slightly worried.

[Aura_Kitten]

i'm planning a homebirth for my second baby, possibly unassisted if i can't find a midwife, and i'm worried that what happened right after my son's birth will happen after this baby's birth. i tore very badly (perinium and cervix, though the cervical tear went unnoticed by my doctors for a year), and i swelled up *down there* so badly i was unable to urinate. i had to have stitches and a catheter, which they left in for two and a half days. granted, this was in a hospital which forced me to lay on my back after i was dilated to 8 cm, i didn't meet the doctor beforehand and they pressured me with drugs until i accepted them, and they told me to push constantly with my legs up in the air, laying mostly on my back, and i pushed for almost 3 hours -- but i'm still worried this could happen at my homebirth and i'd have to call a doctor or go to the hospital.

is this kind of swelling even normal? i had never even heard about it before i had my son and i was absolutely terrified when it happened. is there anything i can do to prevent it, besides having a more relaxed and natural birth?

[Quickening]

Uh, if they made you push like that and in that position then NO WONDER YOU TORE!!!!

The position you instinctively adopt for birthing will be the right one, and you will push when you are ready (or not at all!). There are also other things you can do like perineal massage, taking raspberry leaf extract/tea/pills to tone your uterus and prepare for labour, you can labour in water and even birth in water to take some pressure off.

The severe swelling and tears sounds like a result from being made to push constantly for three hours on your BACK, drugged!! I am incredulous... bloody them, they obviously don't know what the hell they're doing... but you do!!!! Bah, it sounds like hospitals want to drug mothers into compliance! Where's my sniper rifle? hehehe

You will do what is best, have faith in your innate ability to birth naturally without interference : )

If you do tear and you feel it is bad enough to warrant getting stitches, visit your gp for that or see if the hospital will do it for you (i'd leave bubs at home while you run in to get stitched up)

Face your fears, deal with them, trust yourself, work through your fears and have a perfect birth!

[Aura_Kitten]

thanks, Quickening.


as for the drugs, they were horrible! just made me unconscious between contractions and unable to tell them what i wanted and needed during contractions. i think you're right about hospitals wanting to drug mothers into compliance; the other mothers that i've talked with who had the same drug they gave me -- staidol -- all had the same experience.

[pamamidwife]

yes, yes, yes - everything Quickening said!

It will be very different for you this time - pushing only when your body signals you to do so in a position that YOU feel compelled to be in, not a position that is "beneficial" for someone else.

[tinyshoes]

w/ my homebirth, I was suprised at how intense the urge to pee was--but I couldn't at first.

I was freaked out, tried sitting on the toilet w/ rnning water, then tried to pee in the shower w/ a hand-held shower head aimed at my bottom...still no pee.

My homebirth mws offered their catheterization services to calm me (I'm the kind of person that didn't get mad/annoyed at their suggestion, rather, I saw it as a tool & helpful) but by the time I got out of the shower, went upstairs (baby was born on the couch!) to my freshly turned-down bed with my newborn, I tried to pee again and lo and behold--I did, and I could w/ no prob.

Yes, my tissues were swollen, and I'm sure after having a head press on my urethra and tissues my body was a little confused. AND because I was well-hydrated, I'm sure I did have some pee in my bladder.

For me, I just needed to wait 10-15 minutes, relax about peeing (I felt like I had to pee right away so that my uterus could effictivly involute--but that was not a "real" concern; it was a worry I made in my own head.)

Ice packs help reduce the swelling, which is why my mws made some for me and they were ready immidiately post-partum.

I think the human mouth/lips are a good metaphor for the vagina/labia area--it doesn't take much of a punch to cause one's face to really swell up and hurt, and at the same time, the vast blood supply helps things heal very quickly. So in my opinion, pushing out a baby is like getting a physical smack.

A little 'slap' can cause things to swell up, as in my case, and a big ol' punch would cause more swelling (as in klothos case, for example.)

So, like others have said, it is quite unlikely you would endure such severe perineal trauma, birthing safe and sound at home.

And what if you did have some crazy wierd tear or swelling or whatever in your immidiate post-partum? That's okay!

Fears and worries about homebirth are all a part of the journey to home birth, in my opinion. And I am also of the opinion that those "what if's" need to be answered.

Do you have a midwife/GYN that you see for well-woman check-ups? Who noticed the tear--is that a doc that you could talk to about if you homebirth and need assistance post-partum? Talk to your homebirth midwife about your worries, too--maybe she's had experience with the rare tear that needs assitance.

I have a friend who had a HBAC and did tear (in the water, what the heck, but I guess baby flew out of there) and did have to go to the hosptial for stitches. When she told me, I thought it sounded like a huge nightmare--but it wasn't.....her babe was right there, a skilled OB/GYN surgeon fixed her up, she was fed and the GYN ward nurses were wonderful and kind and proud of her homebirth---WHO WOULD'VE THOUGHT!?!?!

(And remember this woman was HBAC, after a classicly unpleasant c-sec birth w/ #1--Pit drip, AROM, oh baby's head isn't moving down, blah blah blah, so she's not a hospital fan AT ALL.)

Empower yourself--"oh jeez, what IF something bad happens" is very different than "boy, I sure don't want X to happen, but if it did, I will do A, B, C, and things will be okay."

Good luck to you on this wonderful journey!!!

[Aura_Kitten]

Do you have a midwife/GYN that you see for well-woman check-ups? Who noticed the tear--is that a doc that you could talk to about if you homebirth and need assistance post-partum? Talk to your homebirth midwife about your worries, too--maybe she's had experience with the rare tear that needs assitance.

i don't yet have a midwife; my only ob/gyn up until this point has been my male md, who isn't really big on the homebirth thing. the cervical tear was dealt with about 2 years ago and according to my dr has healed up pretty much completely by now.

thanks for all your other advice; the analogy is a good one. they didn't offer me the option of waiting for the catheter; but then, at the time my bladder was completely full and i was in agony because they hadn't let me urinate in the two hours before i gave birth. they said, "we'll bring you a bedpan" and i said, "screw you, either let me get up and walk to the ladies room in dignity or i'll hold it..." so i held it for two hours, then coudln't go after i gave birth so they said, "you have to have a catheter now," no explanations, no options. i was terrified!

ugh. :: shudder :: ... hospitals...

[tinyshoes]

oh klothos--it just seems to always suck at the hosptial for one reason or another, doesn't it?!

I keep re-reading your response post--you were only offered a bedpan during labor and you told them you didn't want to use it, they wouldn't let you walk to the bathroom, and they let you go on to birth a baby with urine in your bladder?!?!?!

In my opinion, that's malpractice. A laboring woman should have as empty a bladder as possible, because pee in the bladder interferes with the baby's decent!

No wonder you couldn't pee--you had all sorts of trauma goin' on in your region....it sounds like your body was telling you "pee! pee!" for hours, and when you were finally able to address the call, your body was like, "too late, Lady, we're just going to stay this way now."

Ahhhhhhhhhh, homebirth, with the wild comforts of dignity, food, drink, your own stuff, and your own bathroom.

[Greaseball]

Just remember to not get on your back, no matter what. It is the most dangerous position for birth and almost no woman chooses it when she is allowed to move about freely.

Also, don't push. Better yet, don't have internal exams. This way you won't feel like you have to push when you are told you have reached the almighty 10 centimeters (an arbitrary number, BTW). Babies can be born without effort from the mother. The uterus and its fetal ejection response will do the work on its own time. Pushing against it will just slow everything down.

[Aura_Kitten]

you are all so helpful, thank you.

i knew going into labor that no woman should lay on her back for delivery; i even wrote in my birthplan, which i had given to my (numerous) doctors, that i did *not* want to deliver on my back. nevertheless they said it was "hopsital policy" and that i wasn't allowed to deliver in any other position.

[Greaseball]

There must be something about hospitals that makes people forget their own birth plans. I spent the last 10 weeks of my pregnancy talking about how I was not going to get on my back and that's exactly what I did when I was there.

The only things I didn't go back on were no drugs and having the baby with me at all times.

[Aura_Kitten]

see, the thing is that i never /forgot/ what was in my birth plan. i had just turned 18, i was terrified of hospitals to begin with and extremely intimdated. when i reached 8 cm and they said, "now you have to lay on your back because it's hospital policy..." i said, "why" and they said, "well first let's just check you," and as soon as they had me on my back they strapped the monitor onto me and wouldn't let me get up. i asked to shower, they refused, even though they had offered it earlier in labor. they said women that far dilated should be laying down. the one person i had with me who was supposed to be my support went along with the hospital rules and told me to "just do what they're saying, it's not that bad."

[Quickening]

!!!!!!!!!!!!!!!!!!!

Ack, things like that make me wish i were there at every hospital birth ready to rip into those STUPID MISINFORMED DOCTORS AND THEIR BLOODY POLICIES!!!!!!!!!!

Policy my arse, they sure like throwin that word around like it is illegal to not do as they say! :