Wednesday, January 13, 2010

The Business of Being Born

I watched the documentary The Business of Being Born Monday night as it has been recommended by more than a couple people who know my stance on natural birth. It presented a lot of really good information (albeit, nothing I didn’t already know), but I think the best thing about this movie is the representation of the normalcy of the people seeking natural, un-medicated, uncomplicated births, specifically home births. I think most people think those that choose natural birth are more than a little wacky and those that choose not to give birth in a hospital by a doctor are just plain nuts. This documentary does border on continuing to portray that image but manages to present a good cross section of people that show that those that are choosing these ‘alternative’ options for their child’s birth are normal, educated, informed consumers that have weighed all the options and chose the one that they feel is the safest and most comfortable for them.

I have to say though, watching this has only opened up the wounds that I thought had nearly healed completely from my own birth experience. Even though it did not end up being the labor and birth that I desired I had convinced myself that the interventions that occurred were necessary and in the end I had a beautiful healthy baby girl, and isn’t that what this was all about anyhow? I can’t say that I haven’t replayed the events leading up to her birth over in my head, wondering what went wrong or what I could’ve done differently… I was laboring fine on my own at home, from all accounts I was in active labor for a good 5 hours (early labor for 24 before that) before heading to the hospital where I found out at check-in (to almost everyone’s surprise) that I was dilated to 6 cm, I thought ‘this is going to be a breeze!’ Then the interruptions and interventions began…

I had become pretty swollen towards the end of my pregnancy, although all I really noticed was the size of my feet and lack of ankles, so the first order of business (getting the hep-lock in a vein) proved difficult. I do have to state here that although my doctor is one that supports natural birth the hep-lock was the one point of contention that she would/could not budge on, the whole point of me not wanting an IV was because I didn’t want a needle in my arm so the hep-lock, in my opinion, was no better than being tied to an IV. Two nurses who must have just gotten out of nursing school each tried twice digging around in my arm to find a vein the needle would stay in before finally calling an anesthesiologist to put it in my hand (real comfortable!), this ordeal went on for about an hour where they would leave and come back and while I waited for the anesthesiologist I even began to hope they had forgotten about me…no luck. Needless to say my labor stalled almost immediately, I was still having contractions but they had slowed down to the point where I was able to take a little nap and never really picked up after that. The ‘cascade of interventions,’ as those in the know call it, began. After 6 hours with no progress the decision was made to break my water, 6 more hours with no progress it was time for Pitocin and consequently an epidural. When the baby ‘didn’t react well’ to the contractions induced by the pitocin resulting in turning it off almost immediately, the decision for cesarean was made.

My story is one of many where things are going smoothly until getting to the hospital and you’re put on the clock. There are several theories as to what causes this, some believe the change in venue or the actual act of being transported is enough to interrupt labor causing it to stall. Another theory, which I believe is what happened in my case, is the fight or flight reaction we mammals posses. When any mammal in labor feels they are in danger or that they are in a situation where their newly born off spring won’t be safe, something is triggered that causes their labor to stall. I think it is difficult for most humans (male or female) to feel safe and comfortable in a hospital setting, it’s loud, there are people poking and prodding you at all times of the day or night, the staff are constantly changing, etc. So is it any wonder that when a woman arrives at such an environment in the midst of labor, a very emotionally and physically charged event that is known to make even the most composed woman feel vulnerable and out of control, her body sends a message that she and/or her baby are not safe? Most that are educated about natural birth agree that when they suggested breaking my water I should’ve gotten up and gone home. But, like most people, I didn’t feel that was an option and at that point I was so exhausted from missing two nights of sleep and being in active labor for over 12 hours I was willing to go with the suggestions of my trusted doctor. In my opinion, even if I had walked out and let labor commence on its own again at home, I would’ve eventually had to go back to the hospital and what would make that trip any different than the first?

No one can make this important decision lightly (unfortunately I think the majority do by assuming they have no options) but look at the facts and do a little research. It is hard to overcome the cultural pressure we all feel to go to the hospital to give birth. In my processing of my own birth story I admit to my own visions of what I pictured as giving birth and the hospital bed, the nurses, the nursery, visitors coming to the hospital, they were all part of what I had always envisioned as normal. There are plenty of resources out there that highlight the risks and benefits of all the possible options and interventions, one of my favorites is Henci Goer’s The Thinking Woman’s Guide to a Better Birth. In it she highlights the ins and outs of maternity care and half the book consists of the extensive research and professional references she used in writing the book. The Business of Being Born presents a lot of the important information about the maternity care system in our country in a way that is easily digestible, but be forewarned it is clearly supportive of the out of hospital birth, but given the facts… it’s hard to argue with the facts.

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