Why I Chose Natural Childbirths (and how I did it)

A handful of my friends asked me questions regarding my recent post on Sapphire's labor and delivery. Here are the answers to their questions and most of my thoughts regarding natural childbirth.

First of all I want to emphasize that I am not an expert in childbirth (obviously). I also want to note that I realize this can be a touchy and emotional topic; I mean not to offend. This post is just about my own two experiences, and as they say no two women and no two pregnancies are alike. I planned on natural labors and did all I could to prepare and practice for them. You might be thinking, "prepare and practice?" Indeed. Practice. I'll explain further.

Years ago, and at the beginning of my pregnancy with Winston, I was squeamish at any thought or story of childbirth. I enjoyed listening to friends and other women tell stories, but they made me nervous and sometimes a little sick to my stomach. I tried to push any thought about how that baby boy would actually come into the world out of my mind. When I did think anything, it was, "thank goodness for modern medicine," and figured I'd utilize the blessed epidural. I only briefly considered an un-medicated birth, thinking maybe one day I’d try it.

However, in the back of my mind, I remembered some details from women in my life (my mom, youth leaders, etc); specifically some details about one who had a medicated labor and then years later went natural and loved how she felt afterword, about my mom's only experience with an epidural with her 4th (of 5) children and how much she disliked it (even given how much pain the others were), and my mom's (who is a nurse, BSN) own concerns about how long babies are "stuck" in the birth canal because of epidurals.

When I was about 4 months pregnant with baby #1, one of my friends who was also expecting her first baby and planning a home birth, asked me, "What's your birth plan?" Like a child who gets called on in school and doesn't know the answer, I felt unprepared and a tiny bit embarrassed. I didn't have one, and I hadn't really thought of one. Isn't that something you just deal with near the end of pregnancy?

She had me read an article and told me about her neighbor who just had her 5th baby and 1st homebirth; both were a little inspiring and peaked my interest. The article made complete and total sense to me, and I knew after reading it that I wanted to do all I could to help my baby come safely into the world.

I looked more into it, and read a book called Ina May's Guide To Childbirth by Ina May Gaskin, renowned midwife (see at the very end of this post for my own short opinions and reviews of childbirth books I've read). That book gave me more insight, particularly because it is filled with birth stories written by mothers. I also had some friends who were blogging about their home and natural births. Reading those accounts made me less squeamish and more comfortable with the thought that a baby would have to come out of me, and gave me confidence that I really could “go natural.” The more I read, the more I learned about the many benefits of un-medicated births, including the ability to move around, shorter labors, and reduced risk of c-sections. I also learned about general hospital practices and how to work with and around them.

In addition, Sam and I attended a childbirth class taught by a childbirth educator and doula. She discovered we preferred a natural birth, and spent more time than usual teaching us breathing and pain-coping techniques. The weeks following the class, Sam and I practiced those techniques. I contemplated hiring a doula and probably would have if Winston hadn’t surprised us by coming 3 weeks early.

No matter how much you can read and soak-in from others’ experience, your own experience is the best teacher. My labor withWinston was different than I expected; my doctor told me it would likely be a short labor, but I thought it would be longer than 3 hours. Our practice greatly helped. I moved around a lot during labor, moving from rolling with a birthing ball to walking to leaning to rocking in a chair, etc. I was only on the bed just before pushing. I was able to stay mostly very calm (no cursing or uncontrolled screaming from me). But the best part was the recovery—I was up and out of bed very soon after the baby was born. I walked to the bathroom (I didn’t need a catheter) and walked to my new room by myself. I was very pleased with the experience, and it replayed in my head over and over again for days, months, and even years.

Fast-forward about three years to pregnancy #2. I had a few goals with my next childbirth. I wanted it to be very similar to the first—un-medicated, move around, focus on breathing, walk around after, etc. I also hoped to be more calm and relaxed during the hardest moments of transition and pushing. So, I looked into hypnobirthing.  I didn’t actually attend a class or even read a book that was 100% about using hypnosis during birthing, but I did find some great books, namely:

• Birthing a Better Way: 12 Secrets for Natural Childbirth by Kalena Cook
• Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation by Pam England 
• Spiritual Midwifery by Ina May Gaskin
• Mindful Birthing: Training the Mind, Body, and Heart for Childbirth and Beyond by Nancy Bardacke

I learned more techniques and gained more insight from these books that helped during Sapphire’s birth. Sam and I practiced some breathing and mindfulness/meditation techniques from Mindful Birthing chapter 7 that involved holding ice cubes (sounds funny, but really good practice—not just for childbirth, either). I also really enjoyed the insight from chapter 6 The Dynamic Duo: Pain and Fear of the same book. In fact, it is one I would recommend all to read—pregnant or not. I recalled a lot of that chapter during labor.

In addition to some new things from those books, all throughout the pregnancy I practiced a prenatal yoga that included helpful poses as well as breathing that helped ease discomfort during pregnancy and labor. I remained physically active; I still exercised at least 30-60 minutes a day, 5-6 days a week, including Zumba (until about 35 weeks when my pelvic and hip bones’ protests halted that), hiking, walking, biking, some workout videos, and yoga. Whether or not my exercise during pregnancy affected the length of my labor is unknown, but I’m positive it aided during labor and with my quick recovery.

In summary, I want to combine some main points that stood out to me from all those books.

• Be aware of your care-giver’s opinions and practices; ask questions.
• Be aware of the hospital’s or birth-center’s policies and know how to work with and around them.
• Epidurals are not bad, and I am not (and those authors are not) against them; but it’s wise to know the benefits AND drawbacks so that an informed choice can be made.
• Epidurals slow down labor. Period.
• Epidurals can (though, of course, not always) lead to other complications.
• You never know what your labor will be like—whether long or short; even if you receive an epidural, there will likely be some labor pains you feel before your epidural and likely some pains after your epidural wears off. Perhaps you won’t have time for an epidural or the anesthesiologist won’t be available. It’s a good idea to prepare for an un-medicated childbirth “just in case.”
• Preparing and practicing definitely won’t be a waste of time, as the breathing and meditation techniques can help in all aspects of life—including parenting, dieting, and self-discipline in general. I gained a lot of skills that I’m working on implementing in my life well beyond my childbirth experience.

I’d also like to give my own advice regarding natural labors—take it with a grain of salt.

• Do all you can to prepare your mind and body for childbirth (before and during pregnancy).
• Exercise.
• Eat well.
• Do prenatal yoga (I love this DVD found here: http://amzn.com/B000F6Z4L4).
• Practice mindfulness/meditation and breathing (with or without ice). J
• Read lots of POSITIVE birth stories; don’t let anyone tell you scary ones.
• If you decide to go natural, be careful whom you tell. It seems everyone tries to dissuade you, thinks your crazy, or has some horror story to tell you.
• Have a good support person (husband, doula, labor and delivery nurse, etc.) that can labor with you, not just be in the same room as you.
• Read chapter 6 and 7 from Mindful Birthing.
• Have a written birth plan; discuss with caregiver and take with you to hospital to discuss with nurse and other birth attendants.

Based on the stories I’ve read, it seems women tend to be more pleased with their childbirth experiences when they have taken the time to make a plan and choose a caregiver that can do their best to make that plan a possibility. Sometimes this meant that laboring women (and husbands) had to firmly tell nurses “no” to some practices. My cousin, who is a nurse in labor and delivery, told me to do whatever I wanted and not let the nurses boss me around. Our childbirth educator taught to ask questions about the benefit and drawback of everything the nurses and doctors want to do. This will help you make informed choices given the circumstances, instead of feeling like an object or patient being tugged around.

When I decided to go natural, I committed to it 100% and began preparing and practicing for it throughout pregnancy. I really think that is what made the most difference in my two childbirths.

*******

Book Reviews

I don’t see it absolutely necessary to read all these books; however knowledge is power. I'm glad I read them. Here are my two-cents about the books I read, for what it’s worth.

• Ina May’s Guide to Childbirth, by Ina May Gaskin
• This was the first book I read. I think it gives good perspective, but it is clearly pro-midwife. LOVE that about 1/3 of the book is birth stories. Also love that Ina May shows her own research and statistics. Perhaps it's a little dated as some of the practices she warns against are not commonly practiced today.
• Birthing a Better Way: 12 Secrets for Natural Childbirth by Kalena Cook
•  I would almost recommend this book to any pregnant woman. It’s not anti-epidural, but pro-informed choice. Also includes many birth stories and tips for having a natural birth in our epidural and c-section heavy hospitals.
• Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation by Pam England
• If you are a sentimental person or have really difficult feelings to work through with a previous childbirth, this may be the book for you. Pam England has her classes do a lot of visual representations on past childbirths, fears and hopes of future childbirths. It’s interesting to read through those and to see samples of that “artwork.” It also has some good meditation/breathing-type techniques, as well as good information on tips for laboring and pushing.
• Spiritual Midwifery by Ina May Gaskin
•  I only skimmed this one. Found it to be similar to her other book, but more birth stories and kind of more her history of how she came to be a midwife and kind of a how-to.
• Mindful Birthing: Training the Mind, Body, and Heart for Childbirth and Beyond by Nancy Bardacke
•  By far my favorite. Although I almost stopped reading it. It’s definitely based more on mindfulness, aka meditation in general, but ties it directly to childbirth. I was about to stop reading it when I got to chapter 6 on pain and fear, which I referred to previously. I LOVED that chapter. So much insight; I enjoyed sharing much of that with Sam. Chapter 7 was great, too. It also has some great yoga information, and tips for parenting mindfully. I found some of the book to be trite and at times just plain silly; however, I’m pretty sure I’m going to purchase this book and read it again; I might even try out the guided meditation audio. And not just for my next baby—for real-life stuff.

She's So Adorable: 1 Month Update

Isn't she darling?

We all have loved these last few weeks with Sapphire. Winston can't stop kissing her. To me, she's growing way too quickly; Sam loves his little girl, although he's excited for her to get bigger.

At birth Sapphire was 6 lbs 12 oz, 19 inches.
At 10 days she was 7 lbs 1 oz, 21 inches (they probably measured length wrong in the hospital...2 inches growth in 10 days is unlikely).
At 1 month she is 8 lbs 12 oz, 21 1/2 inches.

This week she moved out of newborn sized diapers, under-onesies, and pajamas; newborn outfits still fit, however (why is sizing always weird?). I wish she'd stay teeny-tiny for just a little bit longer, but alas.

She's been a delightful baby. I think she's easier than Winston was not because Winston was hard, but because she's more content, nurses better, and sleeps longer at night. Plus, now we've done the baby thing before AND she takes a binkie (which I have mixed feelings about...).

I haven't been able to rest, relax, and nap as much this last month as I did when Winston was born (the preschool Winston is much more demanding of my time and focus than newborn Winston was, it seems). Thankfully, though, I recovered remarkably quickly. I started doing yoga 1 week after baby was born and jumped back into Zumba classes 2 weeks after baby. I gained 30 pounds during pregnancy and have only 8 more to go. I have really enjoyed being off work, even if stay-at-home-mom work is exhausting and sometimes tedious.

She's starting to smile--even real, non-reflex smiles; we love them! I really could just snuggle and smooch her all day long.

Happy Halloween!

I Heart The Moby Wrap

And my baby, of course.

Baby In, Baby Out

I saw an idea similar to this on Pinterest a while ago, but I forgot about it until after the baby was born. So, I used the latest photo I had and modeled it after that. It's fun to see. And as small as Sapphire is, it's still amazing to think she fit inside.

PS Aren't those mum flowers beautiful?

Sapphire's Birth Story

Here’s the short version of my labor and Sapphire’s delivery:

Monday October 1, 2012

10:20AM Arrived at the hospital for scheduled induction.

11:00AM 3 cm dilated, 70% effaced. IV in and pitocin started.

12:40PM No real contractions yet. 3 cm dilated, 90% effaced. Doctor broke waters.

1:00PM Started to feel contractions steadily, but very much under control using relaxing and breathing techniques I practiced during pregnancy.

1:40PM Bathroom break removed pressure in pelvic area. More intense contractions.

2:00PM Nurse turned off the pitocin, then checked me. Baby was on its way down and out. Backup help and doctor called.

2:14PM Baby out and in my arms.

Tuesday October 2, 2012

12:00PM Left the hospital and headed home.

For some of you, the above will suffice. Others will want more details—especially if you’re like me and LOVE to hear/read birth stories.

The story really starts with Winston's birth. Ever since he was born, I have been almost euphoric about my next labor and delivery. Sometimes I worried, but mostly I have been excited (it sounds strange, yes) for my next labor and delivery. Perhaps it can be related to a runner’s next marathon? Perhaps?

For better-safe-than-sorry-sake, I kind of planned my work and life schedule around this little baby coming about 3 weeks early, like Winston did. However, at our checkup around that time it was obvious it would not be so. The doctor still thought I’d come early, though. Days turned into weeks and there was little progress. At my 38 (almost 39 week) checkup, I was dilated to 1 ½ and 50-60% effaced, but I had felt little contractions. I had also been measuring small for the last month or so, but each time there was at least some growth—until the last checkup; my uterus measured the same (35 cm when I should have been almost 39). The doctor offered to schedule an induction anytime after 39 weeks. I have very mixed feelings about inductions, and thought I would say “No!” right away, but something caused me to pause and consider the situation. Sam and I decided to think about it. The doctor was in no hurry to make a decision or to bring the baby, though he did say he would not allow me to go beyond 41 weeks, and thought I’d go into labor any day by myself anyway.

That night was a night of much prayer, concern and discussion. The next morning I called the doctor with more questions and concerns. In the end, Sam and I felt the best thing to do was to schedule an induction. We both still held firmly to the hope that I’d go into labor on my own before then. But alas.

Photo taken just before we got in the car to drive to the hospital.
39 weeks 3 days pregnant.

We arrived at the hospital about 10:20 AM.  I was dilated to a 3 and 70% effaced. After computer and paperwork, it was 11:00am by the time I had an IV and pitocin started. They can only start the pitocin at a small amount—4 (whatever the units of measurement are)—and increase by 4 every 30 minutes until it is up to 20. Because they had me on pitocin, I had to stay on monitors for both the baby’s heart rate and my contractions.  Lucky for me, they had a monitor that I could walk around with. But after a little while, the nurse figured out it was working fine on monitoring the baby, but it wasn’t picking up any contractions. “You’ve got to be having some contractions by now,” she said at one point, but all I felt were some small back pains and occasionally some slight lower-abdomen cramping.  I had to change back to the non-mobile monitor, and stay closer to the bedside because of it. I didn’t mind so much as long as I didn’t have to get in the bed—and I didn’t. By 12:30 the pitocin was 16, but I wasn’t feeling contractions.

About that time my doctor came in and talked about whether or not I wanted my water broken. Because I wanted an unmedicated labor, it’s often a benefit to leave the waters as it can act as a cushion and be easier—though longer—to labor. I wanted them broken to speed up the labor. The doctor checked me and I was still dilated to a 3, but up to 90% effaced. He broke the water at 12:40 PM, which wasn’t painful at all. I expected pain, but just felt the sensation of the water gushing out. The doctor commented he’d expect to be back around 5:30PM. Sam laughed and said “it will be sooner than that.” The doctor kind of chuckled and shrugged and headed out.

By 1:00 PM, I was feeling steady contractions. Even better was I could feel the release of tightness and pressure in between the contractions—that was a wonderful relaxing time. I worked through these contractions fairly easily, with the help of Sam using counter-pressure on my lower back (where I felt the majority of the contraction and pressure). I was leaning on a birthing ball that was placed on top of the bed. With each contraction, I rocked back and forth from side to side or rotated my hips in a circular motion. This worked wonderfully as I focused on my breathing, the rotation of my hips, and the soft music we had in the background. When each contraction ended there was a great release of pain that felt so good and gave me energy for the next one. For about 30 minutes I repeated these rocking-breathing-relaxing patterns through contractions that came about every minute to minute in a half.

Around 1:40 PM, I really needed to use the restroom. Emptying my bladder relieved a lot of pressure from my lower pelvic region that made the contractions a little more bearable, but the contractions on the toilet were miserable. It was nice to get back to the exercise ball for the next contraction.

As I returned to the ball and monitors, the nurse came in to adjust the monitor because it wasn’t picking up the baby’s heart rate very well. I had one really, really hard contraction where I lost all focus and the rocking didn’t work any more. She suggested turning off the pitocin, as the contractions were definitely on their own now. She also said anytime I was ready, she could check me again and see how much progress I had made.

At this point I had many thoughts. I knew that I had only been dilated to a 3 just one hour before, that I needed to have the nurse check me. If I was only a 5, I debated in my mind getting an epidural, because that last contraction was WAY difficult and I couldn’t do that all the way up to a 10. But then I wondered if it was just the pitocin making the contractions falsely strong. I decided to wait and see if they calmed down when she turned off the pitocin. I also noticed that I was getting hot very quickly. It reminded me of how hot and sweaty I got toward the end of my labor with Winston. All during these thoughts I had a couple more of those stronger contractions and despite all counter-pressure and rocking and focusing, I couldn’t get back in control. I had one contraction where I voiced how hard it was and that nothing was working anymore. Then on the next contraction, Sam said I screamed out during a contraction, and the nurse knew it meant things were close.

The nurse asked if I felt like I needed to bear down and push. I realized that was exactly how I felt—all that pressure right at the bottom. The nurse just reached up right then and checked me. I wasn’t in the most convenient position, and it was painful as she reached up. She said something about the head being right there,  and she immediately went to the phone. She said something like, “I need help in here now. She is completely ready. Call Doctor Liddle NOW.”

I can’t remember if it was my idea or suggested by the nurse, but I got up on the bed on all fours and had my hospital gown taken off (the amount of heat that suddenly came with my body was too intense). I remember vocalizing that this pressure was worse than I remember. The nurse said if I felt the need to bear down and push just to do it, even if the doctor wasn’t there yet. The next contraction I obliged and pushed. The pressure was intensely, painfully there, but pushing did help me through the contraction. Once again I felt a sweet calm and brief moment of relaxation just before the next contraction. At one point I noticed a bunch of blood all over the bed by my arm; the cap on the IV came undone and blood was coming out through the tube. It made a mess, but the nurse quickly put the cap on again.

I pushed through one or two more contractions on my hands and knees before I heard the doctor come in. I apparently was too high up towards the head of the bed, and he asked if I could come down. I asked if I could squat. The nurses quickly shifted the bottom part of the bed down so I could stand on it, and with a nurse on one shoulder and Sam on the other, I had my hands on my knees and I squatted through the next contraction. I was about to push, but realized squatting just kind of did that for me, and I watched in amazement as I noticed some of the baby’s head was already out—and that she had hair! It was amazing to feel the pressure release as I squatted and to feel and see her head slowly and then suddenly her whole body immerged. I reached down and the doctor gave her to me and I sat back on the bed and sobbed for the intensity and release of pain, for the after shock of it being over so quickly, and the emotions that came from watching my own child enter the world by exiting my body. It was amazing.

Everything else went smoothly. The doctor said I didn’t tear at all. I held our little slippery baby for quite a while as Sam took photos and started calling to announce her birth. She even nursed a little. I showered and they moved us to a different room. I really feel great—and have felt great since she came out. The cramping of my uterus, especially when she nurses, is more painful than those first contractions during labor (and way more noticeable than I ever noticed with Winston), but thankfully they come and go quickly. The day after the birth, I joked with my mom that I just had a baby yesterday, and what hurts the most is the needle prick where they took a sample of my blood that morning.

The doctors and nurses were all very respectful of our desire to leave the hospital as soon as we could, especially given all of their policies and procedures they have to follow. We were able to leave the following morning—out and completely on our way home by noon.

We’re so grateful that little Sapphire entered the world quickly and safely and healthy. Our little family is smitten by her already.

 I’m grateful for our careful, prayerful consideration of the induction and for our doctor’s guidance. He encouraged us to make our own decision. In the end, despite the doctor’s and nurse’s belief and experiences that this induction would take a little longer to progress (especially given I was only dilated to a 3 at the start), this baby came even faster than Winston (his labor was 3 ½ hours after my water broke; this one was 1 ½ hours). The entire pregnancy Sam and I talked about what we would do when I went into labor, since we had to drive about 35-45 minutes to get to the hospital where we delivered. The fear was IF we make it to the hospital. Sam and I are grateful she wasn’t born in the car.

Our Little Miss Baby Belle

Sapphire Belle entered the world at 2:14PM on Monday October 1st.

6 pounds 12 ounces; 19 inches long.

Lots of cute fuzzy hair.

Looks a lot like her daddy.

Absolutely adorable.

We think we'll keep her.