Thursday, July 19, 2012

Natural Childbirth

So Bonnie Jean and I had been looking more seriously at natural childbirth.  Our first child had a very long wait between induction and the epidural being given because labor was progressing too slowly for the epidural to be given.  We had little training for the labor process and didn't know what we were doing.  It ended up being a lot of pain until they gave up and decided that even if she wasn't dialated to a 3 she should still get the epidural.  As soon as she had the epidural the pain went down, she relaxed, and the labor proceeded quickly.  She couldn't walk around or really do anything about the pain because they felt strongly that the moniters should be attached at all times unless she was going to the bathroom, she had an IV, and as a result was essentially tethered to the bed.

So we really wanted to know some options to allow us to work around the stuck phase before an epidural would be possible.  We did do some self study on the bradley method.  The basic concepts he talks about seemed nice, but the nicest parts of them seemed to have been incorporated into the other methods that are widely promoted.  The stats supporting the method seemed encouraging but lacking scientific rigor (like giving a high percentage success rate when only measuring the people who decided not to change and get an epidural half way through the process).  The supposed bad practices being railed against, as far as we could tell, had more to do with the past than the present.

Labor woke my wife up at somewhere between 3-4 AM.  She woke me up around 4:23 when contractions were about 8 minutes apart.  Before we could finish gathering up to go they were coming at 4 minutes apart.

When we got to the hospital they insisted on keeping her hooked up to the monitors during most of the intake and medical questionnaire process.  She wasn't feeling so great at that point.  Once they were done they let her walk around, which felt much better, but she still was feeling like she might probably want an epidural.  We thought we'd try the hospital hot tub next.  That was marvelous, the water helped take the pressure off her back, the heat relaxed her, and things went along swimmingly.  They insisted on checking her again with the monitors since no one had bothered hooking up the portable monitors they had available.  Then, frankly I think they forgot about us.  It was only supposed to be a quick stop for a short monitoring and then back to the tub.  Bonnie Jean was feeling so miserable I went and asked someone if they couldn't hurry up and let us back to the tub.  They checked her again and discovered the hot tub and worked so nicely that she had gone to an 8.  The OB/GYN had another surgery waiting on her so she wanted to break the water in hopes of causing the labor to finish up rapidly.  They moved her into a classic birthing table posture, and being stuck on the table on her back being unable to move around made things miserable, hard to relax, and progress kind of ground to a halt.  Because the anesthesiologist was in surgery, the epidural wasn't an option and narcotic painkillers have a history of making Bonnie Jean feel nauseated and loopy.  So with the exception of some local painkillers injected in anticipation of stitches etc we were pretty much a drug free childbirth.

She started to feel like she needed to push very badly, but was still only between an 8 and a 9, not really ready to give birth.  Eventually it got to a point where there was only one edge of the cervix on the side that hadn't gone anywhere.  They kept telling her to bear down a little bit so they could watch what happened to see how likely it was the baby could get past that little bit of swollen cervix that was left, which left neither Bonnie Jean or I certain whether we should be working on relaxing or pushing because we were being asked to do both more or less at once.  That part of labor was extremely painful because we essentially lost control of the relaxation.  Eventually, the doctor felt that she could just hold that part out of the way and the baby could come past it.  The final part of labor was again very painful, none of the "if you push hard enough you won't feel a thing except a mini orgasm as the baby's head clears" the natural birth promoters were promising.  The doctor injected a painkiller on the part of the cervix that was refusing to retract, which helped some, but it was still some of the worst pain I'd heard my wife go through.  Perhaps if she had been given a more realistic option to stand or move around during the final part of the labor process she wouldn't have been in so much pain, but who knows.  Encouraging her to bear down a little bit to see what would happen when they weren't really wanting her to bear down was NOT a good idea from a making sure the contractions actually accomplish something perspective.  They only stopped telling her to do that when they decided that keeping up their little experiment was going to tear her cervix.  If she had an epidural perhaps that method would have been fine because she would have been in less pain and better able to relax or bear down at will.  But when the relaxing has to happen against an extreme backdrop of pain the whole thing was making it harder for us to do anything useful.  And breaking the water might have been ok if Bonnie Jean could have moved around.  They were just hoping that labor would become so rapid at that point that they wanted to be ready to catch the baby.  Perhaps in most cases that would have worked.  In this case, because it involved having to hold still on the labor table it kind of backfired.

In general I'd say if you are considering natural birth go for it, but be ready to be forceful about not being forgotten about stuck to the monitors for any longer than necessary.  If you have a hot tub at your hospital definitely try it out, it was amazing for us.  Don't let anyone promise you a painless paradise of the baby gliding into sight.  If the pain is managed right and there aren't complications forcing you to do things that interfere with the techniques it can be much more comfortable than it might be.  But don't be surprised by or disappointed by a painful labor.

Since the contractions became less productive as soon as we were out it made us wonder about water birth.  We don't care at all about the theories that supposedly since a baby is in a water type environment before birth exiting into a water environment will be better.  We did like how being in a hot tub allowed Bonnie Jean to profoundly relax in a way that she wasn't achieving elsewhere.  The contractions were so effective in this state of relaxation that she moved from a 4 to an 8 in something around three and a half hours.  We don't know if this would be the case at any typical center offering water birth.  But that hot tub, combined with vigorous massage, verbal support, walking, and moving around was a good ticket to effective labor.

1 comment:

Julia - Finding My Way Softly said...

My mom had relatively easy deliveries, including having one of my sisters at home, (on purpose) and two of my siblings in birthing centers. None of my mother's daughters were that lucky. Out of 4 girls, I am the only one who has not had c-sections. All of my non-adopted nieces and nephews have eventually been delivered by c-section, despite their desires for a "natural birth," like my mother had with all of us. I, on the other hand, had high risk pregnancies, was never going to have the option of a water birth or having my kids outside the hospital, but was able to have my kids vaginally (even the twins ) with an epidural. (Although with the twins they placed the epidermal, but never put any medication in it.)

I think your advice to look at your options, and demand not to be forgotten, are very important. I think the two most important things a father can do are to pay attention to his wife and advocate for her, and to support her decisions, even if she is deciding to change the birth plan!

I hope you whole family is enjoying the new member!