Thursday, July 26, 2012

On Birth

I'm gonna hop on my birth soapbox for a moment.  Feel free to disagree with me, I take no offense to others having a different opinion than me.

As you all may have guessed since I'm having a homebirth...I believe strongly in a woman's ability to birth her baby without medical intervention.

The way the US views and treats birth as something that needs to be fixed and handled and "taken care of", as though it's a disease or affliction, bothers me...a lot.

This is NOT to say that I believe everyone should have their babies at home.  For some women this would be hell and I would never recommend anyone have a homebirth who wasn't fully committed to the whole concept of homebirth.  A woman needs to feel safe and secure to birth her baby, if this ISN'T her home than she should not be at home!

This is NOT to say that I don't believe in pain management in labor.  Again I don't think every woman is comfortable with the idea of childbirth without drug pain management and that's totally fine, I'm not against pain management if that's what the woman WANTS.

This is also NOT to say I don't believe in C-sections.  The fact that we CAN perform C-sections to save mamas and babies is amazing, I would never ever say that C-sections should be stopped completely.

What I am saying is this:

The C-section rate in the US is absolutely appalling.  It's somewhere around 30% and the WHO recommends it never go above 10%.  Some hospitals hover near 50% and higher.  If somehow these crazy C-section rates were saving mamas and babies I might be singing a different tune but considering maternal death rates in the US are somewhere around 50th in the world and infant mortality rates are somewhere around 30th it looks as though our C-sections are NOT saving mamas and babies.  This is astounding and needs to change.

I believe every woman should birth her baby in the environment that is most comfortable FOR HER.  If this is her home I believe all insurance should cover homebirths and I am appalled that there are still states that make homebirth illegal.  By the way my insurance does NOT cover my homebirth, this pisses me off but I refuse to let my insurance dictate where and how I will have my baby.

If a woman is more comfortable in a hospital I believe she should have the right to labor at the hospital WITHOUT PRESSURE to have the baby in a certain amount of time.  And WITHOUT PRESSURE to take pain medications if she doesn't want them.  And WITHOUT PRESSURE to have a  C-section if her labor isn't progressing as swiftly as Dr.'s would like.  AS LONG AS MAMA AND BABY ARE NOT IN DANGER.  I also wish all hospitals would let their mamas move around and eat and drink during labor, statistically, just allowing these small changes would lower the C-section rate DRAMATICALLY.  As my yoga instructor put it refusing to let laboring women eat or drink just in case they need surgery is like saying you should never eat or drink 8 hours before you're going to get in a car just in case you get into an accident and need surgery.  I'm pretty sure in a true emergency, which is when C-sections SHOULD be done, it really doesn't matter if you have food in your stomach.

I don't believe any woman should ever be induced unless it is an emergency or if the woman is past 42 weeks.  A normal healthy pregnancy is 37-42 weeks, not 36-40.

A baby that is "too big" does not count as a reason to be induced.  I know way too many women who were induced for their "too big" baby only to pop out a little 6 or 7 lber.  I also know women who've popped out 9 lbers without a tear, so who's to say that baby is too big?  An ultrasound to determine size is really unreliable that late in pregnancy.  And you know what?  Babies are rarely too big to fit out of the mamas that made them.  Evolutionarily speaking it's ridiculous to think there are all these women who make huge babies and can't fit them out of their bodies.  The female body doesn't work like does a damn good job of making a baby that will fit, even if it takes some maneuvering and work from both mama and baby.

Complications from gestational diabetes or preeclampsia or issues with amniotic fluid, either too low or too high do count as emergencies if they are causing distress in mama or baby and valid reasons to induce before 42 weeks.  I'm not saying I don't believe in inductions for real reasons.

I don't believe any Dr. EVER should suggest a C-section for any reason other than a true emergency.  The first rule of medicine is DO NO HARM and yet we have OB's all over the country promoting major surgery over a normal bodily process.  A C-section is way more harmful to both baby and mama than a vaginal birth.

Hemorrhaging, baby heart decelerations, mama's blood pressure, baby in distress are all valid reasons to C-section to save both mama and baby...but failure to dilate 24 hours after an induction IS NOT A REASON TO C-SECTION!!!!

Baby getting "stuck"?  Oh for goodness sake, unhook that woman and let her labor on her hands and knees and see if she can't UNSTICK baby before you C-section her!!!  A "stuck" baby should not automatically mean surgery.  There ARE situations in which a baby is stuck and baby is in distress and baby needs to come out NOW, but's actually quite rare and that would be a TRUE emergency.  A "stuck" baby with no signs of fetal distress should not be sectioned, mama should just be allowed to change positions.

Elective C-sections.  Big Sigh.  This is America, I guess if you let people have plastic surgery to within an inch of their life you gotta let them elect to have major surgery to get a baby out as well.  But I disagree with elective C-sections.


That means you need to be birthing your baby in an appropriate environment for your particular pregnancy and birth.

There is a reason that midwives won't accept clients that are high-risk.  High-risk pregnancies are outside the norm and become a MEDICAL issue.  The appropriate place for them is with a Dr. and at a hospital.  That's what OB's are trained for, problems in pregnancy.  They are NOT well trained in low-risk normal healthy pregnancy, labor and deliveries.  We're coming to a point in this country in which many OB's have literally NEVER seen a natural birth.

A normal low-risk pregnancy is not a medical issue and does not need to be "treated".  In this day and age it's awesome that we are all monitored so that we can avoid or treat preventable problems, such as gestational hypertension but regardless of whether the medical community is involved women, with the help of midwives, will continue to get pregnant and have babies all on their own, the process doesn't NEED medical help.  And the help it does need should be all about SAVING MORE mamas and babies not about saving Dr.'s from being sued.


  1. Agree with all of the above. Induction is hell. Being induced unnecessarily IMO denied me the birthing process I wanted. It was hell. However thank god for my epi. Induced + back labour hurts like a mofo. No visuaosations could reduce that pain for me. A homebirth is a wonderful experience and I hope it all goes to plan!!

  2. haha, tell us how you really feel :). I agree, we are birthing at a hospital, not sure if I would do a home birth (at least not with this baby for sure just because of how it's gone so far) but definitely want to do all I can to avoid drugs/induction/c-section of any kind. It is funny, growing up (and being a stupind kid) I always thought I would want an elective c-section. Ha! not a chance now, i want the whole birth experience and I know I will feel upset and ripped off if I don't get it. The c-section rates are insane in Canada too, and 90% (which floored me!) get epidurals! I had no idea. Good luck with the home birth - can't wait to read about it!!!

  3. well said! Even though I went to a OB/GYN, my Dr. left every medical decision up to me, regarding medication and how much I wanted him to interfere with the natural process. I loved that about him. the only thing I had no choice on was my induction, but that was medically necessary.
    I know a girl whose Dr. pretty much forced her to have a C-section, telling her that vaginal birth was "so much more dangerous and full of complications" and so she elected a C-section at 39 weeks to 1) have a small baby and 2) make sure "nothing happened" during birth. Totally had to bite my tongue because that pissed me off.

  4. I love that you have such a realistic view on this. Too often this subject brings out the extremists and I just want to shake them and let them know that there are many options for many reasons. But I agree with pretty much everything you said....and this comes from a woman who had two c-sections....and one was elective.
    My first baby was frank breech and success rates of a version on these babies is really really low and carries its own risks. Me and my OB opted for a c-section....I dont' regret it. It was a great complications and I got a beautiful baby out of it. Baby #2 was perfectly in had been over 2 years and I could have opted for a vbac....but I didn't. Once again...there are certain risks there too that, although may have been low....I wasn't really mentally prepared anymore to birth no babies....I had a tried and true method of getting my babies out and I was going to just stick to that. Once again...all went well, healthy baby, good recovery and I don't get all hung up on the fact that I never got to push out my babies. The goal was always the they got here didn't really matter to me as long as it was the right decision for me, my Dr. and my baby at that moment in time. I have been witness to several live births and it is an amazing miracle every time. I wish you the exact birth experience you want and I know that if that plan needs to be altered for either the health of you ro the will do it without regret knowing you did everything you could for your baby.


  5. Amen. I agree with you on all points lady. The differences in a hospital birth here in the UK compared to the US is just astounding. My hospital encourages an active labor. They discourage the use of the hospital bed. They tell you to bring snacks and drinks that you like so that you're comfortable. They do not encourage c-sections and will not induce labor just because you want the baby out. They will offer induction from 10 days overdue and onward. You have the right to wait until 14 days. I think that here you have a lot more say in how you want your birth to go if it's straightforward and not complicated. I'm glad you are doing a home birth Jesica. If we had more space that's what we would be doing.

  6. Amen. I agree with you on all points lady. The differences in a hospital birth here in the UK compared to the US is just astounding. My hospital encourages an active labor. They discourage the use of the hospital bed. They tell you to bring snacks and drinks that you like so that you're comfortable. They do not encourage c-sections and will not induce labor just because you want the baby out. They will offer induction from 10 days overdue and onward. You have the right to wait until 14 days. I think that here you have a lot more say in how you want your birth to go if it's straightforward and not complicated. I'm glad you are doing a home birth Jesica. If we had more space that's what we would be doing.

  7. Just like Megan, Amen amen amen!!! Couldn't agree more with everything said here. Only point I'd add is that births should also not be dictated by doctor's schedules. Inductions and C section rates dramatically go up on Thursdays and Fridays. Doctors don't want to be bothered on the weekends... maybe they're in the wrong profession?! A normal, healthy pregnancy should be allowed to progress in it's own time. Thanks for writing this post and putting down all my own thoughts, it's nice to see it all laid out like that. I hope everything goes as planned for you and I can't wait to read all about it because I'm right behind you :)

  8. I could've written this myself!!! Awesome!!!

  9. What an interesting read, thanks! Here in South Africa (& in particular the area I stay) your choices are limited when it comes to public hospitals. If you opt to have your baby at a public clinic, you're going to push. The nurses stay out of your way while you pace the corridors up & down, either silently screaming with each contraction or just getting on with it. Once baby decides it is time, you are assisted with the actual birthing. No painkillers, no epidural, nothing. The actual birth of my daughter took all of 10 minutes, then she was whisked away to be cleaned. In the recovery ward, you're told to lay on your stomach & wait for baby to return to you. Very impersonal. "Quick & effecient" is how I remember the ward sister describe the whole process. Only if there are complications, you will be transferred to a state hospital by ambulance. Lucky for me that wasn't the case. In a matter of hours I was back home with my newborn (you get sent home the same day if all goes well, otherwise once again, you get transferred to a state hospital if there are any complications) I have two friends who proudly told me "too posh to push" - C-section by choice! Almost bit my tongue in half just trying to keep my comments to myself. Their babies were brought into this world a day apart, needless to say they are no longer friends with one another because one "took the shine" off the other. Pathetic, I know...

  10. Agreed! Excellent post!
    My husband and I are choosing a hospital birth, but are aiming for as natural an experience as possible. Luckily our hospital is pretty easy going (they allow labouring moms to eat, they let you walk around, encourage VBAC's etc.). To me, it's important to be there 'just in case' but we're going to try for as few interventions as possible, since one usually leads to another.
    We will not allow ourselves to be pushed into anything without knowing all of our options and the risks. My husband especially won't let that happen.
    I think a lot of people aren't making informed decisions, rather trusting what they're told, which sadly isn't necessarily in their best interest.

  11. I did see the business of being born a while back and decided then I wanted the least amount of intervention possible. Just nearing 20 weeks, so thinking about my plan now.

  12. I enjoyed your post also. I love that while you are very invested in home birthing you acknowledge all options, safety and opinions. My first birth was without intervention (although in a hospital) and I had 4th degree tearing because my daughter became distressed and they had to get her out. After that I'm not sure I would have had more children if I didn't have the option of an epidural and a pain free way of delivery:) So now I happily embrace the epidural and an easy and enjoyable delivery. I also have been induced due to my husband's unavoidable travel schedule with work. Again these both worked out beautifully for our family and we had healthy 8 and 9 pounders to show for it.
    I wish you the best in your birthing experience and I'm very happy that we have so many birth choices as well!!!

  13. I totally agree that OB's are c-section happy. I love this post!

  14. Amen, Mama!!! This hospital birth, with insurance is going to cost me more than my homebirth did without tell me why insurance isn't covering homebirth??? Lame. This post sounds like you're reading The Thinking Woman's Guide to a Better Birth. I just started it the other night. Super good. If you haven't read it, I totally recommend it!!

  15. Have you seen the More Business of Being Born segment on c-sections in Brazil? Now that is some crazy shit. 90% c-section rate. 90%!!! And the "First do no harm" thing isn't brought up enough. I agree with all your points here and can't wait to hear your home birth story! Not long now!

  16. Great post and I totally agree with it! Thankfully, Finland isn't like the US. I'm sure some women do homebirths here, I just personally don't know anyone who has had one. The hospital encourages you to bring snacks (for partner and yourself), moving about as laying on your back the entire time is not the best position, they don't push c-sections unless it is an emergency and then they can have the baby out in 8 minutes and they also won't push drugs/epidural on you unless you ask or it is talked over.

    I'm looking forward to labor and delivery and most of all, having my little one in my arms.