Following are the notes I wrote before our very first Trust Birth meeting. In the end, I put it in outline format, so this isn't EXACTLY what was said, but I wanted to get a clear idea of what I wanted to say. Five women attended, and we had a great time!
I'm
so glad to see all of you here tonight! Since it's our first
meeting, I thought I would share with you why I have such a passion
for Trust Birth. See, I am a very unlikely person to spread the word
that natural birth is safe. Though I've always believed that in
theory, I've never actually experienced an unhindered birth, even
though I have three children. I do however know all about the risk
of interventions. During my first birth, I had both demerol, which
made me so loopy I lost several hours of the labour experience, and
an epidural as well, all because I was assigned a hostile l&d
nurse. I had already been in labour for more than 24 hours, and I
was tired. When this nurse checked me to see how dilated I was, I
was given the absolute worst pelvic exam of my life. I mean we're
talking excruciating pain. I had this idea that I was going to have
a drug-free birth, and she completely broke my spirit with a heavy
hand. I think a lot of us forget about that factor. You spend all
this time picking your doctor and developing a relationship with him
or her, and they're really not the people who are going to affect
your labour. And if you're anything like me, they may not even be
there at all. When your baby arrives at 6:02 in the morning, you're
going to be pot luck in the doctor department. The doctor on call at
my first birth was also a real gem. I won't go into details, because
it could be a trigger subject, but if you're interested in exactly
what happened, let me know and I'll tell you.
My
second birth went much smoother. My blood pressure was getting a bit
high, and I was retaining more water than a sea sponge. I think my
feet were roughly the size of cantaloupes, I was having contractions
pretty religiously every 15 minutes for the last month of my
pregnancy, and I was already dilated to a four when I went in for my
prenatal exam on a Friday afternoon. My doctor recommended that we
induce, so we scheduled a date for the following Wednesday. After
the doctor fiasco with my first birth, ensuring that MY doctor would
be at this one sounded like music to my ears.
Fast
forward 11 years to the birth of this little guy here. I have a
wonderful husband, (this is my second marriage, by the way, so my
hubby wasn't present at either of my girls' births) and he knew that
my first labour had not gone so smoothly, and I just sort of assumed
that he would be assertive enough to take care of me when I was in
labour, because I'm just not. Some women really are able to voice
what kind of birth they want and stick to it, but I'm not one of
those women. I am in other things. I mean, don't even think about
telling me that my kid should eat in the bathroom because you might
catch a glimpse of boob. But during childbirth, not so much. So I
really should have spelled it out for my husband. If there's someone
in that room bringing me down, I need you to kick them out. I don't
care who they are, we can be reassigned. But I didn't tell him that,
and even though he knew I was upset, I think he just assumed it was
because I was nervous, and I tend to be high-strung when I'm nervous.
Anyway, we knew that Zachariah was likely to be a big baby. My
second child was a full two pounds bigger than my first one, and my
husband was a 10 plus pound baby. So if babies get subsequently
bigger, this one could potentially be a pretty good size. When I got
to 39 weeks and was dilated to a four again, inducing sounded like a
pretty good idea. I enjoyed my induction with my second child. I
mean, as much as you can enjoy being hooked up to an IV with drugs
giving you killer contractions. But this labour did not go as
smoothly as that one did. Once again, I had a nurse who was
condescending, and controlling. She had me in tears before I even
had the hospital gown on. Honestly, I wanted to turn around and go
home, but I felt committed to it at that point. Now, my husband and
I had taken the hospital tour, and I expected to be able to do things
like use a birthing ball, and you know, actually go to the bathroom
to pee. Not with this nurse. She did let me sit in a rocking chair
once, because I asked when my doctor was in the room. And man, if
looks could kill, I would be stone dead now. But that was what it
took to get anything out of this woman. I had been begging for water
for what felt like hours, and only got some when my doctor was there,
too. After a while, I needed to go to the restroom, and asked if I
could. The nurse brought me a bedpan. Seriously. Because she
didn't want to have to hook me back up to the monitors when I was
finished. I asked for an epidural after that. Because peeing in a
bedpan is humiliating, and I would rather be catheterised.
Basically, it all went downhill from there. My blood pressure
dropped really low, which caused Zachariah's heart rate to drop as
well. They gave me oxygen, and I think it must have been cranked
pretty high, because I could barely keep my eyes open. After several
hours of laying in bed doing nothing,I completely stopped
progressing. As a matter of fact, I actually moved backwards. My
cervix swelled. The doctor called it CPD, which means that the
baby's head is too large to move through the mom's pelvis. So after
12 hours on pitocin, they wheeled me into an OR, and I had a
cesarean. That had been my worst fear for the entire pregnancy, and
it happened. He weighed 9 pounds, which is admittedly more than the
middle child was, but with a significantly smaller head
circumference.
Now
I'm not telling you all of this to scare you, or to be a negative
Nellie. Certainly the choices I made like being induced affected the
outcome of my birth, so a lot of my problems I brought on myself. I
know that people can, and DO have really positive experiences giving
birth in hospitals. But talking to other mothers, I realised that my
experiences were not exactly unique. Women all over the country are
checking into hospitals wanting one thing, but getting something
completely different. You know, if there's one thing you should
never have to fight for, it's the right not to be mistreated when
you're birthing a baby.
Which
is what brought me here. It took me three times to get the message,
but I finally realised that birth is NOT supposed to be this way. I
blogged about my experience, and one of my close friends shared it in
some of the natural birthing communities that she's a part of, and I
met a midwife named Carla Hartley. She is actually the lady who
started the Trust Birth Initiative. I looked for a group meeting
here in Dallas hoping to find some healing there, and discovered that
there wasn't one. As unlikely as I am for this task, I hoped that by
sharing my experiences – those decisions I made that lead me to
crummy birth experiences, could maybe help other women from making
those same mistakes. Since having my son, I've talked to a lot of
moms who had also had traumatising birth experiences, and it's an
epidemic! Women are being diagnosed with Post Traumatic Stress
Syndrome from childbirth. This is not right. And our society, as a
whole has the medical model of childbirth so entrenched that some
people will actually get angry when you suggest that labour can
happen without a bunch of professionals interfering. We really need
to get back to the basics of birth here in the US.
During
the seventeenth and eighteenth centuries, about 1 percent of all
births ended in the mother's death as a result of exhaustion,
dehydration, infection, hemorrhage, or convulsions. Today 1 in 3
births will end in a cesarean section. Yep, I'm right in line with
those statistics. Three births, one ending in a C. OK, so I'm
sorry, but that doesn't compute. So 300 years ago only 1 percent of
births ended in disaster, but today 30 percent can't cut it? What
are we de-evolving?
I
want to read you an excerpt from an essay written by
Judith Lothian is a childbirth educator
in Brooklyn, New York, and the Chair of the Lamaze International
Certification Council.
In the last month of pregnancy, the
cervix softens and ripens like a piece of fruit. Contractions of
the uterus become noticeable, and the baby settles into the pelvis.
The contractions become stronger, the cervix stretches and opens,
and the baby moves lower and rotates, eventually moving down the
birth canal. With each contraction, pain sends a signal to the
brain and oxytocin is released. With the release of oxytocin, the
contractions increase in intensity. As the pain of contractions
increases, more oxytocin is released and the contractions become
harder.
The pain of labor is what most women
worry about. It is important to understand that the pain of the
contractions in labor is valuable. It is an important way in which
nature actually helps women find their own ways of facilitating
birth. In a very real sense, the pain of each contraction becomes a
guide for the laboring woman. The positions and activities she
chooses in response to what she feels actually help labor progress
by increasing the strength and efficiency of the contractions and
encouraging the baby to settle in and move down the birth canal.
When the pain is entirely removed, the feedback system is disrupted
and labor is likely to slow down and become less efficient. As
labor progresses and pain increases, endorphins (much more potent
than morphine) are released in increasing amounts. The result is a
decrease in pain perception, quite naturally. Nature's narcotic!
The rising level of endorphins also contributes to a shift from a
thinking, rational mind-set to a more instinctive one. Endorphins
create a dream-like state, which actually helps women manage the
tasks of birthing. Inner experiences become more important than the
external environment. As labor progresses and the pain of labor
increases, women “go into themselves,” become much less aware
and, at the same time, much more focused on the work of labor, and
are able to tap into an inner wisdom.
A woman surrounded by family,
friends, and health care providers who remind her of the power of
labor and encourage her quietly and patiently is a woman who is not
afraid. Her support team is totally present and comforts her as she
does the hard work of labor. She eats and drinks and, even if labor
lasts a long time, she has the energy she needs to persevere. She
rests between contractions. No one looks at the clock. Everyone
trusts the process of birth and believes that she has the strength
and the wisdom to give birth.
The woman moves in response to what
she feels. Whether she gives birth in a hospital, birthing center,
or at home, she is able to use a wide variety of comfort measures;
for example, moving freely, listening to music, taking a shower or
bath, and having her feet and hands massaged. She is able to create
an environment that is just what she needs as she does the hard
work of labor and birth. She pushes her baby down the birth canal,
responding now to the pressure of contractions and the baby as he
rotates through the pelvis and moves down the birth canal. She
moves, changes position, and grunts, sometimes holding her
breath—all in response to what she is feeling. In this way, she
not only protects the muscles of the birth canal and perineum but
also protects her baby as he is born. A great surge of adrenaline
insures that the mother is alert, even if her labor has been long.
She is totally focused on her baby, ready and eager to embrace him.
Baby is eager and alert, too. The stimulation of his journey has
primed him for the transition to life outside the womb.
With her baby in her arms, the mother
is engrossed, excited, at peace, proud, and astounded at the
miracle she has produced. No one tells her what to do. They know
that she knows what to do—not because she and her baby
have read the books or attended Lamaze class, but because their
journey has physically and emotionally prepared them both for this
moment. The weight of her baby on her belly helps her uterus
contract and expel the placenta. Baby stays warm in his mother's
arms. Baby knows just what to do to survive in the world he has
entered. He is awake and looks around. Within seconds or minutes,
he has his hands in his mouth and is smacking his lips.
Unpressured, he slowly but methodically crawls to his mother's
breast and self-attaches. As he nurses, his mother's uterus
contracts, insuring that bleeding will not be excessive. The two
greet each other unhurried, confident, and unpressured. Together,
over the next hours and days, they will get to know each other and
fall in love.
For
all of its simplicity, nature's plan for birth actually requires a
fair amount of flexibility. Each mother and each baby are different.
While the anatomy and physiology are standard, how each labor and
birth proceeds is fine-tuned through the active involvement of the
laboring woman. All through labor, her body tells her what is
happening and helps her discover what she needs to do to help. The
active involvement of the laboring woman is a critical piece of
nature's plan for birth, and it is the least understood. The hard
work of labor is not meant to be accomplished alone. Changing
position, avoiding exhaustion, and staying adequately nourished
require assistance. So across the world, women giving birth are
supported, encouraged, and comforted by family, friends, and
professional birth attendants. Giving birth as nature intended is not
“biting the bullet and letting it happen.”
Childbirth
is an intense act of love and passion. Interfering with the process
can really hinder things. The best way – the very best way to have
that natural birth that you want is going to be to stay out of the
hospital. Really, stay home. Because that's where you're going to
be the most comfortable. Nowhere else are you going to be free to
let loose and labour the way you need to labour. But I know that
idea takes a little getting used to, and there are lots of other
alternatives out there. We're actually really fortunate here in DFW,
because there are a dozen or so birthing centres in the area that are
staffed with midwives and can be a happy medium for moms who don't
want to go to a hospital, but can't quite get used to the idea of
birthing at home. And if that's still too far out there for you,
there are a select few midwives who practise out of Baylor Dallas,
McKinney Medical Centre, and Presby Allen. And I know there are
probably some of you here who may be risked out of a home birth, or a
birth centre. You may have health conditions that require you to
birth with an OB. But most of you can still have a natural birth if
that's what you really want. Remember that 1 percent in the 18th
century? You can find an OB who's natural birth friendly. Honestly,
if I had it to do all over again and HAD to have a hospital birth, I
would stick with the same doctor I had, because I really just love
her. What I wouldn't do is agree to an induction. That really,
really, really increases your chances of having a cesarean. I would
also hire a doula. Doulas take the pressure off of you and your
partner. They go to bat for you with those L&D nurses and remind
them of your desires for birth. They can also be the bad guy for you
and refuse the interventions that you don't want.
And
while we're on the subject of interventions, you can refuse those,
you know. Those vaginal exams that you get every week for the last
month of your pregnancy don't tell you anything. I've walked around
for DAYS for all three of my pregnancies dilated to 4 centemetres.
Doesn't mean a thing. And there are very few real reasons for an
induction. So do your research, and know what interventions you're
willing to have and which ones you're not, and exercise your right to
say no. That doctor you hired? Remember that YOU hired THEM. Not
the other way around. You're giving them their paycheck. And if
they won't work with you to provide you the kind of care you want,
you can fire them. Keep that
in mind when you're deciding who will or won't be present at your
birth. Just because you've always gone to that doctor, or because
your mother, or your sister or your best friend's aunt, or whoever
used that doctor, or midwife... If you're not clicking with that
person, then mama, you need to find a new care provider.
Look,
I'm no expert. I'm just an average momma who had what unfortunately
has become typical birth experiences. I certainly don't have all the
answers. But there has to be a better way than what is happening
now, and it's not going to change if we don't speak up and start
demanding better. Our babies deserve to have a better entrance into
the world than loud shouts of “push, push”. Or worse yet, the
bright lights of an OR. I'm so glad you all came here tonight. We
may be small now, but I hope that we can all spread the word that
birth doesn't have to be this big scary thing. It can be beautiful,
and spiritual. It's time for women to get back to the simplicity of
birth the way it was designed to be.
