When we decided to start our family and I finally got pregnant, I already had anxiety about how I was going to bring our baby into the world. I have a low tolerance for pain, but I hate needles more. It helped that having children was something I knew I always wanted, and that I had zero fear about labor itself.
That lack of fear is pretty unusual. Movies, tv shows, magazines, and pretty much every other media that ever deals with childbirth makes it out to be this awful, scary thing. When you talk about labor while pregnant, the first thing everyone wants to know is if you’re scared. And if you say “no” then you get this giant side-eye, and all this judgment that you must think you’re better than everyone else. And if it’s your first kid, forget it. “You obviously don’t know what you’re talking about because you’ve never done it before, here let me tell you about my horrible traumatic birth.”
And now, having done it, those stories make me sad.
We decided early on that we would go for a natural birth, and began looking into natural birth methods and classes. We ended up deciding on the Bradley Method and took a 10 week class. When we first told my family we were expecting, the first thing my father said was “get the drugs.” That was really my first indicator how difficult this was going to be.
The birth classes, along with other wonderful educational birth materials – Business of Being Born, anyone? – blew my mind when it came to talking about routine medical procedures used during pregnancy and birth. I had always thought that giving birth in a hospital, getting an IV, being hooked up to machines, and being confined to a bed was just how it was done. And this is a very common experience for women in the US, as are other medical interventions or “help.” I didn’t want any of that, though. But speaking to mothers who did it that way – or doctors, for that matter – made it seem like I was putting myself in danger. “Doctors know best!” seemed to be the childbirth mantra.
MY MOTHER’S DAUGHTERS
Most pregnant women tend to look to the mothers that birthed them for advice on these things, or would like to. I certainly did, even with our rocky past. But with pregnancy and birth being something so important to me, I assumed that she would be excited for my choices and rally around with support. After all, she had already been supportive of us starting a family before getting married, so I figured that I wouldn’t have much trouble breaking tradition in other areas too.
But instead, I was met with hesitation, doubt, fear, worry, with a sprinkle of condescension. After all, she was already a mother. She’d been through it twice, what else was there to know?
While pregnant with me, my mother also tried for a natural birth. She went with a different method than I did, and took her classes at the hospital. These classes include – and even emphasize – the possibility of medical “help” like drugs to speed up or induce labor, epidurals, episiotomies, and c-sections. She came to the hospital while in labor, everything progressing normally, but was given drugs to speed it up anyway.
It’s actually a very common practice for Pitocin to be given to laboring women, even if they don’t need it. After that, unsurprisingly, she found herself overwhelmed with labor pains. She asked for an epidural, but was too far along to get one. (This is not the case anymore, today they’ll stick you in the spine even as the baby is crowning.) So she had to complete her labor overwhelmed and in a state of panic. This panic transfers to the baby, who is already stressed out from the medically-enhanced labor, and it sets off alarms on the monitors and everyone panics that the baby has to come immediately. In addition to all the “help” she was given before, she also got an episiotomy in order to “get the baby out faster.”
After that bad experience, she reconsidered her previous decisions. When she was pregnant with my sister, she decided that she would get the epidural right away. Again, she went to the hospital, enjoyed her labor much more since she couldn’t feel a thing, but for some strange reason – or possibly being numb from the waist down – she was not very effective at pushing. Again, it became a situation where the baby had to come right away. Since she was incapacitated with her epidural, she was carted off for a c-section.
Even after undergoing major abdominal surgery, she was still much happier with the second experience. The way she recalls both births to me, the interventions were no big deal. She didn’t notice the IV was there, she hardly remembers pain from the episiotomy, the c-section was the easiest thing ever, apparently stomach staples didn’t hinder her recovery, and all in all, everything was fine. What was I so worried about?
Every conversation we had about birth involved her trying to reassure me that I wouldn’t care about all these things that I was terrified of. “You’ll change your mind.” “Just don’t look at the needle.” “You don’t know, contractions are so painful.” “I know you, you like to do things the easy way.”
And then the conversations turned to suspicion. “Why don’t you trust doctors?” “What do you have to prove to anyone?” “What if something happens?” “You’re so contrarian, always have been.” “I just don’t see what the big deal is.”
It wasn’t just my mother, everyone I told was like this. Some were more polite about it than others, but the consensus was that I was being difficult and jeopardizing my health the baby by not immediately submitting fully to hospital policy. I wasn’t planning a home birth with no supervision, I planned to give birth in a medical environment!
All the resistance put me on edge. Shouldn’t I be able to choose how I give birth? And if I want medical interventions or not? My pregnancy was progressing normally, I was healthy and considered low risk, the baby seemed fine, and all screenings for abnormalities were negative. No matter how educated I became on the subject, I couldn’t get my choices taken seriously.
Why is giving birth even a routine medical procedure? While there are some instances that require medical intervention and surgery – such as pre-ecclampsia and placenta previa – birth is completely natural and the body is literally built to do it. The uterus is a giant muscle, every contraction serves a purpose, and women very rarely grow babies too big to fit through the pelvis. A common reason for induction and/or scheduled c-section is the worry that the baby is getting too big, but there is no statistical evidence to back this up. Cephalo-pelvic disproportion (CPD) is overdiagnosed at an alarming rate, because methods of estimating fetal size are wildly inaccurate and can be off as much as a pound over or under.
Hospital policies vary by hospital and by state. Here’s the policy of the hospital in which I was going to deliver:
- You had to spend 45 minutes in triage alone without any support roles in order for the labor and delivery nurses to determine if you were really in labor.
- During this time, you get a routine IV in place, are hooked up to a fetal monitor, and the clock starts. While these measures have good intentions, their implementation misses the mark. The IV is a handy way for them to give you drugs to speed up your labor. The fetal monitor, while convenient for doctors, isn’t accurate, and any bad readings off that machine can start a panic that baby is in danger.
- If your labor is progressing slowly, they speed it up. If doing this causes labor to be too painful, pain management drugs are given. These drugs – such as epidurals – make doing the hard work of labor even harder.
- If you can’t effectively push while numbed from the waist down – likely – the next steps are:
- Either cut your lady parts – which in the end only saves you about 15 minutes of pushing – or
- Pull the baby out with a vacuum or forceps – for which the aforementioned cutting is required – or surgery to get the baby out.
- This hospital has a c-section rate of 40%. The national average is 32.9%. The World Health Organization states that anything over 15% is doing more harm than good.
- When the baby is finally born, mom and baby are separated to make sure the baby is healthy – even though the healthiest place for a brand spanking new baby is with its mother.
- They whisk the baby away to the nursery for observation – where it might get a bottle of formula even if you’ve explicitly said you don’t want this.
- Baby gets a bath, which isn’t necessary for the first two weeks. It’s especially dangerous in the first 24 hours when the baby can’t regulate its own temperature.
- After the bath, the baby is placed on a warming tray to make sure the body temperature doesn’t drop too low. This entire situation could be avoided by having skin-to-skin contact with the mother after delivery, but that’s not hospital policy.
Knowing all of this made me very incredibly nervous. I didn’t want any of these things to be a part of my birth. I sat down with my boyfriend and our doula to write a birth plan, specifically stating what I wanted, and what I didn’t want. This was my only chance to have a say about what happened to me, and there were still things I couldn’t control.
Bringing up these concerns with my mother – or anyone else – was useless. She kept telling me that after the ordeal of giving birth, that I wouldn’t care if they had to stitch up my vagina, or if they take my baby away for 2 hours. Maybe I wouldn’t, but what if I did? And why shouldn’t I e able to choose? After all, I’m paying these people!
After learning these policies, I realized that my mother didn’t really make the decisions she thought she did. She didn’t fully know her options. You can ask for a heparin lock instead of an IV. You can ask that they monitor the baby manually instead of continuously. You don’t have to be confined to a bed. You can deny Pitocin. But you can’t deny observation in the nursery. If you give birth in the hospital, you give birth the way they want you to, and you have to fight for any deviation.
MY BIRTH STORY
Since my job was to have the baby, and it was going to take most of my time and concentration, it was my boyfriend and doula’s job to make sure that my wishes were being met and my birth plan followed. Needless to say, this wasn’t easy.
By the time I made it to 36 weeks, I saw my OB every week. At these visits, he started to say things like “when you get your IV” and “I don’t want you to go more than a week past your due date” and “sure, you can try to go natural, but most women can’t handle it” – even though he knew my plans for a natural birth. I began losing confidence that my choices would mean anything once I got to the hospital.
I transferred out of the care of my OB and into the care of a midwife at 37 weeks. I can’t even describe how different those experiences were. I came in with my birth plan, ready to fight for it. But when I went for my first visit, my midwife basically said, “Yeah, you can do whatever you want.” That was the end of the conversation. I finally felt like someone actually cared about my birth experience and needs.
I went into labor 6 days past my due date, labored for 13 hours, and gave birth completely naturally with no medications in the water at the birth center. There was no intervention besides back massages, words of encouragement, and lots of Clif bars and Gatorade to give me strength. My son was born weighing 9 lbs 2 oz, 22 inches long, with no harm done to any of my parts. The entire experience was exactly what I wanted, and given the chance I wouldn’t change a thing.
My experience was so great that I want to tell everyone about it. I have no horror story to tell, no awful memories, no haunting stress. Sometimes I feel guilty that I can’t commiserate with others on the agony of childbirth. But I know that I enjoyed my experience because the choices that I made were respected. Everyone should have this freedom of choice.
I’ve spent the past few years getting really involved in the politics behind women’s rights and reproductive choices. I firmly believe that everyone is capable of making medical decisions about their own body. I feel even more strongly about it now after being pregnant. I believe women know what they want, and should be trusted with their decisions, whether it’s the decision to get permanently sterilized before the age of 30 and with no children, to have an abortion for whatever reason, or to have 20 kids Duggar-style. It only makes sense to continue this trust once a pregnancy is being carried to term. If a woman wants to schedule her c-section around business meetings and in conjunction with a tummy tuck, then she should be able to. And if a woman wants to give birth completely naturally, no one should get in the way.
Choice goes past the decision to be pregnant. Everyone who is pregnant should have the choice of maternity care and birth. Giving birth is such a personal and intense experience, and every woman should be able to do it however she wants. Women who have no desire to endure the intensity of labor or wait out the last few weeks of pregnancy and discomfort or choose to schedule their c-section for any reason should be able to do so. But women who want to experience the natural process of birth without medical interventions should be able to also, and anything in between.
Thankfully, I’m not the only one who feels this way. Today, September 03, there is a nationwide event taking place to protest the state of birth in our country. It’s called the Improving Birth National Rally for Change and the purpose is just that. To improve birth and move away from unnecessary inductions and c-sections. To question the motives behind harmful hospital policies, and the high maternal and infant mortality rates our country faces. To implement evidence-based care instead of medical interventions for staff convenience. To let mothers-to-be truly choose how they want to give birth, and empower them with those choices. Their slogan is “When you know better, you do better” and I think that’s true for everyone. Once educated and supported, we are all capable of making decisions about our lives, our body and our birth.
Featured photo by Monica Barrientes