Necessary/Unnecessary: A round of birth stories

The fourth Lamaze Healthy Birth Carnival about "avoiding unnecessary or routine interventions" is about to begin and I hope I'm not too late! I have several birth stories to share, all featuring long, exhausting, non-progressive labors.

Paxye, a mother of four, recently wrote about her first two births. Both began in birth centers in Quebec, and both were very long, posterior labors. She transferred to a hospital after a day and a half of laboring and very nearly had a cesarean with her first baby--the only reason she didn't was her persistent refusal and her son's birth one minute before the absolute deadline her doctors gave her for a vaginal birth. Her second labor followed much the same pattern, but she insisted on staying at the birth center and, with a very supportive midwife, gave birth on her own power. Her third birth was a planned unassisted birth, one that went very smoothly and quickly compared to her first two. A year after that birth, she wrote about why she chose unassisted birth. She just gave birth to her fourth child and first daughter Wilhelmina. It was a long, stop-and-start, posterior labor like her first two births. She commented:

As I grew in my knowledge and my confidence the stories show a progression. The first ended up being a hospital transfer and a whole array of interventions short of a C-Section, but only because I would not consent. The second, with me refusing the transfer and staying at the birth centre but still with more intervention than I would have liked and then finally my second unassisted birth [Wilhelmina], which resembled the first two labours, yet I had all of the control.

Jenne's first birth, a planned unmedicated hospital with CNMs, turned into a traumatic ordeal when she had a long period of "failure to progress" early in labor at 3 cms. She wrote about this birth for the Lamaze Healthy Birth Carnival #4. In her words:

I was bullied, harassed, threatened and manipulated into accepting pitocin augmentation and AROM. I knew it was not necessary and I felt no need--physical or emotional--to speed up my labor. I was coping well and was trusting the natural process that birth is.

Eventually as I was so adamantly refusing to consent, I was summarily kicked out of the hospital. I say it that way because there was no gentleness or supportiveness in the attitude of the attendants. They used it as a threat to get me to cooperate. When I didn't, they rudely told me to leave and left it at that.

You can read the full birth story here. This birth was so traumatic that she developed PTSD. Jenne has also channeled those negative experiences into positive action; she helped found the support group Solace for Mothers. Jenne gave birth unassisted to her second baby about a month after Dio was born. She recently revisited what birth means to her, if you're interested in reading that.


Amy Romano's sister Katherine just had a homebirth-turned hospital transfer-turned c-section. She wrote about the labor and birth in the post my lovely c-section. She labored at home for a long, long time and finally decided to transfer after no cervical progression. She tried an epidural, pitocin, and sleep to see if that would help her labor pick up. Eventually she chose to move to a cesarean section and, although it was the last thing she had planned for, she felt very positively about her decision.

And, if you've been reading my blog, you heard about my sister-in-law's birth in Failure to progress or reason to be patient? She wanted an unmedicated birth, but after a marathon labor and several hours of no progress past 8 cms, she chose a few interventions. After 8 hours of no progress, she tried AROM and an IV for hydration. She gave it another 2 hours and, when she was still 8 cms dilated and starting to fall asleep standing up, she chose an epidural (to help her sleep) and Pitocin (to augment the contractions). That did the trick, and she gave birth vaginally just a few hours later.

So I've been mulling over the question "what makes an intervention necessary or unnecessary?" The prominent theme in these four sets of birth stories is that the women who felt the interventions were necessary and welcome (Katherine and my SIL), rather than unnecessary and traumatizing (Paxye and Jenne), freely chose the interventions on their own--on their own request, on their own timetable, and on their own initiative. They knew it was time for assistance. They were the primary actors in their births, rather than recipients of others' agendas. They held the locus of control, even when that meant asking others to do things for or to them at some point (IV, epidural, Pitocin, or c-section).