How to achieve natural birth? - Mothering Forums

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#1 of 49 Old 07-19-2004, 01:41 AM - Thread Starter
 
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I'm 31 wks pregnant today, and am late in the game thinking about this. My physician is a mainstream OB and I will be giving birth in a hospital that is highly rate, but has a 30% c-section rate. I would like to avoid interventions as much as possible. I am not opposed to pain relief, such as epidural, but would like to avoid if at all possible to avoid the intervention cascade. I am feeling increasingly depressed (?) that I won't be able to assert myself in the delivery room and will end up just having the barrage of usual interventions. Anyways, my husband is very supportive. This weekend we had our childbirth classes and the midwife instructor was very encouraging for natural birth and had many suggestions. No. 1 being stay at home as long as possible!

What should I do now in the meantime? Is there reading I should do? Videos we should watch? How do we go about preparing? I'm worried that we'll just be overwhelmed and easily led into interventions by the nurses.

I'm sure these seem like silly questions. I'm just more in the mainstream, I suppose, and most (all) of my friends have had epidurals and then also things like inductions, c-sections, etc.

TIA!
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#2 of 49 Old 07-19-2004, 02:05 AM
 
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I am feeling increasingly depressed (?) that I won't be able to assert myself in the delivery room and will end up just having the barrage of usual interventions
if you're concerned about that, i'd suggest having an adocate with you in the delivery room who will be your voice when the going gets tough. you can't always count on your 1 support person (who is there to support you during labor + birth) to also be a vocal advocate against unnecessary interventions.

about how to deal with labor + birth in general... recognize that birth is a normal, natural process (no matter how much or what the nurses may say to the contrary ). take each rush as it comes, breathe, and learn to relax your whole body. you can do this right now: close your eyes and be aware of every point of tension in your body ~ then consciously release it.
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#3 of 49 Old 07-19-2004, 02:30 AM
 
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I agree with Klothos....

If you are having a hospital birth, and wish to avoid certain procedures, DO NOT go to the hospital without someone to advocate for you. Someone besides your partner. Take it from me (I wanted totally natural birth and had about 10 interventions, including a cesarean.) it is INCREDIBLY hard to advocate for yourself while in labor and delivery. Ditto for your partner, who will also be very emotionally involved and busy with your labor. I strongly adive you to hire a professional, a doula. It would be well worth the expense to avoid having procedures done to you and your baby that you do not want.

Also, may I just say....if you wish to avoid a cascade of interventions, I would give some serious thought to saying no to an epidural. It will leave you flat in bed in a terrible position for your body to do its work in. You may be required also to have an IV and continuous monitoring while it is in, which means you will be hooked up to 3 things while flat in your hospital bed. Epidurals can also cause labor to stall, which may lead to Pitocin or a cesarean. And that's not even mentioning all the side effects for your newborn. Just some food for thought!
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#4 of 49 Old 07-19-2004, 03:37 AM
 
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You sound alot like I did when pregnant with my 1st (hospital birth). I DID end up w/the epidural, IV and constant EFM, but that's about it, and I consider myself lucky to have made it out of there w/out a c-section (thankfully, I labored at home the majority). But I still lost any semblance of control overy my birth when I accepted the epidural. I could only birth on my back, did the stupid coached to 10 pushing and had my feet in the stirrups. Ugh. My 2nd was born naturally in the water at my midwife's freestanding birthcenter. Wonderful birth!

My first suggestion, is to stay out of the hospital bed at all costs. Once they get you hooked up to the EFM (and they will want you in that bed w/the belts on ASAP and for as long as they can keep you there!), they don't like to let you go. I found labor in bed to be excrutiating. I was doing great laboring when moving, walking, leaning over DH and all the other things I did at home for the many hours of labor before going to the hospital.

Once they got me tied down to the stupid bed, it was all over. And the "shushing" from the nurses when I vocalized (I was not screaming, but moaning thru contractions), didn't help either.

I keep hearing from other new moms "I was doing ok until I had to get in bed with that monitor". Of course, mabye laying down will feel good to you in labor, you never know!

Ask them, no TELL them, to use a doppler on you and refuse to get on the bed at all. I would also seriously consider refusing all internal exams, they really tell you nothing about when babe will be here. You will know when you feel baby coming down and see the head crowning, and so will they!

Think about what relaxes you now. Write down 5 things you want your DH to do/tell you while in labor. Make him memorize them. Read Birthing From Within and Ina May Gaskin. Practice vocalizing through contractions and releasing your tension. And yes, get a doula. So worth it, I would never set foot in a hospital without one after my first experience. It is very hard to fight and birth all at the same time. And you just shouldn't have too!

Good luck
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#5 of 49 Old 07-19-2004, 03:45 AM
 
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everything watermamma said is so true.

especially: My first suggestion, is to stay out of the hospital bed at all costs. Once they get you hooked up to the EFM (and they will want you in that bed w/the belts on ASAP and for as long as they can keep you there!), they don't like to let you go.

disgusting but entirely the truth.

w/ my first, they told me they were going to do a quick check for dilation... which suddenly became, "you're at 8 cm., now you have to stay in bed on your back because it's hospital policy." it hurt so much, slowed down labor, and made the entire experience become horrible.

don't let them pull that crap. remember: you always have a right to pull off the monitors and give birth the way that your body tells you to!
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#6 of 49 Old 07-19-2004, 03:54 AM
 
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My midwife says they can do a monitor strip standing up.

I strongly stongly recomend the doula!!!

What classes are you doing.

I think its great you are asking for suggestions. you may get more than you can handle. I have some thoughts but I am trying to have this baby tomorrow so I will have to post when I can

Take Care
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#7 of 49 Old 07-19-2004, 02:07 PM
 
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Isn't the hospital supposed to be where you go to have a safe birth? Aren't doctors supposed to make birth safer? Then how come women have to go to so much trouble to protect their birth process from hospital workers and the hospital environment? It's just so crazy.

Anyway, I agree that you will want to stay home as long as possible, and have someone there specifically to be your advocate. A doula may or may not be the best person to do that -- some hospitals don't care for doulas, and can make them leave if they are perceived to be causing too much trouble. (i.e., declining interventions on your behalf, or encouraging you not to get interventions that the hospital staff would prefer you have.)

These aren't silly question, either. They're very important questions, and it's to your credit that you are looking for answers. Have you read A Good Birth, A Safe Birth? I seem to remember strategies for avoiding interventions in there.
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#8 of 49 Old 07-19-2004, 02:13 PM
 
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I agree with everyone else who said to have an advocate along with you. Just an FYI: agreeing to an epidural is agreeing to a long string of interventions. You will have continuous monitoring. You will have a continuous IV with fluids. You may need pitocin, as the epi tends to slow things down. If things slow down, you are more likely to have AROM. After AROM, you are more prone to infection and maternal fever, which would then necessitate antibiotics and possible fetal distress. You are more likely to end up with a forceps delivery and/or an episiotomy because you can't feel to push and you will be flat on your back. Etcetera.

That said, I'm not coming from a holier-than-thou position. I had an epidural. Just wanted to give you more info so you can make an informed decision.
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#9 of 49 Old 07-19-2004, 02:32 PM
 
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Its not too late in the game to change care providers. Is there a birth center within a reasonable distance? FWIW, I changed from a family pratice doc to a homebirth midwife at 36 weeks with my 2nd pregnancy. I also changed HB midwives at 37 weeks because of an unexpected move across country. It worked out great both times! Its never too late to switch to a care provider that respects your wants and needs...you won't regret it.

You need someone who is willing to work with you not someone that you have to fight against. Labor is not the time to have to defend yourself...you should be protected.

Good luck!
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#10 of 49 Old 07-19-2004, 02:32 PM
 
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The only thing I have to add to all of this wonderful advise is to write out a Birthing Plan. There are a few websites that give you a format to follow, this way, when you are in pain, you will have all of your requests written down and (in Canada) this is your legal "voice" when you may not be able to answer all of the questions. I also advise that you write down "I do not want an epidural offered to me! I will ask for one when I feel I need it". Or something to that effect. Otherwise you may have a nurse, like one of mine, who decides to offer it EVERY time she saw me. :
BTW I had an epidural with my first, and it caused me to dialate from 1.5 cms to 10 in 2 hours! With my second, the nurse was barely able catch dd before I pushed her out, no one knew I was ready to push but me! No pain meds ot intervention required!
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#11 of 49 Old 07-19-2004, 02:38 PM
 
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When I was in labor my brain went into sort of a hormone-induced fuzz. I wasn't able to stand up for myself even when I KNEW that the hospital staff was telling lies (l"lying flat on your back is no different from other labor positions" "Don't push or you'll damage your cervix" etc...).

Actually, the only reliable way to avoid hospital interventions is don't go to the hospital until you are quite certain that the baby is ready to come. Some of the indicators are what the Bradley Method people call "self-doubt", and feeling like you need to take a shit but you can't. Maybe there are other indicators.

There are all kinds of reasons that they will try to bully you into the hospital too soon, for example, if your water breaks, if you go into labor but it doesn't progress quickly or if they think you are past your due date. Don't fall for any of it .

Anyhow, the best laid plans go awry. I went too soon because there were 3ft of snow on the ground and I was worried we wouldn't be able to get through. As the hospital they basically tortured me until they induced fetal distress and then did a forcepts delivery. No doubt they will do the same to you if you give them a chance.

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#12 of 49 Old 07-19-2004, 03:44 PM
 
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I went into a hospital birth with the same ideas as you have about avoiding interventions. I thought I'd done my research. I had a doula. I didn't go to the hospital til I was 5cm. I thought I was more actually but I think I was in so much pain cause I had back labor. I ended up a c/s In hindsight I wish I'd changed providers.

The problem I had was a posterior baby and my labor wouldn't progress. Now no one pushed me into a c/s - the staff were quite tactful about that. No one pushed me into an epidural. But after about 24 hours of labor, only 1cm progress, I found myself stuck because the OB staff had no experience in helping my labor progress by natural methods. I bet if I was in a birthing center or had a midwife at home even, I could have birthed naturally. I've since heard of lots of things I could have done. Actually I'd heard standing and walking around was good but I didn't want to do that because I was in so much pain. Strangely enough lying down on my side was less painful. If I'd had a strong midwife who'd have given me a push in the right direction at the time, I think it would have helped.

I think it is possible to have a natural birth in a hospital but it's not easy especially if you run into difficulties like malpositioning. You're going to be in an environment where they don't have the expertise to deal with that. Then they'll have nothing to offer you except interventions which might make things worse. I chose an epidural for the wrong reason I think. After no progress for about 16 hours, I thought I'd try the epidural because I had heard from other women that sometimes it can relax women and the labor might progress. But when the baby is malpositioned I don't think this is true, and in fact, it made it worse. And the intervention cascade happened and I ended up with a c/s.

If you plan on having more children, do anything and everything you possibly can to avoid a c/s. Because if you think having a natural childbirth in a hospital is depressing, read up on trying to have a natural VBAC in a hospital. It's even worse.

Sorry to sound so negative. I just regret not changing providers. I'm a pretty assertive person and thought I could handle the hospital staff. I just didn't know what to do about posterior babies and either did they.
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#13 of 49 Old 07-19-2004, 03:53 PM
 
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Wombat -

My L and D sound very similar to yours (except I was induced at 1cm) I had a posterior baby, too....and being on my side felt the best, too. I wish I had had a different care provider, too. Or stayed home. They really encouraged me to lay down at the hospital, when they should have had me up and moving. I ended up with a c/section, too. (I'm planning a home VBAC in 12 weeks!)
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#14 of 49 Old 07-19-2004, 04:05 PM
 
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I had two un-medicated births in a hospital and it was not a problem. I would second some earlier recommendations:

* Write a birth plan in which you express your desire to avoid medications (and other interventions) and request that you not be offered any pain medications, but that you will let them know if you want them.

* "Natural Childbirth the Bradley Way", was, I thought, a pretty good read

* A hot shower was a must for me.

* All that said, with my first I was so out of it from pain and exhaustion, that I couldn't talk much to express my needs or even really formulate coherent thoughts by transition/pushing. With my second I gave my DH instructions on simple things I wanted him to do (such as bring me a glass of water or OJ every hour) and that was helpful.

Good luck!

Tanya
Mom to John (age 11), James (age 9) & Katherine (age 5)
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#15 of 49 Old 07-19-2004, 05:09 PM
 
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Lots of good information already mentioned.

If you haven't already, read Kitzinger's Complete Book of Pregnancy and Childbirth A ton of excellent information on just about everything regarding natural childbirth and pregnancy. Also, read Ina May's newer book Guide to Childbirth It has the most inspiring birth stories I have ever read, as well as excellent information on childbirth. After reading it you will know how natural childbirth is and can be.

Write a birth plan

Consider hiring a Doula to be an advocate for what you want and to help you labor.

Strongly consider refusing any pain mediations. These will dull your senses and weaken your body's a bility to labor naturaly. Instead, walk around, use a birth ball, different positions, use a shower or tub.

Labor at home as long as possible before going to the hospital.

Consider finding a doctor or midwife who understands what you want.

Good luck

Karen Mommy of McKenna 2003 & Alysson 2004 homebirth.jpg Expecting stork-girl.gif an early Christmas Present
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#16 of 49 Old 07-19-2004, 05:54 PM
 
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about the birth plan ~ while i agree it's a great idea to have one written, be warned that some hospitals and care providers will completely ignore it.

i wrote a birth plan w/ my first and even took it in to the doctor(s), and had them put a copy of it in my medical chart / file so that they'd know my wishes beforehand... and they still completely ignored everything i had written. :
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#17 of 49 Old 07-19-2004, 09:06 PM - Thread Starter
 
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Thank you so much for all your suggestions! I will read through them all carefully and pick up the recommended books.

I'm going to foward this to my DH so we can further discuss if we should hire a doula or consider an outside advocate. I don't think we will change providers, but we can at least discuss what our plans our.

I agree not taking pain relief will help avoid the intervention cascade, so that is our plan. It is hard to predict since I don't know if the baby will be positioned properly, but I want to go in fully informed.

Thanks again for all the suggestions!
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#18 of 49 Old 07-19-2004, 09:53 PM
 
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Dont have much to add, but wanted to post these 2 links on optimal fetal positioning:

http://www.homebirth.org.uk/ofp.htm
www.spinningbabies.com

Like Lucysmama and Wombat, I also had a cesarean for malposition with my 1st child, although my DS was frank breech. Positioning is SO important and not something that should be ignored (I dont think anyways).

Good luck with your birth! I wish you the best!
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#19 of 49 Old 07-20-2004, 12:56 AM
 
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Lynsey, you beat me to posting those links!

Positioning is very important, and it is such a shame that most care providers don't discuss with you how to maximize your chances of having an optimally positioned baby!
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#20 of 49 Old 07-20-2004, 04:25 PM
 
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Switch providers! We switched twice during our pregnancy including at 28 weeks. It worked out well. We had a midwife at the hospital and it was covered by my sucky insurance yet the midwife was chill and left us alone for the most part.

DS1 2004 ~ DS2 2005 ~ DD1 2008 ~ DS3 2010 ~ DD2 born at 31 weeks Oct. 2014
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#21 of 49 Old 07-21-2004, 11:19 PM - Thread Starter
 
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I called my insurance today and they don't cover a doula at all. Not too big of a surprise, I guess. We may still look for one.

I also went to the library and checked out several books. They only had one of the ones recommended here - I may need to go to the downtown library for more selection. I'll read over these first!

Thanks!
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#22 of 49 Old 07-22-2004, 12:54 PM
 
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Does your library do transfers from other libraries? That would be easier on you than having to traipse all over looking for stuff.
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#23 of 49 Old 07-23-2004, 04:40 PM
 
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I just read a paragraph in Gurmukh's Prenatal Yoga book that has had me thinking for DAYS...

"Don't try to have a homebirth at a hospital and a hospital birth [meaning all the technology] at home"

Decide what you want and realize that it is going to be hard - if not rare - to have an interventionless birth at a hospital. They are just not set up that way.

Call around - do not be afraid to switch providers, hospitals, etc.

Good Luck
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#24 of 49 Old 07-23-2004, 08:36 PM
 
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For a Doula, contact www.dona.org see if you can find a doula in training to take you as part of her "attended births" or a MW in training who can advocate for you while attending one of her required births.

Some doulas in training/MWs in training will take you on free or for minimal cost. We have found that Doulas in our area cost $300 or more. We WILL be having one if I have a hospital birth. It's simply not an option, since DH is fighting me on a homebirth (because of cost).

Have your DH read (even if he hates reading) The Birth Partner.

Try The Thinking Woman's Guide to Better Birth and Birthing From Within.

I agree with everything that the others have said. AVOID ALL INTERVENTION Beginning with pain meds and internal exams! The more intervention, the less freedom, the higher the risk of a c/s.

I also agree that if there's a hospital with a lower c/s rate RUN RUN AS FAST AS YOU CAN to that hospital. 30% is VERY HIGH (above the rate for the whole country!). Find a care provider who is 100% on your side, someone who believes in birth the way you do. Ask the provider you have now, what his/her c/s rate is at this time. If it's over 10% then run away!

Good luck to you!
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#25 of 49 Old 07-24-2004, 07:43 PM
 
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I hope this does not sound too abrupt, but if you do not like to be bit, do not play with snakes.

IOW, get a doula, a midwife, and stay at home.

It is not too late to change your mind.

If you do not want a cascade of interventions, why go where the interventions are?

You need to remember that when you are in the hospital, you are on their turf. It is their territory and they make the rules. The rules are designed for their convenience not yours. If they "lose" your well thought out birth plan - what do you do then while in labor?, - write one out between contractions? They are in charge!

JMHO, born out of years of experience through watching and listening.

YOu will remember your first baby's birthday for the rest of your life.

I have talked to old women who could not remember what they had for breakfast, but they could give me a blow-by-blow full account of their first baby's birth.

This is a significant day in YOUR life and will affect the relationship with your SO and with your new baby and the rest of your family.

Be honest and informed and good luck.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#26 of 49 Old 07-26-2004, 12:16 AM
 
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Hi,
Great thread! I just wanted to add something to all the wonderful ideas you've already gotten.

I am a doula, a fairly new one, and after my first few clients I was very suprised and amazed to learn how little most women seemed to know about their doctors "rules" (rolling eyes) or the policies and procedures of the hospital where they plan to give birth. As a part of my birth plan package, I now give my clients a sheet with a list of questions for their care provider to fill out, you could also call or visit your hospital to ask the same questions (because it does not matter if you doc says yes when the hospital says no). It is still a work in progress and far from perfect (it is fill in the blank so won't get you as much info as a good, in depth chat will) but i think it is a good place to start and identify areas where you doc/hospitals policies are not in line with your wishes. I'm happy to share it with you if you like. When you've got those questions answered you've got a really good stepping off point to writing your birth plan, if your doc/hospital encourages eating and drinking - you can leave those items off your birth plan. But if you get the sheet back and it says that you must be continuously monitored from the time you are admitted to L/D - you know that not only should this item go on the birth plan, but that you also need to discuss this with your doc LONG before the first contraction hits. I also tell my clients to ask their docs to sign their completed plan after reviewing it line by line (keep it short, only the most important points, so your wishes don't get skimmed over). Doesn't mean the hospital will respect it, but at least gives you some evidence to hold up when you say "But my doc said it was okay".

I also have my clients practice saying "NO" in various ways and situations - it is a harder word to say than you think. You and your husband could roll play some situations so that both of you get comfortable with declining interventions, etc. If you've said the words before, they'll be much easier to say when you're in the midst of labour.

Ditto the suggestion to look into Optimal Fetal Positioning - and better yet, have a doula with you who understands the principals. In my (admitedly limited) experience, I've already had three labours where babies positioning caused problems that were "fixed" using the techniques I learned in the book (Sit Up and Take Notice by Pauline Scott and Understanding and Teachign Optimal Foetal Positioning by Jean Sutton and Pauline Scott).

Regarding changing care providers/birth location - I really think that if you are this nervous about the possiblity of interventions negatively influencing your birth - you owe it to yourself to at least carefully consider the option, or at least to consider why you do not feel open to changing. With only a year of doula experience under my belt, I can tell you that I firmly believe that the choice of caregiver is THE most important one that a pregnant woman makes. More important than birth place, more important than any choice in labour, more important than the size and position of the baby. This choice has the greatest impact on not only the actual events of the birth, but also on your perception of the experience. I encourage you, whatever you do, to make an active and informed decision on this factor.

Best of luck,
Jeanette
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#27 of 49 Old 07-26-2004, 12:37 AM
 
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You can read all about natural birth techniques etc. but if you don't have a provider and institution who are on the same page as you - forget about it.

After witnessing too many horror stories from friends of mine, I knew I wanted a different birth experience. I read the book "Thinking Women's Guide to Better Birth" by Goer and decided on a free standing birth center.

I was not able to deliver at the BC because of pre-e/PIH but was able to labor with BC midwife at hospital. I ended up delivering my son vaginally but only after pushing for 4 hours. After talking with numerous people in the childbirth community, I learned that being allowed to push for 4 hours is almost unheard of and that my vaginal birth was made possible by "a midwife who was advocating for me".

A major cause of c-sections is not allowing births to start naturally - "baby is too big, small. late, labor is too slow etc" If your mainstream provider decides to induce/augment you for one of these reasons, the cascade of interventions are going to start and then they will decide when time is up.

Seek out a provider who has the statistics you are comfortable with.
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#28 of 49 Old 07-26-2004, 12:39 AM
 
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Having had done this twice, once with drugs and once without, the natural drugs that your body produces are phenominal. I suggest focusing on the pain instead of trying to escape it. Then you know where it is going and what to expect.SURRENDER!Never such an empowering experience as giving birth! I had a beautiful hospital birth... they do happen! So along with all of the smart mama advice above, Have a beautiful safe birth xox

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#29 of 49 Old 07-26-2004, 10:22 PM
 
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"The first intervention in natural childbirth is the one that a healthy woman does herself when she walks out the front door of her own home in labour." -Michael Rosenthal, Ob/Gyn.
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#30 of 49 Old 07-26-2004, 10:24 PM
 
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Quote:
Originally Posted by pamamidwife
"The first intervention in natural childbirth is the one that a healthy woman does herself when she walks out the front door of her own home in labour." -Michael Rosenthal, Ob/Gyn.
I totally agree!!

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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