It's coming out of WHERE?! Begun 2/8/2012, 20 weeks 2 days

Childbirth is a somewhat controversial topic, with a lot of people who have a lot of strong opinions about it. I'm writing about this topic not to preach or stir up controversy, but because childbirth has been on my mind quite a lot lately. My intention is to share my thoughts and desires, not to claim that there is a right or wrong way to give birth. What's best for me isn't best for everyone, and many women don't want the birthing experience I want. That's fine. This is my blog about what I want for me. For anyone keeping track, this post is the result of a couple weeks of thought and reflection, and wasn't all originally written in one day. I'm now 23 weeks and 6 days.


First, a little about me. I'm the kind of person who avoids taking medicine, all kinds. I never take anything unless a particular malady is bad enough to interfere with my daily life, and if I have an option I will always try a non-medicinal cure first. When I have a headache I chug water or maybe try something caffeinated. If that doesn't work I give myself a neck rub, or if I have time I take a nap. I'm not anti-medicine. I always have over the counter pain killers of some kind in the house, and often some half used cold remedy (if it hasn't expired yet) as well. If my pounding headache will not lighten up and I have no time to nap I will gladly pop a couple pills to help me focus and get through the day. My attitude is more about need. If I don't feel I need the pain dulled or the cold symptoms lessened, I will tough it out. I am lucky; I do not suffer migraines or chronic headaches and get sick rarely enough that my cold and flu medicine keeps expiring on me. Not everyone has the luxury of feeling the need for medication as seldom as I do, and many people prefer the convenience of feeling better and lack my stubborn inner voice insisting that I don't really need to take anything.

As you may guess, one of my initial reasons for wanting to go for a natural childbirth is my aversion to using unnecessary pain medication. Another reason is curiosity; I want to see what it's like, to find out if I'm as tough as I think I am, if labor is really as unbearable as society would have me believe. I trust my body and I want to find out what it can do. There is evidence that epidurals can cause infants to be born sleepy and sluggish, which interferes with their immediate ability to begin breastfeeding. Since I intend to breastfeed and have been warned that my mother and grandmother both found it difficult to do so, I want as little interference as possible when it comes to establishing successful breastfeeding with my newborn. I will have at least an hour with my baby before they will want to weigh and measure her, and I want her functioning at her very best during that time.

There's also the idea that mother nature knows best, and if childbirth has been (mostly) successful done the old fashioned way since our species has existed, who am I to argue?  Doctors used to bleed sick people, mercury was used topically and ingested to treat all kinds of illnesses and injuries, and heroin was taken as cough medicine. At the time, these practices were cutting edge medicine! Obviously we have much higher standards for testing new treatments and technologies these days, and a much better understanding of the human body and how it works. But that doesn't mean that doctors always know best. Just because a practice has become mainstream and doesn't result in death or injury the vast majority of the time, doesn't mean it's always the best way to go. I'm lucky to live in a time when we have lifesaving technology and doctors with the years of training and knowledge to help in the small chance that something could go catastrophically wrong, but I have every reason to believe my birth will be normal and healthy.

I should mention that I know I may not get the birth experience that I want. I have been warned that it is important to be flexible when it comes to giving birth, because things happen to the healthiest women with the least complicated pregnancies and there is no way to see the future. If I don't go into labor on my own by 42 weeks as counted from my last menstrual cycle, steps will be taken to get the baby out ready or not. Lego was breech during the last ultrasound, and there is a small chance she won't flip to be head down. I know I will be disappointed, but of course the most important thing is ending up with a healthy baby. I also have no way of knowing how I will cope with labor, or if I will change my mind in the midst of it. So I guess a natural birth is more of a  birth preference than a birth plan.

I got a book from the library. It's called "Birth Matters, A Midwife's Manifesta" By Ina May Gaskin. I also have on hold a few other books about childbirth including her much more famous book, "Ina May's Guide to Childbirth", and have been waiting for several weeks to get it. Anyway, "Birth Matters" is the first book I have been able to read on the subject of childbirth since I've been pregnant, and in one day I was almost halfway through. The first part discusses childbirth as being natural, normal, and healthy, especially when attended by knowledgeable and sensitive women who know how to put the laboring woman at ease and give her confidence in her body's innate ability to give birth.

The author discusses hormones released during labor and how adrenaline, a fight or flight stress hormone, interferes with the process of labor and increases pain response, while oxytocin produced by the woman's body (not artificial oxytocin used to speed up or induce labor) not only aids labor but also reduces pain, helps her body open, and sends feelings of love and joy through the mother promoting bonding between her and her newborn. Oxytocin and adrenaline are produced inversely to each other; as levels of one go up, levels of the other go down.

The book describes how joyful birth can be, and painless. Yes, painless. Not for everyone (dang!), but even those who feel pain don't have to fear it or experience it as unbearable. A woman who feels safe and supported in a comfortable environment will produce little to no adrenaline, while a woman who has strangers coming unannounced in and out of her hospital room to take measurements and who discourage her from getting out of bed or eating or drinking will feel much more out of control and vulnerable, and will be more likely to experience pain and fear brought on by adrenaline.

The book includes birth stories, and the first one is by a woman who moved into a cabin next door to a midwife in a rural farming community, a few weeks before giving birth. While waiting for labor to begin she was visited daily by the midwife and spent the rest of her time walking and exploring, getting to know to locals, and just relaxing and reading. No stress, no worry, and no rush to get the baby out by a 42 week deadline. When she did go into labor the midwife stayed with her the whole time (no shift changes), helped her find ways to get her labor to progress, and encouraged her to follow her body's cues to eat or drink or move around and help the baby on it's way. After 26 hours (I think) of labor she gave birth to a healthy baby, with very minimal amounts of tearing. She stayed in the cabin another few weeks, visited daily by the midwife who made sure she was recovering physically and gave her emotional support and advice about caring for her newborn. I hope my birth experience can be half as pleasant.

Confession time. I was very tired after a long busy day, and full of pregnancy hormones while I was reading about all this. The feelings of relief and validation that came over me when the author described how good giving birth can be had me literally bawling. I felt like the author saw the tiny, terrified part I didn't even know was buried inside of me, and soothed it. She knows I can give birth the way I want to. My body was made to give birth. It was made to do so without need of medical interventions. I felt so empowered.

Mainstream society discourages women who want a natural childbirth: It will hurt too much, you will change your mind. Giving birth is dangerous, think of everything that can go wrong, think of your innocent baby. Why would anyone want to endure all that pain if they don't have to? Doctors know what you need better than you do, don't tell them how to do their job. It felt so wonderful to read confirmation of my own intuition; that in the animal kingdom, human women are not uniquely incapable of safe and healthy reproduction. Our pelvis may be one of a kind, but human women are just as good at giving birth as are monkeys, dogs, lions, elephants, and any other mammal. Our brains are what gets in the way, not our bodies.

One of the reasons I opted for the birth center and Nurse-Midwives at Swedish-Ballard is that I want care that approaches pregnancy and birth from a viewpoint of wellness and normalcy. Pregnancy is not a disease, and birth is a normal and natural biological function- not a pathological condition in need of curing. OB-Gyns may cognitively know that pregnancy and birth are normal and healthy, but in the US their training does not expose them to natural, uncomplicated childbirth that is allowed to progress as long as it takes. Most doctors and nurses never witness a birth that is not subjected to routine interventions like artificial oxytocin to speed things up, epidurals, and episiotomies. More likely than not the woman will be confined to bed, increasing the likelihood of a forceps or vacuum delivery, which increases the chances of damage to both mother and baby.

I'm not trying to knock OBs. They don't spend all that time and effort in school for nothing and they can and do save lives. But OBs are surgeons, and their training exposes them to situations that often require surgery. They are trained to treat problems, not how to recognize the difference between what is part of a normal birth (a lot of variety can be considered normal in childbirth, just like in every other aspect of human health) and what truly requires intervention. OBs also have to fear malpractice lawsuits in a society that increasingly demands medical and surgical intervention, and OBs get paid more by insurance companies for C-section deliveries than for vaginal deliveries. C-sections have the convenience of being predictably scheduled in a non-emergency and even in an emergency (or "emergency") they take a predictable amount of time, allowing the OB to know they will make it home for dinner.

The C-section rate in the US is up around 33% of births, when the World Health Organization recommends a 10-15% C-section rate. Disproportional numbers of babies are now born on weekdays between 9 and 5, and weekend births have dropped dramatically.  People, not just doctors, like to know when their baby will come so they can make plans and stay on schedule. C-sections are portrayed as easy surgeries, much quicker, cleaner, and more painless than vaginal deliveries. The recovery time of a C-section, which is a major abdominal surgery complete with risk of the list of complications that comes with any major surgery, is downplayed, even though it is longer and more painful than recovery from vaginal birth (unless there was severe tearing, which can happen if an infant is pulled out too quickly by vacuum or forceps, among other reasons).

I recently watched the documentary "Pregnant in America". It came out around the same time as "Business of Being Born", but had a much lower budget and much less experienced and influential director. Many of the same experts were interviewed in both films. The thing that stuck out to me about "Pregnant in America" was near the end, in an interview with a male doctor. He talked about one particular woman who, after hours of labor warned everyone in the room to get back, because she was having her baby NOW. She proceeded to give birth, and the doctor said that despite his having witnessed many other natural births, this was the first time he had ever seen a woman in her full power. He said it scared him, badly.

Ina May Gaskin talks about how she tells women to "let their monkey do it", meaning that women shouldn't try to think about how they will get their baby out, and instead let go and allow their inner wild animal to take over. She mentioned that when she gave birth she pictured herself as a lioness, powerful and beautiful.

When it comes time, that's what I want. I want to unleash my inner warrior princess and give birth like a goddess in all her glory. I want to calmly bring forth my child in an act of strength and beauty. I want my inner lioness-monkey to take command and give birth with a roar of triumph. I want to be savage, strong, and serene. I want to frighten the male doctor who won't actually be in the room to witness my power. Me and my baby were made for this, and I want to do it our way.