Birthing Choices: Doctor’s Intervention or Mother Nature's Intention?
Finding out I was pregnant was one of the greatest surprises of my life. I vividly remember the moment I realized that I could see a plus sign forming on the pregnancy test. My heart pounded loudly in my ears and neither John nor I could believe it was true. In fact,we bought two more tests just to be sure. Even the digital test agreed, "pregnant".
We weren't ready for this. Our lives were full of instability; a product of our non-stop schedules and workaholic natures. I was barely keeping my head above water financially, a choice I had made when I decided to focus my life on activism instead of continuing to climb the corporate ladder. I knew one day my priorities would change, but I thought I’d have more time to really create the ideal environment to raise a family.
I quickly realized that I knew little to nothing about the process of growing a human being inside of me, let alone birthing or raising one. I thought back to what I had been taught about reproduction growing up and remembered it being surrounded in fear and shame. We are shown disgusting, disfigured genitalia in school as we are taught to avoid sex. Women are pressured by the medical industrial complex their entire young adult lives to poison their bodies with birth control. We're told its immoral to have children if you're not married (an institution that ends 50% of the time in divorce, which is GREAT for children!).
No wonder John and I were nervous, we had been indoctrinated by a society that surrounds the idea of reproduction in fear and shame. It didn't take us long to realize how backward this was - every parent I spoke to told me what a blessing children are and that honestly, no one is ever ready. After the initial shock subsided we dove into research and began talking to our close friends that were also parents. One of the first pieces of advice I got from a dear friend was to watch the documentary, The Business of Being Born, by Ricki Lake. We found the video on Netflix and settled in for an evening that would change both of our misguided perspectives dramatically. Ricki Lake became a birthing activist after her first birth didn't go the way she had hoped. In the hospital she was pressured into unwanted interventions and felt that birthing could and should be so much more. She began attending conferences, talking to experts and decided to have her second birth at home. She actually shows the home birth video in the documentary and I must admit, it had me in tears. In this riveting documentary Ricki contrasts several hospital and several home/birthing center births. It was the difference in how the babies reacted upon being first brought into the world that convinced me to further explore "alternative" or "natural" birthing options. The babies born in non-hospital environments seemed much more calm and were instantly put into their mothers arms to nurse and bond while the babies born in hospital environments seemed to scream and cry as they were flipped around, examined, and poked and prodded by medical personnel wearing space suits. While I expected home births to be more serene and calm than hospital births, I was surprised to find that they are actually more safe as well. Did you know that over one third of the births in the United States take place via Cesarean section? This extremely intense and invasive medical procedure was at one time only used in very serious medical emergencies where the life of the baby or mother were in danger. Today, it appears the dramatic percentage of woman undergoing surgery in order to deliver their babies may be in part due to the high intervention rate during early labor. According to a 2010 USA Today article, over 44% of the women who attempt vaginal delivery are induced, meaning they have their labor artificially stimulated by a drug such as pitocin. CNN reports that nearly half of those women (undergoing induction) will give birth via Cesarean section. This is striking when compared to the Cesarean rate for women who wait for spontaneous labor, a consistent 6-8%. With such a high Cesarean rate, one might wonder why these interventions are used so frequently in our society. From my research there seems to be five major trends regarding medically unnecessary (non-emergency) interventions into the birthing process. One: The woman goes to the hospital entirely too early and the hospital pressures her into some sort of intervention in order to speed up the labor which often, but not always, results in a spiral of other interventions. A common example would be the early breaking of the water to “speed up” the rate of labor; however, this puts the mother at risk of infection and the baby at risk of damaging in the birth canal and often results in the next intervention of drug induced induction because the baby cannot survive without amniotic fluid very long. Two: The woman takes an epidural to ease the pain of contractions and labor slows to a near halt, resulting in artificial induction of labor to counter-act the slowing caused by the pain medicine. Three: The doctor convinces the woman that there is some medical threat looming in the future that can be prevented by the early induction of labor. One such threat is that baby will be too big for the mother to push out, which is incredibly rare and rather unlikely when you consider the pregnancy hormones that cause the loosening of joints (yes, including your hips) in order to facilitate the process of birth. Four: Some sort of scheduling issue arises such as the doctor going on vacation (yes this happened to someone very close to John and I) or the doctor pushing the woman to induce so he/she can be the one to deliver the baby. It has been reported that OBGYNs only get paid in full if they deliver the baby themselves. Five: The baby decides he or she is not ready to enter the world on their pre-determined “due date” (40 weeks gestation) causing the doctor to scare the mother into inducing. Which is strange considering stillborn rates decrease at 41 weeks and most first time moms give birth between 41 and 42 weeks. Considering how high the intervention rates have become in our country and how often there are interventions performed when they are not necessary, one finds it hardly surprising that the United States has the highest infant mortality rate of any Western civilization. These are the issues that lead me to explore another way when it came to my own birthing choices. Upon further research I found study after study that show the simple presence of a birthing Doula (experienced non-medical birthing assistant) lowers the rates of epidurals, induction, and other interventions including Cesarean Section. This is likely because they are trained to help calm the mother and build her confidence instead of scaring her and making her feel weak. Doula’s also protect the mother by demanding hospitals stick to their birthing plan and advocating on behalf of the mother during her time of great pain and wild emotion. These rates decreased even further when compared to mothers who birth with an experienced midwife at home or in birthing centers (outside of the usual hospital environment). In fact, most other countries have midwives attending births even when a doctor is needed to deal with a medical emergency. As we armed ourselves with research, John and I became increasingly determined to keep our birthing experience away from the hospital environment. We decided to hire the best midwife in Texas with full confidence that she can deal with most minor medical issues (such as cord around neck or breech baby) and the confidence that she has built strong working relationships with doctors at local hospitals who will respect our birthing wishes in the event of a medical emergency. Not only did she open the first birthing center in Texas, but she is also known for her extensive apprenticeship program in which she trains other women to walk in her footsteps. We knew she was our perfect match when we found out she has spent decades as an activist and could not only understand our lifestyle choices, but respect them as well. In addition to carefully researching who would be helping deliver our baby, we also researched the various ways to ensure our baby has a peaceful transition into the world. We finally settled on the idea of a home birth with a birthing tub so baby could enter the world in the most loving and secure environment that we could provide. Daddy will get to catch baby and he won’t be forced to wear a space suit in order to participate actively in the labor. As a team, we are prepared to welcome baby without all of the fluorescent lights, medications and loud noises. Both of our mothers will be here to attend the birth with our midwife and her two assistants. We could not be happier with our choice to provide baby with this setup as their entrance to the physical world. Did I mention the entire prenatal, birth, and post-partum service provided by our midwife is costing us under $4,000, including the cost for the birthing supplies? If the risks imposed by medical interventions aren’t enough to have you consider a non-hospital birth, maybe the cost will. A typical hospital birth now runs around $20,000! Currently I am two days “overdue” and patiently awaiting the arrival of the newest addition to our family. I look forward to describing our experience using the midwife from start to finish in a future article, including the results of our planned home birth. Happy birthing! Catherine’s daughter, Aliana Elizabeth, was born at home in Texas on October 3, 2011.