new nurse would come in due to a shift change or a new dr came in, they would communicate to one another that I was intending to go without an epi. The new dr (I saw 5 of the 7 drs in my practice during the course of my birthing ) would casually communicate that he or she understood I did not want epi, and I do not recall anyone ever offering one. I think this says a lot about my hospital and my doctors, though, both of which are fairly progressive. It sounds like your hospital is too, since you mentioned they have tubs and feng shui suites (how do you get one, by the way? Random, or can you request one?) Anyway, my point is that the way we had the room set (and especially with the music we had playing), I don't think anyone saw fit to question my intention to birth without an epi (though, again, I ultimately elected one on my own accord, which I only mention for those not familiar with my experience.)

I do hope that you have the birth experience you desire. I will say that I think of my baby's birth every now and again. It was without question the single most beautiful and empowering experience of my life. I wish the same for you and for all mommas-to-be.

 

[Clio]

In regards to unnecessary c/s, well, I have to admit im a bit skeptical myself since two of my friends who recently gave birth had scheduled c/s's due to the size of the baby. Both girls gave birth to babies a full pound under what the estimated birth weight was. Both say they wish they had been given an option in retrospect. So statistically among the friends recently giving birth, the odds point to big baby=scheduled c/s, and so im just more skeptical and nervous about it than probably your average person.

Again, I reeeeeeeeally appreciate all of the words of advice and encouragement! I have the mindset of being able to do it, which I think it half the battle!

Charbie, to add one one more data point

With my third child, I measured ahead throughout the pregnancy, and an ultrasound at 38 weeks said he was at about 9.5 lbs. Now, late term ultrasounds are not very accurate, but given the other evidence, there was some concern about a large baby. My doctor, husband, and I sat down to talk, and we ended up with 3 options - 1) schedule an induction that week, 2) schedule a c-section for the next week, or 3) wait until I went into labor naturally and see how things went, knowing that he could be a pretty large baby by that point.

We went with option 1. He was born at 38.5 weeks and was, indeed, 9.5 lbs. There was a moment when he got stuck (big baby, big round head, hand by his face) and it looked like I might be headed to a c-section. The nurse and doctor and I tried different positions for pushing, though, and got him out. So, a big baby doesn't necessarily mean c-section.

I think that some doctors are more risk-averse than others. Everyone's desired outcome, after all, is a healthy baby + healthy mom. I'm glad, though, that my doctor walked us through the options and truly left it up to us to choose. I did not feel pressured to pick one plan over any other.

 

[zipzapgirl]

I just wanted to add another book to the reading list I've been reading this week:
Birthing From Within by Pam England and Rob Horowitz
It's a little new-agey and emotionally centered, but there are also lots of practical tips for thinking, preparing and undergoing labor. Around Chapter 25 they do exercises with ice cubes where you do different mental exercises to deal with the discomfort of holding the ice cube. I am going to try these out - I think they might be a good prep for building mental strength.

 

[MonkeyPie]

Charbie - I have another tip for you. In our hypnobirthing class, we talked about setting the room, both for your comfort and also to send a message to the medical professionals (in addition to telling them, verbally and in writing, if you wish) what your intentions are. Suggestions were to keep lights dim, bring in your own music, etc. We played meditative/chanting type music throughout my labor. I loved it! And, I have to say, at my hospital, everyone was VERY AWARE that I wanted a natural birth. No one offered me an epidural. Instead, when a new nurse would come in due to a shift change or a new dr came in, they would communicate to one another that I was intending to go without an epi. The new dr (I saw 5 of the 7 drs in my practice during the course of my birthing ) would casually communicate that he or she understood I did not want epi, and I do not recall anyone ever offering one. I think this says a lot about my hospital and my doctors, though, both of which are fairly progressive. It sounds like your hospital is too, since you mentioned they have tubs and feng shui suites (how do you get one, by the way? Random, or can you request one?) Anyway, my point is that the way we had the room set (and especially with the music we had playing), I don't think anyone saw fit to question my intention to birth without an epi (though, again, I ultimately elected one on my own accord, which I only mention for those not familiar with my experience.)

I do hope that you have the birth experience you desire. I will say that I think of my baby's birth every now and again. It was without question the single most beautiful and empowering experience of my life. I wish the same for you and for all mommas-to-be.

Your L&D sounds awesome. I wish every mom could have this!

 

[jstarfireb]

If you look at the data, babies are predominately born Monday through Friday, with significant dips on the weekends. There is no rational explanation for this but physicians scheduling their inductions and deliveries to free up their weekends.

I'm not offended, I think you make some good points, but this made me laugh because even doctors deserve to have a weekend off Of course they schedule during a weekday - that is when almost ANY surgery would be scheduled. Weekends are generally for emergencies for a reason.

Absolutely. Hospitals are short-staffed on weekends (and evenings for that matter), often with only one doctor on call for each specialty, and a lot of the ancillary staff unavailable. Inductions and elective C-sections, as well as any elective surgeries, SHOULD be scheduled on weekdays so the few doctors that are there on weekends are available to respond to true emergencies.

 

[KatyWI]

Aaaaaand back to the topic at hand...

Charbie, I too hope for an unmedicated childbirth and I really enjoyed Your Best Birth (basically the companion to The Business of Being Born) by Ricki Lake and Abby Epstein. In addition, I think in the other thread someone recommended Pushed by Jennifer Block, which I stopped in the middle of (when I started not being able to stay awake ) but am definitely enjoying. I plan to also read Ina May Gaskin's book as others have recommended, I've heard really good things.

I've been told that not being confined to a bed is the biggest key, that to be able to move around as your body tells you to is crucial to managing the pain of labor. Perhaps just as important is having a hospital and a medical staff that are respectful of your needs. If a nurse offered me an epidural for a third time after I had specifically said I wasn't interested I would at least yell at her and demand a different nurse, but I would be temped to gag her with a bedpan. I don't normally have anger issues, but that is completely disrespectful.

The hospital where I will deliver is considered "Baby Friendly" and has fabulous breastfeeding support, and although you cannot deliver in water (yet, they're working on it) you can labor in a tub if available, which I've heard is a godsend. They will also let you play your own music, set your mood, and I've been told they are very good about letting people have the kind of birth experience they want (unless, of course, medical necessity dictates otherwise).

I'd say the absolute best thing you can do for yourself is to be well informed (which it seems you are), open-minded in case interventions are necessary (which again, you are) and make sure you advocate for yourself and your DH is fully on board so he can advocate for you if you are busy, you know, laboring. I think a doula is also a great option if you might need the extra support, but I don't plan to hire one myself.

Best of luck! Can't wait to hear how it goes for you and to "meet" that little peanut!!

 

[Deelight]

I actually posted a reply a few days ago but it got eaten and have not had a chance to reply since

I gave birth earlier this year to DD who was 9lbs 12, vaccum assisted without an epi the only pain relief (I use that term loosely as it did not work) was the gas.

Like you I was scared of the epi I had heard the horror stories and I was scared that would lead to a ceasar I did ask for an epi twice during labour according to DH the first time the nurse talked me out it and the second time it was ignored - I asked my Dh why he didn't push for one when I asked and he told me that after the nurse talked me out of it I seemed slightly better - I think to an extent he was a little ovewrwhelemed so my number one advice is try it but have your DH clear on what to do if you change your mind about something.

Things that really helped me:

* Warm showers OMG the best pain relief ever it really helped me relax and just go with it
* Birthing ball to rock on
* Pressure massage on my lower back
* Singing - I had DH make me CD's in catagories (upbeat, relaxing, happy, mellow etc) so these were playing during labour when the pain got to much I sung my way through the contractions - as stupid as this sounds it helped me to focus on something else apart from the pain I think at one point during the pushing The Animals we gotta get out of this place came on - gave the doc and the nurses something to laugh at
* Cold wet compresses on my forehead - I don't know if everyone sweats like a pig in labour but I did and it was exhausting I had a midwife who volunterred to help during labour sponge my head when I didn't even ask - this women was seriously my favourite person she is an angel - this helped give me energy and keep going, DH also feed me water which I could not get enough of.
* Visualisations - this really only worked early on but I manged to get some 10 minute nap in between contractions which helped as I ended up in labour for just over 30hrs from start to finish


I wish you luck really despite it all it is an amazing experience and once you hold the baby the pain does start to disappear heck I felt like I could go for a run the next day and wanted to (crazy hormones )

 

[AprilBaby]

Just curious, what happened to Lamaze? My kids were all born in the 80's and we didn't get epidurals because "it was bad for the baby" I did 4 drug free births between 8.2 and 9.4 lbs and have no regrets. Lamaze worked beautifully.

 

[jstarfireb]

Just curious, what happened to Lamaze? My kids were all born in the 80's and we didn't get epidurals because "it was bad for the baby" I did 4 drug free births between 8.2 and 9.4 lbs and have no regrets. Lamaze worked beautifully.

I don't think anything happened to Lamaze (didn't Charbie say in one of her posts that she's participating in it?). I do think many of their techniques are helpful (breathing, massage, movement, cold compresses, vertical position, etc.), except for their decidedly anti-intervention stance. I don't think Lamaze techniques and medical interventions need to be mutually exclusive. Anyway, I'm sure you weren't stating this as a fact because you put it in quotes, but nowadays it's pretty clear that epidurals aren't "bad for the baby." In fact, they can be GOOD for the baby if the mother is hyperventilating due to pain. By taking away the stimulus to hyperventilate, they help with the baby's pH balance. Also, they're much safer for the baby than IV opioids (pain medications), which can suppress that baby's breathing and neurological functioning after birth. I may have mentioned all this earlier in the thread, but I just wanted to reiterate it because I like to address commonly held myths about epidurals and other procedures when I hear them.

But it's still a personal choice, and there's nothing wrong with going without an epidural if that's what you want. Just as there's nothing wrong with getting one if that's what you want.