Our next meeting will be Thursday, Dec. 13th from 7-9pm. We will be sharing inspiring natural birth stories. Bring your birth videos or birth stories along with a food item to share! We will also be watching the birth video Psalm & Zoya, which shows the unassisted home birth of twins. Nursing babies are welcome.
Many women have been told the lie that their pelvises are “too small” to give birth to their babies. Often, this is diagnosed during a pelvic exam where the woman is lying on her back. Guess what? Lying on your back closes the pelvic opening into the very smallest it could possibly be. Lying on your back also prevents your tail bone from moving out of the way. Moving onto your side for pushing and birth will at least give your tail bone somewhere to go so that your baby has more room to move through your pelvis. Squatting widens the pelvic opening by as much as 30%, which can mean the difference between a normal, vaginal birth and major abdominal surgery (c-section).
Sometimes doctors will say that the baby is “too big” either after feeling the mother’s belly or via ultrasound. Neither of these methods are accurate ways to determine the baby’s weight. Ultrasound can be off by as much as +/- 2 lbs. A supposed “giant” 9-pound baby could really be 7 pounds (or 11). The bottom line is that it is extremely rare for a woman to grow a baby too large for her to birth. Baby fat squishes. Baby heads mold. Upright positions such as sitting on a birth ball, rocking in a chair leaning forward, walking, squatting, and kneeling all gain the added benefits of gravity pulling the baby’s head onto the cervix (speeding up progress) and getting the baby into a good position. Movement during labor is also important. Changing positions every half an hour or so rocks the baby through your pelvis, much like rocking a ring over the knuckle of your finger.
I’ve known doctors to comment along the lines of “well, your pelvis isn’t going to get any bigger, we should induce early to make sure your baby will fit.” First of all, your pelvis does get bigger with a spontaneous (not induced) labor due to the hormones that cause the ligaments in your pelvis to soften and loosen. Second of all, inducing labor increases rather than reduces the chance of cesarean section due to the fact that the cervix will only dilate when it is ready. Many inductions do result in vaginal births, particularly if the woman’s Bishop’s score is higher than 9, but labor tends to be harder, longer, and filled with many more interventions (all of which increase the risks to mother and baby).
True CPD can only be determined after a spontaneous (not induced) labor during which a woman has used upright positions such as squatting. If a baby still doesn’t move down into the pelvis after many hours of encouraging the baby to get in the perfect position (alternating with periods of rest) and the woman feels like she’s done everything she can, a c-section may indeed be preferable. It really should be the woman’s choice. If she’s willing to keep going, everyone else needs to keep going with her, without pressuring her to comply to their wishes. Most of the time when a baby isn’t descending, the baby simply needs to adjust his or her position (which means the mother needs to adjust hers) . Patience is one virtue that is required for anyone in the birth room. Once a baby has reached 0 station in the pelvis, that is a pretty clear indication that the baby will indeed fit.
Observe now, a group of women who had c-sections for babies that were “too big” or for pelvises that were “too small” who have gone on to birth even larger babies vaginally (VBAC).
I can’t count the number of times I’ve watched the scenario play out or read what seems to be the same birth story over and over only with different women playing the starring role. It never ceases to amaze me that women duplicate the same choices as another and yet expect an entirely different birth experience. If you pick the medically-minded doctor, expect that he’ll want to medically manage your birth.
“Oh, I know that Dr. So-and-so doesn’t have a great reputation for being supportive of natural childbirth but he’s so nice that I’m sure he’ll be supportive of me.” Pleasant conversation and kind looks aside, actions speak louder than words. If Dr. “Nice Guy” has a track record of inducing most of his patients as early as a week before their due dates or thinks he’s doing women a favor by slicing up their genitals with a “generous” episiotomy, guess what kind of “care” you can expect? Do you want that?
Be smart. Figure out the kind birth experience you’d like to have and choose a care provider that normally attends that kind of birth. If you knowingly choose a doctor who has a high c-section rate, believes that any intelligent woman would choose an epidural, thinks episiotomies are necessary, regards a woman’s body as very likely to kill her baby at any moment, and induces woman all the time for psuedo-medical reasons to outright convenience, I have to call you very unwise or even insane. There’s a quote about the definition of insanity being doing the same thing over and over and expecting a different outcome. Learn from the mistakes of other women who have gone before you. Learn what other women have done to successfully create their joyful natural birth experiences and do what they did! Imitate the good choices and ignore the bad.
Keep in mind that most doctors and nurses in a hospital setting have never, ever seen a truly natural birth. It is an entirely foreign concept to many of them and few of them think natural childbirth is any kind of worthy goal. These providers are not trained to sit by and let a very safe natural process unfold. They have a high regard for technology. They are trained to use it. And they do.
Does your care provider discourage birth plans by saying things like:
- “You can’t plan a birth. Women who come in with birth plans end up having c-sections.” This comment speaks volumes about the care provider’s beliefs regarding birth. They don’t trust birth. In their view, birth is an emergency waiting to happen. They believe that at any moment something can go drastically wrong. They fail to see the connection between their interventions and the resulting complications since very, very few of them have any experience with normal, natural birth.
- “The only birth plan a woman should have is ‘Go to hospital. Have baby.'” Unfortunately, some doctors or nurses are so hostile toward the idea of a woman being in control of her birth experience and being an active participant in the decision-making process that they will sabotage her efforts. This can be subtle “you’re still 6 cm” to overt “I don’t know why you’re wanting to suffer like this. Why don’t you just get an epidural?”
- “We won’t accept patients who write birth plans (or use a doula or whatever).” Is your doctor the one giving birth? Oh, that’s right. Only YOU can give birth to your baby. At least with this comment you’re alerted well in advance that this provider is definitely not open to supporting you in your birth choices.
- “We’ll work with you.” This comment is a tactic to string a woman along until she’s so far into her pregnancy that she feels like it’s too late to switch to a more supportive provider. Sadly, some doctors will tell a woman what she wants to hear, fooling her into believing that he will be supportive when it comes time for the birth. It’s a shocking and hurtful surprise for her to discover that he’s actually quite disdainful of her personal beliefs about birth and may even go so far as to teach her a lesson about who the expert really is when it comes to birth.
- “You’d better plan on having a small baby because your pelvis is too tiny for an average or large baby. We should induce you a couple of weeks early to be safe.” Keep in mind that there is NO way to accurately measure the inside of a woman’s pelvis to determine whether or not the opening is large enough for her baby to fit through. When a woman is on her back (as she is during a pelvic exam) her pelvis is closed to the very smallest it could possibly be. Squatting opens the pelvis by about 30%, which during pushing can mean the difference between a vaginal birth and a c-section. The ONLY way to know if a baby is indeed too large to be birthed vaginally is for a woman to have a spontaneous (not induced) labor during which she spends a lot of time in upright positions. During a naturally started labor her body’s natural hormones do the wonderful work of softening the ligaments in the pelvis, which allows it to expand and open. This does not happen with an induced labor. Inducing for a big baby increases the rate of c-section and poses significant risks to both mother and baby.
What’s a mama to do?
Women have a strange loyalty to their doctors, even if they are certain their doctor is not a good fit for them. Don’t let that be you. If you’ve discovered that Dr. “Nice Guy” may be someone you want to invite over for dinner but you no longer want him to come to your birth, what can you do about it? You have two feet. Walk away! Ask independent (out-of-hospital) childbirth educators, doulas, and La Leche League members who the supportive care providers are in your community. Believe me, they know. And it’s never too late to switch! Some mamas have even fired their doctors while in labor. Of course, it’s much more peaceful to know in advance that your doctor or midwife has a proven track record of being supportive of your ideal birth.
Here is an excerpt from one of my Hypnobabies student’s birth stories:
“Right after the birth I felt so full of energy and excitement! I did it! I birthed my baby! And without any drugs whatsoever! This goal of mine had taken a lot of preparation on my part but really having my doula there made the biggest difference of all I believe. I feel so confident about my body and my strength as a woman. Having a child is an amazing experience… I replay that night so many times in my mind… It always makes me smile…”
You can read the full story here on my Hypnobabies classes website.
Cesareans posted greater risks for both mothers and babies. The World Health Organization says that c-section rates should be less than 15%. In the United States the c-section rate was at 30% in 2006. And it appears to be rising.
VBAC awareness, “Someone Like Me”.
Cesarean birth experience of the woman who created the above.
We met last night and watched the documentary Born in the USA. We had a nice-sized group of women and had an enjoyable, informative talk after the film regarding the type of care women receive in various birth settings. The general consensus of the group was that midwifery care is far preferable to obstetric care due to the respect and autonomy women retain while under the care of a midwife. In the film an obstetrician is seen condescendingly telling a woman “that’s not a choice” the same way a mother might tell her three-year-old that it’s not a choice to hit his sister.
Use of Technology
The group also concluded that obstetricians employ the use of technology despite knowing that these interventions result in greater injury without improving outcomes. In one scene a group of obstetricians gather to discuss some cases. They laughingly talk about how one woman’s c-section may have been induced by the interventions she received. They state that breaking a woman’s water has never been shown to speed things up but that they all do it anyway. In another scene an obstetrician states that continuous fetal monitoring doesn’t improve outcomes for normal births but that it provides a record that may be used in a lawsuit. Obstetric tradition and fear of lawsuit are major factors as to why obstetricians intervene so readily.
Continuous fetal monitoring also makes it easier for nurses to watch multiple patients at once. The group discussed that in a home birth setting it’s common for there to be two or three midwives and assistants caring for one laboring woman. In a hospital setting it is common for one nurse to be watching two or three laboring women at the same time. That division of attention requires a nurse to rely more heavily on machines such as the electronic fetal monitor to alert her if there is any problem. In a home birth setting two or three pairs of watchful eyes are there to make sure everything is still normal and safe. An obstetrician who now works as the medical director of a birth center commented that even though he’d attended thousands of births he’d never stayed with one women throughout the course of an entire labor the way he sees the midwives at the birth center do routinely.
The group also determined that women in a home birth setting are much more likely to be supported and encouraged which results in safer, more joyful birth experiences. During the home birth shown in the film we saw the midwife giving lots of encouragement and (when needed) suggestions. The baby’s head was in an unfavorable position. Rather than reaching for technology to correct the “problem” the midwife instructed the mother to move around and use various positions to get the baby to adjust her head. It worked and the woman gave birth under her own power to a large and healthy baby.
The lack of support generally found in a hospital setting was glaringly obvious during one particular obstetrician-attended birth. The woman was at 3 cm and expressed that she wanted to have a natural birth. The obstetrician, arms crossed, said that that was fine but that if she stayed “this comfortable” then they’d need to give her pitocin. Later on the OB came in again, repeated that drugs are available and that pitocin is a good idea. The laboring woman decided to get pitocin and “something to help her sleep”. She got a shot of narcotics and some pitocin. The pitocin made her very uncomfortable (which is what the doctor wanted) and the woman decided to get an epidural. The doctor said that’s probably the best thing. She then commented to the camera that the woman and her husband were well-educated but that unfortunately sometimes things happen outside of their control. Later on the woman was given two more hours to finish dilating and ultimately had a c-section because the doctor said biology (not all the unnecessary interventions) had shown that she can’t give birth without surgery. This birth was particularly upsetting for us as a group because we saw this woman’s choices and desires being undermined at every step.
The treatment of babies after the birth was also startlingly different between hospitals and home. In the hospital births shown, babies were frequently separated from their mothers and left alone to cry, terrified, in warmers and isolettes while people around them either ignored them, walked away, or laughed at their distress. In the c-section birth described above the mother and her husband mentioned that the mother was the last person to get to hold her baby, which wasn’t for several hours after the birth. That is inexcusable, even in a surgical birth situation. In the home and birth center births, babies were immediately given to their mothers and they stayed there for a good long while with no pressure to take the baby away for measuring, weighing, cleaning, tests, and procedures.
The ultimate conclusion of the group was that normal, healthy women carrying normal, healthy babies would have safer, more respectful, and more enjoyable birth experiences outside of a hospital setting where they would receive undivided attention from competent midwives, encouragement, and support to give birth in the manner that best suits them.
Join us next time as we share inspiring birth stories. Bring your positive birth videos and birth stories to instill confidence that it is possible to have beautiful, safe, empowering natural births. We will watch another short film, a birth video called Psalm & Zoya which shows the unassisted home birth of twins.