Looking for a Mother-Friendly Care Provider?

Are you seeking a care provider that provides a more natural and normal approach to women during labor and birth? Choices in Childbirth, a non-profit organization dedicated to improving maternity care by helping women make informed decisions, has created a Provider Network that allows women to search for a Mother-Friendly care provider in their area. A Mother-Friendly provider abides by the 10 principles, created by the Coalition for Improving Maternity Care Services (CIMS):

1. Offers all birthing mothers:

  • Unrestricted access to the birth companions of her choice, including fathers, partners, children, family members, and friends;
  • Unrestricted access to continuous emotional and physical support from a skilled woman—for example, a doula,* or labor-support professional;
  • Access to professional midwifery care.

2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.

3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.

4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication), and discourages the use of the lithotomy (flat on back with legs elevated) position.

5. Has clearly defined policies and procedures for:

  • collaborating and consulting throughout the perinatal period with other maternity services, including communicating with the original caregiver when transfer from one birth site to another is necessary;
  • linking the mother and baby to appropriate community resources, including prenatal and post-discharge follow-up and breastfeeding support.

6. Does not routinely employ practices and procedures that are unsupported by scientific evidence, including but not limited to the following:

  • shaving;
  • enemas;
  • IVs (intravenous drip);
  • withholding nourishment or water;
  • early rupture of membranes*;
  • electronic fetal monitoring;

other interventions are limited as follows:

  • Has an induction* rate of 10% or less;†
  • Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
  • Has a total cesarean rate of 10% or less in community hospitals, and 15% or less in tertiary care (high-risk) hospitals;
  • Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal of 75% or more.

7. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.

8. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.

9. Discourages non-religious circumcision of the newborn.

10. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding:

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff;
  2. Train all health care staff in skills necessary to implement this policy;
  3. Inform all pregnant women about the benefits and management of breastfeeding;
  4. Help mothers initiate breastfeeding within a half-hour of birth;
  5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants;
  6. Give newborn infants no food or drink other than breast milk unless medically indicated;
  7. Practice rooming in: allow mothers and infants to remain together 24 hours a day;
  8. Encourage breastfeeding on demand;
  9. Give no artificial teat or pacifiers (also called dummies or soothers) to breastfeeding infants;
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospitals or clinics

Life Changes, Decisions and the Passion For Birth Workshop

Most know that I really got involved with Lamaze when I decided I wanted to become a childbirth educator. I started getting involved with the childbirth community when I was young – 19 to be exact – and I was trained as a postpartum doula for a local agency. I loved what I did, and ended up working towards becoming a birth doula.  When my children came along, the unpredictable schedule of a doula made it far more difficult to really take on clients, and I ached for a new birth related field that I could charge into while being able to schedule childcare for my boys.

The more I read and learned, the more I knew I needed to become a childbirth educator. There is such a need for it, especially in my shoreline area of Connecticut. But then came the newest journey… which organization did I want to go through?  Which path did I want to take, and what kind of training did I want to commit to?

There are so many – I never realized! ICEA, Lamaze, CAPPA, Bradley, ALACE… my head started spinning until one of my mentors, and now good friend, came to my rescue.  Robin Elise Weiss, famous childbirth educator, writer, and Renaissance woman in the birth field suggested taking a Passion for Birth workshop to become Lamaze educated and possibly certified.

My ears and interest perked up then. And the best part was, my mentor was going to travel across the country and teach the weekend workshop for me!  This all took place in February. I scheduled my workshop for late July knowing I wouldn’t have anything else going on. (HAHA!) Life happened, and this weekend, the weekend of my Passion for Birth workshop, just happened to fall inbetween two giant events I never thought I would go through with. One being having my wisdom teeth out (last weekend) and next weekend I manned up to go to the BlogHer conference.

Friday I will start the training that very well may change my life altogether, and change the lives of women locally some day.

To learn more about becoming a Lamaze Childbirth Educator, check out some of this information :

Passion For Birth Workshops
Get Certified with Lamaze

Lamaze Childbirth Educator Training

The Mother Lode of Pain: Getting It All Wrong at the Boston Globe

This post was published in 2006 on the original Giving Birth with Confidence blog. It provides concrete information on the role of pain in labor and shares a beautiful analogy that describes why women would want to experience childbirth fully.

Dr. Darshak Sanghavi author of “The Mother Lode of Pain,” the cover story of the Boston Globe Magazine on July 23, 2006, skims the surface of historical and empirical research and presents us with the most biased and inaccurate story I have read in many years.

At the center of the story is Dr. Sanghvi’s belief that choosing to feel pain in labor is “odd.” “Especially when there is effective, safe, and available pain relief.” He suggests that women who choose to have a normal, natural birth and experience the pain that accompanies labor and birth are “attracting notice”, “setting up an artificial trial that precedes entry into a highly selective sorority”. He goes on to say “It creates drama. It captures attention”.  His most shocking, and utterly ridiculous statement is “…reliance on pain to create meaning during childbirth indicates a constricted imagination.”

If Dr. Sanghavi had actually done a serious rather than a superficial review of the literature including consulting the Cochrane Library for the most current research and recommendations for maternity care he would have discovered that pain during labor and birth is not “an utterly primitive thing” but plays an incredibly important role.

Pain early in labor lets women know they are in labor. And as oxytocin levels rise, the uterus contracts more effectively to dilate and efface the cervix, and the pain increases. Women respond to the pain they are feeling by trying to find comfort in a wide variety of ways (if allowed any degree of freedom). They moan, change position, walk, sit in a tub of water, are massaged, eat and drink, sing, listen to music. The list is endless. The key is that each woman in labor manages her pain in unique ways that work for her. What she is feeling guides her to finding just the right thing to do. Eventually endorphins kick in and the result is that women go into a dream-like, highly intuitive state and that helps them manage the pain of contractions too. Without pain there is not the same kind of endorphin release. Not surprisingly, if pain is eliminated (with an epidural) naturally occurring oxytocin is not released in increasing amounts. The normal, natural process of birth has been interfered with and there is a need for medical interventions…starting with pitocin. Being able to manage the pain of labor actually helps labor progress by insuring high levels of oxytocin and also by encouraging the mother to move helping baby to settle into and move through the pelvis. Pain is also protective especially during second stage as the baby moves through the pelvis and is born. Women who do not have an epidural respond to what they are feeling at this stage by changing position, and tensing and releasing vaginal and pelvic floor muscles, and in that process protect the birth canal, the perineum and the baby. Pain promotes the progress of labor, protects mother and baby, and helps women find comfort. It is not an unnecessary side effect and eliminating it completely alters the course of labor and sets the stage for interventions and complications.

Women choose to experience (and manage) the pain of labor because it makes birth safer for them and for their babies. At the end of the day the reward for that hard, sacred work are feelings of elation, even ecstasy. And a baby that is alert, competent, and able to nurse easily and well right from the get go. If Dr. Sanghavi had more than a rudimentary knowledge of the process of normal birth and the important role pain plays in that process he might not think the way he does.

As I write this I am looking out the window to the sea in rural Ireland. Later today I will walk down a small lane through farmers’ fields to a little cove to swim. I could get there a lot quicker if I drove it and since the walk back up that lane is very steep in several spots driving would be so much easier. And it takes so much time to walk. The swim would be the same. I would be relaxed and refreshed at the end of my outing. But this is what I would have missed. Feeling the sun and the wind on my face. The sense of well being as I walk, slowly and them more rapidly, getting into a rhythm. Stopping to pick wild flowers (not part of the plan at the start). Picking and eating a few blackberries from the bushes that line the lane. Watching a boat on the sea and wondering what it is doing. Stopping to watch a calf nursing. Smelling the honeysuckle. Chatting with a farmer friend who is moving his cattle from one field to another. And on the way home, up that steep hill, changing the way I walk, slowing up, sweating with the exertion, taking breaks, noticing the blueness of the sky, delighting in how good the wind feels blowing my hair, stopping again to talk, now about how cold the sea was, how fine the day is. Taking gulps of icy water. Eating part of a chocolate bar. Daydreaming. Shaking my legs as they resist the climb. I arrive home refreshed, relaxed and tired. The swim happened. But so much more did too. And therefore the meaning of this lovely afternoon is totally different. I wonder if Dr. Sanghavi thinks that my decision to walk not ride to my little cove is odd and indicates a constricted imagination?

And what if I had not been permitted to eat and drink on my walk, what if I had been tethered to an intravenous and continuous monitoring (just in case I slipped and fell and broke my ankle), what if my pulse was taken every few minutes to make sure I wasn’t too stressed? What if I had to do it all in great haste? That walk would most certainly have lost its allure. In fact instead of a delightful challenge it would become a misery. The ride in the car would seem reasonable!  Like medication in labor — safe, effective and available?

I am irate that thousands of women will read an article that perpetuates the myths that pain in labor serves no purpose and that working hard in labor is “odd.”

One Mom-to-Be’s Experience with Childbirth Class

Kate at 33 Weeks

Kate, blogger at This Place Is Now a Home, writes about her experience and surprising reaction to attending childbirth education class. This post is being republished with permission and was originally posted on June 14, 2010 on Kate’s blog. Since that date and just two short days ago, Kate gave birth to a beautiful little boy. Congratulations!

Over the weekend Benjamin and I attended a 2-day long chilbirth class. Me? I’m a junky for learning (GEEK alert!), and I was looking forward to the weekend, notebook and pen in hand.  Benjamin, however, has never really been a fan of sitting in a classroom for hours on end, and not surprisingly, he was NOT really looking forward to 2 full days of talking about babies and vaginas and breathing techniques. But being the wonderful husband that he is, he humored me, and we packed our pillows in the car and headed for class early on Saturday morning.

We were one of only 4 couples in the class, so it was very small, which was nice. The class was taught by a labor and delivery nurse who had three kids, so she really knew her stuff! She was verging on a little too enthusiastic (even for me), but her information was good and her experience was vast. The first day we went through the mechanics/logistics of childbirth. The second day we went through interventions (c-sections, forceps, vacuums, pain management options, etc.) and worked on some relaxation techniques with our partners to practice getting through tough contractions and the physical/emotional stress of labor. Even though 90% of the material was not new information for me, I was still struck by just how amazing my body is. What it has already accomplished in creating a life and nurturing that child almost to full-term is unbelievable. And the process of getting that little baby OUT of my nurturing womb? Even more unbelievable.

I expected to see a movie akin to “The Miracle of Life” or whatever that movie is that everyone watches in 7th grade (the one I probably covered my eyes through at the time, since I don’t remember a second of it). But instead, we were shown an equally dated but far more interesting movie of three different births and how they played out. You see, when it comes down to it, I don’t need to know the biology behind the baby’s creation… I need to know what I need to do to get him out when the time comes. This movie showed three couples who each went into labor with a certain idea of how things were going to go, and all three of them ended up surprised by how they actually went. If there’s one thing I learned from this class, it’s that you cannot plan or control your birth story — the baby’s directing this show.

I went into the class thinking that I would like to try to manage my pain on my own for as long as possible once I go into labor, and then I would get an epidural and hopefully pop my baby out without too many medical interventions. That was my “plan”.  To be honest, that’s probably still my “plan”. But the frank discussion of all the little things epidurals require (being pumped full of fluids, getting a catheter, not being able to walk around due to numb legs, possibly not being able to feel when/where to push if the epidural is too strong, getting a gigantic needle stuck in my back, etc.) scared me more than the thought of contractions. Believe me, I realize I may be singing a different tune when I actually feel what an active labor contraction feels like, but the class definitely opened my eyes up to some of the realities of the labor process that I wasn’t really aware of before and gave me some new things to think about.

When we first started class, our instructor asked us what we were most scared/nervous about. Everyone in the class mentioned something about labor (the pain, not getting to the hospital in time, the pain, having something wrong with the baby, and oh did I mention the pain?). Except me. I am mostly worried about the recovery. I’m nervous about bleeding for weeks on end and recovering from tears and stitches. I’m nervous about not being able to walk my dog or lift my baby or be active again. Maybe I have some mental block that has kept me from being scared of the actual birth? Or maybe I just figure that is a finite period of time and I can get through it? Not sure why I still feel so calm and serene about that part.

All in all I think the class was definitely worth attending. It was a little long, and it took up an entire weekend that we might have preferred to spend doing other things, but it certainly helped me begin to grasp the reality of what my body is about to go through, and what Benjamin and I can do to make it easier/better. And hey, the deep breathing and massage techniques we practiced weren’t so bad either.

Great Expectations: Liz @ 14 Weeks

The fog has lifted!  I’m on my way back to normal (as normal as a pregnant woman can feel.)  After one final week of ridiculous nausea, I’m feeling much better.  The fatigue seems to have diminished and has returned to my usual level of mom-doula-wife fatigue. I am hopeful that I have turned a corner and will finally be able to eat foods that have slightly more nutritional value than spiral-shaped macaroni and cheese.

Since my uterus is tipped backwards, the baby’s heartbeat has been previously undetectable with the midwife’s handheld doppler.  We were hoping that it would be this week and had explained to three very excited kids that we might be able to hear the baby at my check-up the other day.  However, no one could have anticipated what happened when my midwife put the doppler to my belly. After the usual few seconds of static, the sounds of a truck driver on a CB radio began emanating from my uterus!  The looks on the children’s faces were priceless, and the midwife remarked, “Mmm, that’s never happened before!”  After a solid 20 seconds of trucker talk, she was able to pick up the right frequency again, and finally we heard the familiar thumping of a baby’s heart.  Needless to say, I was a bit skeptical that it was actually my baby after the major technological glitch, but it was still a fabulous sound.

I’ve also been reassured by the tiny little movements that I’ve been feeling lately. After over a week of ruling out gas, and discovering that there is a pattern to the movements (usually after a big sneeze, which is happening a lot lately, or eating a meal), I am convinced that it’s definitely my little nugget squirming around in there.

Pregnant with Disabilities: Type 1 Diabetes

Today’s post is the third and final in this week’s series devoted to pregnancy and disabilities. Giving Birth with Confidence is contributing these posts as part of the Bloggers Unite event, People First: Empowering People with Disabilities. The blogging event aims to raise awareness about empowering people with disabilities by sharing stories around the ‘Net in support of people with disabilities and the groups who work to empower them.

Kerri is a new mom to a beautiful baby girl and has been living with type 1 diabetes since she was six years old. The following post, which discusses pregnancy with type 1 diabetes, was originally published on Kerri’s blog, Six Until Me, on February 19, 2010 and is being republished with her permission.

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It’s All Rainbows and Unicorns

I love BSparl [nickname given to baby in utero, stands for "Baby Sparl"-- Sparl being Kerri's last name].  I love her little feet and her pouty lips and that feeling I get when she rolls around inside of me.  I love knowing that my daughter is just a few weeks away from becoming a part of our Sparling family, and I know that every moment of this pregnancy is completely worth every iota of effort and worry.

That being said …Rainbow not included.

I’m starting to lose my mind a little bit.

I’ve blogged about the details of the doctor’s appointments, and the ultrasound scans, and the way that diabetes has impacted my pregnancy, and vice versa.  But by the end of my posts, I feel better having purged the feelings and worry.  And I want to reassure women who have type 1 diabetes that a pregnancy is possible, and enjoyable, and like they all say – so, so worth it.

But, like I said, I’m starting to crack a bit.  On Tuesday, I’ll be at 30 weeks, seven and a half months pregnant with just under nine weeks left to go.  And these last few weeks have been … well, not exactly rainbows and unicorns.

  • Like last week, when a string of 200′s had me bump my basal so high, on the heels of amped up nerves, that I overdid it and ended up with two 50 mg/dl’s in the middle of the night.
  • Or on Monday, when a carefully measured breakfast and a carefully calculated bolus, delivered 45 minutes before the meal, sent my blood sugars rocketing up to 248 mg/dl and held there for two hours.  
  • Or the other day, when i realized that pregnancy is actually ten months long, not nine.  Damn lunar months, and why the hell didn’t someone give me a head’s up about that?
  • Or that yesterday, Joslin gave me the run down on the rest of my appointments that are scheduled.  There are 20 of them.  I don’t understand how people manage a high risk pregnancy and keep their jobs. 
  • Or that next week, I’m having the eye dilation that will determine BSparl’s method of arrival, and I’m really nervous about it.  I’m nervous about vaginal birth or c-section.  Doesn’t matter.  Just “giving birth” has my stomach twisty.
  • Or the fact that I’m craving carbs (nasty carbs, like cheeseburgers and chicken nuggets and pastries) and am having a very hard time not caving to these cravings.  I can’t have anything even close to a sleeve of Ritz crackers in the house or they will disappear within a day’s time.  I’m ravenous for these rotten carbs, and I’ve crocheted three scarves in efforts to curb the cravings.
  • Or that every time my numbers are out of range, I want to hold her little hands and tell her I’m sorry.
  • Or yesterday, when a perfect Dexcom flatline overnight was shaken by a cheese stick and a cup of decaf tea, leaving me with a blood sugar of 350 mg/dl and on the cusp of a panic attack.  What does this do to my baby?  Is she okay when I’m spending an hour over 300 mg/dl, without much food at all in my system?  Does she hurt when I am chugging water and stressing out but trying to control my emotions because I want her little womb to be serene and calm, not the spin cycle of diabetes chaos that I am so good at tossing her into lately?

Diabetics have healthy babies all the time.  I know this.  I’ve read this, others have proven this, and I hope to write those words myself in a few weeks.  But honestly, the mental part of pregnancy is more than I was prepared to deal with.  The guilt of every blood sugar and every miscalculation makes my heart ache, and I have found myself praying more in the last seven months than I ever have the thirty years before. 

I want to paint that “rainbows and unicorns” picture for you guys.  I want to make pregnancy seem like it’s the most beautiful thing on the planet and even a person with type 1 diabetes can see the nine (ten?!) months through safely.  But as my delivery date draws closer, I’m not sure.  And I’m scared.  And I feel stupid because I have zero control over my emotions these days, leaving plenty of tears in my wake. (I’ve become a mega-wuss.)

Ugh, downer of a post.  I really can’t wait to have the baby, but I know that part of why I want her out is because I believe she’ll be safer once she’s in the world and outside of me.  I know that Chris and I can take care of her, as parents, and keep her as safe as any other couple who loves their child.  It’s the whole “now” process that has me in knots, wondering if I’m taking good care of her now.  I want the absolute best for my daughter, and I feel so guilty because I know that my body creates a challenge in some ways.

Just a few more weeks.  Every test, every infusion set change, every moment of blood work, every doctor’s appointment, every time I pay the co-pay or the parking garage fee, every refilled prescription, every new CGM sensor, every curbed craving … everything.  Everything is worth it if I can get to the end of this and have her out, safely. 

And then she and I will get matching mommy and daughter tattoos – hers a rainbow, and mine a unicorn.

(Note to people who may think I’ve completely lost my mind:  Kidding about the tattoos.  But I might buy her a t-shirt.)

Pregnant with Disabilities: Depression

Today’s post is the second in this week’s series devoted to pregnancy and disabilities. Giving Birth with Confidence is contributing these posts as part of the Bloggers Unite event, People First: Empowering People with Disabilities. The blogging event aims to raise awareness about empowering people with disabilities by sharing stories around the ‘Net in support of people with disabilities and the groups who work to empower them.

Sherean is mother to a 20-month-old happy and healthy boy named Hunter and lives with on-again, off-again depression. Her post talks about dealing with and treating depression during her pregnancy. Sherean blogs at Random Neural Firings.

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There’s a lot of press about postpartum depression. I mean, who hasn’t heard of Brooke Shields squaring off against Tom Cruise over it? I was prepared for postpartum depression. I’d struggled with depression before, mostly in my 20’s, but some in my 30’s, and knew that put me at a higher risk.

What I didn’t know is that you can also get depression DURING pregnancy — perinatal depression, it’s often called. I got it, big time, along with a big wallop of anxiety. So bad I had to see a psychiatrist and was treated for it with medication. Of course, this made me feel guilty and like I was going to hurt my baby. The doctor explained that the risks with the medication weren’t known, but they did know the damage that depression and anxiety could do to a developing fetus. Small comfort, right?

I took the meds and cried. My husband was wonderfully supportive. By mid second trimester, the hormones that were causing those problems went away, I guess, and I felt better. Just like the psychiatrist predicted. But the fact that I had depression during pregnancy put me at an even higher risk for postpartum so we were vigilant, watching for signs. Fortunately, I dodged that bullet.

I felt like such a bad pregnant woman. I hated being pregnant. I felt sick: you name it and I got it. I even got RLS (Restless Leg Syndrome) in pregnancy. The physical problems on top of the depression made for a pretty unhappy time. I remember crying on the couch and feeling soooo guilty that I wasn’t feeling happy. Everyone’s happy when they’re pregnant, right?

I knew I had depression and I knew it was triggered by something in my chemical stew. I’d been pregnant twice before (miscarriages); one pregnancy made it to 11 weeks and I didn’t have anywhere near this kind of anxiety. So the minute I sorted out that this wasn’t “normal” pregnancy hormone stuff, I marched my butt to my Ob and said “help.”

My son was born completely happy and healthy. I was thrilled and am thrilled every single day. He is such a delight. I can barely remember what it was like when I was pregnant to curl up on the couch and not want to read or watch TV or eat. It really is hard to remember, even though it wasn’t that long ago. It’s like once the happy hormones kicked in, I developed amnesia about how awful it all was. I would not wish that on anyone. I agreed to be interviewed and photographed for a piece in the New York Times on the subject, because I hope if you’re struggling, you’ll speak up, too. There is help. You will get through it and you will get better.

Guest Post at Nature Moms Blog

Check it out: Giving Birth with Confidence is appearing in a guest blog post on Nature Moms Blog! Nature Moms Blog provides information about natural and green living as it relates to raising a family. In her own words, blog owner and writer, Tiffany, says about her blog, “You will find information about health challenges presented by the not so natural world around us and how we can heal without the latest miracle pharma drug.” We like that!

Pregnant with Disabilities: Seizures

 

Today’s post is the first in this week’s series devoted to pregnancy and disabilities. Giving Birth with Confidence is contributing these posts as part of the Bloggers Unite event, People First: Empowering People with Disabilities. The blogging event aims to raise awareness about empowering people with disabilities by sharing stories around the ‘Net in support of people with disabilities and the groups who work to empower them.

Meet Jennifer, a mother of two who has a chronic seizure condition. Below, she tells the stories of her two, very different birth experiences and how her condition affected her treatment and day-to-day life. Jennifer blogs at A Day in the Life of Choice Spirit.

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First Birth

After receiving a Depo-Provera overdose, I suffer from psychogenic non-epileptic seizures (PNES), coupled with infertility. I finally became pregnant after meeting a doctor who used Metformin to control my fertility.  Upon pregnancy, my PNES stopped for 6 months! I enjoyed being pregnant, but had to overcome a lot to be able to have the opportunity to try to birth naturally. No midwife would accept my case for home birth because of my seizures, and I switched Ob/Gyns three times to find one who didn’t immediately move to schedule a cesarean. 

In my third trimester, the PNES returned and I had to deal with increasing seizure activity in addition to rising blood pressures and a doctor who treated my rising blood pressures as pre-eclampsia regardless of the evidence that the blood pressure was induced by my PNES. I spent quite a lot of time in the Labor and Delivery ward at my local hospital ensuring that my baby was safe –  he always was — but I had to overcome the prejudices and fear of doctors and hospital staff who didn’t understand my condition and refused to listen to me when I tried to explain that PNES is not epilepsy and doesn’t respond to traditional epilepsy treatments. 

After an agonizing 3 months, labor arrived and I went to the hospital… but far too early.  I fought tooth and nail with the hospital staff for 2 days before my doctor scared me into a cesarean to ostensibly save my baby. I reluctantly agreed to the cesarean and my perfect baby boy was ripped from my body with perfect Apgar scores.  During labor and delivery, I had no PNES activity, but this didn’t stop the staff from treating me like an invalid and making me feel like an inadequate mother.  According to them, I was incapable of caring for my child, nursing my child, or caring for myself. This led to me having trouble bonding with him. I ended up with post-partum depression, which, coupled with the PNES, was nearly more than I could bear.  But with help from my husband and a loving God, I made it through it all.

Baby #2

Three years later, I became pregnant again. I had spent the last 3 years studying my options and becoming better informed about pregnancy and specifically, VBAC.  I knew that no midwife would take me on, especially since in the intervening years — in addition to my PNES — I had contracted type II diabetes and chronic hypertension.  But armed with the knowledge that my PNES didn’t affect my unborn child, I was determined to be treated with respect during pregnancy and childbirth. 

I learned that my previous doctor wouldn’t take me on for VBAC, so I was referred to a specialist clinic in Seattle.  After spending more money than I could count traveling back and forth to Seattle, and dealing with a condescending doctor who was insistent that I was too fragile to VBAC,  I switched doctors. I found a clinic in Tacoma that wasn’t afraid of my PNES — the disease that did not give me the 6 month reprieve that I had enjoyed during my last pregnancy. 

I fell several times during my pregnancy – once so hard that I landed in the ER with a sprained elbow and wrist!  The continued seizures drained me physically and emotionally, but I didn’t worry that my child would be injured by my convulsions and I took measures to ensure that I was safe from accidental falls.  After my severe fall, my husband took over the household duties so that I could focus on the pregnancy and reduce my stress.  My PNES never became a concern to my doctors, and with tight control of my other conditions, I was able to mostly gestate in peace.  I did, however, deal with a lot of ignorance from medical staff and in the end, they tried to scare me into scheduling a repeat cesarean at 38 weeks without even an attempt of trial of labor. This came despite their own admission that I had controlled my diabetes and hypertension carefully and that ultrasound after ultrasound showed that my baby was perfectly healthy. 

I realized that this clinic was more concerned with their bottom line than with helping me achieve a VBAC.  I decided to labor at home and go into my local hospital in active labor rather than head to the hospital in Tacoma.  But because of my seizures, the local hospital refused to care for me and threatened to airlift transfer me to Seattle. This was the same hospital and doctor who had delivered my first child –  they KNEW about my seizures and refused to care for me despite knowing that they did not cause problems last time. My husband and I reluctantly drove to the Tacoma hospital. After determining that I was not in active labor, they did an ultrasound to see if the baby was tolerating my prodromal labor.  She was doing fine, but the placenta was not – it was completely calcified. I knew as soon as I saw that bright white placenta that I wasn’t going to get my VBAC… especially with my blood pressure so high.

I made the decision to have a cesarean — but I wasn’t upset! I mean, sure, I was disappointed, feeling a loss of something I had worked so hard to achieve… but really, the whole point of working for a VBAC was to give my baby girl the best start in life. And at that moment, a VBAC wasn’t the best choice, considering my circumstances. If I would have waited for labor to start on its own, it could have been weeks and by that time, my placenta may have given out entirely… it was just too risky. IT WAS MY CHOICE. That made all the difference.

I returned to Tacoma 5 days later and had the most wonderful experience I could have had for a cesarean birth. I was treated with respect and dignity and at no time was I made to feel broken or inadequate.  I bonded wonderfully with my sweet daughter and came home happy and confident, despite not having achieved my VBAC.

Practices that Promote Healthy Birth: Avoid Common Interventions

Today, childbirth is viewed as and transpires as more of a medical procedure than a natural bodily function. Women who seek to have a natural birth often look for resources and information on how to achieve a more natural experience instead of one that is over-medicalized.

Truthfully, if you want to avoid all common hospital interventions, the best place to give birth (for low-risk women) is either at home or in a birth center. In my own experience, confronting hospital staff to avoid simple things like an IV line can bring added stress that just isn’t part of an enjoyable birth experience. That being said, birth should take place where you feel most comfortable, and if that is in a hospital, the best thing to do is educate yourself about the choices and risks and related to common medical interventions.

 

Common Medical Birth Interventions

  • IV for fluids
  • Epidural anesthesia
  • Continous electronic fetal monitoring
  • Pitocin
  • Artificially breaking the bag of water
  • Episiotomy

Most of these interventions are medically unnecessary, but are used in many hospitals today in the United States. An IV, for example, is used to administer fluids and medication, if necessary. However, when women are allowed to eat and drink during labor, an IV for fluids is not necessary. Recent studies show that there is no need to prevent a woman from eating and drinking while she is in labor

Continuous electronic fetal monitoring is also over-used in low-risk women. In recent years, The American Congress of Obstetricians and Gynecologists (ACOG) has shown that in the 40 years that electronic fetal monitoring has been the norm, there have been no improved outcomes in mothers or babies. Of course, like anything, there are some situations when it is necessary, but mostly in high-risk cases. 

Epidurals for those who choose to use them for labor can be the right fit, but they are not risk free. Epidurals can slow labor and pose other risks to mothers and babies. There are other, more natural and effective ways to help relieve the pain of labor

Pitocin can cause contractions, but it can also cause contractions that are too strong and result in fetal distress and bring on a cascade of interventions

Episiotomy has been shown in recent years to be medically unnecessary in the majority of cases. 

Skipping Common Interventions

There are several ways to avoid routine hospital interventions.

  • Hire a birth doula to help be your advocate and employ natural pain relieving strategies
  • Write a birth plan and provide copies to your provider and hospital staff on call during your stay
  • Talk to your provider about your expectations and practices and procedures you are concerned about
  • Take a tour of your hospital
  • Research your chosen hospital’s cesarean and intervention statistics prior to giving birth

These simple steps can help you avoid common medical interventions and increase your chance of having a safe and healthy birth experience.