Everyone has an opinion about childbirth. People who have given birth before are adamant that others should (or should not) have experiences like theirs. It seems that the web is full of natural-birth advocates, whereas real life is full of medicated-birth advocates. Doulas and midwives say that the best place to give birth is at home or in a stand-alone birthing center. Doctors and disbelieving lay people insist that the only safe place to give birth is at a hospital. Many people assume that birth will happen in a hospital, with a doctor in attendance, and anything else occurs only if you wait too long to head for the hospital. Others assume that if you go to the hospital, you'll end up with a Cesarian or a cookie-cutter vaginal birth that you weren't really present for anyway, because of the drugs. Even if you go natural, people will push Lamaze, or Bradley, or waterbirth, or hypnobirth ... No matter what the opinion is, it seems like everyone has one, or at least an assumption about what childbirth will look like.
That's what I loved about this book--they didn't.
This quote from the introduction pretty well sums up the philosophy of this book: "The best and most satisfying birth experiences happen when you're able to make choices in labor and delivery that are based on who you are, not someone some childbirth expert tells you that you should be." So if you feel most comfortable giving birth at home, go for it! If a homey birth center is more up your alley, feel free. And if you feel most protected and comfortable in a hospital setting, that's exactly where you should be. Narcotics, epidural, natural pain management strategies--you'll know what methods will work best for you based on how you handle stress and pain in your normal, not-giving-birth-at-the-moment life.
I started this book feeling pretty confident that I wanted a natural birth in a stand-alone birthing center, with a midwife to catch the baby and my husband and a doula to help coach me through it. I wanted a natural birth because I truly do believe that a medication-free birth is best for the baby--narcotics can cause a baby to born sleepy, so sleepy in some cases that the child can't even breathe without help; an epidural is difficult to dose right, and if you're given too high a dose, you may not feel your body's cues to push or be able to push effectively when you try, resulting in the need for an emergency Cesarian, which is major abdominal surgery. I figured that the best way to have a natural birth was to birth in a location where that was the only option--there would be no pressure, no repeated offers, and a major relocation to the hospital if I changed my mind. But I also have to admit--I was pretty scared of the whole notion of natural childbirth. By the time I get back to the States, I may or may not have time for a natural childbirth course. Even if I take one, they often seem to rely on one's ability to relax using visualization, which is not my strong point. And the more I read about birth, the more I am told that fear, anxiety, and an inability to manage the pain of contractions combine to stall labor, resulting in a Cesarian ... which I absolutely do not want unless it's necessary to save the life of my baby.
As I read this book, I started thinking about my natural coping strategies. What do I do when I'm afraid, stressed out, and in pain? My first response, at least to pain: Go to the medicine cabinet. Uh-oh, Houston, we have a problem. Because I really do want to avoid medication during childbirth, yet I also really do have a notoriously low tolerance for pain. And the natural coping strategies that I've read about so far really don't fit my personality all that well, either. I can't visualize to save my life. I do eventually relax in a hot tub or pool, but never until I can be confident that everyone else is engaged somewhere else, and no one is paying attention to me--unlikely if I'm using a birth pool to take the edge off of contractions during labor, with my attentive husband and doula hovering over me. When I'm in pain, I don't "walk it off." I tend to freeze, sink into the couch or bed, and maybe rock back and forth just a little. My main coping strategy is prayer, combined when possible with a generous dose of medication. I haven't seen either of those strategies listed in any natural childbirth books!
So where does that leave me? Someone who wants a natural birth but who seriously doubts her ability to have one? This book helped me realize that it really doesn't have to be an all-or-nothing proposition. I can give birth in a hospital, with a doctor or nurse midwife who is supportive of my preference for natural birth. But if my labor stalls and it starts looking like a Cesarian is in my future, or I just can't handle it, I'm exhausted, and I need to sleep--to remove myself from my body so that I stop fighting the work my contractions are trying to do--I can request an epidural. And the knowledge that I can request an epidural, that I don't have to handle the pain indefinitely if I feel like I can't do it, will allow me to focus on one contraction at a time, which I think I can handle. And if I can't, there's the epidural. After all, if I can't relax enough for my contractions to fulfill their function, I'm headed for a Cesarian. As much as I shudder to think of a needle going that close to my spine, a catheter staying there, an IV pumping me full of fluids to avoid a sudden drop in blood pressure--all of those things will happen by necessity if I have to have a Cesarian. Why not try everything possible to avoid one?
So here's what I'm currently thinking I want in childbirth. Keep in mind, though, that as I do more research on natural childbirth methods, gather information about classes that may be available once I'm back home, and come into more information in general, I may change my mind. And that's okay. But here's what I'm currently thinking:
- I intend to deliver in a hospital, with my husband and a doula by my side, using natural coping strategies. However, it will give me peace of mind to know that medication is available if I need it. (I'm still going to have to get myself okay with the idea that I'll probably have to have an IV, or at least a hep-lock, soon after I arrive at the hospital, but that's a compromise I think I can make.)
- There is a women's center 30-45 minutes from my hometown that is staffed by two female obstetricians and one female midwife. Seeing as how I've never had a pelvic exam from a male doctor, and the very thought makes me tense up like crazy, I think I need to give them a call on Tuesday (after the holiday), ask a few questions, and see if they could be a good match for me. I don't want a male doctor doing a routine exam to cause me to tense up and stall my labor on the big day--and I know myself well enough to know that I will never be comfortable with a man who is not my husband doing anything "down there." This women's center was recommended by a doula who is a firm advocate of natural childbirth, so I'm pretty sure that they will be supportive of my desires for a natural childbirth. But they also deliver in a hospital, and the doula who recommended them knows that I want the option of pain medication, so I'm thinking that will be an option too. I'll confirm all of this when I talk to them. And I already know that these practitioners are preferred providers for my insurance, which is a big financial plus!
- I want to hire a doula who is very experienced in natural childbirth, but who also can function well within a medicated childbirth situation. I have referrals for two women--one a newly certified midwife who still does doula work while building her midwife practice, and one who is in training to be a midwife. I'm thinking they will be comfortable functioning as doulas in any birth situation, but their midwife training will be particularly useful when it comes to helping me keep the birth natural. I've already sent emails to these women, so I'm waiting to see if they're available and how much they charge before I start trying to figure out which of them is the better match for us.
- I'm still hoping to find a natural childbirth class that will work for me, and maybe even a last-minute "crash course" for my husband.
- My ultimate goal at the end of the day--or the beginning of the day, depending on when the baby decides to arrive--is a healthy baby and a healthy mama. My secondary goal is vaginal birth, as opposed to a Cesarian. (Cesarians are fine for those who need or want them--please don't think I'm saying anything other than that--but I'd really rather avoid surgery if at all possible.) My tertiary goal is a natural vaginal birth, as opposed to a medicated vaginal birth.