Childbirth

Years ago, childbirth was completely natural—no medication, no doctors and no cesarean sections. In colonial times women delivered their babies with the assistance of a midwife. Something interesting I learned a few years ago while attending a program for OB/GYN residents at SUNY Stonybrook Medical School was that the incidence of infant mortality initially rose when women switched from home childbirth with a midwife to hospital childbirth by a physician. The doctor who was telling the story explained that in the early 1900s, physicians would tend to sick patients and then deliver a baby without so much as washing their hands leading to an increase in infant deaths. An article on Our Bodies Ourselves supports this, “A scholar who conducted an intensive study concluded that the 41 percent increase in infant mortality due to birth injuries between 1915 and 1929 was due to obstetrical interference in birth.”

Fast-forward to present time and it seems that more and more women are having their labor induced, and many women are having their babies delivered via C-section. According to the Centers for Disease Control, in 2009 32.9% of babies were delivered via C-section. From 1990 to 2006, The American College of Obstetrics and Gynecology reported a steep rise in induced labor—from 10% in 1990 to 22% in 2006. Since approximately 50% of induced labors end up in C-section, this could be a major contributing factor in the rising number of C-sections.

INDUCING VS. LETTING NATURE TAKE ITS COURSE

When I was pregnant with my son, I went one week past my due date. My doctors told me if I went a week late, then they would induce me. I of course, was so excited to meet my new baby that anything that might get that little person out sounded good to me. My mother, the voice of reason kept cautioning me not to let them induce. Everyone who we knew who was induced ended up delivering by C-section. I still opted for the induction. Shortly after Pitocin was administered, I felt the worst most excruciating contraction imaginable. I quickly called for my epidural, and the rest was pain-free. The only way I knew when to push was by looking at the monitor. My labor progressed so quickly that the Pitocin didn’t wear off in time. While I was still able to deliver vaginally, the Pitocin and Epidural were not without their caveats. I felt horrible after my delivery. I had a fever and I could not stand, much less walk without getting dizzy and fainting. A nurse used smelling salts to bring me to. I also had pain for several weeks following the birth of my son. I’m not sure if any of this would have been the case if I had let nature take its course.

Two years later I was 39 weeks pregnant with my daughter when I went into labor at midnight—this time without the help of modern medicine. I wasn’t sure if it was labor at first because it really didn’t hurt very much. Within an hour of the first contraction they were three minutes apart. I went to the hospital, where I was examined in the triage section of labor and delivery. My water broke while in triage. By the time I got to my labor and delivery room, I was already dilated nine centimeters—still no medications. At this point, an epidural was not an option, and I won’t lie, I was scared. I was consumed by the memory of that one contraction I had with Pitocin during my first delivery and I kept waiting for it to feel like that. It never did. Every contraction I had with my daughter combined, was not nearly as bad as one contraction with Pitocin. My delivery was a breeze. My daughter was out in one push. I was up walking within a half an hour of her birth. My experience made me realize that childbirth is a truly natural thing and while there may be a place for extraordinary measures, one week overdue is not reason enough for an induction.

There are some natural ways to induce labor, but whether they actually work is still up for debate. The first method is walking. I can honestly say this method had no effect on me. I walked regularly throughout both pregnancies, and even a rigorous two-hour walk did not bring on labor. Many experts suggest sex could bring on labor. According to WhatToExpect.com, sperm contains prostaglandins which are hormones that help ready the cervix for delivery. In addition, orgasms release the chemical oxytocin which can trigger contractions. Acupuncture is another method, and according to WebMD a small study out of the University of North Carolina indicated that 70% of women went into labor after acupuncture compared to 50% who did not receive acupuncture. Many midwives swear by the use of Evening Primrose to naturally induce labor, according to an article on eHow. Like sperm, Evening Primrose is high in prostaglandins.

When deciding to induce labor, the most important thing to keep in mind is whether it’s truly necessary. If you’re being induced solely because your baby is a few days overdue, then in hindsight, I would consider waiting. According to the American College of Obstetricians and Gynecologists (ACOG), “labor should be induced only when it is more risky for the baby to remain inside the mother’s uterus than to be born.” The American Pregnancy Association lists the medical reasons for when inducing labor is appropriate: when a complication like hypertension, preeclampsia, heart disease, gestational diabetes or bleeding during pregnancy develops; the baby is in danger of not getting enough oxygen and nutrients; the amniotic sac has ruptured and labor hasn’t started within 24 hours; or there is an infection inside the uterus.

VBAC

Many women will have a c-section for a child and may like to try vaginal birth for subsequent pregnancies. VBAC (Vaginal Birth After Cesarean) can be a difficult option, since not all Obstetricians are willing to perform one. If this is something you feel strongly about, then you need to find a physician who listens to your concerns and will be open to a VBAC. VBAC Community is a great resource for women who want to have a vaginal birth after cesarean. From offering lists of VBAC-friendly doctors to support groups, this site offers valuable insight into VBAC and reminds women they are not alone, and that VBACs are usually considered a safe option.

When asked about why she created the site, founder Kristine Contento-Angell explained, “I was surprised at how isolating the experience of facing a VBAC was. Family and friends didn’t quite understand the complexity of the emotions involved.” She went on to say, “I encourage women to keep searching for support groups and doctors, which is why I created the VBAC Community website.”

VBACs are a great option for many reasons. With vaginal births women can often have many more children. As with any surgery, C-sections are generally riskier than vaginal births (of course there are circumstances when this is not the case). According to WebMD, some of the benefits of a VBAC compared to a subsequent C-section include: avoiding another scar on your uterus, which is important for future pregnancies. The more scars on your uterus, then the greater the chance of complications with future pregnancies; less pain after delivery; a lower risk of infection; and a more active role for mother and her partner in the birth of the baby. If VBAC is something you’re serious about, then it’s important you find a doctor who will respect your wishes and do his/her best to help you reach that outcome.

Whatever way you deliver your baby, remember that you’re bringing a wonderful new life into the world. If it doesn’t go the way you planned, that’s okay. Consider it the first of many things that won’t go as planned when dealing with children. The best thing you can do is be as educated as possible about your options and try to do things as natural as possible. Don’t rush your baby into the world. He’ll come when he’s ready, and you’ll be happy you waited, even though I’m sure you’ll be anxious to meet the newest little person in your life.