Monday, October 02, 2006

Naming My Fears

These are my biggest fears. I am going to list them no matter how silly they might seem on paper. Instead of pretending they don’t exist, I am going to broadcast them to whoever wants to read them.

In no particular order:

1. Having a cesarean section. Even if it was truly “necessary.” (I would be skeptical of that diagnosis for anything but a very small number of reasons, including: complete placenta previa, cord prolapse, shoulder/transverse presentation that doesn’t resolve with labor, or massive placental abruption.)

2. Having an operative delivery (forceps or vacuum extraction).

3. Transferring to a hospital and having to fight for what I want.

4. “Losing it” during labor and transferring to a hospital and later regretting it.

5. Taking pain medications and then having people smirk and say “I told you so.” Obviously I would have to be in a hospital for that.

6. Making the wrong decision about where to birth, and whom to invite. I honestly cannot say I know 100% that planning to birth unassisted is the right choice. I’d say it’s more like 90%. I cannot think of any more appealing alternatives though. I do have a good midwife friend who might be able to come, but it’s not certain. She also lives 3 hours away so I cannot plan on having her there on time.

7. Wanting a certain kind of birth so much that I will ignore what is really best for me. Maybe I would have a better experience with a “low profile midwife” (I love Michel Odent’s term!!). Or maybe I invite a midwife for the birth, but I would have been better off by myself.

8. My husband freaking out when I am in labor and disrupting me. Let’s face it—adrenaline is not a good thing for laboring women to be around.

9. Losing the baby and having people blame me for it. My husband especially.

Those are my biggest fears. Now what to do about them...comments or suggestions appreciated!

9 comments:

  1. Our first child became stuck in the birth canal and couldn't be born without a doctor and forceps. This is just one case but I understand it's common. How do those who home birth handle situations like this? That would make me nervous as well.

    Good luck, regardless of any decisions you make :o)

    Andrew
    To Love, Honor and Dismay

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  2. If you look at published statistics of forceps, vacuum extraction, and c-sections, you will notice right away that women who birth in a hospital are much more likely to "need" these interventions.

    For example, Cesarean rates among healthy women birthing in hospitals are about 20% (and close to 30% for the overall population). Cesarean rates for healthy women planning home births are usually between 1-4%.

    The difference in forceps & vacuum extraction rates are also strikingly different. In The Farm Study (2,028 pregnancies in a home birth practice in Tennessee), 0.5% of women had forceps delivieries, and 0.05% ahd vacuum extractions. Compare these numbers to the national averages for forceps and vacuum extraction, which were around 2.2% and 5.2% as of 2000.

    Now what would account for such a huge difference? Here are the most common causes of "stuck" babies:

    1. Laboring woman's mobility. If a woman is drugged (especially with epidural or spinal anesthetics) she is unable to move to help the baby into a more favorable position.

    2. Hospital policies regarding freedom of movement and choice of birthing positions. It's often policy that women have to stay in bed during labor, especially when they are pushing. Almost all American women give birth on their backs, either in stirrups or in a partially reclined position with their legs supported, despite evidence that these are the WORST positions for pushing a baby out, short of hanging upside down from one's ankles. Giving birth lying down closes the pelvis and pushes the sacrum upwards, into the birth canal.

    3. Artitrary time limits on any stage of labor. Who is to say a baby is truly stuck? How can you really know? Most hospitals and doctors have some sort of time limit on the pushing stage, usually around 2 hours. After a certain amount of time has elapsed, care providers will suggest interventions, such as Pitocin, forceps, vacuum or Cesarean sections. I personally know a woman who pushed for 11 HOURS with her 5th baby. (This baby had a hand beside its head, making descent more difficult). Most doctors would have used forceps or cut her open after a few hours, but she had a very patient OB who saw no reason to intervene simply because the baby was slow to emerge. Kudos to him!

    It makes sense that women birthing at home, with no arbitrary rules about what position she has to assume and no one telling them that their time is up, will have fewer "stuck" babies. They can change positions multiple times to allow the pelvis to flex and the baby to wiggle into place.

    In a worst case scenario, women with a truly stuck baby can always transfer to a hospital. There's a place for medical intervention. It can be a blessing when it's truly needed. It can also cause deep harm when used too often, as is unfortunately the case in our culture.

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  3. Firstly, I want to tell you that luck has nothing to do with anything....things will progress how they are meant to.

    Secondly, I am impressed with your research and knowledge and my brain itches a little that you haven't firmly made the choice to be at home unassisted yet, when clearly you know what you can expect, and that it is the safer choice.

    Thirdly, I will tell you again, because I believe it and I am pretty sure you believe it too, you just need reminding....YOU CAN DO THIS! YOUR BODY WAS MADE FOR THIS! BIRTH IS THE SAFEST THING YOU WILL EVER PHYSICALLY DO!

    LAstly, I am really enjoying reading your blog.

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  4. Thanks for your encouragement! I wrote this post to examine any fears I was having and to get them out in the open. Kind of a cobweb clearing session. Now I hope to be able to leave my worries behind and concentrate on creating the experience that I want.

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  5. Rixa,
    your list of fears is so honest, and so healthy. Aside from fear of what goes on at hospitals, most of these are just pre-labor anxieties (of the 'fear of fear' kind) which will evaporate once you are laboring in the here-and-now. You'll automatically stop wondering how you WILL experience it all, because finally you are experiencing it! Taking it one contraction, one breath at a time, not thinking in future abstractions.

    Is your less than 100% confidence in UC'ing (and sorry if I'm just reading into things) coming from fears of not having adequate support while at home? Because I see a theme of: transfer or not, stick with plan or not, dh freak out or not.... which have to do with the burden of making a decision potentially at a moment when you are most stressed and least prepared to do so.

    The voice of the 10% wishing for some more *potential* support is telling you something valid. You can explore it without compromising your faith in yourself or in unhindered birth in general. This is good work you're doing! I'm curious where you'll go with it -- I certainly have no hard and fast answers to similar questions that pop into my head :)

    Judit

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  6. Judit,

    You've nailed things right on the head! Yes, I do wonder about having enough support at home. My husband is quite supportive of home birth in general, but more apprehensive of not having, in his words, "someone responsible." (I should have him post his own list of fears here!!). He is worried that he will have to "take control" and make decisions for me--which I keep telling him is not his job. I don't want him to do anything but be there for me 100% and encourage me if I get discouraged.

    We've tried talking about the upcoming birth but unfortunately it doesn't always get very far. He has expressed a desire to have a "backup plan," so I am trying to create that for him. I've been looking into having K (my midwife friend from Iowa) as a possible backup, as well as finding women from my circle of friends who I would feel comfortable inviting if I wanted/needed female support.

    You know what's kind of ironic? I can say with 100% honesty to my friends that "you can do this" and "your body was made to give birth," but then I find myself somewhat less convinced about my own birth!

    I was meditating last night about some of these issues, and I realized that I have to focus on living in each moment, rather than fretting about the future. I feel confident and peaceful with my pregnancy, and I know that I am healthy. I love feeling this baby move around. That is enough to know.

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  7. Well jeez Rixa, of course, because you've simply never done this before!
    You believe that everybody can birth unassisted, because you know that every *body* can birth unassisted. But not necessarily every psyche, under every imaginable circumstance, is perfectly self-reliant. Our physical bodies have clear cut boundaries, but as for the rest of us...

    In retrospect, because I'd never given birth before, 90% of MY reasons for having a midwife there was for pure encouragement. Yes, she did a wonderful job of supporting and having faith whenever mine briefly wavered -- and also in retrospect, I wonder how much MORE wonderful that birth could have been had she done nothing else.

    I have no doubt that that could have been arranged, had it occured to us to ask ;-)

    ...clueless as I was about the real meaning of unhindered, it never even crossed my mind. Duh.

    You are travelling on the exact path for the best birth for you.

    Judit

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  8. Oh no, You got to be the one saying "I told you so!"

    I thought my successful homebirth would be a blunt "I told you so" to my in-laws, but no, they are still worried about all of our "strange" lifestyle choices.

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  9. Not having a UC but you've totally named my fears as well... in order... 3,4,2,1, and 8!

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