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Choices in Childbirth

By December 16, 2011 - 5:05pm

Today I am refreshed. I have recuperated from the sleepless night in which I witnessed my first home birth. Well… almost witnessed. I arrived a few minutes too late. Baby was still wet in daddy’s arms, and mom was busy getting showered with the assistance of the midwife. Baby had already been to breast only moments after arriving from his water birth. That first magical moment, the moment when mom pull brings her baby close and they lock eyes for the first time had already occurred… and I had missed it.

I quickly began a appraising how I could assist, but there wasn’t much to do really. Everything was under control. No chaos, no excitement… well, big sister was doing a fine job of containing her excitement at witnessing the arrival of her newest sibling. Mom’s friend, the birth photographer, had put down her camera, walked across the blue tarp lining the living room floor, and was drying the newborn. Grandmother, who was sitting in the corner across the room, told me that birth was rather quiet, and mom didn’t make a fuss, she just said “something is happening” and the baby was born.

The other grandmother was preparing the room, so that mom and baby could settle in to relax and breastfeed some more. There wasn’t much for me to do really. So I was able to marvel at the symphony.

This was the family’s sixth home birth, so they pretty much had everything well orchestrated. As mom settled in to bed, I was amazed at her appearance. She looked beautiful and invigorated, her face aglow, and her hair tidy. Baby went to breast instantly and her family settled around to behold.

Sister set about to assist in whatever way she could. She delicately and patiently offered blankets for baby and refreshments for mom while sneaking a closer look every now and again. Dad fetched this and that at mom’s request. Grandmothers had their duties. Everyone played their part superbly and I was in awe.

I had imagined a more chaotic situation with palpable fear. I expected to see ruffled hair and towels strew around the room to mop up puddles of red. I pictured hurried excitement and near panic as I am accustomed. What I saw and felt was calmness, and peace, and I reminded myself that birth need not be feared. Instead it should be embraced and must be respected.

We must guard the normalcy of birth not only to prevent harm, but to ensure that the most important matters are allowed to occur unimpeded. Something magical happens when a mother holds her baby in her arms. In that moment when a baby and mom first lock eyes and even more so when a baby goes to breast, some critical things are happening for both mother and baby that science cannot fully understand or replicate. Biological and physiological changes are occurring that affect both baby and mother. It’s chemical, and primal, and visceral and does more for a mother and child than any medication or instrument or brightly lit room can ever do. That is why we need midwives who are trained to guard the normalcy of birth, and trained to intervene when necessary.

There are reasons that birth is not supposed to be complicated by intervention. When we begin to complicate birth, we begin to interfere with what is supposed to happen. When we add intervention to what is natural it is distorted and cannot be repaired. So we must be cautious with intervention.

We think of birth in terms of risk because birth can be unsafe. When women and babies had poor nutrition, and unhealthy mothers had new babies before their bodies were ready, fear was appropriate and intervention was necessary. When there is illness and birth combined, fear is appropriate and intervention necessary. But when mothers and babies are healthy, intervention can be risky. Medicalized birth is overflowing with risk. Intervention is coupled with risk.

Intravenous catheters increase risk for infection and fluid overload. Fluid overload increases risk of, breast edema, poor latch, and engorgement which increases a newborns risk for dehydration and jaundice. Fluid overload increases the risk of pulmonary edema, bladder trauma, and subsequent urinary problems. Depriving mothers of oral nutrition while in labor increases a mother’s risk of exhaustion and difficulty with pushing and with breastfeeding. Artificial rupture of membranes increases risk of infection for mother and baby, and reduces cushioning on the umbilical cord which can stress a baby. This can then interfere with a newborns transition to life outside of the womb, and increase his risk for separation from mother, and whole other cascade of interventions which lead to more risks. An intervention as simple as suctioning a baby’s mouth and nose, could cause trauma and interfere with his ability to feed for hours, or perhaps days. Rupture of membranes usually requires birth to occur in a prescribed amount of time and if birth takes too long, cesarean section will often be advised. Artificial oxytocin administration bypasses natural pain relieving endorphins which increases a mother’s desire for artificial pain relief, which affects baby. How and when a mother pushes during labor can greatly affect both mom and baby. If a mom pushes before she has the urge, she can become exhausted. If mom pushes while holding her breath she can decrease oxygen to the baby and he becomes stressed. If mom pushes while lying flat, she fights against gravity and increases exhaustion and decreases blood supply to the baby. You see the pattern. All of these things can affect those first few magical moments of life.

No matter where birth occurs, it is not without risk. This is why it is important to know your risks, know your options, and make informed decisions about what is important for you and your baby. Be an informed and active participant in the choices surrounding your birth. If you do not choose, someone will make the choice for you and your baby.

Group Leader

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