Business of Being Born
Sometime mid-pregnancy, back in January, my daughter-in-law decided to make the switch from regular OB to midwife--from labor room to birthing room--from no support to using a doula--who is there to coach, guide, and comfort her from the earliest start of labor on through breastfeeding.
With 1 out of 3 births ending up as C-sections, she wanted to up her odds for a normal delivery.
Soon after that, my son & daughter-in-law rented Ricki Lake and Abby Epstein's documentary about giving birth in the U.S., The Business of Being Born. That's when they knew they had made the best possible decision.
But, babies & births are unpredictable. If they should need a C-section or a specialist, it's all one floor down--or up--or down the hall.
I got caught up in their enthusiasm, rented the film, and found myself aghast at how much labor & delivery had changed, even from when I gave birth almost 30 years ago--which was natural, without monitors or anesthesia. And I felt downright elated when seeing the experiences of moms who chose the midwife route. The film is a must-see for anyone thinking about pregnancy.
2. Squatting is less stressful for the mom--puts gravity to work--but it's inconvenient for the doctor--who wants to stand up & have a clear view of the birth canal.
3. Almost 1/3 of U.S. women now have C-sections. 40-45% of women in New York's Suffolk & Westchester counties end up having C-sections.
4. C-sections should only be performed when needed to guarantee the well-being of the mother and infant--never out of convenience. It should not be the first choice for healthy mothers. C-sections are major surgery--increasing risks to mother & baby.
5. Normal labor clears liquid from the infant's lungs, preparing the baby to breathe outside the womb--Cesarean's impede this process. Studies have shown that a vaginal birth “primes” a baby’s immune system by exposing it to various bacteria as it moves through the birth canal. In one large study babies born by C-section were 80% more likely to develop asthma.
6. Pitocin, the drug used to stimulate labor, can cause painful contractions, which then assures the use of an epidural to relieve pain--which then slows down the contractions--can lead to more drugs--or fetal distress--and may increase the doctor's recommendation for a Cesarean. Pitocin sets a mother up for "cascade of medical interventions".
7. Normal labor is slow, unpredictable & unprofitable. Compare 12 hours of normal labor with the possible 20 minutes for a Cesarean--complete with an anesthesiologist.
8. Interesting that C-Sections seem to increase at 4 o'clock in the afternoon & 10 o'clock at night.
9. Attendance at Lamaze classes (natural childbirth) has dropped 14% between 2000-2005.
10. Obstetricians have surgical training. Normal deliveries are just "so boring". Hospitals thrive on a high turnover. Speeding labor helps to fill & empty beds more quickly.
11. 80% of women have epidurals today. In years past the epidural was not given until the mother was 5 centimeters dilated--to insure that labor would not slow down. If you were too far along--you were encouraged to "just tough it out". All that has changed. Now mom can have an epidural as soon as she's admitted to the hospital, if she wants one.
12. Once you have an epidural you're going to be closely monitored. Labor slows--pelvic muscles slacken--you have to watch a monitor to even know when to push--you increase your chances for a C-section or a forceps delivery or vacuum extraction. In 1/5 of women, blood pressure drops--which can cut off oxygen to the baby--another reason for a C-section.
13. Midwives & lactation specialists see differences in the babies whose moms had epidurals. They are more sluggish, may be harder to soothe, and frequently have trouble latching onto the breast.
My recommendations:
Check out Ricki Lake and Abby Epstein's brand-new book: Your Best Birth. Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience. New York: Wellness Central, 2009.
Favorite quote from the film:
Watch the documentary, "The Business of Being Born"
Click here if you don't see the trailer.
Bless you.
My third child was "delivered" by a physician who had agreed not to interfere unless it was medically necessary. He had been recommended by friends. I had already had 2 children with natural childbirth.
I had a checkup on a Friday afternoon the week the baby was due. With no explanation, the doctor ordered me to go to the hospital. He would not answer my questions, and I was too compliant - should have demanded an answer before cooperating with anything. When I got to the hospital, he was perturbed that I hadn't gotten there more quickly - but I lived in another town and had to pick up my kids and take them to the person who would be caring for them while I was in the hospital. He punctured the water bag, and left. When he returned, he was wearing dress clothes and was clearly put out that labor had not commenced. He had labor induced. He was curt the whole time.
Seven years later, when I became pregnant with my 4th child, I read Immaculate Deception and discovered that obstetricians frequently induced labor in women ON FRIDAY AFTERNOONS to clear their weekends!!!!!!
Posted by: Beverly Alexander | May 31, 2009 at 12:53 AM
Thanks so much for sharing your experience, Bev. It's hard to believe. I was the exactly the same way--too compliant! And once you've gone into labor--you're not in the best position to negotiate, argue or ask questions.
It really helps to know all the birthing options--which is why Ricki & Abby's book & their documentary are must-sees!
Who wouldn't want a midwife who meets you at the hospital when you arrive--and stays with you throughout? And a doula who is there is answer all your questions & relieve your fears. Husbands are great--but honestly, what do they know about giving birth?
Although natural with no anesthesia, both my deliveries were do-it-yourself affairs. The Dr. showed up at the last minute.
Seeing the film shows the possibility of a whole different experience. Who knew back then that there are actually some low tech maneuvers & movements that would have relieved back labor?
I also love how Ricki says--for nine months you're told to not have as much as a wine cooler--and then when you're in labor "they're offering you narcotics and opium derivatives and stuff that, chemically speaking, looks a lot like cocaine?"
Posted by: The Healthy Librarian | May 31, 2009 at 09:54 AM
This post and the documentary are musts for prospective moms, but also for fathers. Most men are clueless when it comes to the vital issues involved in birth. Most of this, I'm sorry to have to admit, was new to me. My excuse is that when I became a father -- we're talking 45 years ago -- fathers were officially banned from the entire process. I dropped my wife off at the hospital and went back to work. I got a call at work a few hours later and went to the hospital where a nurse held up our new son for me to look at through a glass partition for a minute or so. Then I went back to work. Having a baby? What's the big deal? Now, as the grandfather of 9,I know it is a big deal. However, for reasons I don't understand, none of the mothers of my grandkids have wanted me holding their hands during birth or viewed me as in any way relevant to this amazing event. If not for this post, I would have remained blissfully ignorant of the vitally important issues involved. On a more upbeat note, the mothers of my grandchildren are very happy to have me love these kids to pieces -- though occasionally when our play gets noisy and disruptive, I am given a "timeout" along with them. By now you are a grandmom. Let me tell you something: you are being reborn, baby! Congratulations on this post and "your" new baby.
Posted by: George Pollock | May 31, 2009 at 06:22 PM