Monday, November 10, 2008

Baby Peterson Preparation: Part 1

As you can imagine, much of my time and mental energy these days are devoted to the impending birth of Baby Peterson. In an effort to share some of what I'm learning with friends and family, but mostly in the hopes of solidifying my opinions by writing them out, this is the first of several blog entries I hope to post which will outline some of the big decisions we've been making in the Peterson household during the past 6 months.
It didn't take long for me to decide that I want a natural (drug and intervention-free) childbirth in February. My decision came after reading lots and lots of childbirth books and online articles, as well as conversations with my husband and also friends who have had amazing, empowering natural childbirths.

Before I go any further, let me say that although I'm discussing my family's personal decisions here, my opinions about what I want for my own childbirth are by no means a reflection of how I feel about other women's childbirth choices and experiences. Childbirth is a deeply personal event between a woman and her partner, and I wholeheartedly support each woman's right to make her own choices about her body and her baby during pregnancy and childbirth.

Some of the reasons I've chosen to pursue a natural childbirth:
  • Most importantly, I believe that my body is made to give birth, and can successfully birth my child on its own without the various interventions and pain medications which have become the norm in American maternal care. Natural childbirth will allow me to experience labor the way nature intended it.
  • I feel that giving birth naturally will be one of the most amazing, empowering, and potentially spiritual experiences I'll have the opportunity for in this life.
  • Interventions such as epidurals, pitocin (labor induction drug) and other pain medications do have risks and can often lead to a cesarean section, which can also be risky for mother and baby. Choosing natural childbirth means choosing not to add unnecessary risk for myself or my baby. I do not consider the benefit of less pain during childbirth to outweigh the potential risks associated with interventions
  • I understand that the pain I will feel during labor is "pain with a purpose". It is different from other pains - it happens in order to exit the baby from my body in the most safe and healthy way. The pain I experience will send signals to my brain, which will then release natural birthing hormones including oxytocin and endorphins, which in turn fuel labor and increase dilation, and the cycle will continue this way. This feedback mechanism will be interrupted by drugs and interventions. My baby and I will work together in a natural hormonal system that will build in intensity until the baby is born. I understand that by working with my body in response to the pain I feel, I will also be helping my baby to get into the proper position for birth.
  • A cesarean is major abdominal surgery and may make it difficult to care for my baby in the first few weeks postpartum. After a vaginal birth with medications your body needs to recover from the birth and clean the medication out of your system. Depending on the timing of your medications, your baby may also need to clear some of the medications out of her system. A natural childbirth gives us both the best chances for a speedy recovery.

I also recognize that the birth I have may very well be very different than the birth I am wishing and preparing for. While I am preparing for a natural childbirth, I am also preparing to be open to each moment and to do what needs to be done for my own health and the health of my baby. I recognize that there may be situations in which I may have to be open to drugs and other interventions, such as: exhaustion, failure to progress in a timely manner (once I've tried every effort to augment it naturally), or fetal distress. If my labor is abnormal and the benefits of drugs or an epidural outweigh the risks, I will welcome them. I will accept that I did the best I could and will stay present and involved in my birth.

Factors which I believe will help me achieve the birth experience I want:

1. support team

2. choice of a birth place

3. privacy, warmth and darkness

4. water

5. preparation and education

6. freedom of movement (intermittent rather than continuous fetal monitoring allows you to move around the room and position yourself in ways to cope with pain and move the baby into position for birth)

7. ability to eat and drink during labor (Makes sense that you need nourishment during the most athletic event of your life! Many hospitals do not allow food or drink other than ice chips during labor)

8. alternative pain techniques (aromatherapy, massage, music, chanting/vocalizations, breathing and meditation, etc...)

So, with all this in mind, this is what we've been busy with:

1. We've been hard at work assembling my birth team:

Brian Of course my husband is the most important part of my support team. Brian has been so wonderfully supportive of me since the moment we started discussing having children, and even more so since the day we got that positive pregnancy test!

Brian has been 100% behind my wishes for a medication and intervention-free childbirth, and has defended our decision to anyone and everyone who asks about it. He and I have chosen the midwives, hospital, and other support people together. He's happily read every article and book I've put in front of him and we've had so many exciting conversations about what we want for the birth of our first child.

Midwives: The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes (rather than medical emergencies that need to be handled by obstetricians, anesthesiologists, and surgeons). The Midwives Model of Care includes: Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle; Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support; Minimizing technological interventions; and Identifying and referring women who require obstetrical attention.

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean sections.

We looked long and hard (for the first 4 months of this pregnancy) for a midwife or midwife group that we felt excited about. We visited a free-standing birth center and talked about the idea of homebirth. While neither of those options appealed to us (at least not for our first birth), we knew that many hospitals have midwives on staff for healthy, low-risk pregnancies. After speaking with several midwife groups and visiting a couple hospitals, we were so happy to find the Center for Midwifery at University of Colorado Hospital.

After touring the in-hospital birth center and meeting one of the four midwives in the group, we knew we had finally found the place where our baby will be born and the caregiver group who we'll be seeing throughout the pregnancy and during the birth.

As long as my pregnancy stays low risk and I don't develop any complications now or during the birth, we will not be seeing an obstetrician at all and will work exclusively with our midwives.

Doula: The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Numerous clinical studies have found that a doula’s presence at birth tends to reduce negative feelings about one’s childbirth experience and results in shorter labors with fewer complications, namely:
  • 50% reduction in the cesarean rate

  • 25% shorter labor

  • 60% reduction in epidural requests

  • 40% reduction in pitocin (a labor-inducing drug) use

  • 30% reduction in analgesia (pain medication) use

  • 40% reduction in forceps and vacuum extraction delivery

Doulas also offer support to the husband or partner during labor and have been shown to strengthen family relationships after birth.

We spent a lot of time looking for a doula who will be just right for us, and were so pleased to find her in our own neighborhood. Brandy Segin, at Aspen Leaf Birth Services is a mother of three who lives just a mile from our house. As soon as we met her, we could tell that she was the right person to bring into one of the most intimate, private experiences of our lives. Her demeanor is comforting and reassuring, yet assertive at the same time. I can tell that she'll be able to offer me the support and strength that I'll need to help me have a positive birth experience.

2. Choice of Birth Place
I believe that the birth environment will be personally one of the most important factors in achieving the birth I want. I plan to stay at home, where I am most comfortable, for as long as possible before going to the hospital. Although we have decided to have this baby in a hospital, I wanted to find a hospital that feels comfortable, safe, quiet, and peaceful.

After narrowing down the hospitals in the Denver area that have midwifery groups, and visiting one hospital that definitely did not meet the above description, we were thrilled with the birth center at University of Colorado hospital. The hospital is new and clean and doesn't smell like a hospital. The labor and delivery rooms are HUGE and have two bathrooms (one with a shower and one with a bathtub), lots of natural light, rocking chairs, birth balls, and plenty of room to MOVE! The nurses we met during our tour were helpful and calm. I feel really excited about having my baby at this hospital.

3. Privacy, Warmth, and Darkness

Someone wise once said that the same environment that gets the baby inside of you is the best environment for getting that baby out of you. :)

My husband and doula have agreed to be the protectors of my birth environment. Important factors to me are minimal interruptions and strangers in the room, no fluorescent lighting (we plan to bring our own lighting), quiet, music of our choice, and no television or cell phones)

4. Water, water, and more water The University of Colorado hospital is the only hospital in the state of Colorado and one of very few in the country to allow waterbirths!

Birthing in water is one of the most beneficial things that can be offered to a woman in labor. Women report that they enjoy their labors and find that the water allows complete freedom of movement and deep concentration.

I've always been drawn to warm water...I take at least one bath a week and find that when I am stressed out, frustrated, or sad, nothing helps like some quiet time in a hot bathtub. It makes perfect sense to me that laboring and possibly birthing my baby in water will make my birth experience more enjoyable.
Known benefits of water labor and waterbirth (
  • Facilitates mobility and enables the mother to assume any position which is comfortable for labor and birth. No one has to help the mother get into a new position. She moves as her body and the position of the baby dictate. Movement helps open the pelvis, allowing the baby to descend.
  • Speeds up labor
  • Reduces blood pressure
  • Gives mother more feelings of control
  • Provides significant pain relief
  • Promotes relaxation
  • Conserves her energy
  • Reduces the need for drugs and interventions
  • Gives mother a private protected space
  • Reduces perineal trauma and eliminates episiotomies
  • Reduces cesarean section rates
  • Is highly rated by mothers - typically stating they would consider giving birth in water again
  • Is highly rated by experienced providers
  • Encourages an easier birth for mother and a gentler welcome for baby

Our midwives and doula are extremely supportive of waterbirth, and Brian and I are carefully and seriously considering this option.

5. Childbirth Classes

Our doula, Brandy, will also be our childbirth educator. She'll be doing a series of private childbirth classes for us in the privacy of our own home. I am so excited to start this phase of our birth preparation. Having private classes will allow Brandy to design the classes specifically for us. We'll have complete freedom to spend extra time on topics of special interest to us. The classes will cover all the basics of childbirth education including: nutrition, the stages of labor, interventions, birth plan preparation, basic newborn procedures and breastfeeding. In addition to the basics, our classes will focus on relaxation, position changes, comfort measures and coping practices Brandy has found to really work for women in her practice as a doula and during her midwife training. Brandy teaches from a variety of natural birth techniques including Lamaze, Bradley, Hynobirthing, and Birthing from Within.

As you can see, we've been hard at work preparing for Baby Peterson's birth in an effort to give her the healthiest, most gentle welcome into this world and to start us off on the right foot as parents and as a family.

Topics for Baby Peterson Preparation: Part 2, Green Pregnancy and Parenting:
  • choices in beauty products

  • how to make a non-toxic cleaning kit

  • cloth diapering

  • natural toys

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