When a baby is conceived it is a very private, very emotional, very bonding experience. A good birth will involve these things as well. The time and place where you bring your baby into the world needs to be a place you feel comfortable and safe. For some, that place is their home. Others would not feel safe at home and so they should not even conciser a homebirth. When you tour the birthing facility, not only get acquainted with it, but also get comfortable with it.
Go as drug-free as possible. In my opinion, drug-free is the best way to go. Alternative ways to cope with the pain include having your husband press on your hips- squeezing the top of your pelvis- also called the Bovine Squeeze since people stole the idea from laboring cows!, or laboring in a hot tub. (I've heard more than one person say that hot water is better than an epidural!) But my all time personal favorite pain managing technique is making out. No idea why, but when Nathan kissed me, any pain (there's that word again... can't think of a good alternative... unpleasant intensity?) just melted away. It was the weirdest sensation. I could feel the contraction begin, feel it building, then Nathan would start kissing me and it just melted. Again, I HIGHLY recommend that one! Other things that can help make birth more comfortable and relaxing are massage, bouncing on a birth ball, low lights, relaxing music, and soft scented candles.
Other benefits of going drug free are that you are better able to understand what your body is trying to tell you to do: walk, stand still, sway, moo, squat, pseudo belly dance, whatever. Sometimes bodies give some really weird instructions during labor, be sure you pay attention and are ready to go with whatever you and your baby need. Plus drug-free is so much better for the baby!! Any drug that makes its way into your bloodstream has, by default, also made it into your baby's bloodstream. The placenta holds nothing back. In this case that's a problem because once a drug is in your system your fabulous kidneys begin removing the drug immediately so your dose begins to be reduced almost on impact. However, a baby's kidneys still have a ways to go before they are able to function. Birth drugs have been found in babies' systems as late as one month after birth. I often wonder if birthing drugs are the reason so many people say their babies aren't very responsive till they're a month old. (All the brand new babies I've ever held were drug-free and pretty alert. But since I have no other babies to compare them to, my “alert” might be another persons' “unresponsive?”)
Get a Douala. A Douala is not a replacement for your husband, she is your personal, private birth guru to make sure you, your husband, and your baby are cared for in the way you want. Your husband is there to support you. A Douala is there to be your personal expert on all things birth. She is also there to interface with the staff. Remember, for the people who work there, this is their job. When they get up and go to work, this is what they do. If you want something that is uncommon (like walking while laboring, or not wanting the staff to mention an epidural, you know it's there, if you want one, you'll ask!) there's a chance the staff might forget and accidentally give you their “standard” birth. Your Douala will go over your birth plan with you, talk you through hospital protocol, and explain any hospital practices or policies that you have questions about. When you go into labor, she will meet you at the hospital and stay with you through your whole labor and delivery. Most are also trained to help facilitate breastfeeding (if you are planning on doing that.) Having that one same professional with you start to finish can be worth hiring a Douala, forget all the other awesome stuff they do! Hospital staffs are on a rotation and they go home when their shift is over. Your Douala can get the new nurse up to speed on your labor and your wishes without having to interrupt you and your progress. In case you haven't noticed, I am a huge fan of Doualas. They are even great for home birth. They provide a wealth of knowledge, a huge support (sometimes Dad needs someone to talk to during labor, “Is this normal? What's happening now? Are babies supposed to be that color?”) plus they are a friendly face who believes in you and in the birth process. =)
Ask for delayed cord clamping. This one is really hard to get doctors to do. Not because they don't want to but because it is such a habit and so hard to catch before it's already been done. All the blood in the cord and placenta is the baby's. As they are being born they are still relying on you for their food and oxygen. That means their blood has been leaving their body, traveling to you, then returning. When the cord is allowed to stop pulsating before it is clamped that means that the baby's body has stopped sending blood to the placenta. When a cord is clamped right away a baby loses a high enough percentage of their blood that it can make their recovery from birth more difficult that it needs to be. The other benefit to delayed cord clamping I got to see firsthand less than a week ago. My girlfriend had a baby that required resuscitation. When she was born she had no interest in breathing and it was a very scary minute? Five minutes? That they worked on her. However, her cord had not been clamped and so the whole time she was getting oxygen through her placenta, just as she had her whole life previous to that point. Her heart rate remained strong the whole time; she just didn't want to use her own lunges. Had her cord been clamped, she would have been without oxygen that whole time and would probably have ended up in the NICU, but, as it turned out, she just took a sec to catch her breath. Then she was fine. All thanks to delayed cord clamping. =)
Wipe off the eye goop they will put in your baby's eyes. It's done just in case you have gonorrhea as that can cause blindness if a baby gets it in their eyes during birth. If you and your husband have an exclusive relationship, you have zero risk of having gonorrhea. But since we live in such a promiscuous culture, birthing facilities are required by law to give eye goop to all babies, just in case.
There are a myriad of positions that can help labor progress and encourage dilation. Laying flat on your back is not one of them. This position is left over from the days when women couldn't deliver on their own and this was the position easiest for the doctors. But when you are flat on your back, the angle of your spine as it connects to your pelvis makes your baby's trip through the birth canal an uphill climb. Birth is hard enough without having to fight gravity. A few positions that take advantage of gravity are standing, leaning against a wall, sitting on a birth ball, sitting on the toilet, and squatting. Avoid a low squat, but one where your thighs are about parallel with the floor can actually give you an extra centimeter or two! You can sit on the edge of a chair or have your husband or Douala squat too and sit on their thigh with your arm around their neck. You don't want to do anything that is going to wear you out, let your husband be your support physically as well as emotionally. One of my favorite laboring positions is hanging by my arms. Some birth facilities have birth bars (they look kind of like the rails in handicap bathroom stalls) but if they don't have one you can always hang on someone's neck. I did a lot of hanging on Nathan's neck for Bree's birth. (To be honest, that was one of my favorite parts of that labor. There was something really powerful about having Nathan support me so much physically.)
You don't need to be strapped in bed to the fetal heart monitor. First off, any time you move it messes up the reading. (And moving is SO important during labor!!) They might try to give you an internal monitor which can be more reliable, but for that they literally use a screw to attach a wire to the top of your baby's head. Without any numbing agent. (At least not when last I heard.) And once your baby is born the puncture can get infected. I have no idea why this practice was even developed in the first place. Eww... So, suppose you are happily laboring somewhere other than the bed and someone says that they really need you back in bed so they can check your baby's heart rate. (I do support checking the heart rate! It's easy and a great indicator of fetal stress!) Tell them to get the hand-held Doppler. Remember, you are the one in labor, you know what your body needs to be doing. Let them do a little to make this process easier for you.
A little more on relaxing during birth:
It is vitally important to relax during labor because it is literally impossible to birth while anxious. In the wild, pregnant animals have a “fight or flight” instinct that halts labor. If a gazelle is in labor and a lion appears on the horizon, her labor will stop, allowing her to find a safer location, and her labor will resume. That same instinct is at work in human mothers who are uncomfortable with being poked, prodded, hooked up to machines, and put on display for med-students all while she lays half naked strapped to a bed. (Luckily this is no longer the only face of birth available in the US! As I said earlier, hospitals have come a long way in improving things!) When the “fight or flight” instinct kicks in, the muscles on the bottom half of the uterus clamp down to halt the labor. If a woman's labor slows, hospitals are in the habit of administering pitocin to speed things up. This causes the muscles at the top of the uterus to start working overtime. In this situation the woman's body is literally working against itself, trying to keep the baby in AND push it out at the same time. This is amazingly painful. It can actually get to the point where a cesarean is required because the uterus has been locked into an amazingly tight knot.
Honestly though, even in the best case scenario, pitocin is still really hard on your body. When your body is gearing up for birth naturally, it starts things slow and works up to full strength allowing you to slowly get more and more focused on the task at hand. The best way I can describe this is that my body takes my brain away. Any thought for the goings-on around me are totally forgotten and my entire focus is bent on working with my baby to bring him/her earth side. As this ramping up progresses, distractions (pulling my focus back out, onto my surroundings) can cause contractions to be more painful than when I am able to ride them out in my own internal process. Pitocin works the opposite way. The initial contractions come on very strong, and as your kidneys do their job of removing the foreign substance from your bloodstream, the intensity diminishes. So natural labor starts slow and increases in intensity while pitocin hits you like a ton of bricks (as one of my friends described it) and looses strength from there. With pitocin there is no “gearing up” to help your body prepare.
So that's everything I can think of! Thanks for sticking it out! ;-) It is such an exciting time to be alive! Right now the old knowledge of midwifery is once again becoming available and at the same time we have amazing hospitals that are able to step in when things go wrong! I think it's pretty cool. =)
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