Would you tell your friend she has no chance at the birth she wants? UPDATE! posts 35 & 36 & 41

[myfairbabies]

I have a pretty close friend that I have watched kind of transform over the last year from very mainstream to crunchier and crunchier. She bought my baby pacifiers 8 months ago, and 2 weeks ago made fun of the people that gave her pacifiers at her baby shower. She used to think breastfeeding was something to be done in private, now she talks about nursing her future toddler. She is stocked on sposies and today she asked me about cloth diapers and said she thought they would be better!

She is 38 weeks pregnant with #1 and within the last 3 weeks has decided she wants a natural birth. The OB she chose (I think because her sister used him) won't let her go past 41 weeks and when she told him she didn't want an episiotomy, he said that he would "try" but that they probably wouldn't be able to avoid it because most women need one. She and her dh just made out their birth plan and it's full of things that I KNOW will not happen with this doc, or are extremely unlikely. DH wants to catch the baby, she wants a natural birth, they want to delay cord cutting etc etc. I mentioned to her a few days ago that the hospital has a great midwives program that is who I transferred to when our homebirth didn't work out, and that I know lots of people that switch this late in the game. But for whatever reason, I don't think she's interested in changing docs. My dh and I tried to tell them the other day that their doc was not going to be cooperative their plan, but I don't think it sunk in. At one point she mumbled about how it probably would be better to just have the baby at home, but it would be pretty expensive at this point. I just know they will be disappointed, possibly end up with a c-section or other traumatic birth when it might be avoided. I let her borrow some mothering mags and Birthing from Within (l'm looking for my Ina May books too) when she asked me the best way to prepare this late for a natural birth. I also told her to hire a doula if they could, and to stay home for as long as possible (among other things). Should I be more blunt about it? From reading this, it sounds like I have done enough, but I feel like I could have been more straightforward with how unlikely it is and that if she chooses to stay with this doctor, she should just accept a different kind of birth. DH thinks I should not say anymore, they'll have a bad experience, and then they'll be prepared next time. I just don't want to see them get hurt, because I had a traumatic birth. What do you think? Shut my mouth?

[lovebug]

this is a hard one. i have the other side of the fence and WANT a HB, but everyone feels the need to tell me the dangers of a HB and what not. its funny how its 'ok' to blab the dangers of a HB to someone who wants it, but you have to shut you mouth in this situation...

if it were me i would ask her how much she REALLY wants this. if she say something like "i want this so bad it hurts" or whatever i would tell her your thoughts. but make sure you point out you are only doing this because you want to support her.

i am sure others will have a more wise POV. but i think supporting her and helping her put the plan into action (even if that mean moving to a MW) is the best way to go about it!

s and good luck!

[rainashine]

I'm a mother that no one said anything to and ended up with a c-section. If you don't think she's really heard you I'd write her a very blunt email and end by saying you won't bring it up again but you are available is she has any questions. I wish someone would have said something to me. So many people did after the fact but not one did beforehand.

If she sticks with her doctor, that's her choice. If she has the terrible birth you think she will, don't say a word. Hug her and listen to her and help her prepare for next time.

[Romana]

I think that the most important and determinative factor in whether a woman gets a desired NCB is who her HCP is. And I tell anyone who is interested in NCB that. So I would be very straightforward and tell her in a kind but very honest way, saying, "I care about you and I just want to see you able to have the kind of birth you feel is best for your baby. I completely understand if you decide to stay with your OB, but in my experience it would be very unlikely for you to be able to have a NCB with this OB, based on what you've said about him. There is no harm in just meeting with one of the midwives to discuss your pregnancy and your options. Here is the number for the group. No matter what you choose, I hope you have a wonderful birth. I just wanted to share that with you since I didn't know until recently that you wanted a natural birth."

Something along those lines. But I would tell her. I think the mother's preparedness is very important, but especially for a first-time mom, choice of HCP is more determinative as to success in getting a NCB. GL!

[womenswisdom]

I would be VERY blunt about what I knew. I would also encourage her to talk more with the OB about the birth plan. Ask her what she plans to do if she gets to 41 weeks. Ask her what she plans to do if the OB is getting ready to cut an episiotomy. So many moms just kind of go along hoping for the best and don't want to think about the concrete realities of their situation. I would want a friend to figuratively slap me upside the head if I was headed down that path.

[Annie Mac]

I'm not sure what more you *can* do. It seems to me like you've already told her your opinion on her doctor as well as suggesting alternatives. It's really up to her at this point. And who knows? It might not be as bad as you are imagining.

I don't know her, but do you find she processes her thoughts by talking about them? Perhaps she's just working out certain fears by verbalizing different scenarios, and is in actuality OK with this doctor.

[myfairbabies]

I think part of the reason for not switching is that she is worried about cost (they are pretty poor right now, on a payment plan with current doc, but do have insurance), and maybe she'll think it's rude or mean to drop the doc. She's a very nice, giving person. They don't have internet, so I can't point her here, or write her an email. I think I will try to tell her though. I like the idea of saying that I care about her, want her to be happy, and if this is what she really wants, this is what she should do, but if not, that's ok too. Keep the ideas coming!

[listipton]

I had a close friend who was interested in a natural birth after I had ds. I gave her all the info she asked for, etc. and was supportive. We talked about the importance of your practitioner being on board with a natural delivery. This was her third child and she has high risk pregnancies and was in the doctors office once a week. He told her early on that she could have a natural birth and that he would 'do his best' to support it, no episiotomy, etc., so she thought she was prepared. Until the delivery. When he asked her repeatedly if she wanted an epidural, was induced and told her he had to use an internal fetal monitor, and would only let her deliver if she was in stirrups. That friend is my hero b/c she did it without any pain meds, and I don't know that I could honestly have done it her way. She was really lucky in that she had a fast labor and her body cooperated with all the demands of the OB. She told me her birth story and I had to bite my tongue through the whole thing because she was really happy with her birth and I didn't want to ruin it for her (she was still on her birth high). After a couple of weeks, we were able to talk about it more objectively and I think she gets why I was kept harping on her to consider a different labor approach. I guess what I'm trying to say is that even though she thought she knew what a natural birth actually was, she still pictured the Hollywood version only without an epidural. Your friend may be thinking the same thing despite all the talking you've done about the subject so far, and it may take actually having the cascade of interventions for her to understand. Definitely talk to her about it again, maybe watch 'The Business of Being Born' with her, and be supportive if she ends up sticking with her OB. You're a good friend to be so concerned and she'll appreciate it whether she takes your advice or not .

[thefreckledmama]

Normally I err on the side of not butting in, but since she came right out and asked you "what she could do?" I think the door has been opened for you to be (lovingly) blunt with her. I would either call her or ideally arrange a sit-down and really lay out your thoughts and feelings about the reality of her plans.

Also, I would suggest she come to MDC and read some of the stories and experiences that moms have had...good and bad...which can help add some perspective beyond what you yourself are able to share.

[*MamaJen*]

A friend's daughter wanted a natural birth but was seeing a very mainstream OB. Midway through the pregnancy, I helped her find a free doula, and that kind of opened up the floodgates for her. She started doing more and more research, I was on the phone with her a few times. At 37 weeks she went in to her OB with her doula and her birth plan, and the experience was so horrible she called her mother in tears. At 38 weeks I helped her find a midwife who would take her on for a really reduced rate, and around 40 weeks she had a beautiful homebirth that she'll cherish forever.
I think your friend deserves to have someone speak honestly to her about birth. I would give it one more try. Tell her about the standard hospital interventions, and why she might run into obstacles. Tell her she still has the option of switching providers. If she doesn't want to hear it, don't push it, but she deserves to at least have access to that information.

[*MamaJen*]

Also, have they seen Business of Being Born?

[Poodge]

I would say something. I watched the Business of Being Born and thought I had all the things I needed in place to have a natural birth at a hospital with an OB. While I ended up having a vaginal birth that was 98% positive I did end up with many things (epi, pit, internal mointoring, purple pushing, threatened with a C/S, ect) I didn't want because in truth I was NOT prepared. I wish someone had been more blunt with me the first time around. That just the will to have a natural birth and a husband that was supportive was not going to be enough in our case to avoid all the interventions. I lived and I learned and I will do better next time. But if I had known then....

As a side note I watche BOBB again after my birth and saw it in a different light having been through birth.

[NettleTea]

Originally Posted by *MamaJen*

Also, have they seen Business of Being Born?

[miriam]

Give her the name of a local midwife you would recommend. The rest is up to her.

[mambera]

Originally Posted by Poodge

As a side note I watche BOBB again after my birth and saw it in a different light having been through birth.

That's interesting... What struck you differently the second time around?

[lizsky]

Originally Posted by myfairbabies

I also told her to hire a doula if they could, and to stay home for as long as possible (among other things).

I'm 36weeks along with my 1st, and am pretty new to the NCB scene. I didn't understand what a doula was or how helpful they could be until a few friends explained it to me. (We've hired one and switched to a MW). You said $ is tight for her, but perhaps you know of a lower cost or free doula? Or maybe folks in the finding your tribe section might know of one. Your friend might be open to that even if she's not comfortable switching providers, and would have someone to help with comfort measures and advocacy.

[annekh23]

I would be frank with her, she's making these birth choices for herself, you're not pressurising her and I'd be upset with a friend who knew my doctor wouldn't allow them, but kept their mouth shut.

Ask her if she's asked her doctor if DH can catch the baby (and the other things) and if she believes the answer. Ask her what she is prepared to compromise on.

It is possible to have a great natural birth in hospital with an intervention happy doctor, but you do need to be prepared for it. I have a friend who waivered at the end between switching to a midwife and working with her doctor, in a hospital which doesn't really do choice. When it came down to it, it was her husband that made the difference, though it definitely helped that he is a doctor in the same hospital. I quizzed him on how he managed it and he said he just told people what to do - which sounds bossy, but you can still be polite, just phrase things as this is what we are doing, not we'd really appreciate it you could possibly allow us to do this.

[*MamaJen*]

Originally Posted by lizsky

I'm 36weeks along with my 1st, and am pretty new to the NCB scene. I didn't understand what a doula was or how helpful they could be until a few friends explained it to me. (We've hired one and switched to a MW). You said $ is tight for her, but perhaps you know of a lower cost or free doula? Or maybe folks in the finding your tribe section might know of one. Your friend might be open to that even if she's not comfortable switching providers, and would have someone to help with comfort measures and advocacy.

Yeah, at the very least, strongly urge her to get a doula.

[emnic77]

Originally Posted by listipton

I had a close friend who was interested in a natural birth after I had ds. I gave her all the info she asked for, etc. and was supportive. We talked about the importance of your practitioner being on board with a natural delivery. This was her third child and she has high risk pregnancies and was in the doctors office once a week. He told her early on that she could have a natural birth and that he would 'do his best' to support it, no episiotomy, etc., so she thought she was prepared. Until the delivery. When he asked her repeatedly if she wanted an epidural, was induced and told her he had to use an internal fetal monitor, and would only let her deliver if she was in stirrups.

I'm sorry, not to go off topic, but this is just so absurd that I would be hysterically laughing if I weren't so awful. What did he think he was going to do, hold the baby in there until she got in the stirrups? Like a finger in the dam, or what?? How utterly ridiculous..."won't let you deliver"...okay, as if you can stop that or she needs your permission, dude. Good luck with that!

I agree with what most have said, these are HER choices she's making, it's not like you're pressuring her, you're helping her understand the best way to meet those goals. Good luck!

[kltroy]

I think the real issue is that she has something that seems FINE. So right until she decides it's not fine, she is going to cling to it. I remember feeling the same way about my first group of medwives. And about the first daycare that my son went to. In both cases, I stuck with it because it was a LOT of effort to make a change. I convinced myself that it was ok. I was worried that I would hurt someone's feelings by switching. I actually stuck w/ the medwives through my son's birth (he ended up breech, and a scheduled c-section, so it didn't matter at the end of the day how great - or not - they would have been). But I pulled my son out of the daycare 1 month into it because I wasn't happy.

Anyway, my point is, she's afraid to switch this late in the game. She probably thinks she *cant* switch this late. My mom actually switched from an OB to a midwife when she was 36 weeks pregnant with me for the exact same reasons. (She had a great natural birth and I was over 10 lbs!)

I think the only way she can really get it through her head that this doctor isn't going to help her get what she wants is if she sits down with the doc and talks through her birth plan and gauges the reaction. Then, if your friend is receptive to the idea, maybe you could hook her up with a midwife who could take her - possibly just a phone conversation or similar - so that she could go through her birth plan with that midwife too. Once she can compare and contrast the two conversations, you've done your job, and the decision that she makes will be truly informed. That's all you can really do.