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May

Amen, sister. I'm delurking here to say that perhaps the best thing about having had a natural childbirth was the ability to end the (extremely well-intentioned, totally loving) "well-- you don't KNOW what it's like..." from every woman with vaginal-born children that I know. I look forward to being knocked up again so I can say "I plan for a natural childbirth, but who knows?" without encountering all the disclaimers. I KNOW you don't (that I didn't) know, and I admire your flexibility-- but I also know that your attitude and open-mindedness will carry you a far way toward meeting this baby in the best possible way-- whatever that may be. Best of luck-- you're much in my thoughts (and not in a creepy stalking way!)

Ollie

As long as you keep a large bottle of tequila VERY close by, just in case, ok?

Of course, I kid. I wish you a very easy and beautiful homebirthing. I'm eagerly anticipating "the post".

Jody

Safe traveling, Jo.

Un-named ( I'm afraid I may be lynched!)

Hmmmm ..... you offer so very much to think about. One very decisive factor, I agree, is what background, experience and support a woman has available.
As for myself, when the OB told me @ 36 weeks that I had to have a section (babe wedged his head between my liver and ribs, making "manual" extraction imperative) - well, I'm not ashamed to say I grabbed his hands and started kissing them, then proceded to jig myself out of the office. As a nurse who had worked L&D .... well, its not called "labor" for no reason! I had absolutely no problem with avoiding it!
And for each of my next 4 deliveries I chose (insisted!!) on the same mode. By my 4th pregnancy a fellow nursing friend gave me a tee shirt saying " Cut me - Slice me - ANYTHING but labor!". What can I say - I am chicken-shit hearted.
On a more serious note, I am one of those who do not advocate home-birthing, but very much support midwives IN A HOSPITAL SETTING, for several reasons. One, no matter how well trained,knowlegable, intentioned and experienced a midwife may be, the bottomline is that they are NOT medically trained doctors.
As for the birth itself I just personally feel that as long as the medical support is available, I want it - RIGHT THERE, at the hospital.
I would NEVER have imagined saying all this to a woman so verrrrry close to her "time" - but I have to say that you have impressed me as being a very exceptional woman - and I wish you the most beautiful and joyous experience when the time comes (which, btw, for the benefit of your many readers nerves - could you please git the show on the road?? It is excruiating waiting for this!! :) )

fisherwife

Glad to know you've got the best possible attitude going in...and I did mean my comments in love. Thanks, and may your cervix be "favorable" very soon for labor.

Pam

May you have the type of birth experience you will always treasure! Can't wait to hear the good news (about baby and new place to live)!

(Coming from a woman who pushed for 3.5 hours and ended up with a C-section b/c my son has a head roughly the size of Russia and decided to look off to the left the entire time like he was in a dreamy Olan Mills portrait.)

Naomi

My reason for wanting to avoid pain medication was that after reading about the risks and benefits of the various options, I thought that if I could get through childbirth without using pain meds, I would probably have a quicker and easier recovery. That's why I wanted to do it. In the case of my first delivery, I can say very emphatically that I was right about this. (I'll skip the elaboration just because it's a long story, not because it was anything traumatic or scary.) And anyway, up until transition labor, it just wasn't that bad. At one point I asked to have my dilation checked because I thought that if I weren't pretty close to complete, I wanted pain meds. I was at 8, and I was pushing less than a half hour later. Even if I had asked for pain meds at that point, given that they wanted to give you an IV of fluids before you got the epidural, and given that it takes time for the anaesthesiologist to get there and so on, I wouldn't have gotten any pain relief until I was holding my baby.

The main reason I'm commenting, though, is that I just had to respond to this line:

I don't go into childbirth imagining that it'll be a psychedelic party (although wouldn't that be cool?)

With my second, I wound up cooling my heels in L&D for a reeeeeeally long time, because my water had broken and I refused pitocin. (My midwives didn't have any silly 24-hours-or-else rule, they were totally fine just waiting for me to go into labor.) The second night I was there, I was having contractions but they were 15 minutes apart and appeared to be petering out. I was afraid I wouldn't sleep at all, so my midwife gave me a scrip for a sleeping pill, Ambien.

Well, it turned out I really was in labor, and since I couldn't sleep through the actual contractions, the Ambien made me hallucinate.

I saw puppy dogs and alligators, a giant technicolored frond-waving plant, and lots of other interesting stuff. While I was pushing, I saw giant rigatoni noodles coming down from the ceiling.

In some ways the Ambien made a pretty good labor drug: your midwife will tell you to just take the contractions one at a time, and, well, I didn't have much choice, as I was too stoned to contemplate the next one. Also, if I hadn't taken the Ambien, I probably would have been very worried that I was having these really seriously intense contractions and yet they were still fifteen freaking minutes apart.

They never got any closer than fifteen minutes. Right up until I had two right in a row and then announced that I had to push. By the time the midwife got there to check my dilation, the baby was crowning, and she was out about two minutes after that.

So, y'know. I actually wouldn't recommend a psychedelic labor party. But it was still a pretty good experience overall. And the really weird thng is, as soon as the baby was out, the hallucinations went away. Go figure. I'm still never taking Ambien again.

Good luck, Jo (I keep checking your blog when I'm up at weird hours, just to see if you're in labor yet).

Shamhat

Ah, anesthesia...the magic epidural. Well, there ain't no such thing as a free lunch.

I guess what we know at this point in the US is that almost 75% of women can indeed give birth vaginally with an epidural. But who can tell if you're in the unlucky 25%?

I admitted a woman 2 nights ago with a baby who was straight OA--all back in the front. When I arrived last night to take her back from the day nurse, her baby had turned to OP. She had a vacuum extraction, with all the necessary perineal damage that entails, and she was one of the lucky ones. Without anesthesia to muck up the process, OA babies do not rotate into OP during labor.

Her doctor even told her, "It was the epidural. Studies show that they encourage malpresentation."

Jo, all of my births went pretty much the way I planned. And I'm not special. You can give birth. When the baby is ready, the process takes you over and you ride it until the baby slides out, and that's all there is to it.

Oh, and, uh, avoid lithotomy. Duh.

Naomi

Oh, I meant to say above, about pain meds -- there was actually a clear benefit (to me) to going without pain meds if I could get through labor that way. There really doesn't seem to be any plus to dental work without novocaine if you need it. I attach no moral superiority to my pain-med-free labors, because for one thing, it's not just that pain tolerance varies -- the actual pain itself is different for different women, for all sorts of reasons (the position of the baby, to name one important one).

And I have never ever thought of a c-section as the easy way out -- I had my appendix out when I was 15, so I have done the abdominal surgery thing. Recovering from a vaginal delivery was a snap compared to recovering from abdominal surgery! And an appendectomy is actually much less invasive surgery than a c-section.

Nicole

Funny that Un-named cites being "chicken-shit hearted" as her rationale for opting for sections--I cite being a giant pansy as my reason for avoiding drugs. Have you seen the size of the needle they have to shove INTO YOUR SPINE for an epidural?! No thanks!

You totally impress me with your intelligent, levelheaded approach, in your writing and in your life, to something that is so emotional and subjective. As blessed as you are feeling to have this baby, remember that your baby is truly blessed to have you.

Heather

I really appreciate the discussion on this. I was thwarted in my first attempt at a home birth before my labor even started; i had health problems that made it a very bad idea. I am hoping that next time, if there is a next time, I won't be encountering those same problems, and can give homebirthing another go. My labor, despite the hospital setting , was still wonderful- because at the end of it, there was my healthy little boy and a healthy, albeit tired, me. That is what it is all about , right ?
And Finally, woman, when are you going to have this baby ?!?!?! I am chacking the blog several times a day, waiting for a quick little message of " oh ( insert favorite four-letter word), this really does hurt!" Really, I am very excited- strangely so, having never met you. I am thinking of you, and this precious baby, who my word, let's hope this lolly-gagging isn't a sign of things to come in his/her little future .
lots and lots of love

sara

I know what you mean about the "Oh, honey, I know you plan unmedicated, but just wait and see" comments. Like the other poster above, it wasn't until baby #2 that I was able to reply to them with "Of course, but you know, I do know what labor feels like."

I feel so fortunate that the one and only hospital in my town has a very flexible L&D unit, full of nurses who seem equally comfortable with us "No meds please but could you fill up the hot tub for me" women as they are with the "Here's my preregistration forms can you call the anesthesiologist?" patients. I delivered with midwives both times, enjoyed the hot tub, drank and snacked as necessary. Like a homebirth, but without my neighbors getting annoyed at all the noise at 2am. Kinda.

I hope it's soon for you, Jo - and I hope for you that whatever happens, however this baby makes it from the inside to the outside, you feel respected by those who are there to help it happen. Because the commenter who said in the previous string that women think they can *control* the process and are mistaken -- is mistaken. Its not about being able to control the process. Its about being treated with respect *during* the process. And its about the process being more than using the most factory-mass-production efficent ways to arrive at the end result.

MollieBee

Dude...I can't freakin wait for you to pop that sucker out.

amy

And then sometimes things go better than planned. I gave birth to my first child this past December at a birthcenter (converted from a lovely old Victorian home) with one midwife and one birth assistant in attendance. I had expected pain and tearing and a long labor. I pain (oh yes, I haven't forgotten), a small tear, a TWO HOUR labor, and an 8 pound 9 ounce baby girl. I like to brag to my girlfriends that God loves me more them for granting me such a short labor:) Good Luck with your birth, and may it go better than planned.

Brandee

Did you do the castor oil??? Even after that graphic and awful description of the woman having loose stools all over her doctor?? Woman, you are brave!!!!

Kristine

Just let me know when to light my candle. when someone I "know" is in labor, it's delicious to burn a candle and think of her.

Kristine

Sarah L

You rock. I hope you have your baby soon, (I need it to arrive by Tues eve, if you wouldn't mind...)

I will be out of the country for 2 1/2 weeks, and it will just be excriciating!

Sarah

Foster

" I don't go into childbirth imagining that it'll be a psychedelic party "

Well, according to the book "Spiritual Midwifery," it will be. Good luck!!

21stCenturyMom

Jo - do skip the castor oil. It is so not worth it (I know this from experience).

The combination of understanding what labor and delivery is about and being ready and willing to go with whatever comes your way is a winning one. I can hardly wait to hear your birth story.

As Mr. Rogers used to say, "Speedy delivery!"

lorrie

I am not trying to be a snarky troll here, but isn't saying that "Women are designed to give birth" a bit disingenous?

Women are designed to get pregnant, too, but I hear that those comments are not welcomed in the infertility community. I wasn't able to even get as far as a pregnancy, let alone birth.

I am not worshiping the medical establishment blindly, in fact I think they're very bad at thinking outside the box (what is the CAUSE of this disease? don't just give me a pill to cope with symptoms)..

but many babies are just not going to get out safely without high tech medical intervention--too big, lying transverse, etc. (yep, I know all about midwives trying to turn babies--it didn't work for my sil)

Of course carefully screened well nourished women with documented low risks are going to have a high percentage of safe homebirths. They could birth in a police car or in the most high tech hospital in the world safely.

best to you.

e

Re amputations of yore- they did have anaesthetics- it was called brandy, and plenty of it, thanks.

Do they give you gas and air at a home birth in the US? I had it for all three labours. It gave me something to do in #1 in hospital but didn't help at all, ditto #2. Labour #3 was so short and intense (1 minute contractions, with 30-45 seconds between) for last hour and a half, that I couldn't be bothered with the gas and air.

It made me feel like I'd had a couple of drinks, which might have pleasant if I were in the pub, but was just annoying in labour.

As you say, the pain of labour is very unlike any other pain. It is utterly finite in duration- you know that the minute the baby is born, there's no more pain; the endorphins you build up make you feel on 7th heaven after a few hours, and are supposed to assist in the bonding process. Very unlike the pain of surgery healing, which can go on for weeks.

Shamhat

"Of course carefully screened well nourished women with documented low risks are going to have a high percentage of safe homebirths. They could birth in a police car or in the most high tech hospital in the world safely."

I don't think that's true.

First, home birth clientele in the US are not "documented low risk." I would say that in New Jersey in the 90's at least half were VBACs. That's because the midwives weren't licensed and had to be paid out of pocket, and most women would prefer a free birth at the hospital unless they were convinced they wouldn't have a chance of birthing vaginally. Often it takes personal experience to really understand that the cycle of intervention can indeed sabotage YOUR labor and birth.

I will stand behind the "well-nourished," because most midwives do extensive nutritional counseling. Most American OB's assume that anyone who appears to be able to afford food is well-nourished. They're wrong. And I think "gestational diabetic" women, who wouldn't be called low risk, do better with midwifery management because of the nutritional counseling.

However, I would also point out that here in Manhattan, where the c/sec rate is about 30%, there's a birthing center at Bellevue with a 3% c/sec rate. They serve immigrants. Well. I've been told by their volunteer doulas that it's rare to come across a client who can speak English. I, uh, guess they're low risk for some reason.

I, personally, am demographically a section. Not one of my female friends from Caltech had a vaginal birth for their first child. Few of my male friends' wives did. Those who had one for their second worked hard to get it. Being white, rich, and educated are factors against a birthing woman. But that's not what you think of as "high risk," is it?

As for babies being "too big," well, I prersonally discount any "too big" story (AOD, FTP, CPD, etc) that does not include labor while standing and on hands and knees. Your body may indeed make a baby that won't fit in lithotomy, but unless you had ricketts as a child, had your pelvis crushed in a car accident, or the baby has hydrocephaly, the baby will fit through your pelvis.

AmyinMotown

Wow. I was, quite frankly, enraged by some of the comments from the last post and this one.
I am NOT stupid, misinformed, or blinded by the medical establishment. I wanted pain meds because I do not deal with pain well and I wanted the birth of my long-awaited daughter to be a beautiful and happy experience for all of us, not a memory of wrenching misery. I was quite open to whhatever came--wannted to try to go as long as possible without pain meds and maanaged pre-labor anxiety by visualizing a gentle, easy birth andd reminding myself that my body had spent nine months preparing to do this task.
And I ended up with a c-section ((less than six hours after my water broke). Her heartrate was dropping every time I had a contraction. Any of you in my shoes, listening to your baby's heartrate slowly ebb to almost nothing, who still would DARE to tell me c-sections are second class births and if I were just better informed and less sheeplike I didn't have to have the intervention, can go to hell. I tried two and a half years for this baby and am not likely to have another. I would have removed my uterus myself with a grapefruit spoon to get her out safely. Had my OB not swept into the room and taken charge of the situation, my precious girl might not be here. That''s a thought I cannot bear.

Jo, I don't think that putting down those of us who feel comfortable with a more medicalized approach was your intent, or in fact, your action. But many of these comments made me feel marginalized and angry.

perceval

I don't know if you remember me - I was due 13/08, delivered my baby by Caesarean birth on 08/08. I applaud your Zen attitude - be in the moment, enjoy every second.

Should you end up in theatre, I'd highly recommend asking for the screen to be down, and for the anaesthesist or obs/gyn to talk you through the procedure as it unfolds. Our daughter was brought right back to us after her first checks, I held her skin-to-skin while I was sewn back up, I breastfed in recovery, shortly after delivery, which is when she was weighed and measured.

It's one of the miracles of modern medicine, and yes, I feel like I gave birth. I'm still hoping for a VBAC some time down the line, but that doesn't diminish the experience I had.

Enjoy the birth experience, wherever it may take you!

Faerie

I had a section due to heartrate dropping dramatically and his head just WOULD NOT COME DOWN!! My midwife was REALLY concerned and she says she has rarely recommended a c-section in her career w/o a damn good excuse.

I have PCOS like you Jo. One of those funny little side effects no one ever told me about, that I asked my RE about AFTER the birth of my son, is an unusually narrow pelvic opening (RE confirmed this, haha "Did I forget to mention that? Well it's only in prelimenry studies, wow can't believe that happened to YOU!". I remember when the OB opened me up she said "My GOD that's a tiny pelvis!" I joked about having a tiny pelvis, but such a large ass.

Later the next day as I recovered in a rocking chair, nursing my son, my midwife came in to check on me. She said she had tried everything she could to get my pelvis to open up, but it just wouldn't budge. I asked her if things would have gone differently if A: I had not been induced or B: if I had not had an epidural. She said I most likely would not have gone into labor on my own w/ how high his head was and I most certainly would have ended up w/ a section regardless of the anesthesia I received.

She also mentioned that had I been laboring at home, or had this happened in the times when c-sections were not available: my baby would have died and I would have risked hemorraging out. There was no "warning" for me. Things progressed to the point of pushing and then suddenly that darling heartrate dropped. He was out 1/2 an hour later. They gave him to me as they wheeled me back to my room and he was nursing w/in the hour. It was a wonderful experience and one I hope to never repeat again. My future children (Please Lord!!) will all be delivered via csection.

So I too am a little...hmm...hurt by some of the comments regarding csections, but not by your posts. I love your posts and I must refresh this blog 10 times a day waiting for THE POST. I wish you the best of luck, and I know that no matter how your birth story ends up, you will be deliriously happy and giddy and then somewhat taken back by the realities of having a newborn ala: getupgrrl lol.

Enjoy your sleep!!

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