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Old 06-15-2009, 11:27 AM
 
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Originally Posted by Delicateflower View Post
This is the problem with bad education about these things. If some has an epidural, they need to have IV fluids, they need to have cEFM, they are most likely going to have to push in the lithotomy position. You're going to look worse than foolish asking for an epidural but trying to refuse the IV and monitors that come along with it.
Ah I should have clarified. I understand cEFM with an epi, but at least you don't need cEFM before the epidural. (And I would imagine lots of women could labor a bit longer before asking for the epi if they weren't tied to the dang machine & so could get into a shower or bath!)

Also, I didn't think IV fluids would be required. An IV port, sure (Hep-lock, I had one even with my 100% natural birth - hospital policy to have the port there.) As another poster said, "nothing by mouth" is to prevent mama from aspirating stomach contents if she vomits when asleep under general anestheia due to needing CS. well, if she already has an epidural, then she DEFINITELY won't need general anesthesia anyway! Besides, even WITH general anesthia, it's not that great to do nothing-by-mouth:
  • clear fluids drain from the stomach quickly anyway
  • nothing by mouth makes stomach contents very acidic (natural stomach juices) which can damange the esophagus when coming up
  • aspirating vomitus was more an issue decades ago when they used black face masks, but now that they're clear, much less of an issue
To me, "nothing by mouth" is a PINNACLE of stupid, non-evidence-based maternity care. If they want to really play it safe, OK, I can sorta understand a "clear-fluids only" rule - but nothing at all? Asinine! (& it STILL makes me angry that this is the standard at world-famous Johns Hopkins hospital!)

As for pushing, I thought mamas with epis could be raised up into a semi-reclining/ supported squat? That's how my sister pushed out both of hers with epis - not flat on her back.
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Old 06-15-2009, 02:40 PM
 
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But they are refusing mothers food and drink with an epidural. I ate 3 crackers while in labor with my daughter. I asked for an epidural and one anethesologist (sp?) refused to give me one. Another anestheologist agreed.
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Old 06-15-2009, 03:00 PM
 
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But they are refusing mothers food and drink with an epidural. I ate 3 crackers while in labor with my daughter. I asked for an epidural and one anethesologist (sp?) refused to give me one. Another anestheologist agreed.
There is no evidence to support this, please make a formal complaint to your hospital. The more women who complain about shoddy treatment, the sooner things over there will get changed. It's not going to happen any other way.

I hate the birth= sex analogy. It's not like sex. It's a rite of passage, an initiation, sheer hard work. It's NOT about getting on with someone else or intimacy because it's something that a woman has to get through as best she can. It's exhilarating, yes, and inherently joyful but to compare it to sex trivialises both.

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Old 06-15-2009, 04:59 PM
 
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But they are refusing mothers food and drink with an epidural.
I know... and that was my point.. I was trying to say that American women need to:
  1. Get educated on what evidenced-based care is
  2. DEMAND IT!

Even if you DO want an epidural - you still have to get educated & demand evidenced-based care. Although, yeah, you may lose the battle anyway, but it's a battle we need to work for.

Incidentally, i was told that at John's Hopkins, I couldn't eat or drink especially if I wanted an epidural. "No anesthesiologist would touch you." So absurd. But they had a "nothing by mouth" rule for ALL laboring Mamas anyway.
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Old 06-15-2009, 06:07 PM
 
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What if sex were like birth?
But it's not. Birth is inherently painful. Pain that can be managed a variety of ways and that certainly can be minimized, no doubt. But painful nevertheless. Sex isn't inherently painful. So I don't think the analogy holds. I like the analogy of climbing a mountain or running a marathon better. If all you heard about that was how horrible it was, you may never realize that it can also be rewarding and empowering, for those who want to do it.
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Old 06-16-2009, 01:04 AM
 
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Also, I didn't think IV fluids would be required. An IV port, sure (Hep-lock, I had one even with my 100% natural birth - hospital policy to have the port there.) As another poster said, "nothing by mouth" is to prevent mama from aspirating stomach contents if she vomits when asleep under general anestheia due to needing CS. well, if she already has an epidural, then she DEFINITELY won't need general anesthesia anyway! Besides, even WITH general anesthia, it's not that great to do nothing-by-mouth:
Clarifying that IV fliud running is required at my hospital, other hospitals I worked at, and every hospital I have heard of for epidural because the loss of maternal blood pressure after the epidural procedure is fast and the first line of intervention is a fast running IV fluid bolus. (Its not every epidural that this happens, but a fair number of them.) Many anesthesiologists require a litre of fliud to be infused prior to epidural to prevent this.
Many mothers do require general anesthesia while having epidurals. The reason being if the c-section super emergent, leaving no time to bolus the epidural. The epidurals are bolused prior to c-sections because while they can cover labor pains, they don't cover surgical pains. Another reason for general anesthesia while having an epidural is if the epidural fails during labor, or the bolus given prior to c-section did not work effectivley. Wanted to clarify. And just want to say, I don't agree with nothing by mouth during labor.

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Old 06-16-2009, 12:28 PM - Thread Starter
 
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Originally Posted by Wisegal View Post
But it's not. Birth is inherently painful. Pain that can be managed a variety of ways and that certainly can be minimized, no doubt. But painful nevertheless. Sex isn't inherently painful. So I don't think the analogy holds. I like the analogy of climbing a mountain or running a marathon better. If all you heard about that was how horrible it was, you may never realize that it can also be rewarding and empowering, for those who want to do it.
Welcome to MDC. Birth is not inherently painful. You can't go making general statements like that. Yes, most women experience pain, including myself. But not all women do. If the pain was inherent then ALL women would experience it.

The analogy to sex, while not perfect, was only to show society's views of birth.

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what if i told you that my DD2's birth was ecstatically joyful, that i was on a newborn high for months, that every time people asked me about her birth i couldn't help but grin and gush? that it literally felt like heaven touched earth for a moment when she was born? what, then, if i told you it was an elective c-section?
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And I am another c-section only mother who had ecstatic, wonderful, empowering births. And the funny thing is, I went into my first c-section with compleat and total terror. I thought it was going to be the most horrible experience of my life, and instead it was one of the most amazing ones
I think its wonderful that you felt this way about your childrens' births. So I have another question for you. Do you find that people don't want to hear about your positive birth stories either? Are your tales of joy and empowerment dismissed and ignored just as much as the natural birth ones? Are only the tales of terror and pain acceptable to people?

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Old 06-16-2009, 12:45 PM
 
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Welcome to MDC. Birth is not inherently painful. You can't go making general statements like that. Yes, most women experience pain, including myself. But not all women do. If the pain was inherent then ALL women would experience it.

The analogy to sex, while not perfect, was only to show society's views of birth.

I think its wonderful that you felt this way about your childrens' births. So I have another question for you. Do you find that people don't want to hear about your positive birth stories either? Are your tales of joy and empowerment dismissed and ignored just as much as the natural birth ones? Are only the tales of terror and pain acceptable to people?
Pretty much. With dd2 I had people e-mailing me c-section horror stories and telling stories about a friend of a friend who had awful things happen to them during their c-section. Happy stories make less drama then the painful ones. Nobody wants to hear my happy, not that painful c-section story, they want to listen to the ones that are full of gruesome details.

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Old 06-16-2009, 01:21 PM
 
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Clarifying that IV fliud running is required at my hospital, other hospitals I worked at, and every hospital I have heard of for epidural because the loss of maternal blood pressure after the epidural procedure is fast and the first line of intervention is a fast running IV fluid bolus.
Yes, I remember reading that in "The Thinking Woman's Guide to a better birth." I know it's often done, but I thought the evidence showed that the bolus IV fluids were actually not that effective in counter acting the BP drop?? I can't check, as my copy of the book is out on loan.

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Another reason for general anesthesia while having an epidural is if the epidural fails during labor,
Oh yes, good point. I know they fail or only work on one side enough that an epidural is certainly no gaurantee that general anesthesia won't be necessary for CS. True. I stand corrected.
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Old 06-16-2009, 02:16 PM - Thread Starter
 
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Pretty much. With dd2 I had people e-mailing me c-section horror stories and telling stories about a friend of a friend who had awful things happen to them during their c-section. Happy stories make less drama then the painful ones. Nobody wants to hear my happy, not that painful c-section story, they want to listen to the ones that are full of gruesome details.
What an awful thing to do to an expectant mother. Ugh. I just don't get people. Why would someone do this?

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Old 06-16-2009, 03:01 PM
 
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What an awful thing to do to an expectant mother. Ugh. I just don't get people. Why would someone do this?
Because they were trying to convince me to ignore my insticts and medical advice and have a vbac. Apparently a mother's insticts should only be followed if it is leading you towards a natural birth. I know they were trying to be helpful, but e-mailing someone who is planning on a c-section a list of all the reasons to not have a c-section is just rude.

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Old 06-16-2009, 07:52 PM
 
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Without knowing the full particulars of the situation you refer to, I think this is too broad a comment:

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e-mailing someone who is planning on a c-section a list of all the reasons to not have a c-section is just rude.
Taking this comment at face value suggests it's rude to share information with someone simply because that information is contrary to what he/she already thinks.

Is it rude for someone who is convinced of the wonderful benefits (:Puke) of circumcision to share their information with me? The context of the method of delivery, the relationship between the parties, the previous communication, etc. could make it rude. The simple act of sharing information is not rude.

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Old 06-16-2009, 08:11 PM
 
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Without knowing the full particulars of the situation you refer to, I think this is too broad a comment:



Taking this comment at face value suggests it's rude to share information with someone simply because that information is contrary to what he/she already thinks.

Is it rude for someone who is convinced of the wonderful benefits (:Puke) of circumcision to share their information with me? The context of the method of delivery, the relationship between the parties, the previous communication, etc. could make it rude. The simple act of sharing information is not rude.
We aren't talking about circumsion, we are talking about a method of giving birth. It is insulting to even compare the two. Circumcision involves inflicting unbelievable amounts of pain on an innocent baby. If a woman has already done the research and has decided to go with a c-section, then IMO it is rude to send her information about how her choice is wrong. I spent my last pregnancy trying to surround myself with positive thoughts, and it was really upsetting to recieve pms from strangers telling me c-section horror stories and trying to convince me to vbac.

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Old 06-16-2009, 10:48 PM
 
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We aren't talking about circumsion, we are talking about a method of giving birth. It is insulting to even compare the two. Circumcision involves inflicting unbelievable amounts of pain on an innocent baby. If a woman has already done the research and has decided to go with a c-section, then IMO it is rude to send her information about how her choice is wrong. I spent my last pregnancy trying to surround myself with positive thoughts, and it was really upsetting to recieve pms from strangers telling me c-section horror stories and trying to convince me to vbac.
I dont agree that its rude- unless said in a nasty way. If someone has had a horror C-section experience, they were probably trying to help you avoid that. I would see that as coming from a place of kindness in trying to spare you what they went through. Again depends on the way they said it, but most people are just trying to help the best way they know how.

If I had an awful experience with a homebirth midwife and someone had said they had researched thought she was the best choice and were going to use her, I would definitely feel compelled to tell them all the stuff that had happened to me because of her just to warn them. I would feel awful if I didnt and then they came back with the same experience.
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Old 06-17-2009, 01:16 PM
 
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I dont agree that its rude- unless said in a nasty way. If someone has had a horror C-section experience, they were probably trying to help you avoid that. I would see that as coming from a place of kindness in trying to spare you what they went through. Again depends on the way they said it, but most people are just trying to help the best way they know how.

If I had an awful experience with a homebirth midwife and someone had said they had researched thought she was the best choice and were going to use her, I would definitely feel compelled to tell them all the stuff that had happened to me because of her just to warn them. I would feel awful if I didnt and then they came back with the same experience.
When you were planning your homebirth, would you have found it helpful if strangers sent you pms filled with hombirth/natural birth horror stories? Maybe I'm just super sensitive when I am pregnant, but a link to a blog about a mom who died the day after her c-section and who never even got to hold her baby was NOT helpful.

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Old 06-17-2009, 02:30 PM
 
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When you were planning your homebirth, would you have found it helpful if strangers sent you pms filled with hombirth/natural birth horror stories? Maybe I'm just super sensitive when I am pregnant, but a link to a blog about a mom who died the day after her c-section and who never even got to hold her baby was NOT helpful.
That does not sound helpful at all. It sucks that people can be so thoughtless sometimes.

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Old 06-17-2009, 06:54 PM
 
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When you were planning your homebirth, would you have found it helpful if strangers sent you pms filled with hombirth/natural birth horror stories? Maybe I'm just super sensitive when I am pregnant, but a link to a blog about a mom who died the day after her c-section and who never even got to hold her baby was NOT helpful.
Yeah that is not very cool, I thought you meant they were sending you their personal stories. But I will say that I had to basically explain myself everytime I said I was having a homebirth. The *best* responses were "oh you're brave" (not really, I think its brave to go to a hospital ). And the others wanted me to justify myself. I got a lot of "what if something goes wrong?" "Homebirth is not safe" etc etc. And they werent just comments, they wanted me to answer, I guess to prove myself. I did the get the "I know a mom who died cause the baby came at home" etc.

So it can swing both ways I guess. But fear-mongering is not helpful at all, I agree! Personal stories I think are fine, but just trying to bully someone is not.
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Old 06-17-2009, 08:33 PM
 
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Anyway, the problem comes when natural birth is seen as bizarre and, worst of all POINTLESS! When epidurals are viewed as having NO RISK and going natural is viewed as utterly senseless & stupid.

Women who decide in advance of any labor that they want an epidural... I have to wonder:
1. How truly educated are they on the risks of epidural & the risks of the cascade of interventions it often leads to?
But more so:
2. Have they opened their mind to the concept of a natural, empowering birth?

They must think that the concept of a natural birth that is painful, but is still wonderful & empowering is just impossible?? Why else would they not even TRY to experience it & ride the labor ride?

Seriously, I don't get it. I can't see any other reason BUT that they really think that natural birth 'makes as much sense as natural dentistry' - in other words - natural birth is STUPID & pointless & there is simply NO VALUE in feeling birth?

THAT is what I find so sad.
Exactly! Really struggled with that when my close friend decided way before pregnancy that she was getting an epidural and that's that. Obviously it was her choice - but, yeah, what you said ran through my head many many times and made me sad. Still does.

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it's that childbirth can be estatic if you let go of EVERYTHING, all your preconceptions about birth, and just BE in that moment when your baby is born.
YES! So true. And what often saddens me about the mothers who want their epidurals at 8 months is the feeling I get from them that they don't want to experience their births at all, rather to tune them out as much as possible and get them over with in as little time as they can. It really has everything to do with attitude and very little to do with the actual way of giving birth.

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As for pushing, I thought mamas with epis could be raised up into a semi-reclining/ supported squat? That's how my sister pushed out both of hers with epis - not flat on her back.
Yes, they can. My friend who got the epidural was on her side/semi-reclining. They don't generally do the lithotomy thing here at all.

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I hate the birth= sex analogy. It's not like sex. It's a rite of passage, an initiation, sheer hard work. It's NOT about getting on with someone else or intimacy because it's something that a woman has to get through as best she can. It's exhilarating, yes, and inherently joyful but to compare it to sex trivialises both.
Good point. I don't think childbirth is comparable to sex either - though I do think that, as "the other end of sex", it is sexual in nature.

I saw my mom give birth at home to my little brother, and yeah, she was in pain, but was that an issue? No, because she accepted the pain, worked through it, and it was just part of the experience of getting my brother out. Because of that, and having been raised around homebirth, epidural is not even an option for me. By which I mean not that I am ideologically against it (though I am for myself) but rather that it doesn't even cross my mind when I think of childbirth and I'm always mildly surprised to realize that all my friends take it as a given in childbirth.
I also think the intense fear and avoidance around childbirth pain has a lot to do with our culture's intense fear and avoidance of pain in general. Pain used to just be a part of life that you dealt with - not very nice maybe, but there, and not a huge deal. Now, the ibuprofen bottle is always waiting. Not to mention that daily life is a lot more comfortable than it used to be - people just aren't used to discomfort/pain. And pain is definitely seen as a Bad Thing, in and of itself. Of course pain can be useless and bad, in childbirth too, but in itself? No. I think it is there much of the time to get your attention, to help you focus, go inward. To deal with pain you certainly have to do that. (Of course, focusing and going inward is not something mainstream western culture promotes either.) When people simply reject all pain off the bat as a Bad Thing, without considering whether or not it is an integral part of life or an experience or whether or not it's really going to kill them (so to speak) it really limits existence. In my opinion.
Also, I am not at all judging people who take painkillers! Personal journey, personal choice. Heck, I take painkillers when I notice that the headache I have is not helpful pain. I am only trying to point out a general pattern in our society that I have noticed and that I believe contributes to the widespread refusal to acknowledge childbirth as anything but torture.

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Old 06-17-2009, 11:06 PM
 
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Yeah that is not very cool, I thought you meant they were sending you their personal stories. But I will say that I had to basically explain myself everytime I said I was having a homebirth. The *best* responses were "oh you're brave" (not really, I think its brave to go to a hospital ). And the others wanted me to justify myself. I got a lot of "what if something goes wrong?" "Homebirth is not safe" etc etc. And they werent just comments, they wanted me to answer, I guess to prove myself. I did the get the "I know a mom who died cause the baby came at home" etc.

So it can swing both ways I guess. But fear-mongering is not helpful at all, I agree! Personal stories I think are fine, but just trying to bully someone is not.
I don't believe that it is fine to send personal birth horror stories to people that you don't really know or who aren't asking for opinions. I know some people who have had some really, really bad homebirth and natural birth experiences, but I don't think it would right for me to pm every person I see who says they have decided on a homebirth or a natural birth these stories. Having a vbac is not an option for me, so recieving personal stories of c-sections gone bad was just depressing and didn't help at all.

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Old 06-18-2009, 05:01 AM
 
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I don't believe that it is fine to send personal birth horror stories to people that you don't really know or who aren't asking for opinions. I know some people who have had some really, really bad homebirth and natural birth experiences, but I don't think it would right for me to pm every person I see who says they have decided on a homebirth or a natural birth these stories. Having a vbac is not an option for me, so recieving personal stories of c-sections gone bad was just depressing and didn't help at all.
I meant 'personal' as in their OWN stories. I dont see a problem with that. You chose to post to tell people you didnt really know, that you were planning a C-section. Those people chose to write to you. If you didnt want strangers to know your decision you shouldnt have told them IMHO. If you had personally had a terrible homebirth, perhaps you'd feel more inclined to tell people your opinion on it when they told you they were planning one. I dont see the difference. People are (for the most part) trying to help. Otherwise they wouldnt have bothered taking the time to write to you. Perhaps some are misguided in their approach, or shouldnt really comment. But I doubt anyone who shared a personal story with you did it to purposefully hurt you. They more than likely didnt want you to go through the same thing and thought their warning would help.
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Old 06-18-2009, 10:11 PM - Thread Starter
 
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I meant 'personal' as in their OWN stories. I dont see a problem with that. You chose to post to tell people you didnt really know, that you were planning a C-section. Those people chose to write to you. If you didnt want strangers to know your decision you shouldnt have told them IMHO.
Just because she shares her intentions doesn't mean she wants to hear horror stories. Likewise, I felt free to share my intentions of having a homebirth to everybody who would listen. Only one person told me what she thought was a horror story. (In truth it was a successful non-emergency transfer story with a happy ending.) Even so, when she planned her 3rd cesarean, I did not send her information on why she should not. She's a grown woman and can make decisions for herself. Just because its not the decision I would have made does not mean that I need to talk her out of it.
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If you had personally had a terrible homebirth, perhaps you'd feel more inclined to tell people your opinion on it when they told you they were planning one. I dont see the difference. People are (for the most part) trying to help. Otherwise they wouldnt have bothered taking the time to write to you. Perhaps some are misguided in their approach, or shouldnt really comment. But I doubt anyone who shared a personal story with you did it to purposefully hurt you. They more than likely didnt want you to go through the same thing and thought their warning would help.
They didn't share a personal story with her. They told her about a mom who died before even getting to hold her child. This is not constructive or helpful.

Again, we (as a society) can't seem to tell positive birth stories. Only horror stories.

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Old 06-19-2009, 11:16 AM
 
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I'm a big homebirth supporter. I love to hear about mamas choosing to homebirth.

But I think we sell mama instinct short when we assume that mama instinct only counts when it's telling her to stay out of the hospital. I think the kinds of things felix is talking about are horrible. If she seemed unaware that VBAC was possible, or looking for options, then I think it's fine to say "Hey, did you know you have options other than ERC?" And then she could say "Yeah, but I'm not a candidate/not interested/whatever" and that should be end of story. But horror stories are never cool in my book. I hate seeing posts when people are trying to have a good hospital birth and a ton of people pop in with their hospital horror stories and try to sway the person to a homebirth or UC no matter what the OP has said regarding that. I think people should be realistic. Hospital birth is not that same as homebirth and usually you do have to compromise at least a bit on your desires if you don't want to fight the whole time. But not every doctor and nurse is out to get you and I've attended some perfectly lovely, respectful hospital births, including my own transfer.

I know after my second birth I wanted to shout from the rooftops how amazing homebirth was and that everyone should have one. After two uncomplicated and exhilerating deliveries, I didn't have the same perspective I do having tons of pain and rare stuff occurring. I would still absolutely homebirth again in a heartbeat and encourage others to do so. But, I also have an entirely different experience of pain to draw from. The pain of my other two deliveries was bad, but managable. This pain was not at ALL managable. I can see if people's previous experiences include a labor like my last one was, they would say heck no am I going natural.

Also, last story...my best friend planned a homebirth with her first and developed preeclampsia and transferred for an induction. With her second, she planned a hospital birth. That is what she was comfortable with and what her instincts told her to do. We had many conversations where I did actively try to get her to think about homebirth again, or a birth center. Lo and behold late in her pregnancy she developed pre-e again and needed to be induced again. So her initial decisions ended up being right on and she was in a much better position to deal with what was happening (already had a relationship with her doc, etc.)

I think it's unfortunate how much misinformation is propagated. But I also think we need to trust mamas more. Women choose epidural hospital births out of more than just ignorance, and it's extremely disrespectful to assume otherwise and try to jam information down their throat. I mainly try to just be a good example. I talk about my out of hospital experience and make myself available to answer questions but I will never pressure anyone again.

mama to 3 girls: Abigail 2.12.05, Eliana 8.26.06, Willa 1.9.09
RN-BSN 5/11, CBE, former doula
AmieV is offline  
Old 06-20-2009, 05:38 PM
 
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AmieV, you are so right. I also think of it in the way that I don't want someone trying to convince me to have a hospital birth, so why should I try to convince someone to have a homebirth? It's such a personal choice.
What does get to me, though, is when women often seem actively unwilling to educate themselves at all. For example, when my friend attended the hospital birth prep class she mentioned to me that they didn't get all that much info on the reasons for/against getting an epidural because most of the time was taken up by one woman's protest against the nurse's explanation that they try to use natural pain relief first in that hospital. When I asked my friend, in a very neutral straightforward way (though she knows I am pro-homebirth), if she wanted info on epidural (because I could direct her to some), she quickly replied "oh no, I don't want to know anything, I already decided I'm having one". She went on to give birth uneventfully in the hospital, with an epidural, pitocin given without notifying her, an overbearing midwife who told her not to scream, and an (unnecessary) episiotomy. And she was happy. But it still bothers me, because she didn't choose it - she decided that she didn't want a choice. She actively chose not to educate herself about options, or to read a single word about birth, or about how birth is not only a medical event for that matter. It just makes me sad, no matter how much I tell myself that it's not my life, wasn't my birth to be sad about.
So you know, I don't have any beef with choosing a medicated hospital birth after educating yourself about birth, getting to know the birth process and common hospital procedures at least minimally. Or just because you feel that you will be safer in the hospital (like your friend's intuition). Or heck, just because you WANT the presence of the doctor and nurses. It's every woman's personal choice. What bothers me is when women refuse to educate themselves, and basically choose to cop out of the entire thing, giving themselves up totally to the "authorities" or the hospital establishment, refusing to think for themselves. It's like when you watch Baby Story and you see the medical establishment/cultural atmosphere around birth conspiring to just rob women of their births, and it makes you mad, even though it's not really your business. It's maddening because those women don't even realize they have a choice, and if you told them that they did they probably wouldn't even want to hear it.

Me treehugger.gif and DH caffix.gif and sweet baby DD heartbeat.gif born 08/2011.

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