It's Baby Time Part 3 of 3: Don't Do Drugs (Stay in School)

Before reading this post, make sure to catch up on Part 1 and Part 2 of "It's Baby Time."   In those posts, I talked all about why we want a natural birth and decided against giving birth in a hospital.  This post is essentially the culmination of everything.


Why I Do Not Want an Epidural

God created women's bodies to give birth.  When you give birth naturally, your body produces various hormones to help you cope with the pain.  If you are pumping artificial hormones and drugs into your body, your body cannot physically respond the same way.  I'm trying to do everything "right" in pregnancy... eat healthy, make sure I get enough protein, avoid alcohol, ibuprofen, nitrates, the list goes on.  I've given up the occasional glass of wine, artificial sweeteners, and my old caffeine habits so that I can birth the healthiest baby girl possible.  So.... to me, it doesn't make sense that when the baby is still in my body, that I would pump in anesthetics... drugs powerful enough to numb the lower half of my body...  for my comfort... at the risk of my health and my baby's health?

Most women just think, "Worst pain of my life... where do I sign so I DON'T feel that."  Well, what about researching the risks or complications?  Or thinking about the fact that those drugs ARE going to your baby who is still inside of you?  Not to mention... epidurals don't even always work.  I've talked to a few friends that have told me they still felt everything anyway, or that they still felt the pain on one half of their body.  Don't just read the materials your doctor gives you or tells you.  Do your own research.

Studies seem to be somewhat ambiguous on the short and long term side effects of epidurals.  For example, on one side, I've read that drugs and labor positions can cause minimal brain damage to your child.  This means that your child may still be within normal ranges, but he or she may have lowered intelligence, speech and reading difficulties, shortened attention span, hyperactivity, or awkward physical coordination.  According to The American Pregnancy Association, most studies suggest that "some babies will have trouble latching on, which can lead to breastfeeding difficulties.  Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries, and episiotomies."  Other studies say the risk of side effects on you and your baby are incredibly low, and that the benefits outweigh the risks.  If it allows you to rest during labor and relieves the pain with minimal risk, then why not?  If it feels good, do it.  This post could be 10 pages long with all of the research on both sides of this issue.  But it seems pretty simple to me.

If the short and long term effects are not 100% known, and there is no conclusive evidence, then why would I risk my health or the health of my unborn child if I can do it naturally?  I realize how common they are, and how it may make the labor incredibly more pleasant, and how much people love them... so go ahead and comment as you will, those are just my thoughts. :)

Additionally, if you have an epidural, you lose your ability to move around on your own, and it makes your labor longer. Laying down with your back on a table and feet up in stirrups may be convenient for the doctors, but doesn't it make more sense to use gravity to maximize pushing efficiency?  Do a quick google search on best labor positions.  You will find that lying on your back or leaning on your back during labor can put stress on the oxygen supply to your baby.  If you are numbed from the waste down and confined to a hospital bed... your'e pretty stuck.  I'd like to be able to move around in labor, and do whatever my body feels like doing in the given moment.  From what I've heard, when it comes time, my body will know what to do, and I'd like to be able to feel that.

Conclusion

These are some of the reasons that Scott and I are so excited for Kaelyn to make her way into this universe.  We have done research on what we would like Kaelyn's birth to be like, and are very much looking forward to the experience.  We recently read "The Husband Coached Childbirth" by Dr. Robert Bradley, and are so excited to work together as a team to bring her into the world.  Ultimately, the decisions other parents make about childbirth are indeed their decisions, and I completely understand that what is best for us may not be best for everybody.  I would never judge anyone for making one decision or another, I just want others to understand why we have created our birth plan this way.

It would be my desire that others would take a more active role in birth education and be able to make more informed decisions when it comes to birth and labor.  Birth center... hospital... drugs... no drugs... We just need to do our homework, regardless of what we decide.  I feel like a lot of people just go to the hospital because that's what everyone else does, or get an epidural because they're afraid of pain, and there's not much else they take into consideration.  For such a major, life-changing event, I hope that more moms and dads take more active roles in what they want their birthing process to look like.  There are pros and cons to both sides... and everybody is different.  Labor, birth, and parenting have everything to do with what the parents feel is best for them and their baby.  And this is what is best for us.

References

AmericanPregnancyAssociation.org

Movies: Pregnancy in America and The Business of Being Born

U.S. Department of Health and Human Services' National Vital Statistics Reports, Volume 58, Number 11, "Trends and Characteristics of Home and Other Out-of-Hospital Births in the US, 1990-2006"

U.S. Agency for Healthcare Research and Quality: http://hcupnet.ahrg.gov/

World Health Organization Fact Sheet on Skilled Birth Attendants, 2008

It's Baby Time Part 2 of 3: You're Not Giving Birth in a Hospital??!

Before reading this post, make sure you read Part 1 of "It's Baby Time."  In my last post, I talked about why we want a natural childbirth and about our decision to give birth at a birth center.  Today's post is on why we don't want to give birth in a hospital.

I would like to preface these next two posts by saying that this is not meant to be a judgement on anyone else who chooses hospital births and epidurals! :)  I just wanted to explain our thought process so that others will understand why we are making the decision that we are.  Everyone is different, and no one can tell you what is right for you.  I am just advocating that families be fully informed and aware before making these kinds of decisions, and not just make choices based off of what everyone else does or out of fear.  That being said...


Why We Do Not Want to Give Birth in a Hospital

Historically speaking, in the United States, it used to be more common to NOT give birth in the hospital.  In 1940, 44% of births were out-of-hospital (U.S. Dept of Health and Human Services, 2010).  In 1969, that number had dropped to around 1% and has remained around there for several decades.  It may be uncommon to have an out-of-hospital birth in America, but comparatively, around the world a third of all births take place in the home even without a skilled attendant (World Health Organization, 2008).  Anyway, it's not about what everyone else is doing... let's look at our top reasons for not wanting to give birth in a hospital:

1) Increased risk of unneccessary medical interventions and C-sections

2) Longer recovery periods

3) Extremely expensive

1) First of all, it's not necessarily safer to give birth in the hospital!  If I go to the hospital, I have a 1-in-3 chance of having major abdominal surgery, also known as a cesarean birth (National Center for Health Statistics).  Are C-sections and other medical interventions extremely helpful and absolutely necessary at times?  YES!  But do 1-in-3 moms truly have emergencies and need a C-section?  This is not the norm!  I don't know anyone that has ever had a C-section that would advocate that it is the best way to go.  Not your ideal uplifting birth experience to be sure.  A giant cut is made in your belly, and your baby is pulled out.  Then, you can expect to stay in the hospital for 2-4 days, and recovery will take about 4-6 weeks.  Not only is it more expensive, but there are major risks from the surgery itself and from the anesthesia.  I'm not really wanting to spend my first few days or weeks with my new baby on pain killers.

Oh, and there is also a small chance that the baby could have breathing problems, be sluggish after birth, or that you may have increased bleeding requiring a blood transfusion, an infection in the incision, uterus, or nearby organs, reactions to the medications, injuries to the bowel or bladder, or blood clots.  If you've had a C-section, then you are at an increased risk in your next births for having the placenta implant to low or too deep in the uterus which can cause severe bleeding during labor and delivery.  Also, studies show that cesarean delivery has negative effects on breastfeeding, and rates of breastfeeding moms who have had c-sections versus vaginal births were significantly lower. 

But.. this isn't a post about why you don't want to have a C-section.  It's about the fact that if you go to an American hospital, you have approximately a 1-in-3 chance of getting a C-section.  And if you're induced, your risk of C-section pretty much doubles.

Once again, if I need to have an emergency C-section, I will be very thankful for the doctors and for current medical technology.  They are done for a reason, and they save many lives.  I'm just saying... there are a large majority of unnecessary things that happen in hospitals at the last minute that the mom doesn't have a lot of control over... things she may not have agreed to if she had more knowledge about the various scenarios or if she was in a different mindset.

Why are there so many C-sections?  Does it have anything to do with the fact that the people in charge are surgeons?  As written above, some argue that a large majority of C-sections are not done in case of an emergency, like they are supposed to be.  Here's one scenario that seems to be fairly common...  If you are not progressing quickly enough, according to the doctor, you will likely be given pitocin.  Well, then your contractions are going to be so intense, you will need stronger drugs to help numb the pain, so you get an epidural.  But the epidural is going to slow down your labor, so you'll need more pitocin.  It's a vicious cycle.  And as mentioned previously, if you have an epidural, you are at a much higher risk of having your blood pressure go down, which may change your baby's heart rate (your baby needs oxygen)... you get the picture.   Then, since your baby's heart rate dropped, the doctor will tell you your baby is in fetal distress, and you will be preparing for your C-section.  The baby's heart rate likely dropped because of your drugs... not just out of nowhere for no reason.  I don't think a lot of women understand this ahead of time.  Anyway, I'll write more about epidurals in "It's Baby Time Part 3."  On to the second reason we don't want to give birth in a hospital.

2) If you go to a hospital to deliver, you are going to have a longer recovery period.  The recovery period after a C-section birth is especially long.  At the birth center, we can leave when we feel comfortable (a few hours to 24 hours after) and we're not going to be charged an arm and a leg to stay there after the birth.  Which leads up to the next reason...

3) Expenses!  One of our biggest concerns pre-pregnancy was the cost of labor.  We were on individual insurance plans when we first became pregnant, and so I called about 8 hospitals in our area trying to figure out what the cost would be.  I was asking the hospitals about the cheapest route possible... vaginal birth without an epidural.  The costs averaged around $8,000 and that is NOT including additional newborn care charges or maternity provider charges. That is JUST the birth.  Assuming I don't have to go to the hospital, my cost is going to total around $3,750 at Blossom and it includes ALL of my pre-natal visits and the actual birth.  That's not to mention the compassionate and comprehensive care, the nutritional counseling, the educational videos, and that they're always available anytime I call with a concern or question.

Check out this chart on the average hospital labor and birth charges by method of birth in Arizona (also not including additional newborn care charges or maternity provider charges):

Is that eye-opening or what?  Hospitals are there to help people, but they also make quite a bit of money off of pregnant women!  I would argue too that hospitals are often about time, efficiency, and control, and labor is time-intensive and unpredictable!  Why wait 16-24 hours for a mother to give birth naturally when you can get a baby out easily and efficiently with a 20 minute surgery?  It's unfair to rob a woman of an empowering birth experience and the chance to bond with her baby right after labor, thus potentially damaging her chances to successfully breastfeed, when not absolutely necessary.  But women aren't told about the difficult recovery times and all of the disadvantages.  They just trust the doctor in charge because the doc says it's what you have to do to have the baby be okay and healthy.  Hospitals make so much money off of people having babies and I think it's insane.  Having a baby is a normal life occurrence.  Again, if something were to go wrong, they definitely serve an amazing purpose.  I'm not trying to bash on hospitals.  If we need to go to the hospital for some reason, we will gladly go and be incredibly thankful for modern day medicine and technology.  Things don't always go according to our plans.

We're not done yet!  Keep reading for, "It's Baby Time Part 3 of 3," wrapping up about epidurals.

It's Baby Time Part 1 of 3: Goin' Au Naturale

Recently, I have had a lot of people ask me what hospital we are delivering at.  Another question I have been asked is whether or not I am going to have an epidural.  You should see the looks on people's faces when I tell them that we are delivering at a birthing center completely drug free.  Not only do most people not know what a birthing center is, but when I tell people I'm not getting any drugs they look at me like I have a third eyeball.

Regardless of the chosen method, I am incredibly surprised at the lack of knowledge that people have about the birthing process in general, and how lackadaisical moms-to-be are about what they want their birth to be like.  It's a huge event that deserves a large amount of research and consideration!  This post is not intended to be an "in-your-face, everyone should do it like us post."  Scott and I are going a route that is a little off the beaten path, and with all of the questions I've been getting, I just wanted to explain a little bit about where our thought process is coming from.

Why We Want a Natural Birth

When I became pregnant, I started doing some research on the labor process.  I knew my mom had done 4 natural child births, and I wondered what her reasoning and thought process was.  I watched a few movies such as "The Business of Being Born" and "Pregnant in America" and did some research on epidurals.  I talked to friends who have given birth at home as well as naturally in a hospital, and listened to their birth stories.  I also read blogs and listened to friends' stories of those who had given birth in the hospital with epidurals, and I noticed a pattern.

The women who gave birth naturally seemed to go on and on about the beauty of birth and what a wonderful experience it was, and the women who took the normal hospital delivery route told me about the scary complications they had during delivery (fetal distress, abnormal fetal heart-rate, baby pulled out with forceps, mom's blood pressure dropping...).  None of them seemed to be aware (or at least vocal) about the fact that most of these complications were side-effects of the drugs they decided to take!  I kept hearing, "I was so glad the hospital was there to save my baby," when in all actuality, it was likely the hospital that helped cause the complications in the first place....

Then I thought about having a giant needle stuck in my back, and what it would feel like to not be able to feel my body from the waist down.  It didn't seem to make sense to me.  If I'm trying to push a baby out of that region, why would I numb my entire lower body?  Doesn't seem very efficient...  Plus, I hate hospitals to begin with.  The smell, the halls, the sterile ugly walls, and a bunch of sick patients... I am not sick!  I'm just having a baby!  I'm pretty sure God created women to bear children and that women have been doing this for thousands of years.  God has been growing this precious child in my womb, He invented childbirth, and I am in awe of His whole creative process.  He wouldn't give me something I couldn't handle.  I started thinking about a place I could give birth where I could be completely comfortable, relaxed, and not have machines beeping at me and people constantly coming in and out.  Where can I give birth where I feel safe, focused, and can have candles, music, and do whatever I feel like doing without an IV in my arm?  Where can I walk around, lay in a bathtub, or do whatever I feel like doing?  Certainly not in a hospital.  I've been told that birth is faster and easier when you feel most comfortable.  Makes sense to me!  I considered giving birth at home, but didn't want everyone to completely freak out on my first birth, so I decided a birth center would be a good compromise.

What is a Birth Center?

Birth centers are comfortable, homelike medical facilities designed for low risk, healthy, pregnant woman who want an alternative to a hospital or home birth.  Located a couple of blocks from the hospital, I will be giving birth at Blossom Birth and Wellness Center where I feel I am getting the most comprehensive and compassionate prenatal care.  Then, assuming Kaelyn doesn't present herself before 37 weeks, I will give birth here as well.  They also offer different educational classes on a variety of subjects including breastfeeding classes and support groups.  They seek to care for their patients holistically and really seek to understand who you are as a person... What brought you to this point in your life...  What your plans are as a parent...  Every visit we have had here has been at least an hour, and it is the exact opposite of your typical crazy OB/GYN office.  It's quiet, calm, peaceful, and the providers take the time to really get to know you.  It is here that we feel I am getting the most comprehensive and meaningful, informed care, and it is here that I can give birth the way that I want without interventions or interruptions.

And there's a lot more!  Continue on to "It's Baby Time Part 2 of 3" to read more about our thoughts and research on hospital births.