Long post ALERT! (A new public service to my readers)
Those who saw Neal’s video interview at my baby shower know this little secret: I have read about a gajillion books, internet articles, and research studies about pregnancy and childbirth.
I’m not sure I would call it a new hobby; it has felt more like a compulsion, a prerequisite to understanding what on earth was going on with my body and mind. Not that it ultimately told me all that much about my particular health concerns (in the end, the midwives, doctors, and specialists have all agreed that I do not have a “known condition” but rather a unique auto-immune response to pregnancy), but I think it created a touchstone for me to make some sense of difficult and confusing things.
When I first started talking to Neal about my birth plan, he was a bit incredulous — sort of asking, “Now what in the last few months (or your whole health history) makes you think things are going to go the way you want them to?” Perhaps I am unreasonably optimistic, but I absolutely believe that I’m going to have a great labor and delivery. Seriously.
I’ve hesitated a bit to write about this topic publicly because there’s a lot of strong opinions on all different sides, a lot of judgment passed, and a lot of hurt feelings for friends I know who didn’t get what they were hoping for. But inasmuch as I’m chronicling my life and my thoughts on this blog, and this decision-making process has been predominant for me over the last year, I decided to write it down.
So I guess the most basic thing is that I’m planning an unmedicated labor and delivery. There are so many reasons why this felt like the way to go for me (my body’s sometimes-unpredictable response to medications and emotional baggage from doctors/hospitals/mainstream medical community, chief among them), but fundamentally, I believe that my body knows how to do this. As crazy as it sounds when you first think “I have to get something how big out of there?!,” I have felt such a confirmation that this is God’s design and that unnecessary intervention will hinder rather than assist what He has carefully constructed. I feel peace knowing that even my somewhat-broken body was created to do this.
Because I don’t want a highly medicalized birth, my first choice was to give birth at home or at a birthing center. Since our many twists and turns made that an unrealistic option, I had to turn my attention to simulating that environment as much as possible in the hospital. Enter New Beginnings Nurse-Midwife Clinic. The midwives are still pretty much in the medical mainstream and more ready to prescribe medication than I would prefer, but they also look at the pregnancy in a very holistic way and attend a lot of unmedicated births. If they think getting me on my hands and knees to push would be helpful, they’re all for it – something that an epidural generally inhibits and few OBGYNs would consider.
This plan of mine also suggests a certain kind of hospital, which is one of the reasons I was ecstatic to get to the point in pregnancy where I could go to Orem Community Hospital (before 34 weeks, it would not have been safe because the NICU level was not adequate). I have heard only rave reviews about Orem Community in terms of great labor and delivery nurses, more individualized attention, fewer institutional policies to speed up the laboring process, and all-in-one rooms for labor, delivery, recovery, and rooming-in with the baby. I’m still pretty sure that I’m going to have some issues with the hospital, since I plan to decline some routine interventions “against medical advice” (like continuous electronic fetal monitoring and an IV), but it seems like the best option in light of our situation.
Next came our decision to hire a doula – a labor assistant that provides physical and emotional support. Although my midwives are often there for a large part of the labor, rather than just delivery, there is a lot of convincing research (including randomized studies, the gold standard) demonstrating the positive effects of dedicated labor support above and beyond medical personnel. As I got into the childbirth literature, I also began to feel that the pendulum has swung too far in terms of pressure on a husband to be the primary labor support. Neal is as hands-on with my health as any husband could be, but as we’ve approached childbirth, I’ve realized how many emotions and fears he has connected to the process. It seemed unrealistic to ask him to put his own feelings aside and just focus on me and my needs. Enter our doula Melissa, who we felt instantly comfortable with and know will be a calming presence no matter what happens. We also decided to have one of Melissa’s apprentices (she is a doula trainer) attend the birth because, let’s face it, why would you have only one person giving you a massage when you could have two for the same price?! (Remember, I’m a massage hooch
).
So that’s our birth location and our team, but most people who attempt an unmedicated birth also have a “method.” This was actually the trickiest part for us, partly because of timing (few childbirth classes are offered over the December holidays, which would have been the right time according to an early February due date) and the uncertainty about when baby girl would come. Ultimately, it has worked out fine because after reading books on Lamaze, Bradley, hypnobirthing, Birthing from Within, Ina May’s methods (oh, thank heavens for the public library or this compulsion would have broken us!) et al., I realized that I like an eclectic approach. I don’t think I’m a strictly method person; rather I feel more comfortable compiling a toolbox of ideas, practicing them all, and seeing what helps in the moment. Luckily, our doula Melissa also offers private childbirth classes from a similar perspective, compiling what she’s found to be best practices over 14 years in the field.
Even though I’m not sure at all what will prove most helpful in the moment, these things feel like good preparation:
- Progressive relaxation — every night Neal reads a script that walks me through measured breathing and focused relaxation.
- Supported squats — since squatting can be an effective way to help the baby descend, I really wanted to get comfortable with the position . . . and it’s a good thing we’ve practiced because man, those first few tries were AWK-WARD with a fat cow like me. Neal enjoys showing me how easy it is for him to do!
- Hydrotherapy — warm water has helped me a lot with other pains and injuries, so I’ve assumed that it will play a key role in labor. The only problem was that because of my skin condition, I haven’t been allowed to take baths throughout the pregnancy, so we’ve been working on ways to get comfortable in the bathtub now that I am packing 30 extra pounds.
So, wow, this is like a monster post . . . and I still had a few more things to write. If you are not bored out of your mind by this topic, stay tuned for part two about facing my childbirth fears.