Wednesday, March 19, 2014

Birthing Experience Vs.Birthing Safety

There is one phrase that I hear that makes me cringe, "My birth experience wasn't what I wanted." And although I sympathize with more extreme cases, I don't sympathize with those that complain over "unnecessary medical intervention," and include getting an IV and having the baby monitored as "unnecessary". Sometimes having a baby isn't about the mom, in fact it is always about the baby.

 I just watched "The Business of Being Born," and within ten minutes of hearing statistics, I was ready to chuck something at the TV. The moment it mentioned "midwives" in the US vs. the rest of the world, I knew I was in for an hour of untruths. I hate the term midwife. Why? Well certified midwives in the US don't have to go to school. They attend some training and call it a day. Certified NURSE midwives are completely different and have at least a masters degree and typically work in doctor's offices or hospital birthing centers. The rest of the world only uses the term "midwife" for those who go to extensive school/training like our NURSE midwives. Make sense? We already have highly-educated nurse midwives, and I simply don't understand using a second-class midwife.

Do not mix up the two. The homebirths you see are done by a midwife who hasn't ever worked in a hospital and seen first-hand "real" life-threatening births. So when a life-threatening birth happens, how is she suppose to spot it before it is too late? Midwives here are more like doulas, which are great to have for support, as a spokesperson, and someone to help you through the labor. When it comes to having a completely normal and safe birth, then yes homebirths with a midwife are probably the best experience ever. The midwife has learned all the techniques to deal with the pain and delivered countless babies. But, and this is a big BUT, what if something does go wrong? Is this beautiful homebirth experience worth the risk?

I'm guessing you can tell I am against homebirths? I am all about having a good birthing experience without an epidural, prolonged cord-cutting, and birthing in the water. I am not for homebirths--unless you don't make it to the hospital in time. The statistics you read can be confusing, and pro-homebirthers love to claim that homebirths are as safe or safer than hospital births. This is not true.

For starters, most people who have homebirths have gone through a screening to ensure they are a good candidates for safely birthing at home. This takes out any high-risk labors, previous C-sections, multiples, and women with pre-existing medical conditions. So the hospital pool is a combination of everyone, while homebirths are the ideal safe births. This immediately throws off the statistics.

Secondly, if a home-birth goes wrong and baby is transferred to the hospital, the hospital gets to add that "homebirth" into their numbers. This also includes babies born at home but pass-away in the ambulance or at the hospital.

Thirdly, studies that truly reflect low-risk women in a hospital setting vs. homebirth, show that homebirths are two to three times more likely to end in death.

Fourthly, The Midwives Alliance of North America (MANA) has never released the honest data of homebirths risks to the public. If they showed homebirths were safer, you can be dang sure they would share the data.

So yes, I think homebirths are a risk. I understand why women want them. They sound amazing, but I will never tell a women to have one. In the end it is the mom's choice, and I definitely respect that, but knowing all the facts before making a final decision is a must. This doesn't me rushing to a certified midwife and asking for her thoughts.

As for delivering in a hospital, I say go for whatever you want! You want your doula there? Do it. You want to labor at home? Go for it. You want to labor in the tub and walk around? Then do. I think before writing out a birth plan, it is always proactive to ask yourself, "Is this <insert detail> really going to affect my birth experience or is it safer for the baby?" While we all envision how we want our labor and delivery to go, it really can take us anywhere. Yes, I do believe that C-sections are overdone, and many women feel like they were robbed of an experience when they are rushed to surgery, but all doctors aren't quick to cut. I was in labor with Lincoln for 12 hours and his heart rate was insane, and guess what? When it dropped to 40 and the nurse panicked for a C-section, the doctor calmly said, "give it a few seconds," and then helped me push my son out.

While I love reading birth stories, it saddens me to hear people disappointed in holding their baby for the first time; too caught up on their missed vision, they forget to embrace the miracle happening right in front of them. Being prepared, but open to "interventions" will help you appreciate the gift of creating a baby inside you for nine full months, even if it is done with medicine. I am so blessed and thankful to live in the world we do. One hundred years ago 7% of women died in childbirth, and now that number is below 1%. How miraculous! I will always put birthing safety above my birthing experience.

For more information, statistics, and truths about homebirths check out this doctor's website. I found it very interesting, especially since I was looking at delivering our next baby at a birthing center. After learning more about midwives and talking to Scott, I realized it wasn't for me. I don't have a problem with birthing centers though, as they have strict regulations and fast transportation to hospitals.


Tuesday, March 18, 2014

Writing a Birth Plan

Birth plans are an excellent way to prepare yourself for labor. Although I don't think they are necessary to bring with you to the hospital, I definitely recommend writing one at home. I didn't have one written out for my first son, but I had one mentally in place without even realizing it. It was experiencing labor the first time, that helped me write out what I wanted the next time. Everyone has ideas of what they want to have happen in the delivery room, and whether your birth is all natural, a C-section, or at home, you can still have a birth plan in place.

My first Birth Plan Was Something Like This
-Go to hospital at first signs of Labor
-Get epidural when I start to feel pain
- Labor pain free
-Push Baby Out
-Scott cuts cord

When I decided to get induced, my birth plan went like this instead
-Arrive at hospital at 7:00
-Have my water broken
-Get Pitocin if my labor does not progress
-Receive epidural when I am dilated to a 5
-Have baby
-Scott cuts cord
-Breast Feed

With Maverick my Birth Plan Was This
-Do not get induced until 41 weeks
-Have membranes stripped at 38 weeks
-No Pitocin unless necessary
-Go to hospital when contractions hurt and are 3-5 minutes apart
-Get epidural
-Scott cuts cord
-Breast feed immediately after delivery
-No binkies
-No formula
-No bottles
-Lots of stool softener!

As you can see, my birth plan was focused on having success at breastfeeding, and it took Lincoln's birth to help me create it. I did not bring it with me to the hospital, as I knew what I wanted and also knew my hospital supported breastfeeding. The most important thing you can do before writing a birth plan is to visit your hospital to get a complete feel for it. Most things that are on birth plans are already done anyways. Other things are not an option, so know your hospital beforehand. Nurses respect birth plans, but writing one that is realistic will help your nurse follow it exactly how you want.

Most Hospitals:
-Offer the partner to cut the cord
-Do not give formula to a baby unless instructed to
-Place the baby on the mom's chest immediately after birth
-Require you to get an IV in case you need to be rushed to surgery
-Do not take the baby to the nursery, but place baby in bed next to yours
-Require baby to be monitored during labor (this can be done with a portable device so you can still walk around during labor).
-Do not give the baby a bottle unless instructed to
-Ask if students can observe, and you can say no
-Respect your decision to go without pain medication
-Will perform a C-section only if the life of the baby is in danger

The best birth plans are short and simple, but writing a long one is a great way to start and prepare yourself. If you want to give the nurses your birth plan, make it a short list. Create a longer one for you including everything from visitors, what to wear, pictures, medication, breastfeeding, and what you want to happen at home.

Your birth plan might not go exactly as planned, but this is what makes labor and delivery so much fun! The unknown is what keeps you on edge, helps you get through the pain, and gets you through the last pushes. No matter where your birth takes you, keeping a positive attitude will ensure you an experience you'll remember with a smile. If you refuse to except that you might have to get an IV or have baby suctioned out, then you might be a little disappointed in your birth.

Lincoln's birth did not go how I planned, but it was one of the happiest days of my life and I treasure the entire labor experience. He had a hole in his heart and was whisked away to the NICU before I could breastfeed him. After delivery, I didn't get to hold him again for two hours. A part of me is glad that I didn't have this huge birth plan with expectations written out. You might say "ignorance is bliss." I have read way too many birth stories about how a mom was "traumatized" by her hospital experience because she had to have an epidural, Pitocin, and couldn't eat. Those things shouldn't make your birth experience any less special or amazing. Be prepared, be open, and enjoy it because not everyone is blessed to give birth. I can't wait to experience labor again, and I am sure the next time around my birth plan will be the longest yet! I am already planning to go natural for my third. We will see! Hopefully in two years.