Wednesday, September 10, 2014

Why I Chose Home Birth

When I learned I was pregnant the first time, my husband was in the military.  Of course, I would birth in the hospital.  The medical services were free, and everyone knows that the hospital is where you are "supposed" to give birth.  I was 23 years old, and didn't know that anyone voluntarily gave birth anywhere else than at the hospital.

I was excited to join the ranks of those who had borne children.  I myself was an only child from a broken home, and had always wished for a complete family.  I had never been around anyone who had a baby, had never cared for a baby, and really didn't know anything about birth at all.  During my pregnancy I bought and read ONE book about pregnancy, birth, and childcare.  That was the extent of my childbirth education.

In the military, as soon as you have a positive pregnancy test, you take what used to be called an OB history class.  Everyone is "required" to take it so that they can program you with information about what they expect you to do.  They give out some nutrition information, but no one really pays any attention to it, at least I didn't, and in retrospect the nutrition information was incomplete and not very good.

I began to go to my monthly appointments.  Unfortunately, the doctor who was assigned to all the pregnant women in my husband's unit was just transferring in, and they weren't booking appointments for her yet, so I was seeing another doctor who would not be delivering my baby, and who I didn't know and didn't feel any confidence in.  He took my measurements and tested my urine every month, but that's about it.  Every month I would ask when my doctor was going to be available, and he would tell me that he didn't really know.  I continued to see him each month.

Finally, when I was in my 8th month of pregnancy, I asked at the front desk about when I was going to be able to finally see my doctor, and they informed me that she had been seeing patients for several months.  I was a bit angry, because I had been asking my substitute doctor about it for a while, and I felt he had misinformed me.  I finally began to see my "real" doctor, and the first time I was in her office she began to ask me about the amount of weight I had gained, my blood pressure, and the trace of protein in my urine which my other doctor had not been concerned about.  She asked me if I was seeing spots before my eyes, having abdominal pain, dizziness, or ringing in my ears.  I told her no, I felt wonderful.  She told me that I should not gain any more weight during the pregnancy, and that if my pressure didn't go down, they would hospitalize me until the baby was born.  I had one ultrasound which was normal.

I left feeling a little bewildered.  The substitute doctor hadn't shown any concern about my weight, blood pressure, etc.  Now this doctor was scaring me by being so aggressive.  That month, I watched what I ate scrupulously, and when I went back to see her the next time, I had not gained anything, and had even lost 1/2 a pound.  I knew she was going to be so proud of me for not gaining.  But when I went into her office, she looked up and said to me, "You are going into the hospital today."

I was stunned.  I demanded to know why.  She told me I had pre-eclampsia, and she was really surprised that I didn't have those spots, pain, dizziness, and ringing.  I told her I never felt better.  She insisted that I WAS going to be admitted.  I told her I had to go home first to get some things, and to have someone drive me back to the hospital.  She didn't want to let me, but finally she agreed.  I was admitted that day, feeling very bewildered.

My first and only experience with being hospitalized was one I will never forget.  The nurses were very rough, and they expected me to unquestioningly obey whatever they said to do.  I didn't understand why I had to do the things they were asking, and I remember feeling scared and crying most of the time.  They started an IV on me right away, and the lady who started it obviously didn't know what she was doing.  She bruised me badly and my hand swelled up.  I was forced to lie on my left side all the time because this lowers blood pressure, supposedly.   They put me on a high protein diet, and gave me a multi-vitamin supplement.  They also put me on a blood pressure lowering medication, and phenobarbitol to keep me from having seizures.  I was seen every other day by my regular family practice doctor, and every other day by an OB-GYN.

I was on an emotional roller coaster all the time.  One day the family practice doctor would come in and say, "If you don't improve, you'll be staying here until the baby is born."  I was at 33 weeks, and couldn't imagine staying in this hospital bed for 7 more weeks laying on my left side.  The next day the OB would come and say, "You are doing great.  You'll get to come home in a few days."  The next day the family practice doctor would come back in and say, "No, you are going to stay."  The next day, the OB would say "No, you'll be going home in a couple of days."  Each day I would get my hopes up, and the next day they would be dashed.  Finally, I said to my doctors, "Please get together and talk.  You guys are upsetting me and I need to know what is really going on!"

I did finally get to go home, but was ORDERED to lie on my left side at all times, take my medication, and eat NO SALT whatsoever.  Two weeks before my due date, I went into labor.

I thought I was constipated, and went into the hospital to get something to relieve my bowels.  It turned out to be labor, and I was already 4 centimeters dilated when I went to the hospital.  I was given an enema, not even asked if I wanted one, my pubic hair was shaved, I put on a hospital gown, and was put into a labor room alone with my husband.

Then the waiting began.  Since my husband had been gone for the last three months of my pregnancy, we had not taken childbirth classes together.  I had the mistaken belief that "The doctor will tell me what to do."  How wrong I was.  I didn't know that the doctor rarely comes into the room, unless there is a complication, or the time for the delivery has come.  We were in a room alone, with no one to encourage, reassure, and help us.  I quickly learned that contractions were intense and powerful, and I had trouble coping with them.  They were NOT PAINFUL, but they were so intense, and I didn't know what to do to get through them.  So I started asking for anesthesia.  I mistakenly thought that anesthesia would take away the intensity of the contractions.  They said they couldn't give me anything until I was fully dilated.  So I went through the whole thing with no medication.

During the labor, I was being monitored on the electronic fetal monitor.  They weren't getting good readings, so they came in to tell me they were inserting an internal monitor.  An internal monitor is a corkscrew-shaped electrode that is literally screwed into the head of your baby.  My recollection of the insertion process is that they rammed this rod up inside me, sending me into screams and raising my body up off the table in agony.  The doctor proceeded to sternly lecture me...."Listen, you stop that screaming and think of your baby.  Calm down and be quiet."  My husband wanted to hit him right there, but being in the military was afraid of getting in trouble for hitting an officer.  They proceeded to insert the monitor.

Finally, when I was dilated to ten centimeters, they came in to give me a cervical block.  This consists of two shots, one in each side of the cervix, which numbs the cervix, birth canal, and everything below my waist all the way to my toes.  It wasn't supposed to numb my feet and legs, but it did.  I was very disappointed because, while my tissues were numb, I could still experience the intensity of the contractions.  The pain of the shots was more painful than the birth process.  Anesthesia numbs pain.....I didn't understand that what I was feeling wasn't pain, so anesthesia wasn't going to affect it.  All I was feeling was my body opening up and pushing out the baby.  Unless they put you to sleep, you are still going to experience that, no matter what anesthesia you have.

Because my muscles were numb, I couldn't feel to push my baby out.  They put me on the delivery table, I spread my legs, and a doctor I didn't know and had never seen before in my life looked up my vagina.  I was very embarrassed, but didn't have much time to think about it.  He was telling me to push, but I couldn't because of the numbing effect.  So, without asking me or even telling me what he was doing, he cut an episiotomy and used forceps to pull my little 6 pound 8 ounce baby boy out of me.  As a result of the use of forceps, I tore wide open and required 20 stitches.

I was so happy and relieved that the birth was over.  I was sent to the recovery room while my baby was taken to the nursery.  I just  kept saying to's over, it's over.  I'm not pregnant any more.

After I was taken back to my room, they brought my baby to me.  I wanted to breastfeed, but wasn't really encouraged nor given any assistance in learning.  I did breastfeed, but because my baby (who was two weeks early) was spitting up a lot, they wanted to put him on formula.  Once he was on formula, he began projectile vomiting (which should have given me a clue that the formula didn't agree with him).  They took an x-ray and said he had an intestinal blockage.  He was flown in a helicopter to a hospital in another city, and once he was there, they took another x-ray, they found no blockage.  However, they kept him 5 days anyway to give him antibiotics.  When we got home from the hospital, my milk had dried up, and I was not educated enough to know how to bring it back up.

When my son was about 18 months old, I was given a book a friend found at a garage sale.  It was called "Let's Have Healthy Children" by Adelle Davis (now deceased).  This was the first book I had ever read about nutrition.  From this book I learned that the pre-eclampia symptoms I had experienced with my first pregnancy could have been totally prevented with a high protein diet and certain specific vitamin and mineral supplements.  I was SO LIVID!  I thought about all the things that I had endured with hospitals and doctors, and I was angry! They HAD given me a vitamin and mineral supplement in the hospital, but it was synthetic, so my body could not process and assimilate it as natural vitamins from food would have.  Also, I learned that when a person has larger than normal arms (as I did from the weight gain) that if pressure is take using a normal sized blood pressure cuff, the readings will be inflated.  After taking my blood pressure, they could never understand how I felt so wonderful and not sick, since the readings they were getting were high.  In retrospect, I don't believe that my pressure was nearly as high as they said it was.

At this time, I met a woman who had given birth to all her babies at home.  I was intrigued by this idea.  I hadn't known that anyone did this in America.  I began to research and learn about home birth, and I learned that statistics show home birth to be safer than hospital birth.  I learned that the World Health Organization endorses out-of-hospital maternity care as best for most women.  I knew that my next birth would be a home birth.

Why?  Because the hospital birth experience was demeaning and disempowering.  I was treated as if I didn't know anything.  I was given orders and expected to obey as if I were a child.  I was not supported and encouraged.  My pregnancy problems had actually been induced by my medical care rather than alleviated by it.  I wanted to be in charge of my own birth.

With my next pregnancy, we were living in another state.  When I learned I was pregnant, I immediately decided on a home birth.  We began interviewing midwives, and we finally narrowed it down to two women:  the first was a naturopathic physician who had done about 70 home births, and the second a lay-midwife who was very spiritually oriented and had done about 850 births on her own.  We instantly felt that the lay-midwife was for us.

Every month, she came to my home.  I didn't have to go to an office.  She didn't want me to weigh myself because she said that worrying about weight often made her clients blood pressure go up.  She didn't take my blood pressure unless I asked her to.  She could tell by talking to me and looking at my appearance whether my blood pressure was up or down.  She talked to me about what I was eating, what I was feeling, and I formed a warm, maternal bond with her.  After the birth, I came to realize that the reason I wanted a midwife was because I needed this emotional bonding with another woman.  I hadn't needed any help with the actual birth, but I just enjoyed the warm, supportive relationship with this woman.

I was five days past my due date.  My mother and grandmother had flown in for the birth, and they could only stay a month because round trip plane tickets must be used within 30 days.  Because my last birth had been two weeks early, they came about three weeks before my due date.  They had been at my home three weeks or so, with no signs that I was going to have this baby.  Having so many people staying in our little apartment was so stressful, I just wanted them to go home, and wanted the birth to be over.  One day, my mom said, "I guess this baby isn't going to come before we have to leave."  When I realized they would probably leave before the baby came, I began to plan for a friend from my church to come help at the birth.

The day before I went into labor, I went with my husband to his workplace.  Everyone was on maneuvers, so we were alone in the office.  I spent the day quietly typing some documents for him, and trying to call this friend and ask her if she would help with the birth.  I actually began to feel very relaxed and good about birthing with this friend there instead of my family.  I was never able to reach her, but I realized that I was feeling good about the birth and looking forward to it.

That night, I went into labor.  I now feel that contractions began because of the emotional release I experienced when I realized my family would not be at the birth.  It is a fact that the emotional state of the mother is the number one thing which can interfere with the onset of labor.  When I began to feel relaxed emotionally, my body was able to release the oxytocin which started labor contractions.

Labor lasted about 6 hours from start to finish (as opposed to about 16 with my first birth).  I labored most of these six hours on the toilet, which helped my pelvis open up easily for birth.  When the midwife arrived, I was already ten centimeters dilated and ready to push my baby out.  I had envisioned giving birth on hands and knees because this is an effective position for preventing certain birth complications.  But when the time came, I was too shaky to stay in this position and push.  I ended up lying on my side on the floor with one leg propped up on the bed.  My baby was pushed out as I moaned loudly and twisted a washcloth with both hands above my head.

My second baby, a ten pound baby boy, was born with much more ease, much less discomfort, and extreme emotional satisfaction.  I had been in control, and called the shots.  I birthed the way I wanted.  The only thing the midwife did was cut the cord (something we could have done ourselves) and suck some mucous out of his throat with a tiny piece of tubing.

After the baby was born, I wanted to continue the warm supportive relationship with my midwife.  She, however, didn't seem to want to continue the relationship.  The emotional bond I had felt before seemed to evaporate.

We moved again to a different state.  I decided I wanted to be a midwife because the birth experience was so powerful, and I wanted to experience that again and again.  However, there were obstacles to the study of midwifery in the state I lived in, so I decided to become a Certified Childbirth Educator.  This turned out to be providential;  after much study, I have now come to the conclusion that women are able to give birth in the safest and most satisfying way if they are able to birth unassisted, without the medical interference of a doctor of midwife.  What a waste of energy it would have been to study to be something I would eventually come to feel was unnecessary.

My midwife did nothing that every woman cannot learn to do for herself.  A woman can do her own prenatal care....she can buy urine test strips and test her own urine....she can take her own blood pressure, measure her fundal height, listen to fetal heart tones.  She can read and educate herself and how to detect complications.  She can catch her own baby, cut the umbilical cord, birth and dispose of the placenta, suction the baby if need be.

I learned from my home birth that when I was in control of the birth experience, everything went better.  Being in the hospital automatically makes a woman tense, which often causes her body to not produce the oxytocin needed to have regular, effective contractions.  I learned that having other people at my birth changes the dynamics of the situation so that I do not birth as well.  When someone else is in the room with you while you birth, you are subject to their thoughts, feelings, movements, body language, and expectations.  You do not behave the same as when you are alone.  You do not do the things you would intuitively do if you were alone.  That is what makes assisted birth not as safe or desirable as unassisted birth.  I prefer to call unassisted birth Autonomous Birth, because you can have an unassisted birth with no medical people there, and still have those friends or family members who are at the birth affect you in a negative way.  So in my opinion, not only should birth be unassisted and autonomous, but its best if you are alone.  Alone.  It should cause you to reach deep within yourself for resources you didn't know you had.  It should cause you to pay attention to what your body and intuitions are telling you rather than what other people are telling you.  It should improve your birth experience drastically.

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