Such a Time As This

Faith, Hope, & Love

Did You Make These 3 Labor and Delivery Mistakes?

3 Reasons Why It’s Impossible to Have a Natural Labor and Delivery

labor and delivery mistakes

I recently gave birth to our sixth child.  As I ponder childbirth I realize that our labors are much like our children.  They are each so different.  They are unpredictable.

Each labor and delivery seems to possess its own personality along with its own thoughts, ideas and fears. We had a rather long and drawn out induction with this baby.

That wasn’t my first choice, but nonetheless we were glad we went through with it on the scheduled date. This experience brought up a realization to my husband and I of how strange the “birth culture” is in our region of the world. It seems that it is sometimes almost taboo to talk about labor – even more so a natural labor.  It also seems that labor without the use of pain medication is seen as either an accident or something very strange to participate in, if by choice.

With this past delivery, one of my nurses hadn’t witnessed a childbirth without the use of epidural – well, at least not an induction without the use of an epidural. It dawned on me that not only does our culture, in general, seems to sway us away from natural childbirth, but more specifically, the location in which we give birth has a large impact as well. Each time I set out to go “all natural” but it didn’t always work out that way.  Here are some of the reasons why.

1. What your mother tells you about birth may just be the voice in your inner thoughts

When I was having baby number 1 at the young age of 22, I just knew I wanted to have him without any medicine.  Many people laughed at this notion and many questioned it.
My mother had had two twilight births back in the day when women were actually put to sleep during delivery.  When it was time for me to be born, she had researched other options and decided on Lamaze.

She was prepared for the delivery, but when it came time to go through transition (the difficult part of labor lasting from 7cm  to 10cm dilation,) she tried to back out and asked her nurse for an epidural.
At the time, being 8cm they wouldn’t allow an epidural, per the hospital rules.  So, she was stuck pushing me out au natural and feeling every bit of it.  This was not the thrilling, wonderful experience she had hoped for and consequently she warned me “not to wait” for the meds.

During my own first labor I heard my mother’s words echo in my mind, and I, too, opted for the epidural at the earliest possible moment (5cm in my hospital) … not because I was in terrible pain but purely out of fear at that point.

 

I was afraid of what awaited me and I feared the most terrifying pain of my life.

 

I realize that this is just my personal experience, but it does make me wonder how much our thoughts are directed by those close to us.

 

As I sat down to think how close we are to our children and our moms are to us I did a search for the mother-daughter bond.

 

With this quick websearch in less than 2 seconds many website brought up the many ways that mothers impact their adult daughters: from how they feel about their body image, to their career, and their sexuality.

In this case, possibly the closest person to us as a young woman is our mother.

 

Whether we like to admit it or not our moms are the ones who took care of us when we were young, they were our role model as we  grow and they have much influence over us even as adults.

As she shares her own views and her own birth story she is shaping what our ideas are.

 

Even when our ideas don’t match hers, this influence is great, especially at our most vulnerable time when we are experiencing pain and fear of the unknown.  I’m not sure how to solve this problem, other than to say, our words are powerful and how we think about things are equally powerful.  Surround yourself with people who will support your decision – possibly a doula or family who will advocate for you.

2. Cascade of Interventions

That leads me to the cascade of interventions that many hospitals have as standard procedures.  During my first birth I was progressing just fine on my own.

It took me only two hours to go from 3-5cm.  Labor hadn’t slowed down, it was actually picking up.  At around the same time that I asked for an epidural, the doctor ordered my water be broken and a pitocin drip to be started.

The nurse even commented that I didn’t seem to need pitocin – but some doctors seem all too happy to get their patients delivered quickly which then requires the use of labor augmenting drugs.

These drugs can cause contractions that come closer together, more painfully and can even hyperstimulate the uterus in addition to causing distress in the baby.

In our case our baby did respond in distress not only passing meconium but then having a lowered heartrate.  It made it very important to get baby out when this happened.  This is usually where an emergency c-section would have been performed but in my case vacuum and forceps were used instead.

 According to the CDC and the National Vital Statistics Report of 2011,

“Fetal intolerance of labor (requiring resuscitative measures, further fetal assessment, or operative delivery) was also associated with receipt of epidural/spinal anesthesia. Nearly 78 percent of women who experienced fetal intolerance of labor received epidural/spinal anesthesia compared with 45.3 percent without any other characteristics of labor and delivery.”

 

I didn’t realize it at the time, but there is another way to give birth, but it starts long before the interventions are started.

I also feel it is important to note that some interventions are entirely necessary and rather important – some more necessary or appropriate than others.  The trick is in learning the difference and assessing the risk.

3. Where you deliver might sway your outcome

 

In addition to the use of these drugs and labor augmentation, most hospitals have a system in place to rate pain on a level of 1-10.

 

Nurses and doctors do not like to see anyone in pain, and often suggest pain medication.

 

This is true, even with prior notice of not wanting an epidural.

 

With my 3rd delivery, I also knew that I didn’t want the pain medication.

 

Even with that knowledge, my Dr. had the order for an epidural written up and waiting at the nurses station (just in case).

 

I allowed my doctor to fully induce labor with that pregnancy and found out the hard way how badly pitocin hurts…and how there was not much in the way of natural relief because of being strapped to the monitors.

 

The nurses would come in and suggest an epidural and finally by 6 cm dilated I gave in and allowed the needle to be placed in my back.

 

No sooner had I laid down than the baby descended and I was pushing.  It happened so fast that the epidural had no time to work.

 

I was crying as I realized I would get no pain relief but had to endure the pain of the needle being placed, anyway.

 

I doubt anyone would think having a needle being placed near the spinal cord so close to delivery is particularly fun!  It was excruciatingly painful…  The power of suggestion and the power of pitocin at work!!!

 

 The National Vital Statistics Report from 2011 states that 61% of women in the US receive either epidural or spinal anesthesia during delivery.
“More than three out of five women whose infants were delivered by a medical doctor (63.4 percent) or a doctor of osteopathic medicine (62.5 percent) received epidural/spinal anesthesia compared with less than one in two women attended by a certified nurse midwife (CNM) (49.8 percent)”.
Many CNMs work in medical practices with OBGYNs and deliver in local hospitals.  Many CNMs are more willing to work with their patients and try different birthing and laboring positions.

 

Also, CNMS are more likely to discuss what interventions you are comfortable with.  With my last delivery, although I was induced with pitocin, I was able to stay on a very low dose and because of my midwife, I was able to sit on a birthing ball until the pushing phase.  This helped me tremendously to deal with the pain.

 

My midwife really advocated for me and allowed me to do these things although they were not normal protocol for other doctors in this same hospital.  I was still monitored, though, so no showers or tubs and no walking too far from the bed because of the IV, cords and wires.

 

I will be posting soon with the second installment of our childbirth series and how we went pain-med free for our last three deliveries.

 

Tell me about your experiences with natural labor and delivery! Please leave a comment below.

 

 Click here to read the second installment of this series: Stop Fearing the Unknown and Go for a Natural Birth.

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