Saturday, October 11, 2008

A Change of Mind

I've been thinking about possbily going with a midwife and a birth center for my next baby. I had Jilly with a traditional OB/GYN and a medicated hospital birth. I was quite satisfied with my experience and didn't see why I would want to do it any other way. I have a friend who has very different philosophies on birth, and I heard a lot from her on them. For awhile I didn't think her ideas would work for me, and I would just stick with what I knew and liked. But then she took me to see The Business of Being Born, a documentary, at the Seattle Film Festival. I still held back for a little bit, but ultimately decided to investigate it.

There are a few things that appealed to me with an unmedicated birth. There seems to be less pressure. Obviously, not necessarily less physical pressure, a baby still has to come out. ;-) But less emotional/mental pressure. Pressure to progress in a certain time frame. Pressure to conform to someone else's agenda or standards, as opposed to following your body's cues. Pressure to allow things to be done, interventions like IVs and medication and such. Having a more relaxed birth sounded really nice! I was also relieved to find out that outside of a hospital, you're not restricting from eating or drinking. Certain movements, which are impossible when confined to bed with an epidural, seemed very instinctual and natural. Really, the whole idea of being more present and participatory in the birth of my baby was very appealing.

When I was pregnant with Jilly, I viewed the labor & delivery as something that would happen to me, rather than something I would be doing. That perspective made me place all my faith in my doctor and nursing staff. That also meant that all the decisions were up to them, and they would be doing all the work. I would just lay there and eventually a baby would come out. I obviously didn't have any problems with that philosophy, but I think it was coming from a place of fear, since I had never experienced birth before. Because I've been through it before now, I know better what to expect, not just the process of birth (and how messy it is) but the pain and rhythm of it as well.

I would say that the most frustrating part of Jilly's labor was pushing. All the issues that I had converged in this one period of time. I had an epidural that worked so well, I couldn't feel anything below my waist. I could feel some pressure, right when she was crowning, but other that-nothing. I didn't know she had come out until my sister started crying. I had NO control over any muscles in my legs. I couldn't lift them at all. It made it really difficult to figure out how to push. I had no way to tell if I was doing it right or not, or how to adjust it, since I couldn't feel. I couldn't tell when I was having a contraction either! The IV was really frustrating for me, because it hurt in my hand. Everytime I had to move my hand, it hurt worse. Then the nurses wanted me to grab my leg, to push and I couldn't because the clenching hurt the worst. By the time I started pushing it was almost 2pm. I had been awake since about 2am, having only gotten 2-3 hours of sleep. I was so tired. I hadn't eaten dinner since the night before, so I was starving. I was so exhausted mentally and physically, that I couldn't even vocalize how I was feeling. I just wanted to a sandwich and a nap, but instead everyone was around me, telling me what to do. But I got through it and my sweet little girl was born.

At the end of pushing, Jilly's heartrate decelerated because the umbilical cord was wrapped around her neck and was being compressed as she came through the birth canal. It was taking a little while to get her past the pubic bone, and when her heartrate didn't go back up, the doctor got worried. She brought in a vacuum and assisted the delivery. Because Jilly came out in such a hurry, there was no time for me to stretch. I ended up with some quite painful tearing that I didn't recover from for a long time. As I learned about natural childbirth, I realized that I didn't necessarily have to repeat that experience. By using better positions to push from (standing, squatting, etc) and not having medication masking me ability to feel and use my muscles, I could give birth more effectively and possibly with less damage. Which means recovery should be much easier. That sounds fantastic! Especially when considering that then I would have two (or more) kids, not just one newborn. ;-)

So overall, I realized that giving birth in a hospital with a traditional OB/GYN would make it very difficult to birth the way I want to. There would be pressure to get an IV, have my membranes artifically ruptured, to be given pitocin, and have to lay flat in bed for hours. The thought of having to either give in or continuously fight with hospital staff over it seemed like it would defeat the relaxed, peaceful birth I desire (an experience my friend had gone through and been traumatized because of.) But I was still very uncomfortable with a home birth. I was worried about not having immediate access to equipment and personnel, in the case of something bad happening. Also, I didn't really like the idea of being at home for the birth, strange as that sounds. I think I would feel very claustorphobic and then associate all that pain and discomfort with my home. Plus, birth is REALLY messy. I didn't want to even have to think about that mess being in my home, even if someone else took care of cleaning it! I needed a middle ground. I decided that a birth center, in close proximity to a hospital, with a mid-wife would be the route I wanted to take. I got online and started looking up places around this area and talking to friends who had given birth without intervention, trying to learn everything I could.

There are fears I have about this, however. I do worry about not being in the hospital, mere yards from an OR if the need for a C-Section arose. I worry about my ability to handle the pain and whether I will get too exahusted to go all the way through. I know it worries both Steve and my mom, the two people I count on to keep me sane and get me through things like this, and I don't want to cause them more stress. I worry that I will have to get in the car and go home before I feel ready. (I stayed in the hospital for 2 days after Jilly was born. Most people go home from the birth center 4-6 hours after birth.) I worry that I won't feel comfortable enough. I worry that I'll get caught in the fear-tension-pain cycle and it will be miserable. And I flat out worry that something will go wrong and hurt the baby or me, and/or that I will end up with more pain and an overall negative experience.

But as I explore this more and more, the more confident I feel. I am going to meet with a couple of midwives and ask them tons of questions. I want to not only assuage my own fears, but Steve's as well, so that we are both comfortable with this. I still reserve the right to change my mind and cry for the epidural! ;-) But I think this is something I can do, and more, something I want to do.

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