Unassisted Childbirth

As a way to boost my confidence in my body's ability to give birth, Elizabeth Gilhuly suggested that I check out the Unassisted Childbirth Yahoo group, which is paired with Lana Shanley's work.   At first, I didn't quite understand what they meant by "unassisted" childbirth, but that's exactly what it is: women or parents who labor at home without the presence of any doctors, nurses, or midwives.  That's right!  It's just mom and dad at home ALONE bringing their little bundle of joy into the world.  For me, even though I have a midwife, connecting with the unassisted birth concept is about empowering myself and gaining confidence in my body's ability to give birth through other people's unassisted experiences. Exploring unassisted childbirth also reduces fear in the situation where I just cannot get to the birth center in time and I end up having Lily at home or on the side of the road.

Recommended reading from our Bradley birth class and on the Unassisted Childbirth email list is Emergency Childbirth.

I have two reactions to the concept of planned, unassisted childbirth:

1. WHOA! WHAT IF SOMETHING GOES WRONG?!

Whether alone or with a midwife, if something goes really wrong, the best recourse either way is to call 911.

However, I find extreme comfort in knowing that there is someone checking in with me, someone who has attended many births (in my case, thousands), and can identify problems that we don't see.  My experienced midwife will be there to answer questions we have in the moment, preventing us from getting too excited.  A midwife can reassure us that X, Y, or Z are normal during birth.  She can respond quickly if the baby is not breathing at birth.  And, she can take care of or provide support for cutting the cord, preform an apgar test, and other post-birth routines.

It is my non-expert opinion in this moment that an unassisted childbirth is only an option for women with low-risk pregnancies and invested birth coaches who have done research, taken classes, or otherwise become very familiar with the birth process.  Through discussions with other pregnant moms and women who have given birth, I strongly feel like women who were more prepared have better success with a natural birth.  I've chatted with some pregnant women who have no idea what to expect during labor, but that they just know that the doctor knows best or the drugs will take care of it.  Some of them are scared, because they don't know what to expect.  There are many women who want to have a natural childbirth, but do not understand what is going to happen during birth, so they get caught up in some of the challenges of birth.  A woman's confidence in her body's ability to give birth can make a huge difference in her birth experience.

This isn't always the case, and some very prepared women end up with medication or surgery, and some unprepared women can have a very successful natural birth.  Take my mom for example.  From our conversation yesterday, it sounds like she read some articles about what the medication does to the baby and decided that she wasn't going to have any of that.  She had two natural births with no birth coach in a hospital.  I keep talking about how my mom is an amazing woman, and her snecdotes of why that's true just keep rolling in.

2. OMG, HOW LIBERATING!

What an incredible concept to just give birth at home without assistance.  Though I am not one to opt for an unassisted childbirth, learning more and more about birth, I am pretty confident that I could labor without assistance.  I feel like Cortney and I have got this, and that our midwives are going to be bored just hanging out waiting for the baby to be born.  I can think of many reasons why this would be an option for some folks:

•  Increased control over the birth experience.  Many health care providers have policies and procedures that may not jive with parents' preferences.  For example:
• Most health care practitioners have a date past which they want to induce or transfer to a hospital. 
• If your water breaks, many practitioners view that as the clock has started ticking and they'd like to see the baby born within a certain time frame after that, because they fear the risk of infection.
• In some states, direct entry midwifery is illegal.  Certified-nurse midwives are legal in all 50 states, but most of them work in hospitals.
• Unassisted childbirth is free. Though I don't believe that cost should be the only consideration, it certainly can play a role. 
• Birth happens on it's own time, and no one will be there at all to measure how far along mom is in her progress.  This measuring can actually hinder the birth process.

From to Lana Shanley's website:

Modern physics has proven that the very act of observing something changes it. Birth is essentially an emotional/spiritual/sexual act. And just as most couples would find it hard to relax and have sex with others in the room, many of them feel the same way about birth.

Women’s bodies were designed to give birth. When a woman is physically and psychologically healthy (free from fear, shame, and guilt), babies can often be born easily.

Some women actually prefer to give birth completely alone. Of course, most of them would say they weren’t alone – God, their innerself, or the larger consciousness, was with them, guiding them each step of the way.

Unassisted childbirth is empowering for the woman, her partner, and her baby. Women who have given birth with little or no assistance often describe it as the most fulfilling experience of their lives. With no one around to tell them what to do, when to push, or which position to be in, many women find they know how to give birth.

I have a pretty comfortable amount of control over Lily's birth at the natural birth center where I am giving birth.  However, there are still places where conventional methods can intervene.  If I near 43 weeks, birth center policy won't allow me to deliver at the birth center, and would require a hospital birth.  If my water has broken, and it's close to 24 hours of labor, then according to the birth center policies, we'll have to transfer to the hospital. 

We had two incomes when we started to pay for the birth center, but if I was doing the whole thing alone, I wouldn't have been able to afford it.  My insurance only covered 80% of the birth center fee, but not a certified professional midwife.  For me, it only covers certified-nurse midwives.  But it covers most of in-network prenatal hospital care.

Sure, not everything will go the way I'd like it to go, but knowing that there are more options than just going to the hospital is refreshing.  Would I chose to have Lily at home with no midwife if the birth center's policies prevented me from having her there?  No.  I would certainly go to the hospital.  While I am totally confident in my body's ability to give birth, I do know that I would need help, and everyone will be more comfortable with at least one health care professional checking up on us.

First Sonogram

I know that i just spouted off about hospitals, but there are several things that women who are preggers may want that some midwives just cannot provide.  For us, this is a sonogram and some blood work that we decided we wanted to pursue before really understanding the difference between a hospital birth and a natural birth.  I've read some articles that talked about some concern with over exposure during sonograms and ultrasounds, and Sean mentioned that he read that it was mostly a concern with folks who prolonged their exposure by making videos of the baby in the womb.  As my pregnancy progresses, we're going to find these routines less necessary than the standard schedule, because midwives do have their own less invasive tools for monitoring the fetus.

I didn't think I'd find a need for a sonogram until after our first visit with whichever midwife we chose to go with. We were looking, but not exactly finding the midwife for us. However, I started spotting on and off for the first couple of weeks.  In looking it up in books and online, there were lists of possible explanations for spotting, and some of them were very alarming, like an ectopic pregnancy or a miscarriage.  I was starting to worry that I might be having a miscarriage. And, despite the desire to divorce ourselves completely from the mainstream approach, I made an appointment with the women's center in one of the area hospitals that my pregnant coworker (she's due at the end of March) recommended, and then two weeks ago, we went in to have our first sonogram.

When the technician was doing the sonogram, we could see the little lima bean that was our baby and a heart rate of 142 beats per minute!  It turned out that everything was just fine, but we weren't as far along as we thought.  My last moon time started December 27th, so that would put me at 8 weeks at this visit, but the size of the little pea pod was only 6 weeks and 1 day, which puts the due date later in October than we thought.  My moon times were always flexible, so it didn't surprise me that I ovulated later than we thought.  But, we saw our little munchkin in the womb, oh what a validating experience!

Then, we had an incident.  The technician, who was very sweet, said that we should come back at our actual 8 week visit to see the nurse that we had been scheduled to see that day.  This to keep the visits on track.  She had first told me to come back in two weeks, but changed her mind, and told the gal doing the schedule to have me come back in a week.  This so that we can just check to make sure the baby was in fact growing, because it was a little odd that my due date was so far off.  That schedule gal gave me an appointment day that was two weeks away.  I said that the technician just told us all that I should come back in a week.  She told me to hold on a moment, a moment in which I thought she was going to ask the technician what she had said.  However, she brought over her supervisor to explain to me that I was to come back in two weeks.  That women, having not looked at my file at all, motioned us over to an empty exam room and told us not to be worried, and to make sure to call and ask for her if there was any spotting, and that she would personally take care of me.  Who are you, and why are you involved in this at all? 

We walked back out to the check out counter, expecting to get some kind of appointment card or receipt for the visit.  I was trying not to get upset.  The supervisor was still standing next to us.  I just wanted to collect my appointment card and get on our way.  But, there was no receipt or appointment card being handed to me.  Instead, the schedule gal was just staring at us as if we were stupid.  But, I'm pissed, because her fetching her supervisor indicated to me that she thought we were causing a problem. I didn't care whether we came back in a week or two weeks.  I was just repeating what the technician told the schedule girl to do, which we were all standing there to hear.  The supervisor walked closer to me to comfort me, seeing that I'm getting upset.  I told the supervisor to stop touching me, that I would be fine, and we just wanted to know if they validated parking.  They, of course, did not validate parking.  So, I left upset and even more convinced that the hospital was not the place for us to give birth.

We've since then decided on a different midwife, and more about that part of the story is to come.  I have to make a call to the women's center to see if we can schedule appointments for ultrasounds, but choose to deliver outside of the hospital.  The benefit of sticking with this women's center is that everything is covered 100% by my insurance with no copay.

No Hospital For Our Baby

Sean and I knew that we did not want to give birth in a hospital.  There is this whole rigamarole with hospitals.   Parents have no control over how their baby is born or what happens to them or their babies when birthing in a hospital.  Eh, you get some illusion of control, but if the doctor deems it necessary, that goes out the window.  Parents might have let their provider know of their wishes and birth plan.  But, when you're in the hospital, you're in the domain of doctors.  What you want and what actually happens are two different things.

In the hospital, mothers give birth on their backs with their legs spread wide in stirrups.  This is the best position for the doctor to work.  However, this is not the best position for the mother and baby during birth.  In fact, women are encouraged to stay in bed and not move into comfortable positions.  A women's body will let them know what position it needs to be in if we let it do it's job.  When at a birth center or at home, women can move about and get into a range of positions that facilitate an easier birth for baby and mama, be it on all fours, sitting, standing, walking, on a birthing ball, and/or in a birthing pool.

Hospitals administer unnecessary drugs to facilitate the birth process.  These drugs stop the body from being able to do it's job, and the body knows what it's doing.  A woman should be encouraged to eat and drink normally during labor, because the body needs strength to give birth.  But, a woman in labor is given IV fluids and is unable to eat/drink during labor.  If labor is induced, this speeds up the process of cervix dilation, which causes contractions to come more painfully.  Instead of opening at the natural rate that the cervix wants to, the drugs cause it to open the same distance in a much shorter amount of time.  There are other options for a less painful, but more speedy birth, including just standing or walking around.  But, the mother isn't permitted to really get up and walk around at a certain point.  Natural birthing positions minimize pain, but being on her back and/or after the pain of inducing labor, she might opt for the epidural.  This prevents the body from being able to feel the muscles in the lower abdomen, which prevents a women from knowing when to push.  So, she pushes too hard and doesn't let the baby come naturally.  The baby is coming on the doctor's schedule, not the baby's schedule.  

Speaking of the doctor's schedule, if the labor isn't progressing at a doctor-accepted rate, the doctor can opt for an emergency c-section.  A mother is given all of these drugs and put in a position that's not optimal for child birth.  No wonder things aren't going as planned.  In a country where our c-section rate should be around 15%, it's actually more like 40%.  And, if the doctor wants to do it, you don't really have a say, because it's an emergency at this point.  So, the doctor can opt for major abdominal surgery just because something Mother Nature has been doing for thousands of years is taking too long (according to the doctor).

During a natural labor, a mother can reach down and touch the head of her baby when it's crowning.  A mirror can be used to see the baby as it's starting to be born.  And, fathers can even catch their baby as it's making it's way into the world.  Sean wants to catch out baby.  What an experience for a new dad to be the first person to touch their child as it's born. A natural birth can even be organismic.  Rent Orgasmic Birth and check out Hypnobabies for some ideas. 

Lighting is important when a baby is born.  The womb is comforting and dark.  They have never seen light before, and so little ones should come out into a world that is dimly lit.  Hospitals have lights blaring so that the doctor can see what he/she is doing, and this is very jarring for the newborn.   Home or birth center births allow parents to control the lighting to make it more comforting to a newborn.

When watching videos of natural birth versus hospital birth, the hospital babies are all bloody, but the natural babies are clean.  Something is really wrong with the hospital process if the difference is a bloody baby.  When the little one is born, it is immediately weighed and cleaned, but those first few moments after emerging from the womb are so important.  A baby should immediately be placed in the arms of it's mother.  There are so many studies about the correlation between a baby's development and how much it was touched and held just after birth.  In the first week, a baby should hardly be put down, and newborns should be as close to their mother as possible. 

And, then there are vaccines. There are some useful vaccines.  But vaccines nowadays are preserved cheaply with a highly toxic metal, mercury.  There are stories of children who have tragic and irreversible reactions to vaccines.  The issue with mainstream vaccination is that hospitals are drug pushers and new parents aren't educated about vaccines or given the choice.

Not all pregnant women have a choice of home birth or a birth center, because there are risk factors that make birth in a hospital safer, as things can get sticky quickly.  Hospitals are good for emergency medicine, even emergency medicine during birth  They aren't good for routinely keeping us healthy.  Giving birth is a natural part of life that our bodies do so well on their own.  If it's not broke, don't fix it.

More to come on where we decided to give birth.