Wednesday, June 1, 2011

No Pain Meds?!

No Pain Meds?!

AND you aren’t going to a hospital?? This was the reaction from almost all our friends and family when we shared our decision to have a natural birth. I am pretty sure a lot of them even thought, yeah, whatever, when the time comes, you will take the epidural. Before we got pregnant, or even tried to get pregnant, I thought that I wanted a natural birth, but after we got pregnant so quickly I began researching all my options, and knew that a natural birth was the best choice for everyone.

It took a little while for J to be on board with my decision, and we actually fought about it briefly (and we NEVER fight about anything), but after I shared all my research with him, he was just as sure as me that it was the right choice for us. He was understandably worried about complications for me and for the baby, but the truth is that complications for a normal, healthy pregnancy are rare, and complications usually arise after multiple interventions in the hospital.

We considered a home birth first, but found a local birth center, and decided that was the best choice because they had a huge jacuzzi (we don’t even have a small bathtub in our 1 bedroom place), and we read plenty of stories about laboring in the water helping with the pain- so I made my first prenatal appointment at the birth center, and the rest is history. For the record, though anything the midwife can do at the birthcenter, she will be able to do at your house, and either location is great if you are considering a natural birth.

There are many benefits to birthing with a midwife, either at home or in a freestanding birthcenter.

We chose a midwife because:

They will not induce with pitocin, or try to ‘hurry’ the labor along with pitocin. Pitocin is a synthetic version of the naturally occurring hormone, oxytocin, which is released during orgasm and breastfeeding. Pitocin is used to make the contractions much stronger, and it will make the contractions more painful, often making them double-peak or occur without breaks in-between. This increases the likelihood that the mother will want or receive an epidural. Additionally, it is given through an intravenous drip, therefore, the mother is then resigned to the bed to continue going through contractions. After having gone through labor myself now, I can tell you the last place I wanted to be during contractions was in the bed, on my back. Pitocin also increases the risk of fetal distress, because the stronger contractions can push down on the umbilical cord, decreasing oxygen supply to the baby.

Moreover, it will interfere with the body’s natural ability to produce oxytocin, but will not create the bonding behavior associated with oxytocin, because it is unable to cross the blood-brain barrier.

Once pitocin is started, either to induce or augment labor, it is highly likely that other interventions will follow. There are many risks with epidurals and cesarean sections, so we decided the best way to avoid the epidural and the c-section was to avoid the pitocin, and the best way to avoid the pitocin was to go through a midwife.

Another benefit of a midwife over an OB is the fact that the midwife will be present during the entire labor, while the OB will likely check on you periodically, or may only be there to “catch” the baby. Our midwife was wonderful, and let us have privacy at the times that we wanted it, but was there to help talk me through contractions when I felt I couldn’t go any further.

The most frustrating part of the whole experience was the insurance company – our birth was ¼ to ½ the cost of a hospital birth, but was considered out of network, so we had to pay for everything up front, and will now have to wait to be reimbursed for a portion of it. You have to love our nation’s health care that promotes more expensive options, and then claims they have nothing to do with rising costs.

The rest of the blog is the my birth story if you are interested :)

Terra’s story:

I had timetable braxton hicks start on Thursday April 7th about 5-6 minutes apart - Friday night they turned into real contractions, but were a little irregular. They kept me awake most of the night, and Saturday morning around 4:30am I could no longer sleep - they were about 4-6 minutes apart, and I woke J up saying we are going to have our baby this weekend!

We tried to go about the day with business as usual, trying to rest and walk a lot. I tried to sleep that night, but was unable to. At about 9pm, I placed myself on the birthball, and went through contractions like this for several hours. At about midnight, I was no longer "smiley" and the contractions were about 3 minutes apart, so we decided it was time to go to the birthcenter.

The contractions continued 1-3 minutes apart at the birthcenter, and I was able to sway my hips through them on the footboard of the bed for several hours. My midwife was encouraged saying we must be making progress because they were so frequent and strong. Around 5am I asked her to check me, but not tell me if I was less than 5cm. She checked and said we were almost 5cm. My water had not broken though, and I still hadn't lost my mucus plug. The contractions were pretty strong at this point, and I was beginning to get tired.

At about 8:30am, I was really tired, and beginning to not handle them all that well, so J and I got into the 2 person jacuzzi, and labored there for several hours. Sometimes the contractions slowed down for me (about 6-7 minutes apart) so I was able to rest a little in between them. BUT, when we got out of the jacuzzi, they got really intense really fast, and I really questioned my decision.

At about 2:30pm, I was beginning to doubt that I could really do this. My midwife offered me a mild narcotic, nubane, that would allow me to rest for about 2 hours, but I had a really hard time making the decision, and so we got back in the jacuzzi and labored there for a while, deciding that the narcotic was not what we wanted. She told us she only had offered it maybe 3 or 4 times in her 40 years of practice, but she believed I needed the rest if I was going to continue. I was afraid that Terra would be groggy afterwards, though. I had gone my entire pregnancy without even taking Tylenol or Advil, and I didn't want her to have drugs now.

We got out at about 4:00pm, and for the next several hours, I really didn't think that we could finish the labor. We had tons of food, but I couldn’t really bring myself to eat anything other than some oranges, so my energy was also getting low. Luckily we had taken Bradley classes, and J was amazing and kept reassuring me that we could finish. He also kept trying to put food in my belly. At 6:00pm, I asked my midwife to check me again and break my water if I was far enough along. She checked and I was about an 8, so she broke my water and stretched me to a 9. The contractions got even stronger, so I got in the shower for a bit, and when I got out, I began pushing on my hands and knees supported by J or the birth ball.

I pushed for just over two hours (all on my hands and knees) and at 9:23 pm, Terra was born. J caught her and handed her to me through my legs. I couldn’t believe how big she was! She began rooting and nursing immediately! The midwife and birth assistant left us alone for 30 minutes and then brought us dinner - we took care of measurements and went home after a couple hours.

Terra was amazing the whole time! Her heart rate never faltered, and we called her the little timex!

We were out and about within days, and I walked the dogs when we got home from the birthcenter at 2am (just don't tell my midwife!)

Great resources on natural births.

Orgasmic Birth-documentary and book

Pregnant in America-documentary

The Business of Being Born-documentary

Ina May Gaskin - Midwife and author

Bradley classes- the classes J and I took to achieve a natural birth