Monday, August 19, 2013

Why You Might Want a Natural Birth.

It's been so long since I've blogged.  I miss it.  And I haven't.  I've been quite present online, whether on diaperswappers or Facebook's newsfeed or various forums or discussion boards, or Instagram or craigslist... to the point of having to seriously limit myself.  But blogging, not so much.  I've been seldom opening the computer between one thing & another (smart phone, hello!), and when I do it's usually for a specific task, like DOULA CERTIFICATION COURSEWORK!!!!  (might be slightly looming over my head)  All that to say, I do have a few posts rolling around in my head-- mostly ones that will be helpful to my expectant mama clients.  It's on the brain, what can I say?  If you choose to read this, please know that I am NOT in any way suggesting that those who go a different route-- whether by choice, happenstance or emergency-- are failing, stupid or "wrong."  I'm simply trying to explore the rationale behind the choice, since you know we get asked it! :)

Childbirth-- it's a big deal for most women.  It's something they either look forward to, fear, find inspiring, find intriguing, or find disgusting.  Or, more likely, all of the above in varying degrees.  Movies portray it as a scream-fest involving a scared husband watching his wife being wheeled away as the doors slam in his face, her threatening divorce until she gets an epidural, then sneezing and popping out a pink clean chubby baby (and all the moms say "no way is that a newborn").  Why would anyone want to endure THAT unmedicated??  Isn't it so dangerous, so painful?  I mean, didn't women DIE all the time from childbirth a hundred years ago?  Well... not exactly.

There actually are several reasons why mothers might chose a natural birth, despite having access to medication & technology.  Here are a few I thought of, in no particular order:

1.  God is smart.  He designed birth, and it's a complex, intricate, miraculous process that even the best doctors don't fully understand.  From what begins it to the hormones that regulate it to the way various organs in both baby & mom change radically throughout the process, it's just really really cool.  For thousands of years, women have given birth.  What about the Curse, you ask?  Didn't it mess up childbirth?  Well, yes, women's main role-- as relational care-givers-- is now hard.  But the pain in child-bearing extends far beyond conception, labor & delivery.  It's just as seen in rebellious toddlers, in horrific accidents taking teenagers, and in sending your dearly beloveds off to take their place in their own families.  We mothers will always suffer in so many ways.  But pain & death doesn't summarize motherhood any more than sweat & frustration summarizes work (the arena where men were cursed)-- and neither does it summarize childbirth.  Yes, things can go wrong there, and yes, there is much that we humans can do with the intelligence God has given us to intervene skillfully when those things do go wrong (placenta previa, shoulder dystocia, maternal hemorrhage, etc), but, just as in the rest of life, stuff usually goes the way it's supposed to go.  Great sermon from John Piper on the suffering of motherhood.

2.  Women's bodies were made to birth.  Not only do we have all the right organs, we have all the right hormones & instincts.  This is the fundamental difference between [most] OB/GYN perspectives and a midwife's:  the former views pregnancy/labor/birth as one of many pathologies of the female reproductive system that must be "treated."  Midwifery views it as a natural process, and trains practitioners to watch for warning signs of problems & otherwise just empower women to labor on their own.*  I'll briefly touch on a few aspects of the intricacies of birth:
- the hormone cascade, in which oxytocin (mood-altering bonding hormone & pain killer), prolactin (milk-making hormone), adrenaline (strengthening hormone) and beta-endorphin (opiate & analgesic) all are precisely released.  There is no way to artificially mimic these-- synthetic versions can't cross the blood-brain barrier so can't act as pain-killers, and once the cascade is interrupted  it's difficult to get the train back on the rails, so to speak.
- the beginning of labor itself, which I've blogged about before.  Pregnancy generally lasts longer than the 40 weeks we've come to expect (especially in Caucasian first-time mamas).
- position & its effect on pushing, which is far more instinctive than we Westerners tend to think it can be.  Laying flat on your back is probably the absolute worst way to push, yet if you are medicated & monitored, catheterized and hooked to an IV, it's about the only way you can push.  Women who are unmedicated and thus in tune with their body's instinctive positioning will usually choose to push in a crouched, standing, hands-and-knees or squatting position.
- baby's rotation as it descends, which can be affected by Mom's position while in labor.  Again, an unmedicated mom will be in tune with what she needs.  Here again laying still on a bed is not helpful.  The "wrong" position will be agony, the most helpful will provide relief.
Recommended reading: Ina May's Guide to Childbirth, by Ina May Gaskin

3.  Birth is empowering.  Just like people voluntarily climb mountains, bike across the US, and run marathons, so there is joy in physically, mentally & emotionally "pushing yourself" and seeing just how far you can go.  The bear went over the mountain, why?  To see what he could see!  And probably, to see what he could do.  When women are properly supported in labor, they are admired, affirmed, and encouraged, perhaps like never before in their lives.  They are doing something unique that no one else can ever do:  bring forth that child into this air. The incredible endorphin rush after birth had me saying, seconds after my daughter emerged after 45 hours of labor "let's do that again!"  I have never forgotten the incredible sense of accomplishment and thrill I got from birthing each of my children!  Anything worth doing is hard, and we know that deep in our bones.  After my first natural birth, I felt inducted into the kinship of all the mothers before me, including my own mother, grandmother, and even that teenaged girl laboring in a barn in 1st century Palestine, bringing forth my Savior.

4.  Human imitation is always, at best, just a mimicry-- with plenty of [often unforeseen] pitfalls & side effects not present in the Original.  Think margarine instead of butter, aspartame instead of honey, 'ostomy bags instead of colons... The more we know about birth, the more we realize we don't know about it... and the more amazing it is that so many babies/mamas emerge relatively unscathed in all the impositions various centuries have tried to force on it (Victorian diets of crackers & water & indoor confinements, restrained "twilight sleep," among others).  There are pitfalls & risks at every stage of intervention, from induction (lots of aspects of risk here, from autism to use of pitocin to accidental prematurity), to restriction of food/water intake due to IV use, to use of artificial hormones (pitocin, cervadil), to use of drug-analgesics (such as epidurals), to guided pushing, to use of forceps, to use of surgery.  We simply don't know the long-term effect medications have on infants who receive them (many studies suggest that it's not good), and it's well-documented that epidurals are hard on babies during delivery, and that's just the tip of the iceberg.  Recovery & long-term health for mom, future pregnancies, health of baby, mom & baby's early relationship, all can be affected by interventions. Recommended reading:  Henci Goer's Thinking Woman's Guide to Better Birth. Recommended watching: The Business of Being Born

5. The skills found in natural labor are very beneficial in other areas of life.  Learning to manage pain, to work through physical exertion, to relax & focus despite circumstance, to keep outcome in mind despite process-- these are all very useful!  Labor can be a tremendously powerful unifying agent to husband & wife, sister & sister, mother & daughter, too.  There is something sacred about any birth, and natural birth is particularly beautiful to be a part of.  Spiritually, I learned to trust God for strength in the moment in a way I'd never had to do before.

6.   Pain is not the problem; suffering is.  There are other ways of managing pain besides drugs-- to either minimize, remove, manage, or remove it from the foreground of experience.  This is a crucial point to make.  While I accept that pain may be a part of most women's labor, just as it is in pretty much any other intense physical feat (distance running, team sports tournaments, weight lifting...), suffering can be avoided.  Those of us who birth without pain meds don't like pain.  We just know that some pain can be managed, gotten through, used-- and true suffering can be avoided.  Some methods include:  hydrotherapy (laboring in a deep tub of warm water is called "the midwife's epidural" for good reason!), aromatherapy, massage, position, use of a rebozo (shawl/sling), emotional support, internal focus, self-hypnosis, sterile water injections, movement (slow dancing, belly dancing, walking, swaying, rocking), and controlled vocalizations.

Mamas who've done this, what would you add?

*Note:  notice how OBs usually talk about "delivering a baby," or even "delivering her of a baby" while midwives usually speak of mothers "delivering their babies."

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