This crazy birthing business!

by christy on October 29, 2008

Wow, it’s been 2 weeks since I posted! They’ve been busy ones. Dave moved in. Jack came to visit. I went on a women’s retreat with church in the Poconos and had an awesome time (and meant to post the photos, but haven’t yet taken them off the camera). Evenings out with friends. Exhausted. I’m back to needing 10-11 hours of sleep a night and am quite cranky if I don’t get them.

I did find out that I passed my glucose test with flying colors, and my weight gain, while up the 2nd trimester, has evened out – so I figure that means I can eat anything as much as want with no repercussions? :) I thought I had found some good knock-off Red Hots at the local candy store. They ended up being WAY overpriced and did NOT taste cinnamony – just like wax and corn syrup with a little cinnamon flavour. Yuck.

So I finally got around to watching The Business of Being Born the other day. Wow. Awesome and scary. Jason was doing bills but ended up turning around to watch most of it and was glad he did – he’s glad I’m taking such an interest in the birthing process and now totally understands why I’m so against using medication and having any intervention done unless absolutely medically necessary. I know it will hurt (I mean, duh!), but women have been doing it for a few thousand years, and honestly it scares me more to have them do things to me that aren’t needed and to treat me as a number and not a woman whose body knows what to do. The cycle of epidural (pain relief via needle in the spine) -> pitocin (labour-inducing drug) -> more epidurals -> more pitocin -> baby in distress -> c-section occurs way too often for my comfort, and I trust my body more without drugs than if I’m numb from the waist down, trying to push.

So this morning I saw my doctor and had a list of questions I’d printed out from the TBOBB website. I’d already told him I want no drugs and a doula, which he agreed I should have if it helps me through the process. And he doesn’t do episiotomies unless absolutely necessary, but he said he honestly can’t remember the last time he did one. Whew.

The other questions I had were:

Me: When would you like me to come to the hospital?
Dr: When you’ve been having contractions consistently at 5 minutes apart or your water breaks, but it will really be up to you and how long you think you might want to wait.

Me: What are your protocols regarding inducing labour?
Dr: Well, if you want to induce labour at any time, we can do that. It just depends on if you get to the point that your baby is just too big or if you’re done being pregnant. However, if you want to let nature take its course, that’s perfectly fine, too. There are different philosophies and it depends on what you’re most comfortable with. I would say about 30-50% of women end up using pitocin; their uterus needs help or their membranes have been ruptured too long. You do have the right not to and I can tell you what risks may be involved.

Me: Am I required to get an IV?
Dr: Unfortunately, yes. Just in case some emergency arises. I’ve seen it happen too often where someone gets dehydrated or is in such distress it’s too difficult to get a line in, so it’s much easier to just do it when you come into the hospital. We can put a lock on it, though, so you’re not attached to any machines and can move around.

Me: What is your c-section rate? I saw on the NYU website that theirs is 29.9%.
Dr: Mine is about 10-20%. One thing you have to account for is the fact that in a city like this you have a very diverse population including obese patients, those with diabetes, drug users, etc., and so the rate is going to be higher than, say, rural Iowa. And then of course things happen where the baby is in distress, or perhaps a woman’s pelvis can only deliver an 8 lb. baby when a baby is 10 lbs [I’m not too worried about this – I think my hips are equipped to handle a larger baby!] I know that there are some doctors who are bias and not looking at medical reasons for doing c-sections. I mean, studies have shown that there are certain peak hours that they take place, like at 6PM on a Friday night, but I definitely wouldn’t do that [another fact from TBOBB was that 4PM and 10PM are when the most c-sections occur – just before dinner or when doctors are just tired and want to go home to sleep.]

Me: Will I be able to choose the position in which I give birth?
Dr: (Smiling) I’d be interested in seeing the data supporting different ones. I can tell you the biomedical support for various positions.
Me: I just want to make sure I’m not forced to be flat on my back pushing it out.
Dr: Well, it’s a hospital, not a prison!

Me: And just out of curiosity, how many people do you have due around my date of January 19th? [I actually asked this one because I’m curious how crowded the hospital’s going to be; I don’t know that we can afford a private room, but I don’t know how well I’ll handle being in a room with another mother and her baby for two nights – but I didn’t go into that with the doctor.]
Dr: Well, in a practice like this where we’re mostly serving gynecological patients as opposed to obstetric patients [I think those are the terms he used, or something closely related], we tend to have lower numbers of women giving birth. Most months I only have about five or six women due, and even if another woman is in labour the same time as you, you don’t have to worry that the baby will drop at the same time – it hasn’t happened in my two years here.

Me: OK, I think that’s it for now.
Dr: Did I pass?
Me: Yes, you did. :)

So even though I would prefer to have a home water birth with a midwife (our place is just too small, I think), I feel like my doctor is sympathetic to my concerns and needs. He got a tad defensive as I was asking him questions (but I’m sure he’s been attacked by hormonal, NYC women before, and that’s put him somewhat on edge with lists of questions like this), but he’s got a very calming voice and way about him that makes me trust him. The thing that I most appreciated was how much he told me it was my decision on how to proceed. I will be thankful to have a doula there. We can’t afford to hire a seasoned one, only a newbie doula (on average in this city it’s $500 for one that’s been to less than six births, $800-1000 for up to 15-20 births, and then much more than that for one that’s been around and seen it all), but I trust that she’ll have adequate training and can help me and Jason determine if something truly is medically necessary, or if they’re trying to use scare tactics (they know that a woman will most want to protect her child, so the easiest way to get her to comply is by saying “it’s for the good of the baby”). And, in the end, it’s the law that will allow me to deny any treatment I don’t want, so if some nurse comes at me with pitocin and I say “heck no!”, she has to legally comply. But again, I will do everything for the good of the baby, and to keep myself as healthy as possible (I already had a staph infection and colonitis this past year, I’m good, thank you very much) – that’s what it’s all about.

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