Tuesday, August 11, 2009

Two kinds of births

When it comes to birthing babies, I've done it both ways: super-duper medicalized and the as-crunchy-as-it-gets-in-a-hospital. Both of my babies were breech, and since #1 (Z) didn't turn head-down, I delivered her via a scheduled C-section. Pretty much no one delivers breech babies the old-fashioned way, and as much as I wasn't into the knife, I also wasn't interested in pushing the boundaries of safety only to suffer through a breech delivery.

Anyway, November 5th arrived and with it no labor and no pushing. I just showered, dressed and showed up at the hospital, where they took gave me a nightgown, took my vital signs and wheeled into the OR. Forty-five minutes later: baby!

It wasn't what I wanted, but it was fine. The operation went off without a hitch and my scar is nearly invisible. I endured a rough couple of days in the hospital since I had a bad reaction to the spinal anesthesia and my sleepy newborn lost enough weight that breastfeeding her involved taping formula to my chest for supplemental feedings. Still, a week later I was pushing her stroller around the block and she was nursing like a champ.

When I was pregnant with A, I knew from the start that I'd want a VBAC (vaginal birth after cesarean). Only my second born also favored the heads-up position. Fortunately an external version got her turned vertex and my midwives gave me the go-ahead to wait for labor to kick in.

A couple of days past my official due date, labor started. My first contraction hit at 9:40pm, just as I was going to bed. I stayed up all night, groaning, rocking on a ball and hugging a huge pile of pillows. At 9am, Josh and Trisha (my doula) accompanied me to the midwives' office, and since I was at 7cm, they waved me on to the hospital. You can read the whole birth story here, but suffice it to say I had enough time left to try every non-pharmaceutical labor enhancer and pain reducer before A finally showed her head--a full day later.

Natural childbirth was everything I'd hoped for and more. A whole lot more. I knew the pain would be intense, but I didn't know it would last. So. Long.

An epidural might have helped me since it might have provided me with enough relief that I could have rested a bit before pushing. But I didn't want an epidural because so many women have said yes to the epidural only to have their labors stall. Stalled labor is treated with Pitocin, and those Pitocin-driven contractions call for more pain relief. Intervention follows intervention and too often ends with a C-section. I'd had a C-section and I didn't want another. Particularly after I'd already done so much of the hard, physical work of labor.

What I'd wished for then was just a little relief--something to help me get through that awful period of transition. Something like the nitrous oxide that got my sister through her labors nearly medication-free. Nitrous is a common pain relief medication for laboring mothers in England and Australia, but it is virtually unknown American birthing centers.

Dr. Mark Sloane, author of Birth Day, advocates for the adoption of nitrous oxide and doulas in the delivery room, describing this country's overwhelming reliance on a single kind of pain relief an "epidural monoculture." I read Birth Day as a part of the Silicon Valley Moms Group Wednesday book club. Head over to my local Chicago Moms Blog tomorrow to a wrap-up of posts inspired by the book.