Wednesday, April 7, 2010

Don't Tell Me How to Have My Baby!

"We didn't get into medicine because we want to screw with your lives, we got into medicine because we like mothers and babies and we want to help them."

While phrased in a strange way, I understood where she was coming from. The woman who said that was replying to a series of questions posed by audience members at a meet and greet I attended this week.

It was a chance for pregnant women to ask questions and talk with all of the OBs in our practice, plus the on-call OBs who could possible deliver us in the 30% chance we don't get our own.

My husband and I sat on the second row, eager to hear what women wanted to ask as well as what these obstetricians had to say. I wasn't sure what to expect when I arrived. I had pages of my Prego Planner twisted around my fingers, as I fumbled through my notes, thinking if I was brave enough to ask any of my questions in front of the room of around 40 couples.

I got some of my ideas for questions from the reading the outline of the Lamaze Healthy Birth Practices. Others, from friends like Emily Dicky, who recently had her baby by a cesarean she, and many others in the blogosphere say was unnecessary. I thought getting questions from her that she "would have asked" would be a great way to find the right OB for me.

All of the doctors introduced themselves, and told us about their background. My husband and I listened to their backgrounds and remarks, and found we liked the personalities and stories of my OB, and one other on the end the best... Coincidentally, those were both the women recommended by our family practitioner whom we love.
After their brief introductions they opened it up to questions. Of course, we were all a little hesitant at first, but one woman who appeared to be a little further along than I had the balls to throw out the first one.

"I want a natural labor," she said very matter of fact. "How open are you to allowing things to progress without medical interventions?"

Wow, well I could cross that question off of my list. A few of the doctors answered her question, including mine, stating they love for us to come in with plans, and if we'd like an unmedicated birth to be up front about it, let the hospital staff know when we get their because they make a special effort to pair certain labor and delivery nurses with women depending on the kind of birth we're going for. All of them said their first and foremost job is to get us our baby safe and sound, and secondly, they want us to have a good experience.

The series of questions that followed seemed to be all stolen out of my mouth. In fact, I began to wonder if some of the women in my room were women who've been coaching me online... Women on Twitter who are almost anti-hospital birth and would prefer to deliver at home.

There were questions about stalling in labor, and how long they'll let us go before recommending an intervention, letting the cord pulse for awhile after birth, what positions we can labor in, and if they'd let us walk around. I was honestly quite surprised at the amount of women who had the same questions I did. They each seemed very stern and attentive when listening to the responses.

Of course not everyone in the room had the same concerns, there was another group who wanted to know how a scheduled cesarean process would work, and wanted to know how soon, and how late they could get an epidural. But I was amazed at how knowledgeable and confidant so many of these woman were in their desires. I think sometimes we sell ourselves short in assuming women don't do their research... At least I know I have people telling me to do my research ALL the time, when sometimes I feel like saying: "I bet I've done WAY more research than you did when you were having your first baby."

I think, or at least I hope, in this day and age women are feeling more empowered, and learning more about labor, but they also aren't feeling the need to hide away in their homes simply because they feel like they can't get the level of care they desire from a hospital and doctor.

Speaking from my own experience... I know home birth isn't my thing. Nothing against it, I just don't want to do it. I'd prefer to take a little vacation to the hospital and have people take care of me for awhile. Plus, my insurance covers a hospital birth 100% whereas a home birth would end up costing me much more (not the usual case I know). But I also don't want to be cut open for convenience. I feel like I found a happy medium finding an OB group I really like with a great birthing philosophy, as well as a hospital with great accommodations.

As more questions were asked and answered, my husband and I talked about the responses and took notes. Some of the things I was happy to learn about:

-The baby is placed directly on the mother's belly right after birth and the cord isn't clamped right away.
-Husbands/partners are asked to cut the cord after the baby is born. If they don't want to cut it, that's fine too, but they give them the chance.
-They no longer do episiotomies.
-There's a new policy where women ARE allowed to eat during early labor (whatever they don't mind possibly seeing come back up). During active labor clear liquids/foods are allowed, like popsicles, ice chips, water, etc.
-During early and even active labor, without an epidural women are allowed, even encouraged to walk around to help their labor progress. There are showers in all of our rooms as well and they encourage us to use them.
-They have doula recommendations to help during labor (I'm not getting one, but I've heard some people say OBs don't like doulas... Either a lie, or my practice once again is cooler than most).
-They have other pain medication we can take if we don't want an epidural but want the "edge taken off." They did say it makes you woozy, but that you can still move around on a birthing ball etc, with assistance. I didn't catch the name of the drug but I'll ask at my next appointment.

I like the idea of moving around more, because if I get an epidural they pretty much said I'll have to stay in bed and labor there, on my side or slightly upright (if I can support myself/be supported). But I've also heard that some IV drugs are uncomfortable. So I guess we'll have to see how it goes, but I like knowing I have several options for pain if I decide I don't want to deal with it.

And last but not least, someone asked if we have to labor and deliver on our back or if we could be in a different position. This was something I was really eager to hear their answer too because it's #5 on Lamaze's healthy birth practices "Avoid giving birth on your back and follow your body's urges to push." I watched the video and the "pushing when you feel he urge to push" part seems a little common sense to me, and less complicated than the positions part. One thing it says to do is ask your practitioner during your pregnancy how they feel about different positions so you know if they'll support you during labor.

The doctors were all very nice in saying that they have birthing bars that we can use, and they'll position the bed in different ways if that's what we want to do. They said we can try whatever we want and they'll go with it if it's effective, but they may try suggesting something else if it's not working. They did point out though that the squatting position can to lead to more tearing, which sounds ouchy to me, but I'll have to learn more about other alternative labor positions like kneeling on all fours later, hopefully during our childbirth class, and find ways to avoid that.
(birthing/squatting bars)

Having read quite a bit about laboring in positions OTHER THAN your back, I know sitting up can has benefits like helping with gravity pulling the baby down, ease pain, and a shorter pushing stage of labor among other things. I'm totally happy with that answer for now. I would expect to be given a chance to try something and see how it works, and hey, if a different position works better cool.

And once she's out I'm going to have them put on one of these adorable trendy hospital hats from Tweedle Bug Boutique so she stands out from the crowd (I had to find a way to squeeze in a plug for her adorable first hats!!)

Overall after that experience, and then touring the hospital just after to see where I'll be having my daughter I feel a lot more confidant, trusting, empowered and even excited about labor, probably than every before.

Lately I feel like I've been bombarded with negativity towards obstetricians and hospitals which really was starting to push me into a corner of fear and anxiety about my birthing experience. Even while I tweeted during my #OBmeetandgreet I got responses that were negative, and seemingly trying to counter every positive comment I made about the meeting.

When I mentioned that I could labor [and push] in different positions some replied saying things like "OBs say a lot of vaginal-baby things up until it's time to give birth." Sorry, but what kind of BS is that? And I'm not going to say it was all of the "crunchy" people who were being pessimistic. A few commented saying "you say that now" in reference to my tweet about trying to deliver without an epidural... But honestly, I'd much rather hear things like that than remarks that scream "Your OB is trying to screw up your life."

I wish more of us supported each other in the decisions that we make, and helped each other to have the best experience going forward.

I'm having my baby at a hospital, with an OB. I've made my decision. That doesn't make me better or worse than anyone else, but it works for me, and just because it may not have worked for you doesn't mean I'm doomed.
**PS: For people who were offended by my "hide away at home" remark let me explain my meaning. I don't mean hide in a bad way. Some animals like cats prefer to birth in private places and "hide away." I think that's a more intimate experience and great for those who want that experience in their own personal space. But to me... Instead of compromising my feelings of wanting to have my birth in a hospital environment, I'd rather find a hospital and staff that has the same attitude towards birth that I do, and supports my choices. I'm APPLAUDING women for taking a stance and fighting for what they want. What's the point of telling women we need to be stand up for our rights but not face the issue directly? What's the point of having a list of questions to ask doctors their philosophy on birth if you're just going to say "well, they're lying?" when you happen to find the right one? To me, addressing the issue straight on, and confronting OBs about concerns you have with their practice is moving in a direction of change. If I didn't want to worry about "putting up a fight" and wanted to have a home birth experience with a midwife I'd do it, but I don't. So I'm dealing with the cards I'd dealt for myself.
PPS: My OB does practice evidence-based medicine, I talked to nurses at the hospital as well, and they are VERY big breastfeeding advocates... Contrary to what some have suggested.
PPPS: While I don't love un-supportive comments I DO love birth stories. If you have one you've posted about I'd love to read it. My birth story link up is here.**

This is a part of a blog carnival post about childbirth you can read more Lamaze's Healthy Birth Practices posts here.