Thursday, October 23, 2008

Chime In: Childbirth

Since discovering that Baby Dois was on the way, I have been doing a lot of thinking about birth and my birth options here in the United States. It should come as no great surprise to anyone that I am not exactly eager to repeat my first birth experience. Well, let me qualify that statement a little. I don’t want to be in labor for three days this time around! The only positive I can see from my lengthy first labor is that I now have an extremely high threshold for what I would consider a “short” labor. Hey, if I’m only in labor for half the amount of time with Baby Dois (32 hours instead of 64), I’ll be saying, “Wow, that was fast!” (And most people – Americans, anyway – will still look at me pitiably and say, “You poor thing! Why didn’t your doctor give you a C-section?” But that’s beside the point.)

No, this time around, I would like to order a shorter labor, if you please. And I think I’ve established that I’m fairly easy to please on that score! But in all other respects, my first birth experience was a very positive one. If I could, I would go back to Japan to have this baby. I really would! I miss the maternity system there (which basically gives you two free doctor visits during pregnancy and then reimburses you for your hospital expenses after the delivery). I miss my midwife. I like the OB I found here in Memphis well enough, I suppose. But going to see her is just not the same as going to see Kudo-san, spending the better part of an hour with her, drinking tea and talking, and ending with a wonderful and relaxing incense massage! Truth be told, I even miss my Japanese doctor, who, although he was old and gruff, and spoke next to no English, and smoked – in his office (!), was a true champion for natural childbirth. I am beginning to appreciate in new ways, now that I am Stateside, the gift it was that, despite my lengthy labor, I did not end up with a C-section. And the thought that a second lengthy labor might lead to one here in the United States terrifies me.

The fact that I will likely not be having this baby in Memphis is of some comfort to me. There are not many “alternative birth options” here, I’ve discovered, other than homebirth. There are midwives, but midwives don’t have hospital privileges in Memphis, so if you opt to use a midwife, you have to also opt for a homebirth. I am not opposed to the idea of homebirth, but my personal preference would be to give birth in a freestanding birthing center with a CPM (Certified Professional Midwife) or a CNM (Certified Nurse Midwife). I have already begun to research my options in Michigan, and I’m reassured by what I am finding. There are several birthing centers within an hour’s drive of the Detroit area, and even a group of CNM’s who practice at one of the area hospitals.

I have also been doing a lot of thinking about what I wish I had known the first time, what I wish I had done differently, and what I plan on doing differently this time around. I recently became “blog friends” (through some of my Internet research on prodromal labor) with another woman who has had labor experiences similar to mine, and she encouraged me to do some thinking and reflecting about this. And so I have, and I plan to post some of those thoughts here in the next few days. In the meantime, I would like to invite any readers who have either experienced or would choose a “natural birth,” whether at home, in a birthing center, or in a hospital, whether here in the United States or overseas somewhere, whether recently, or many years ago, to chime in with your thoughts, stories, and suggestions. I am especially interested in answers to the following questions:
  1. How did you arrive at your decision of how and where to birth your baby?
  2. What books, websites, and other sources of information did you find particularly helpful?
  3. Did you write a “birth plan,” and did you find it helpful?
  4. If you chose a hospital birth, did you hire a doula, or labor support person?
  5. If you chose a homebirth, did you have a backup plan? (In other words, did you receive “shadow care” from an OB or family doctor in case complications arose during delivery, requiring a hospital transfer?)
  6. What childbirth method did you choose? Did you take childbirth classes, and did you find them helpful?
  7. Would you make different decisions (i.e. choose a different birth attendant or birth locale) for any subsequent births?


  1. 1. My first birth and subsequent years of research influenced this upcoming birth decision.

    2. Read anything and everything by Ina May Gaskin, Henci Goer and "Pushed" by Jennifer Block

    3. I wrote a birthplan with DD1 and it was totally ignored. Hospital birthplans are routinely ignored but they help you to identify what is important to you. You have to find other ways to enforce your demands.

    4.If you decide on a hospital birth then a doula is worth her weight in gold.

    5. I do have a backup OB for my upcoming birth who does not realize I am planning a homebirth. No sense in creating tension and arguments. She is there if something goes wrong.

    6. No classes, just tons of research, homebirth videos, homebirth books, websites, birth stories and a deep, deep trust of the birthing process.

    7. My birthing decisions are 100% different than the first time around. :)

  2. Hey, Laura, I've only had one so far - but here's my answers to your questions. God Bless you in this pregnancy and in the future.
    1. How did you arrive at your decision of how and where to birth your baby? (The idea of home birth actually scared me a little. I wanted to be in a hospital in case anything went wrong. As the time approached, I discovered that it was the best decision for me because then I could totally relax and concentrate on my job. Had I been at home, I would have been worrying about everything from not wanting to get things dirty, to wondering if we had enough clean towels, etc.)
    2. What books, websites, and other sources of information did you find particularly helpful? (I read just about everything I could get my hands on. We got a big, thick tome from the Mayo Clinic about pregnancy and birth and baby care. It was great.)
    3. Did you write a “birth plan,” and did you find it helpful? (I did, and I found it very helpful in that it solidified in my head what I wanted to happen. But it was never a formal thing with the hospital. They just gave me a choice on things and I picked the one I wanted.)
    4. If you chose a hospital birth, did you hire a doula, or labor support person? (My mom and husband were my support people. I was going to have my "aunt" there with me who used to be a midwife, but by the time the actual labor came along, I felt so prepared for ti that I felt that I did not need her. And I knew that my mom would be all the advocate I'd need since she had had a not-so-good experience having me in a hospital, she'd fight for me all the way.)
    5. If you chose a homebirth, did you have a backup plan? (In other words, did you receive “shadow care” from an OB or family doctor in case complications arose during delivery, requiring a hospital transfer?) (N/A)
    6. What childbirth method did you choose? Did you take childbirth classes, and did you find them helpful?(I found the class we took helpful in that it was more information to use in making my decisions. It was also good for Joe because he was not as obsessed with reading all the books, magazines, websites, etc, like I was. As for the childbirth method I used - I'd have to say it was the Maridy Carpenter method. No breathing techniques I had read about worked. No particular philosophy or stance or position that I had heard of. I had to do it my own way. I was very blessed to have a short labor, though, since it was particularly painful - all in the back, no laying on the bed for me.)
    7. Would you make different decisions (i.e. choose a different birth attendant or birth locale) for any subsequent births? (I would choose to ave an episeotomy (sp?) next time. Ripping in four places is not fun. And I would tell the doc not to yank the placenta out. The resulting D&C was also not fun. Oh, and I would of course be sure to communicate with my baby to come at a time when MY doctor is the one that's on call, rather than one I'd never met. But overall, I really liked the hospital and nursing staff and my experience there.)

    Hope that helps. Maridy

  3. Oh, a subject near and dear to my heart! It is toooooo late to comment right now, so I defer to a later date. But wanted to let you know that I read your post and plan on commenting... ;)
    Laura H...

  4. I also love this topic. :)
    Books: I totally recommend the same books/authors that Sheryl recommended. I'd also recommend the DR. Sears Birthing Book. There are a couple others that I'll have to get back to you with.

    Birthing method/classes: We took the Bradley method classes and though we didn't completely follow their method we definately gleaned a TON from the classes and they taught me how to figure out my own way of relaxing and coping. I think, like Maridy said, every women really has their own style of labor when given a chance to let their body do the work it was made to do, but it certainly helps to have the knowledge of helpful techniques and of what is happening to you. (Of course this being your second child, you know what's happening to you.) (I combined things I learned from Ina May's Guide to Childbirth with techniques from the Bradley Method.) I also liked how the Bradley classes helped educate me and held me accountable for staying healthy and fit during my pregnancy. Since you go for 12 weeks it also provided a kind of "pregnancy support group" which was great. Of course Shawn learned so much and highly recommends the classes because if forces the Dad to learn a lot too as they are often not as keen to read all the books, etc. that we mothers are. :)

    Choosing where to have my baby: I chose a home birth.
    Reason #1: I cannot relax in a clinical setting and having a natural childbirth, unless there was a true emergency, was of upmost importance to me. I'm the opposite of Maridy in that home was the place I knew I would be the most relaxed and feel like I could provide the type of birth for Hannah that was so important to me. I don't/didn't trust the hospital culture here in TN to allow me to have the most natural birth possible. After reading a lot about it--especially in books like "The Thinking woman's guide to Childbirth" by Henci Goer I felt completely safe and at peace about having my baby at home. I interviewed each midwife in this area and found one that I really felt comfortable with. My midwife (Heather Wilson)is a CPM and has delivered over 1300 babies so I knew I was in very capable hands. Her assistant is one of the sweetest, gentlest people I know so with them two, my mom and Shawn I had the perfect team of people surroundng me during my labor and Hannah's birth. Heather also laid out very clearly everything we would need for the birth as far as supplies, etc. so we felt (and were) very prepared.
    Reason #3: Being able to have the same people with me during my whole labor vs. the possibility that my DR. wouldn't be available or nurses would have to change shifts, etc.
    Reason #4: This allowed me the freedom to assure that my prenatal care, birthing choices and postnatal care of Hannah was carried out as I desired without feeling undue pressure or anyone having to "fight" for our choices. (No antibiotic cream in her eyes, no whisking her away from me, no washing off of the vernix, etc.)

    If Nashville had free standing birth centers that would have been my first choice too, esp. for my first baby. But now that I've had a home birth I never want to do it another way!

    I also had a water birth which I would highly recommend. I rented a birthing tub and got in it when Heather felt I was nearing the end of my labor and getting close to pushing. It practically eliminated me having an intense transition period-- or I might just be one of those women that don't have an acute transition, but never-the-less it really helped me to be in the water!

    Birth plan: Writing a birth plan def. helps you clarify what you want and to lay out a course of action for certain things that may/may not happen during the course of your labor. Even if it's not shared with your Dr. it will help you and Rusty to have it clarified before hand. The Bradley Method has a really helpful form for making up a birthing plan. (It helps you think of everything.)

    Home birth back up plan: My midwife is required by TN law to have a back up doctor so I went to see him once during my pregnancy so I would at least know who he was if an emergency happened. This was not required of me but I chose to do it for my own sake. Thankfully he wasn't needed.

    Any different decisions? Actually, I really wouldn't make any different decisions! I was so blessed by Hannah's birth. It is truly one of the highlights of my life-- meaning not simply her arrival into the world, but the whole process of labor and her entrance into our lives. I would love to email you her birth story if you are interested.

    Okay-- I told you this was a favorite topic . . . I'd better go now. I'll be praying for you as you research and make your decisions. Love you!

  5. It has occured to me that most of the people who will want to post on this topic will be advocates of natural birth. Just thought it interesting. ;)

    1) How did you arrive at your decision of how and where to birth your baby? Well, I have a bit of a special situation. See, I am somewhat of a naturalist. I believe in the power of the human body for many things, even more in the power of God and I just plain don't care for medication of any kind unless really neccessary. So when I heard about natural childbirth, I KNEW it was for me! HOWEVER, I have Type 1 Diabetes, so I pretty much live in a world of doctors, medicine and tests. Without which I would definitely NOT be alive today, nor would I have EVER been able to have children!!! When I started researching about natural childbirth on the internet and in some books loned to me (by Heather Rosser, thanks Heather!!), I found out that it is REALLY risky to have a home birth (ok, I live with my in-laws anyway, so that is out already!) and that a freestanding birthing clinic would not accept you either because when you have Diabetes you are automatically considered high risk. So I pretty much resolved that I would have to give birth at a hospital no matter what I wanted to do... BUT I had been recommended to a freestanding birthing center by a good friend of mine, so I thought I would check it out anyway. I would not even have considered it, but the doctor speaks English and has an operating room at his clinic. It was a newly built building and just walking in was like walking into a little corner of America! Nobu and I went during the New Year Holiday just to scope it out a bit. We ended up talking with a nurse on duty about our preferences and the fact that I was Diabetic. And she seemed totally accepting! We made sure that they knew the risks and were knowledgeable and I was absolutely astounded that she said they would accept me!! So I went on to have DJ there by a mostly natural birth (doctor broke my water, stripped my membranes and I ended up having an episiotomy, but otherwise natural. And I could've avoided all that if I was more vocal at times.... but oh well)! anyway, Me! a Diabetic! at a birthing center! I was in awe! ^-^
    And for Jessica's birth, we were going to go to the same place. I was being monitored as they do here, and then at 36.5 weeks I thought that I was going into labor. Went in for observation. Ended up not progressing very well, so the doctor was going to break my water, like he did with DJ. But I found my voice and told him I would rather not if it was not neccessary. He sounded a bit surprised, but was pretty cool about it anyway. The next morning the contractions had stopped and I was no longer in labor of any kind so they sent me home. Before I left the building though, they said the doctor wanted to talk to me. Apparently his pediatrician (who didn't work there when DJ was born) was concerned about what happened with DJ's birth. He had low blood sugar when he was born and they couldn't bring it up so they had sent him to a hospital that could take care of him. That was the ONLY problem (and in fact, by the time he arrived, his blood sugar had come up.... but anyway). So my doctor told me that I would have to go to a hospital to have my baby. He told me that he himself thinks that it is ok, but he has to follow the advice of the ped. grrrrrrrrrrrrrr. So with only a few weeks left, I ended up being transferred to a hospital. Though there were no problems this time, it turned out to be a blessing in disguise, but that is a whole other can of beans. ;)

    2) What books, websites, and other sources of information did you find particularly helpful? Baby Center, Kellymom (but mostly for breastfeeding support). I mostly just surfed the internet high and low for any info I could find on natural childbirth. A friend had loned me the Bradley Method book, but I didn't really read much of it. There was tons of info for the dad and on teamwork between the two of you, but I needed stuff for me. Nobu was not into reading anything on the subject. Again, another can of worms there... I also found friends birth stories helpful. Heather Rosser really was a wealth of all things natural childbirth, nursing and baby related! hehe

    3) Did you write a “birth plan,” and did you find it helpful? I didn't, but I really wish that I had. With Jessica, I didn't but I MADE SURE they knew that I didn't really want a hospital birth and that I wanted to do it as natural as possible and breastfeed exclusively, etc. I should've gone with a birth plan this time around, too. But at least I was a lot more vocal...

    4) If you chose a hospital birth, did you hire a doula, or labor support person? I soooooo wanted one! If I had more time, I might've been able to find one.

    5) If you chose a homebirth, did you have a backup plan? (In other words, did you receive “shadow care” from an OB or family doctor in case complications arose during delivery, requiring a hospital transfer?) Well, at the birthing center, they had everything I would've needed provided I was able to care for my Diabetes myself. Which was fine with me. And in some ways preferable...

    6) What childbirth method did you choose? Did you take childbirth classes, and did you find them helpful? I took the Japanese pregnancy classes given by the clinic when I was pregnant with DJ. Truthfully, they were not very helpful. Only three for the entire pregnancy and only the last one had anything to do with labor. Had someone come with me and attended the birth, they might've actually been helpful... I didn't use any particular method. Nothing really seemed to fit. For me, I picked and choosed from researching different methods and things on the internet. I knew that I would use relaxation and massage for labor, but thought that chanting would just be too weird. I ended up using both of those with DJ, anyway. haha! And with Jessica, relaxation and massage for the labor and God told me what to do for the pushing phase. That is the only way I can describe that part... The nurses kept asking me questions and hustle and bustle, blah blah... But when I quieted myself and just listened, I could hear Him tell me what to do. It was so amazing.
    The other thing that helped was to be as vertical as possible. I noticed with DJ's birth that the labor phase was preogressing very well. But when they moved me into the delivery room and on the table, things slowed down considerably even though I had them raise the head. I didn't let them put my feet up with Jessica's birth and instead kept telling them to raise the head. I seriously was practially completely verticle with her and could see sooooo much more! It was amazing!

    7) Would you make different decisions (i.e. choose a different birth attendant or birth locale) for any subsequent births?
    I think this is one question I will have a lot to think about. Jessica's birth was such a supernatural, powerful event. But I still don't like hospitals!... If I could go back to the birthing clinic, I probably would. I just don't know about that pediatrician anymore.... We will see.

    Sorry for the book. I am still trying to put a lot of things into words, and I guess there is a bit more of the puzzle here. Thanks for letting me get it out. ;)

  6. Sooo... Don't know if I have all the answers or even opinions on all your questions, but here goes.
    1. How was never a question. I wanted natural all the way (especially after seeing that epidural needle!) Where was a little more limited - Josh wanted a hospital birth for Michaela, and there was only one on our insurance. And here in Bolivia, it was even more limited. Well, that is if you want similar health care to in the States. We chose the best clinic in town.

    2. I read and reread What to Expect and the Birth Book (did you give me that or did Rachel?)

    3. I didn't write one - although I had my non-negotiables, like no medication and definitely no shaving (something they do routinely here!). I chose to be a little more flexible on some other things, like episiotomies, seeing as doctors here have pretty strong opinions about them. Next time though another non-negotiable will be no enimas! Another thing they do routinely here.

    4. See number one. I don't think they have such a thing here - although both my doctors were great coaches and Josh was amazing in all 3 labors. Like I said, not a whole lot of choices in Bolivia! Have to say though - I'm sure jealous of Josh's sister and the birthing experiences she's had. Water births look/sound wonderful!

    6. Again, natural all the way. The classes I took in the States - Lamaze and breastfeeding - were the most helpful.

    7. Well, unless we decide to move to a different country, I don't think there's a whole lot of changes we could choose. Although, if I could, I would definitely choose what they call 'parto humanizado' here - meaning natural birth with techniques focused on making mother and baby more comfortable (i.e water birth etc.)

  7. OK Laura, I had one of those horrible computer moments where I wrote an entire book (no joke, the only one who would have competed for as long a response is my sister) and then OF COURSE lost our internet connection (since we are hacking it off our neighbors wireless) and subsequently lost my long long long long post. So, here is the abbreviated version. I think you already know I am also a huge natural birth advocate. After teaching human growth and development to a bunch of college freshman it really became a pet topic when I saw how most of them have been totally brainwashed by our medical community to think there is no other option outside of the traditional medical birth.

    1. I think my opinion about childbirth was formed primarily b/c my mother always talked about birth as though it were the most wonderful, exciting, and natural experience. She had all three of us kids naturally and loved sharing her labor stories, so I just absorbed that attitude. Then I took a parenting class that used Dr. Sears' Parenting Book and I began having an educational interest in natural childbirth. I read about it throughout graduate school and in my years as a psychology college prof. So by the time I got pregnant I had a whole head full of opinions about the topic and new undoubtedly I wanted the most natural childbirth possible.
    Where---I live in one of two states where homebirths are still illegal. I wasn't willing to use a lay midwife and risk getting arrested if something went wrong, so I decided on a hospital birth. I would have chosen a birth center, but again, none in the vicinity. So this was basically decided for me.

    2. I read the Sears' pregnancy and birth books. Answer to Julie's question---I gave you the book Jewels :-). I know I read lots of other stuff, but those were my cover to cover main resource books. Going to a class was also extremely helpful. I would say watching tons of graphic videos was probably even more helpful to me than all the reading (or at least equally as helpful). And interviewing lots of women I love and respect about their birth stories.

    3. Yes I wrote a birth plan and yes it was helpful. Like the other women have said--it helps you clarify what you want and it also helps you know what you are going to need to stand up for if you are in a hospital. I also really loved that my midwife paid attention and advocated for things on it even when I was beyond the point of caring about little details. For example, we had written that Bryan was to "deliver" our baby. Well, I pushing in a squatting position and Bryan was the one holding me up. When my midwife said, "we need to get dad down here to catch the baby" I was like "NO WAY, leave him where he is." She was like "No, we can do this" and she orchestrated for my mom to switch with Bryan so he could catch Corban. Of course I am SO GLAD she stuck to our birth plan even when I didn't want to, because that means so much to Bryan.

    4. Yes, I had a doula. I had a midwife, my mom, Bryan, and a doula. The doula helped me with three primary things:
    1. She got me into a powerful relaxation ritual that really worked for me to get through contractions.
    2. She knew how to work the system in the hospital. Primarily, b/c I was required to be bedridden due to preeclampsyia, she knew she could say I "had to go to the bathroom" every 20 minutes to get me some motion. I wouldn't have been able to assert that myself while concentrating on everything else.
    3. She had some great tricks to relieve some of the back pain during transition.

    5. NA

    6. I didn't have a specific method. Just practiced relaxing in a way that I knew would work for me and then focused on those coping skills during labor. I went to a class and like I said the videos were helpful as well as listening to other women who have birthed before, having a support group of other couples in the class, and practicing relaxation techniques.

    7. If we were to do it again we wouldn't have a doula. I think she was great and I'm glad I had her for my first birth, but I don't think I would need her a second time. Also, I had severe preeclampsia so had to be induced and also had to be monitored and lying down at all times. This restricted me from a lot of things I would like to try next time---I look forward to having a range of motion and also having the option of waterbirth. I would like to have at least one home birth in my life, but again, I won't do that in NE b/c I wouldn't risk using a lay midwife with no back up system in place. Especially after my first pregnancy ended in high risk.

    All together, birthing Corban was one of the best experiences of my life. I drew on an internal strength I never knew I had, relied on my husband's calming presence more than I ever have in the past, felt so nurtured by mother and midwife, and felt so triumphant that despite the obstacles of having an early induced labor I achieved a birth without medications. It was a beautiful, triumphant experience. Speaking of which, your birth story blows me away---you must have some powerful coping skills and felt so proud of yourself! You go girl!