I first met Amanda Devereux over a year ago at a childbirth educator training I was part of in Texas. She stood out: a Registered Nurse turned doula and mother of three, she proclaimed she had “found her tribe” when she met all of us. There is something special about being a birth junkie surrounded (finally!) by other birth junkies rather than people who puke a little in their mouth when you mention what you did with your placenta. She was a lot of fun and I was excited when a short time later my boss decided that Amanda would be one of the people she would bring on to start a doula program.
Well, I wanted to share some words from her today- let’s just say she isn’t your typical nurse! Love her! Enjoy…
There’s no reason to part the curtains – and I’m not talking about the hospital room divider – I’m talking about your labia. In a typical hospital birth a woman is often asked to:
1. Lay back – of course not flat on your back, because we know that’s bad, we’ll incline the bed juuuust a bit. . .*sigh*
2. Pull your legs back/get in stirrups/have other people hold your legs in a “modified squat,” soooo, it’s great, right? . . .
3. Curl up, chin to chest and puuuuuush 2, 3, 4, 5, 6, 7, 8, 9, 10 . . . deep breath and come back and puuuuuuush, 2, 3, 4, . . . , one more. . . and okay, relax.
So, with an epidural during this ‘relax’ part, your vagina isn’t experiencing much relaxation, and it’s not due solely to the emerging baby.
You need to comfort the people around you. Watching you wait until you’re told to push again isn’t entertaining, it’s excruciating! What is entertaining is THERE IS A BABY COMING OUT OF YOUR VAGINA! And those around you want to see this, millimeter by millimeter, act by act. Birth, while exciting and fast in the movies is actually something that takes some real time.
Your vagina is a stage.
The lights are shining, the overhead spotlight is on the star, your emerging baby. But there’s a problem. The curtains are closed. The lush curtains that have protected you and your baby are blocking the view. The doctor who has donned sterile gloves needs somewhere to put his hands, something to do . . . . So, for the sake of the audience and the doctor’s sterile gloves, the curtains are parted. Your labia are held open so that the fruit of your womb can be observed as you bring this miracle to earth. The show must go on!
Pushing can take a long time, particularly when a woman’s birth has been managed and observed. ACOG says a first time mom with an epidural should be allowed 3 hours to push. That’s a long time for your vagina to entertain the crowds and it’s a long time for a health care provider to stand with idle hands. Beyond your vulva’s parted curtains lies your vagina, your birth canal, whose soft tissue waiting to be gently stretched by your baby’s descending head, must now provide a place of rest for the sterile hands. But not much rest is had and of course, having nearly two entire hands pushed into your vagina while pulling around and away from one another is helpful (rolls eyes) in stretching you so that this tissue will be more welcoming and allow a quicker descent of your baby.
and in time. . .
4. We see the head! It’s so close! See the hair! Oh it’s so dark! Look at all that hair!
5. Do you want to see too? (It’s a can’t-miss show)
6. Oh puuuuush . . . . . .
Take a Bow.
Seriously, though. Let me tell you this:
Nobody needs to open the curtains. Your baby doesn’t need a spotlight and your vagina is nobody’s stage. You and your baby are NOT a Broadway show.
When women labor naturally they would never allow this type of manual manipulation of their vulvas and their vaginas to happen (ouch!) and no woman deserves this without consenting, epidural or not. Unfortunately, this is what often happens at the end of the cascade of interventions. Laboring and pushing with an epidural increases a woman’s vulnerability to this type of treatment because of her lack of sensation. Sure, there are times when a healthcare provider needs to assist or assess, but this is rare and should always be done with the mother’s consent.
Women labor and babies come in the dark, in the sunlight and in whatever position the mother finds is best for her; while no one’s looking, even (especially) when the curtains are closed.
Clearly your birth is no Broadway show. What do you do? Prepare for your birth by taking a comprehensive out-of-hospital childbirth course. Take a great birth class (like Birth Boot Camp) and feel confident in both your preparations for birth as well as your ability to birth your baby. Your partner will love it. And, HIRE A DOULA. Hiring a doula has been proven to reduce your need for medical pain management and reduce your cesarean rate by 50%. Doulas are not just for natural birth – our specialty is natural birth, but any and every woman benefits from the skills and knowledge of a professional doula.
Amanda Devereux, RN, BSN, Bbcd, Bbci, CHBE has been fascinated and inspired by pregnancy, birth, and women’s health long before she became a mother. As a devoted Nurse, Doula, Birth Boot Camp Instructor, and Mother of three, she draws from experience and compassion when supporting women beginning their own journeys into motherhood. Amanda is also co-creator and trainer of Birth Boot Camp DOULA and is co-owner of Nola Nesting
Image credit: José Manuel Ríos Valiente