By Nicole Lundrigan
Issue 103, November/December 2000
When I was 15 years old, my sister gave birth to her daughter in a hospital following a 25-hour labor confined to a bed with an IV and an ever-beeping machine. In my mind, I was a terrific labor coach--kneading her lower back, offering her ice chips, and simply being a reassuring and very excited presence during those very long hours. My sister made it clear to the on-duty nurse that I was to accompany her into the delivery room. But after painkillers were administered, my sister got very fuzzy and was no longer able to insist on her wishes. Rudely, the nurse instructed me to step outside--I wasn't needed. My niece was born a little while later, as I was sitting on a wooden chair out in the bright yellow hallway.
Ten years later I discovered that I was pregnant. One morning, after waking to light spotting, I went to my campus clinic for a blood test to ensure that I was not having a miscarriage. A few days later I got a call from a nurse, who informed me in a hushed tone that yes, indeed, I was pregnant. No, "Congratulations." Only, "When can you come in to discuss your options?"
These were my two experiences with medicalized pregnancy and birth. Naturally, I decided to look elsewhere for my prenatal care.
Following the wonderful advice of a friend, I went to visit a midwife. Her office walls were covered with a multitude of photos of babies she'd helped to deliver. I knew I had made the right choice. The visit was relaxed, the midwife showed genuine excitement for my news, and each of my long list of questions was given careful consideration. When I left that day, I was filled with thoughts of natural childbirth, potentially at home.
My plans were met with a great deal of skepticism from others. Words such as irresponsible, ignorant, and downright crazy were not spared. Can you have an epidural at home? You will not be able to handle the pain. What about an episiotomy? You'll surely need one of those to get the baby out. People commented that I should let the doctors handle it--they know how to deliver a baby. What could a 25 year old possibly know about that?
I had to look beyond my generation, beyond my mother's generation, and into my grandmother's generation for support. Lacking the multitude of books on pregnancy, labor, and childbirth, these women had an unwavering confidence in their own capabilities. Time restraints on the second stage of labor were not imposed on them. They were knowledgeable in labor and delivery (enough to know what was safe and when complications were arising), confident in their bodies, and able to trust their maternal instincts. They did not have to refer to a chart. Labor and delivery, even breastfeeding, weren't hidden away from children or young adults. The process was natural.
Today, it seems that a tradition of womanhood that properly belonged to women themselves has been replaced by a tradition of technology.
I confided to my grandmother that I was planning a water birth. For me, it was the logical choice to include water in the birth of my daughter. My medicine chest is practically empty; my bathtub is frequently full. For a headache I don't reach for a pain reliever, I reach for the faucets. When I'm fatigued and cannot sleep, I add a little lavender oil to the tub.
My grandmother felt that birthing in water would be very relaxing. She was confident that I could handle the pain, and ensured me that the discomfort was normal, healthy, and very exciting. She told me of her labor, and the fact that she had made raisin bread to calm herself. The standing helped her labor along, and the task at hand kept her mind off the contractions. While the bread was baking, her son was born. That seemed like a far cry from the hospital experience I had witnessed.
Now that I knew that birth did not have to be an institutional "procedure" I began to read everything that I could on natural childbirth, homebirth, and water birth. I concluded that a delivery without intervention is definitely safer--and that's more likely to happen at home.
I also learned that some doctors prefer to induce pregnant women, which can lead to complications during delivery. When a labor is not going according to a statistically defined schedule, a cesarean section may follow. When an epidural is administered, not only may the baby be affected, but labor can be prolonged, blood pressure can drop, chances of a cesarean increase, and forceps or suction are often needed. The use of water reduces pain, providing a safe alternative to an epidural, and the benefits for both mother and baby are numerous.
I became very determined that the birth of my child was going to be a gentle affair, not a hospital sideshow. It would be an exchange of love between my husband, our unborn baby, and myself. In the end, it was exactly that.
Many people had questions and concerns about water birth. (Others did not want to hear a single word about it until the entire delivery was over. I must say that I appreciated the questions much more.) One of them was, "What if the baby starts to breathe underwater?" I learned that this is extremely unlikely. Research shows that breathing is stimulated by contact with the air or exposure to an extreme change in temperature. I knew the water should be maintained at around 99o F. In part, this was to prevent my becoming overheated during labor, but it is also a temperature that comes very close to the amniotic environment. When my baby emerged, there would be no temperature shock and no exposure to air, so she would not breathe. It should be noted, however, that if a baby's head goes above water level as the mother moves during the birth, care should be taken to ensure that the head is never resubmerged.
Infection is also a common concern for people contemplating water birth. I was giving birth in my own home, where the germs were familiar and posed minimal risk. Water dilutes germs, making a water birth potentially less risky than a "land" birth. Water need not be sterilized like the instruments in a delivery room: if I could drink it, I could give birth in it. I suggested that we have a rinse pail available for people's feet if they planned on getting in and out of the tub frequently, as at several points during labor and delivery my husband was in the tub with me. The student midwife also stepped in the tub a couple of times when I was interested to learn how far I had dilated. At one point I left the water, and the "land" contraction almost floored me. So I decided to pass altogether on leaving, and the student midwife did not mind putting on a pair of shorts and stepping in.
Although there may be less blood loss during a water birth because of reduced stress on the body, it's difficult to estimate any blood loss because the blood is diluted in the water. I worried about this and decided that I would exit the tub immediately if the water became cloudy or obviously colored with blood. As a precaution, I planned to deliver the placenta outside of the tub. That way my midwife could more definitively assess blood loss and watch for any signs of continued bleeding.
While I was aware of these concerns during my labor, I welcomed sinking into the warm water of the ocean blue birthing tub. As soon as I touched the water, I relaxed. It was as if I was given a liquid epidural. My stress level diminished immediately. I had not realized how tightly the muscles in my legs and buttocks were until I entered the water. My jaw unclenched, my contractions were smoother, and I found it much easier to concentrate on my husband's soothing words during the difficult contractions. I could change positions easily. Often my husband supported my neck and helped me to float between contractions. The water became a comforting blanket that enveloped my body and put me at ease.
I had total control during the pushing stage, as is common for women who give birth in water. In fact, I don't recall actively pushing the baby out. It was as if my body took over; it knew exactly what to do. The baby helped a little bit, though, as she was pushing with her legs. The delivery was slow, and my perineum stretched gradually. There was no tearing, just a couple of minor abrasions--again, a common benefit of a water delivery. In hindsight I wondered if doctors would have opted for forceps or suction, as the pushing stage was longer than the statistical average.
The baby's heart rate remained perfectly normal the entire time. As she moved from one warm liquid environment to another, the transition was minimal. Sophia never cried. She simply opened her eyes and looked around at her world in a state of quiet awareness. With the rising sun casting an orange glow into the room, she looked absolutely beautiful.
For me, the key to a healthy and natural childbirth was knowledge. My labor was not an easy or painless one by any means. In fact, I moaned so loudly that the neighborhood dogs joined in. But I recognized that the pain was normal--the stronger the contraction, the closer my baby was to being born. I worked very hard to keep the pain where it belonged--in my abdomen not my head.
Many women underestimate their own capacity to give birth and rely too heavily on the technology that exists. When people state that a doctor delivered their baby, it completely nullifies the hard work of the mother and father. My husband and I delivered our baby right here at home with the unobtrusive assistance of our midwife. It was the most remarkable moment of our lives.
Nicole Lundrigan is a recent graduate of the University of Toronto. She writes that she and her husband Zoltan are discussing having their second baby. "Sophia will be two in a couple of weeks, and I often reflect on the moment she was born. It truly is a life-changing event. I feel so sad to hear women reflect on the labor and delivery of their children with a combination of horror and anguish. Although they love their children dearly, it's almost as if the birthing event itself needs to be grieved."