I’m a big fan of unmedicated childbirth, even after my most recent experience in that regard, which was a major ouch-fest. I’m also a friendly supporter of a free-standing birth center that opened near us a year or so ago, even though my age and various medical conditions mean the midwives there don’t even want me to drive into the parking lot. Because I hang out in some alternative medical spaces, like my chiropractor’s office and the hypnotherapist’s, I know a lot of women who have had their babies there. Many of these women get a look of horror when they hear I have had my babies in the hospital, especially since I had both my babies in the less-preferred local hospital (the other one has birthing suites with tubs). At my last birth hypnosis class, one of the issues we covered was dealing with complications, medical interventions, and medical staff. Since everyone in the room except me was planning to give birth at the birthing center, this part of the discussion focused more and more on me, and as the hypnotherapist talked on and on about the kinds of things that might happen, the other women’s looks of pity intensified.
Pity me not, sisters. I am glad there are more options for empowered births here in the greater Lansing area. I hope the visibility of the birth center encourages more women to consider getting their prenatal education outside the courses offered at the hospital; I hope more women, no matter where they plan to give birth, will consider doing it without an epidural.
But I have been happy with my hospital births. Not that we didn’t have to bang antlers with medical staff both times, in Eric’s case, with the pitocin-pushing resident who checked us in; in Carl’s case, with the world’s dumbest pair of pediatric residents and an on-call hematologist who rubbed me the wrong way (but that was when he was re-admitted for jaundice, not when he was born). And during our stay in the mother-baby center, we did have a nurse or two who reminded us that there’s a nursing shortage. But I have decided that most of the anti-hospital-birth propaganda is a straw-man argument.
A straw-man argument is when you choose the most extreme or weak version of your opponent’s argument and refute it; then you act like you have refuted them completely. In the case of anti-hospital-birth materials, the straw man argument takes two forms: arguing against a version of hospital births that is years out of date (is there any hospital in America that still routinely shaves laboring women, or gives them enemas? Or that snatches babies away to the nursery moments after birth?) and arguing against the worst examples of medical incompetence or arrogance.
Let me give a couple of examples from my own experience. By the reckoning of natural-birth advocates, I had bad experiences both times: in both births, my labor was induced after my water broke. In both births, I had constant fetal monitoring (which, the anti-hospital literature tells you, restricts the mother’s movements and symbolically places the need for medical data above the mother’s needs). The monitors did restrict my movements, though in Eric’s birth, I didn’t care: as it turns out, there was only one position I wanted to be in, and once I was in it, I pretty much stayed in it. Periodically, I would say, “Let’s try the other side,” and my support people would flop me over. I’d have a couple of contractions, say, “Nope, it’s better the other way,” and they’d flop me back.
I had an internal monitor with Eric, and barely noticed it; with Carl, I had an external monitor, and it did get pretty irritating sometimes, but it was most irritating in the hours before I started having contractions, when I was lying, bored and cranky, in a puddle of amniotic fluid in a very uncomfortable bed in Special Obstetrics. When we got to Labor & Delivery, I asked the nurse, “Is there any chance of getting a break from the monitor?” She said, “Nope. We’re seeing some dips on the tape and want to keep an eye on the baby. But if you need to change position, go ahead. We can always re-attach it if we lose the heartbeat.”
That nurse contradicted arguments I’ve seen that the medical staff will force you to lie still for the sake of an uninterrupted strip. It was especially kind of her to encourage me to move, I thought, because Carl was not engaged in my pelvis. He was floating around my uterus at random, and if we lost his heartbeat, it could take the nurse fifteen minutes or more to find it again.
More important than the argument that being on the monitor was not as bad as I had been led to believe it would be, however, is the argument that I’m convinced we needed it. Both my babies were “Nuchal x2,” meaning their cords were wrapped around their necks twice. This seemed to cause Eric more trouble than Carl (Eric is the one who came out blue with an Apgar of 5), but in both labors I was put on an oxygen mask, and in both labors this improved the baby’s heartbeat. And in Carl’s labor, we tried getting me on all fours to relieve the pain in my back, but the monitor showed that in that position, the baby was in distress, probably because he was lying on his cord. I said to David later, “What if we hadn’t been on the monitor? I’d have stayed on all fours because it felt so much better than being on my back. And what might have happened to the baby?”
I have seen studies that show that, if the mother is on a fetal monitor, everyone in the room watches the monitor instead of the mother. During Eric’s labor, David, Scott, and I actually had fun watching the numbers on the monitor. During Carl’s labor, we were too busy to even think about it. I have to concede that once during Eric’s labor a doctor bore out this criticism, though: I was pushing, and our obstetrician told me to stop. I said, “Why? Why do I have to stop? Is something wrong?” She said, “No, your contraction is over.” I said, “No, it’s not.” She looked at the monitor and said, “You’re right: go ahead and push.”
Our new obstetrician, who attended Carl’s birth, never looked at the monitor, so far as I could tell. Whenever I looked at him, he was looking back at me. When I said a contraction was starting and everyone should get ready, he believed me. And when I said, “It’s over,” he would say, “If it’s over, it’s over. Rest a little.” One of many reasons we were glad we had switched practices.
Our nurses disproved the assertion, made at my final birth hypnosis class, that the nurses are so eager to get the baby weighed and measured that they will snatch it away from the mother instantly. They put Carl on my chest right away, of course (Eric had been put directly on my chest, too, even though he was blue and floppy. They just put the oxygen mask right next to him). And when David said, “We’d like the baby to stay with Su until he’s had a chance to nurse,” they said, “Of course. Nursing is the most important thing.” In the event, they waited about two hours to weigh and measure him, because every time they came to check, he was nursing again. They did take vitals and band him while he was on my chest, but I felt no pressure at all to hand him over.
That said, I’ve had my share of bad experiences (the on-call hematologist when Carl was in Pediatrics for his jaundice—standing up to her and her desire to do eight unnecessary blood tests and a CT scan on Carl was one of my finer moments, I think). If you are going to give birth in a hospital, I highly recommend you learn about the various interventions that are possible, think about the circumstances under which you would accept them, be prepared to ask probing questions, make sure one of your support people, at least, is comfortable standing up to authority, and take the time before you end up in Labor & Delivery to find doctors you trust and respect, and who trust and respect you. I changed general practitioners, obstetricians, and hematologists in the past year, all to good effect. Your L&D nurse will have a lot to do with how the experience goes, and what nurse you get is pretty much random. You should be prepared to ask for a different one if the one you get doesn’t feel good to you.
Once you’re in your post-partum room, the nurses will tend to encourage you to send the baby to the nursery. I think this is because they think you look tired and they want to help you get some rest; my friend Adrianne, a hospital social worker, says it’s because they think they can take care of the babies better than the mothers can and they wish the mothers would just get out of the way so they could do that. Whichever is true, if you don’t want to send the baby to the nursery, don’t. Remember: it’s your baby. You’re in charge.
Remember, too, that just because a doctor or nurse wants to do something doesn’t mean it has to happen. I felt that one mistake I made with Eric was allowing too many blood tests early on (to see whether my thrombocytopenia had been transferred, and to make sure it was clearing up). Getting blood from newborn Eric was so difficult that one phlebotomist ended up nearly in tears; and then, the blood samples kept clotting and couldn’t be used, so they’d come around again with their horrible little lancets. In retrospect, I wish I’d put a stop to it. They were trying to check Eric’s blood to see whether it would clot and the samples kept clotting—really, if I hadn’t been sleep-deprived I’d have put that together more quickly.
I decided not to let the same thing happen to Carl, and when the phlebotomist came into the room and said, “We need to repeat the sample for the baby’s CBC because it clotted,” David and I said in unison, “No.” The phlebotomist got my nurse, who tried to talk me into letting them draw blood again. We stood firm; the blood was not drawn; and when our pediatrician came in to check on Carl the next morning, almost the first thing he said was, “So, I see they had trouble getting a blood sample because it clotted. You know what that tells me? The baby has platelets. And they clot.”
All that said, please don’t fear the hospital, and don’t fear the medical interventions that, used appropriately, can help ensure your safety and the well-being of your baby. Mothers arriving at the hospital to give birth are not delivering themselves into the hands of Satan’s Minions. There are human beings there, some of whom are intelligent, thoughtful, respectful, and compassionate, and some of whom are not. Just like human beings everywhere.Posted by Su Penn at May 20, 2004 03:55 PM | TrackBack