Thursday, July 7, 2011

“That’s what you get for not having an epidural!”

By Birth Sense
Today’s post is a birth story that comes to us from a reader who had difficulty finding the support she needed in labor.  This reader had hoped for a different type of birth, but had problems getting her insurance to cover other options than an OB-attended hospital birth.  I have inserted my comments in color in her story below:
“On the very day that I was 38 weeks pregnant, my water broke at 3:30 in the morning. I called the doctor on call, and they wanted me to get over to the hospital as soon as I could so that I wouldn’t get an infection (due to the bag of water broken). Infection is unlikely if a mother stays at home during the time she is waiting for contractions to start, and does not put anything into the vagina.  The cervical exams women are subjected to in the hospital, and the foreign bacteria that their bodies are not accustomed to, make it MORE likely infection will develop in the hospital setting.  My desire was to stay home and labor as long as possible and go in as I was more progressed. But that did not happen.

Once I arrived at the hospital, I was told that the clock had started ticking and that I could have about 6 hours to get things going on my own. If that did not work, then they would need to give me some pitocin. 
Where does the “6 hour” rule come from?  This is an arbitrary figure that has been used by some physicians based on patients who were in the hospital being examined, thus having bacteria introduced into their bodies.  As long as the woman is not GBS positive, there is no harm in waiting for labor to begin; my OB backup is comfortable waiting 24 hours.  Most women will go into labor on their own by 12 hours after the water breaks.  I was walking all over the birth wing and doing different moves that I thought would help. I only had a handful of contractions in all of that 6 hours. When they had done the routine blood work at the hospital when I first arrived, it showed my white blood cells had been a little raised but they weren’t sure why.  White blood cells are almost always slightly elevated during labor.  This is a well-documented fact, and is perfectly normal.
Pitocin was started, much to my dismay. It wasn’t so bad at first until I got to 4 cm and they kept turning the pitocin up. But I still reminded them that I did not want an epidural or anything else. The nurse told me that about 90% of women who come to the hospital in labor usually get an epidural or some kind of meds. She wasn’t use to working with someone who turned down those things. The pitocin made my contractions soo intense and soo close together. WAY more painful than when I was in labor with my first baby, with natural contractions.   Pitocin-induced contractions peak very rapidly, as opposed to the gradual build-up of a natural contraction.  Once a woman is contracting regularly, every 3 minutes or so, pitocin should be gradually turned down and then off, if the woman continues to contract on her own.

The doctor on call came in to see where I was at and he told me I was 9 1/2 cm with some lip still there. I told him I had a STRONG urge to push. He told me not to push yet, turned the pitocin up and left the room. So here I was, trying not to push, but actually could not help but to push because of the pitocin. I told the nurses, I am pushing. I told them I couldn’t physically help it. Never in my life, had I felt so out-of-control of my body.
 It is absolutely true that when the urge to push is very strong, your body pushes no matter how much you blow and pant to avoid pushing.  Current research supports encouraging the laboring woman to push when she feels the urge, just as much as she feels the urge.  This reader should have been encouraged to follow her body’s instincts.  When the doc came back in, he checked me and said I was still at 9 1/2 cm and needed to wait. I practially begged him to put his hands inside of me and help stretch me so I could push this baby out. He didn’t really do much other than to sit at the end of the bed watching me. When I said it hurt soo bad, his reply was “That’s what you get for not getting an epidural.’ I wasn’t saying it hurt soo bad in hopes of getting any pain meds. I was simply being vocal and trying to get through this ordeal. It was helping me to make noise and talk. Many women who are very vocal in labor make this statement.  They find that vocalizing helps them cope, rather than vocalizing being an indication they need drugs.  A care provider should NEVER berate a woman for not choosing an epidural.  FINALLY I was told to push and I did and had been already due to the force of the pit. The doc said baby was face-up…giving him trouble delivering her. He kept saying over and over again, “This baby is just sunny-side up.” After she finally made her grand appearance, the doc began turning up the pitocin again and giving me shots of methergine and some other suppository (misoprostol to stop any potential bleeding. I felt all that was VERY unnessecary. He told me he wanted to say I bled less than I did with my son. My records showed that with my son’s birth, I lost 450cc, which is a reasonable loss for a normal natural birth. And I did not need any type of meds to control bleeding after his birth. So I bled less after my daughter’s birth because of preventive measures that I am not sure I ever needed. Then the doc was gone. I was very sore due to an episiotomy from the uncontrollable pushing too early.


Never once in my whole labor, did my doctor ever lay his hand on me and say, “You’re doing great, keep up the good work.” The nurses never really layed their hands on me to show me different positions or things that may help relieve pain. I felt SOOOO alone. Thank God my husband was there supporting me! He was amazing! I still find myself in tears as I relive my birth experience. My LAST birth experience. Here I am studying to be a doula. I had envisioned my own birth to have gone SOOO different. I knew not to expect everything to go as planned. But NOTHING went as planned. I ended up with an infection after labor which required antibitotics and a longer stay in the hospital. The only wonderful and amazing thing I took away from this birth, was my beautiful and tiny 6 lb 14 oz baby girl!! Some would tell me, “why does it matter how the birth went if the outcome was great.?” “healthy baby and healthy mom, thats all that matters.” But I am a firm believer in the experience as well. Which is why I am sooo determined to get my doula requirements done and start to be that support for women! Some women think they cant have a doula if they decide to have pain meds or end up having a c-section. But doulas cater to all types of births. No women should EVER have to go through her labor and feel like a failure. I have had those feelings, and am trying to get over them. With my labor, we kept hearing what wasn’t going right or how my body wasn’t doing what it was supposed to do. I think there is soo much that could be improved in the whole experience of women in labor. Especially with the doctors, even the nurses…bringing a baby into the world is an incredibly emotional and physically demanding process. I believe those helping and aiding in this process should be emotional and physically invested as welll!

Just wanted to share my experience. I am blessed with 2 beautiful kids! Just wish this last experience could be a story I was proud of telling or that I at least didn’t feel like I failed somehow.
Dear reader, you did not fail in any way.  Your doctor and nurses failed you.  You should have been supported, encouraged, and praised for your efforts.  I think you did an amazing job to endure pitocin-induced contractions without drugs!  That is very, very difficult.  You were not treated well, but I hope you will be able to take those negative experiences and use them both to understand the emotions of other women who have had negative experiences, as well as to help them achieve the birth experience they long for.  You will make a wonderful doula!

Wednesday, July 6, 2011

Home Birth on the Rise by a Dramatic 20 Percent

By LEANNE ITALIE, Associated Press
One mother chose home birth because it was cheaper than going to a hospital. Another gave birth at home because she has multiple sclerosis and feared unnecessary medical intervention. And some choose home births after cesarean sections with their first babies.

Whatever their motivation, all are among a striking trend: Home births increased 20 percent from 2004 to 2008, accounting for 28,357 of 4.2 million U.S. births, according to a study from the Centers for Disease Control and Prevention released in May.

White women led the drive, with 1 in 98 having babies at home in 2008, compared to 1 in 357 black women and 1 in 500 Hispanic women.

Sherry Hopkins, a Las Vegas midwife, said the women whose home births she's attended include a pediatrician, an emergency room doctor and nurses. "We're definitely seeing well-educated and well-informed people who want to give birth at home," she said.

Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, obstetrics and midwifery, said "at first, in the 1970s, it was largely a hippie, countercultural thing to give birth outside of the hospital. Over the years, as the formerly `lay' midwives have become far more sophisticated, so has their clientele."

The American College of Obstetricians and Gynecologists, which certifies OB-GYNs, warns that home births can be unsafe, especially if the mother has high-risk conditions, if a birth attendant is inadequately trained and if there's no nearby hospital in case of emergency. Some doctors also question whether a "feminist machoism" is at play in wanting to give birth at home.

But home birthers say they want to be free of drugs, fetal monitors, IVs and pressure to hurry their labor at the behest of doctors and hospitals. They prefer to labor in tubs of water or on hands and knees, walk around their living rooms or take comfort in their own beds, surrounded by loved ones as they listen to music or hypnosis recordings with the support of midwives and doulas. Some even go without midwives and rely on husbands or other non-professionals for support.

Julie Jacobs, 38, of Baltimore, who has multiple sclerosis, said she "chose midwives and hypnosis because I wanted to surround myself with people who would support me as a birthing mother, rather than view me as an MS patient who would be a liability in need of interventions at every turn."

Her first two children were born in a freestanding birth center operated by midwives. After the center closed, her third child was born at home in 2007. "If I had been in a hospital I probably would have had C-sections for all three," she said. "With the first, I would have been terrified to try a home birth. After the second one I was like, hey, I can't necessarily walk in a straight line, but I can do this."

Some home birthers cite concerns over cesarean sections. The U.S. rate of C-sections in hospitals hovers around 32 percent, soaring up to 60 percent in some areas. In some cases, there's a "too posh to push" mentality of scheduled inductions for convenience sake (Victoria Beckham had three).

Gina Crosley-Corcoran, a Chicago blogger and pre-law student, had a C-section with her first baby and chronicled nightmarish pressure from nurses and doctors to abandon a vaginal birth with her second. She followed up with a third child born at home in April.

"I do think there's a backlash against what's happening in hospitals," she said. "Women are finding that the hospital experience wasn't a good one."

In Portland, Ore., acupuncturist Becca Seitz gave birth to both her children at home, the first time in 2007 because she and her husband were without insurance.

"It was never on my radar, until we couldn't afford otherwise," she said. "I'm granola, but not that granola. It cost us $3,300, as opposed to over $10,000 in a hospital."

Her midwife was prepared with the drug Pitocin, oxygen and other medical equipment.

"They were both born over the toilet," she said. "It was a nice position. It's a way that we're used to pushing."

Dr. Joel Evans, the rare board-certified OB-GYN who supports home birth, said the medical establishment has become "resistant to change, resistant to dialogue, resistant to flexibility."