May 31, 2011

No Doctors, No Drugs, Lots of Critics

Recently in a discussion about birth, I was asked why I "dog" modern medicine, especially when I could run into breech births, cord pinching, wrapping , bleeding out etc. and what my game plan was.

When one decides to do a home birth, we aren’t rejecting modern medicine. We have made educated decisions to know when and where such things are needed and which procedures we can do ourselves. This applies to all of our medical needs. Self-reliance is important to us and self-reliance begins with education. Whether its a simple head cold or  postpartum hemorrhaging, I have done my best to prepare myself for such things, and I have the information and supplies needed to first prevent, and if needed, to treat such things. And more importantly, to know when to ask for help. Education is important. Ignorance makes you helpless.

I find it terribly sad when I hear women comment negatively about birth. I wonder what could have been done differently so that they had a positive outlook on childbirth. I know its not just luck that I have had 8 wonderful births. That can't be coincidence. And with my 9th childbirth experience just around the corner I find it more important to dispel the fears others have of childbirth. Its impossible to have the good support system one needs when so many are fearful and undereducated.


Why do I "dog" modern medicine? I know that many childbirth complications stem from unnecessary intervention. And this is not just my opinion. Inductions are common. Induction greatly intensifies contractions increasing the mother’s pain and fetal distress. Then we have the introduction of epidural. While these relieve the mother of the intense pain temporarily, they prohibit her from birthing naturally. She is usually at this point forced into a non-productive birth position.  This increases her chances of tearing, prevents the baby from descending into the birth canal properly and causes fetal distress. In many cases, had the women been left to start labor on her own and was given the education and support to labor without such drugs, the birth would have gone smoothly. The WHO and other organizations state that the rate of necessary intervention in birth should only be around 10%. Our c-section rate alone is near 50% in some hospitals. These do not stem from natural birth complications rather human interference in a natural process. This is one of my biggest issues with the way we give birth.

One thing that caught my attention was this comment
 "but my obgyn put it plainly when he said we don't perform surgeries or give stitches without some form of anesthetic why should you pop out babies without it."

This points out exactly what is wrong with the way we view birth in America. Birth is not a medical event. It is not surgery. It is a process that Heavenly Father has blessed us with. I have a separate blog post that goes into detail about that. But the idea that babies cannot be born safely without the assistance of a medical professional is a self-destructive thought process. Why should we follow the medical community with blind faith. Why must we take such a beautiful and natural process and make it a frightening medical event. Why do we refuse to take the time and energy to learn as much as we can when it comes to the birth of our most precious gifts. People spend more time ( and money)  and research shopping for a car then they do when it comes to the birth process of their own child.

The first thing any woman who is preparing for children needs to do is take control of her health. Many birth complications can be prevented. Its is the mothers responsibility to make sure she is in the best health possible during her pregnancy. Proper nutrition is key. Prepare your body not only to grow a baby, but to prepare for labor. Keeping your diet balanced can greatly reduce if not eliminate hypertension. Hypertension contributes to about 10% of labor inductions. A high iron diet esp late in pregnancy can help reduce the risks of hemorrhage. Why wouldn't you do all you can to insure the safest delivery possible, even before it begins.

Childbirth in any setting is not without risks. And many will say, well why not just birth in a hospital, just in case. Well,not everyone is comfortable in a hospital. I am one of those people. One thing we need to remember is that babies sometimes die in birth. It doesn't matter where the mother births, its a tragic fact of life. The concern is that if she is at home, it will be blamed on the fact that she home birthed. If she is in a hospital, its just one of those things.

So I want to address common "birth complications". How they usually arise and what my course of action as a home birther is.

Fetal position and cords. Breech presentation as well as posterior and transverse are all normal fetal presentations. These usually only became "complications" when the doctors put women on their backs to birth. The lithomy position hinders the ability to deliver these babies successfully. If a baby begins to present itself in a non-productive position, the mother is advised to change positions to see if the baby can turn. The most ideal position for birth is squatting or hands and knees. As an example, a full face presentation delivery, in most cases depends on if the baby is facing up ( sunny side up--chin towards moms belly button) or not. Sunny side up, or Angel Faces as some call them, can be safely born. If the baby is posterior face first, a safe vaginal delivery is unlikely. This is extremely rare. I would try an inversion to see if the baby could turn its head. If after a few minutes this does not look like a deliverable position, you would then prepare for transfer.

One of the most common birth complications I hear is " the baby's cord was wrapped". I have done alot of research on this one. It sounds terrible to someone who has little or incorrect information on umbilical cords. The umbilical cord is an amazing thing. Heavenly Father knew babies would enjoy the water bubble he created for them and know they would move, twist and turn and even play with their cord. They get it wrapped around their hands, feet, neck. This is all normal. A cord can even stand pinches and knots. A little bit of research on nuchal cords will provide more than enough information to show that it is not a complication, rather a normal part of birth.
From the March of Dimes
What is a nuchal cord?
About 25 percent of babies are born with a nuchal cord (the umbilical cord wrapped around the baby's neck) (1). A nuchal cord, also called nuchal loops, rarely causes any problems. Babies with a nuchal cord are generally healthy. 
 
Sometimes fetal monitoring shows heart rate abnormalities during labor and delivery in babies with a nuchal cord. This may reflect pressure on the cord. However, the pressure is rarely serious enough to cause death or any lasting problems, although occasionally a cesarean delivery may be needed. 
Less frequently, the umbilical cord becomes wrapped around other parts of the baby's body, such as a foot or hand. Generally, this doesn't harm the baby.
There are two concerns with cords. One being a "True knot" these are often quite rare. This can be delivered safely and often, the calmer the delivery, they better for mom and baby.  The biggest concern with cords is prolapse. There are two schools of thought on this. One is that a c-section is the only option. The other is to one push the cord back inside and try to deliver the baby quickly. Again, an inversion would be my first solution. Even if you do decide to transfer, hold the cord inside and sit with your bottom elevated. One way to avoid this is to delay breaking of waters. Most hospitals will rupture waters as a way to "move the birth along". I strongly advise against this.

Hemorrhage. Prevention of hemorrhaging begins during pregnancy. But the risk is increased by interventions in labor. DO NOT FORCE OR RUSH THE PLACENTA! This is a very common reason for hemorrhaging. Forcing a mother to push a baby when her body is not ready or forcing birth by pulling on the baby can increase risk of hemorrhage. ( this is more common in hospitals where the L&D staff are in a hurry) After birth a mother is encouraged to nurse. This is not only beneficial to the baby, but to mother as well. Nursing stimulates painful but, ESSENTIAL uterine contractions. There are occasions where the bleeding is severe. This was the case with my 6th delivery. I bled heavily an hour after birth. The reason for this was due to my neglect to use my better judgment when it came to pain pills for a dental problem I had a week prior to delivery. Fortunately my body recovered on its own, most likely from the intense nursing Olivia did after her birth. In most cases a compressing massage of the uterus and emptying of the bladder will reduce the bleeding. ( that’s why they tell you to pee after birth!!) If needed, most midwives carry Pitocin for this treatment but consumption of the placenta will have a similar result. It is very rare a blood transfusion would be needed. In this case a call to the hospital to prep would be done and they would be ready by the time we got there.

Baby not breathing.  While its ideal the infant take its first breaths right after birth, they do have a few min window. The first thing I do when my babies are born is I hold them with their head lower than their body. You can see here with Ezra. We also delay cord clamping. This gives them the opportunity to have all the oxygen rich blood supplied by the placenta. We clamp the cord when it turns white. Laying the infant skin to skin in mother’s chest and rubbing their back will help stimulate breathing. If you can have oxygen on hand, but if you don't, you can stimulate breathing with your own breaths. I urge every parent, not just home birth parents to know CPR and resuscitation. Kangaroo care has proven to work, even in cases where medical interventions did not.

Neonatal Complications. The "fire drill" procedure they do with a newborn actually creates problems. They grab the newborn, cut the cord asap ( cutting off oxygen) then give the baby oxygen, they put the baby naked alone on a scale and measure and weigh etc. Then they rush to get the newborns temperature back up. To me this system is cruel. It is much more important that my newborn nurses and feels my touch immediately after birth than it is to know how much he weighs or how long she is. As soon as the baby is born they are placed on my chest, skin to skin, cord intact. If the infant needs anything, it should be done while on the mothers chest. Suctioning etc should not be a standard procedure. All of this trauma can interfere with bonding, nursing, etc. Not to mention, that its pretty harsh to do to a newborn.

I know there are more "What ifs"..  These were the most common, so they are the ones I addressed.

I do want to say that I had a wonderful hospital birth with my first. It was wonderful because I had a midwife and a birth friendly hospital. While I was aware of a few things I didn't want done, I  was also ignorant to a few procedures. Ignorance is bliss. I then went on to have 3 midwife attended home births. With our 5th child we decided to go unassisted, or unattended. It was just a decision we decided was best for us. We didn't feel the need for a midwife. And we continued that with our other births.

 We choose home birth for two reasons. First, a hospital does not provide the setting that is conducive to a peaceful birth. Especially if the mothers labor is a long one. A 2-3 or more day labor isn't usually allowed in a hospital, and if it was do you really want to spend that long there. It also doesn't provide the freedom one has at home. At home you can walk around dressed how every you feel comfortable, you can lay in bed, you can lounge on the couch, you can raid the fridge, you can take a hot shower or bath.  We all feel most comforted at home. The more relaxed you can be, the easier labor becomes.

The second reason is intervention. Whether it be someone just touching me or telling me what position I need to be in, or trying to use medical procedures, I don't want to be bothered unless I ask you. I prefer a hands off method for both me and my child unless there is a need.

 I do not expect everyone to choose a home birth, but I want to dispell the myths and fears that surround it. There are so many who cringe at the thought of a homebirth, and they do it based on false information. Most people who who tell me how dangerous it is haven't done any research on the safety factors of home-birth vs hospital birth. The have this preconceived idea that home birth is risky and dangerous and the safest place to be is in a hospital. My first question is why would childbirth, being so vital to the plan of salvation, and the continuance of the human race, be so inherently dangerous that it would be contingent on the interventions of modern medicine? And if so, how did we possibly get to the point we are at? Its no wonder more and more women are choosing to have fewer children, if they have them at all. Its because birth is feared, not revered.

We as women are being told that we are not capable of bearing children on our own. That our one divine and biological duty, and we just aren't good enough to even accomplish that. How insulting it must be to be told that you cant give birth on your own, but your dog sits there with 9 puppies she delivered in the quiet of the night.

Birth is an experience, not a medical event. We shouldn't fear birth. We need to put faith in God. We need to put our faith back into ourselves. Doctors don’t deliver babies. Women give birth.

10 comments:

  1. I'm a week away(about) from having number nine! Loved your post.

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  2. Thank you!! I am about a week away from my 9th child as well! :) Good luck to you!

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  3. I enjoyed reading this post, even though I prefer to deliver in a hospital. I agree that educating yourself is key to helping things go as smoothly as possible.
    I think we do need to enable mothers to accept birth as a natural process and not a medical procedure as well.
    I am expecting #11 in a couple of months and I'm really looking forward to the whole experience. Unfortunately, I have medical issues which prevent me from delivering at home. Fortunately, I have always been blessed with wonderful OBs and midwives who have all helped make each birthing experience as relaxed and safe for me and baby as possible.
    I'd like to know what your other blog is called, off to see if I can find it!
    Thanks for sharing. :)

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  4. I absolutely LOVE your thoughts about birth! It *IS* insulting to have the medical "establishment" telling me that I am incompetent to do something that I am biologically -- anatomically -- outfitted to do! Plus, I love that you have shared the "what to do" information. It's very heartening to know that there are plenty of things I can do for myself and my child if a need arises. It eliminates the worry, which eliminates a great deal of the likelihood that something actually WILL go wrong. I'm in the process of putting my mind at ease, and your blog has really done a great deal to get me there. THANK YOU!!!

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  5. Thank you, thank you, thank you for this. I feel like so many of us are repeating ourselves, saying all this until we are each blue in the face, but it still bears repeating, and you have done your part. Good stuff, mama.

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  6. Thankyou for such inspirational advice on birthing! One thing though, I was quite shocked to see so many of you with such large families (perhaps because I am not religious I haven't been exposed to this before). I come from a large family, and while I would also love to have many of my own kids, I am very concerned about the pressure we are putting on this earth! I mean if we all went around having 9 kids the planet wouldn't last long! Does this concern any of you and if so how have you reconciled it within yourself?

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    1. I love your concern for our life-giving earth. I feel that education, not limitation is the answer to your question. When you think of all the new techniques that are flooding the agricultural area, such as aquaponics and vertical harvesting, we are nowhere near to the capacity that our earth can handle. We just need to produce children who respect it and are intelligent enough and creative enough to believe in themselves.

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  7. What about if you are diagnosed GroupBstrep positive. That exposure can be dangerous to a baby

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