Birth Plans

With the infant invasion looming, I finally started to think seriously and in more detail about what the birth process was going to be like, and what I wanted from it. Like pretty much every American in my situation, all I had ever seen of birth was what I got from movies and TV shows, and those were all either highly dramatic, with women in crisis being whisked into the OR as the husband is left behind, or played for comedy with the wife threatening her husband for getting her into this mess in the first place. And really, that's pretty much everything I knew about birthing: you go into labor, are rushed to the hospital, you scream, maybe make some witty remarks, and then the baby gets pushed out.

Alex and I went into our childbirth preparation class without a lot of expectations. I hoped that we'd learn a little about what we should expect and unexpected things that might happen, and knowing about them ahead of time would keep us from freaking out. Still, I figured: labor, scream, baby, done. Probably an epidural in there somewhere, too.

It wasn't until after our first class that I realized that hey... this is kind of a big deal, with a lot of decisions to be made. I started looking things up, got a few books, and (belatedly) tried to learn everything I could about the whole thing. I was lucky enough to stumble upon some women's stories of their experiences that seemed appealing to me, and then I got Your Best Birth: Know All Your Options, Discover the Natural Choices, and Take Back the Birth Experience, and that's when things changed for me. It's by Ricki Lake and Abby Epstein, and is basically the companion book to their documentary, "The Business of Being Born," which has been described as being the Inconvenient Truth of birthing. If anyone is actually still reading at this point, you're probably thinking, "Um, maybe taking advice from Ricki Lake isn't the best idea." And I swear, I'm not drinking the give-birth-in-a-yurt-and-wrap-the-baby-in-buffalo-skin Kool-Aid, although I do have a lot more respect now for people who choose to go different routes. And I do have some problems with the book; I don't think that it was a particularly rigorous or balanced study and I think that statistics were massaged and spun a bit. Still, the medical professionals aren't playing fair either, so I'm okay with it having an agenda and promoting it.

The majority of women go into the hospital, and the nurses and doctors tell them what to do. You get Pitocin to speed up your labor if the doctor says that you're not progressing fast enough, and you get the epidural because the nurses say that pretty much everyone who has taken Pitocin does, and if you aren't able to give birth within a few hours of that, you get a cesarean section because the doctor says that's the safest way to deliver the baby. Why wouldn't you do it this way? They're the professionals, right? And how many women know that there are other options?

Unfortunately, I still only have small bits and pieces of the story, but I'm pretty damned sure that the way birth is handled in the vast majority of hospitals is not the best way for every woman. The C-section rate in the US is over 30%, which is insanely high. There are a lot of factors in play, including malpractice liability pushing doctors to perform them and the fact that it only takes about an hour to perform a C-section from start to finish. Having Pitocin induced labor and having an epidural are both associated with a higher likelihood of having a C-section as well.

I don't want to get into too many details and statistics about the other drawbacks of having an epidural, but after learning about all of these things, I've decided to try as hard as I can to give birth without one. Now that I've made that decision, I'm wondering if I can do it. We can't afford a doula*, and as much as we learned in two childbirth preparation classes, the whole situation is going to be completely alien to both of us. And, 90% of the women who give birth at my hospital end up getting epidurals, so I'm guessing that the doctors and nurses will be coming in periodically asking me if I want one yet, since everybody else gets one. Will I be able to keep saying no when I'm in agonizing pain? I really don't know. At any rate, even if I do end up with interventions like the Pitocin, epidural, and C-section, I'll know that at least I know that I have a choice, and what those choices mean. And that's a lot farther along than I was two weeks ago.

*A labor doula is an assistant who can provide non-medical ways to deal with pain and anxiety during birth (like positioning, exercise balls, massage, breathing, and acupressure) amongst other things. Doulas are often involved in pre- and post-natal care, too.