Support Normal Birth

[charade]

But doesn't that come back to your original premise (was it yours?....correct me if I'm wrong) that women are responsible and capable of making their own choices and if they choose a home birth or a c-section or anything in between we can't assume that 1) it's necessarily unsafe for them 2) they are "uneducated" and not aware of what they're doing or being "tricked" or "forced" into it. Is it plausible that highly educated women, in their right state of mind may choose home birth and that it is a legitimate option (even a healthier option) for some some women?

That wasn?t me. Think it was someone else on another post. I don?t disagree entirely with that position but I also think that it?s the duty of practitioners and advocates of all kinds of birth options to put as complete and clear a picture out there as they can.

So my comment was about how practitioners present the facts and that they might keep in mind that while they are based in North America, their views online and in books are being read and referenced by people around the world so if they are addressing the North American situation alone, they need to say so explicitly. Further, when quoting global statistics ? these are rarely related to home births which, as you said, would come across unfavourably in global statistics but to other kinds of risk related to medicalised births ? the impression conveyed is that the rest of what they are saying is relevant to women globally who live in similar conditions. At the most, the qualification added would be something like ?access to good nutrition, medical care? etc. which women in urban areas in developed countries would also have access to.

They may be writing for people in Western developed nations but I don?t think this is clear to women who do not live in these nations but who live in very similar (but not the same) circumstances in developing nations. I know of two cases where people who lived a long time in US moved to India and attempted a home birth, with access to the best medical care. One abandoned it (a good thing because she ended up needed an emergency c-sec after a very long labour), but the other ended in the death of the baby. They had had a home birth in the US before and put in place everything that was similar, including being literally five minutes away from the best hospital in the city. It could just be a fluke, but I feel that it could also have something to do with not being in the US, just as I think that even in the West, where you live when you do the home birth makes a difference ? such as how fast an ambulance can get to you in case you need it. Somehow I never see that stressed ? the importance of the back-up plan, maybe to play down the fear factor.

This is just a small quibble about how information is presented and applies to both sides of the debate.

I must add that I do agree with most things on the original poster (and I know home birth was not one of them) you put up. And I am also all for providing midwives in rural areas of developing nations with the best of modern medicine though I also believe that these women deserve hospitals in their areas and the chance to use them.

 

[miran]

jut taking up from what Charade is saying; from my expereince of living in India and in a family full of doctors (the kind who will attend conferences and try keeping up with latest changes in medical practices): In developing coutries when governments or NGOs back up midwives or similar services, it is also with the realization that access to full medical services is still some years off. as much as some governments might genuinely want - they would not be able to provide medical facilities in semi urban or rural areas. training midwives would be relatively faster, less expensive and possible. It would save more lives. There are also many cultural and religious factors. There are many women and families in semi urban and rural areas who would NOT go to a doctor for child birth. The advise coming from doctors or anyone foreign to them is discounted faster. If the same advice were to come fom a midwife from the same community as them or a familiar face, the chances that atleast it would be heard are higher. And lets not even get into epidurals and water births etc, the issues on hand are much more basic.

it's not why home birth advocate home birth in western world. totally differnt reasons and totally different scenarios. if you come to think of it the discussion on this thread doesnt even make sense because we are discussing two different things altogether - just with the same name

 

[TNT]

Back to the original poster (the actual poster not Thanka2!) - all of those things support a natural birth and in theory should be easy to achieve. In Hong Kong (which is where we are living so the context in which I am reading it) it is EXTREMELY difficult to achieve even one or two of these things, let alone all of them. There are many benefits to natural birth (as there are to c sections and pain relief) but it is not an option in most circumstances for women giving birth here, which is truely ridiculous. Thanka2 managed to achieve it with a lot of hard work, but many people who want it - particularly first time mothers who have not been through the process and have to rely on caregivers that in most instances have no interest in ensuring the mother has a natural birth- cannot access it. That is what is truly wrong; that it is not an option available in hospitals in Hong Kong and no alternatives to hospital eg birthing centres,govt supported home births are available.
I wish I knew how this could be changed but I am still struggling with that one....

 

[charade]

jut taking up from what Charade is saying; from my expereince of living in India and in a family full of doctors (the kind who will attend conferences and try keeping up with latest changes in medical practices): In developing coutries when governments or NGOs back up midwives or similar services, it is also with the realization that access to full medical services is still some years off. as much as some governments might genuinely want - they would not be able to provide medical facilities in semi urban or rural areas. training midwives would be relatively faster, less expensive and possible. It would save more lives. There are also many cultural and religious factors. There are many women and families in semi urban and rural areas who would NOT go to a doctor for child birth. The advise coming from doctors or anyone foreign to them is discounted faster. If the same advice were to come fom a midwife from the same community as them or a familiar face, the chances that atleast it would be heard are higher. And lets not even get into epidurals and water births etc, the issues on hand are much more basic.

it's not why home birth advocate home birth in western world. totally differnt reasons and totally different scenarios. if you come to think of it the discussion on this thread doesnt even make sense because we are discussing two different things altogether - just with the same name

Have to clarify, though, that I was referring to a class of people in the developing world who might choose "home birth" in the same way, and under what they believe to be similar circumstances (and which are similar but not the same), to the women in the developed world. So couples in the big cities, with the kind of medical facilities that make a name for themselves with medical tourism, often people with money who have lived in the West. It is these women who are also the audience for the literature on home birth being written in the West and that's why I feel the literature should be more specific.

For those women in rural areas/small towns in developing countries who don't have a choice, it's just called "birth" I guess.

 

[charade]

Back to the original poster (the actual poster not Thanka2!) - all of those things support a natural birth and in theory should be easy to achieve. In Hong Kong (which is where we are living so the context in which I am reading it) it is EXTREMELY difficult to achieve even one or two of these things, let alone all of them. There are many benefits to natural birth (as there are to c sections and pain relief) but it is not an option in most circumstances for women giving birth here, which is truely ridiculous. Thanka2 managed to achieve it with a lot of hard work, but many people who want it - particularly first time mothers who have not been through the process and have to rely on caregivers that in most instances have no interest in ensuring the mother has a natural birth- cannot access it. That is what is truly wrong; that it is not an option available in hospitals in Hong Kong and no alternatives to hospital eg birthing centres,govt supported home births are available.
I wish I knew how this could be changed but I am still struggling with that one....

I agree. Well, some of the points are achievable in public hospitals without a fuss but it's so random what is and what isn't.

Like, on another post, Koan mentioned how they actually delayed cutting the chord and went with her birth plan in Prince of Wales. Queen Mary, I believe, allows rooming in of baby without a fuss.

When they say eating during labour, do they mean "active labour" or from start of labour. I was chomping away right until I was wheeled down and induced because my contractions though intense were not regularly spaced. The nurses were amused becuase I wouldn't let go of my banana even as they dumped me in the wheelchair (someone had told me I should eat till the last minute so I had strength to push). They also got me water in the delivery suite and said I could drink.

So seems like some of the points are in place but spread across different hospitals and very random in terms of execution. Overall, far from ideal I agree.

 

[thanka2]

I was just reading this birth story today. It made me think of the profound experience med-free childbirth was for me. Because I had such a deep experience (not saying easy or wonderful start-to-finish but definitely deep), of course I would advocate that if a woman can choose this, she would. Unless medically indicated (need for c-section etc.) it ends up being a healthier option to not expose mama and baby to drugs in labor. Another interesting post I was reading has to do with natural childbirth fact and opinion.

Birth, this way, for me was a beautiful, memorable event-much like my wedding--that sort of thing. Of course, there are couples who choose to go to the government office (and we did that too--then later had another marriage ceremony), sign a slip of paper--no fancy dress, no reception and that's it for them--they accomplished the goal of getting married. So, to draw an analogy to birth...But, for me, I wanted something more--something I felt it was my right to experience--it was a rite of passage for me in many ways. To give birth on my terms as my body has been designed to do. I wish I could allow women who really doubt the validity of intervention-free, med-free (unless medically indicated) birth to step "inside my skin" and experience what it was like.

But, the practical point that I and others have pointed out is choice. It's hard, and indeed, often impossible to choose what is not supported if your only choice to give birth in a hospital. If you want to be induced, have an epidural and/or a c-section there are plenty of ways to get that done here in HK. Not so true about what it takes to go through natural childbirth. I'm not saying it's impossible to go through it without extra support but the chances of success are greater with support (proper facilities, aids/tools, trained professionals, allowance of doulas, preparation classes).

As the birth story above illustrates--the power of warm water to ease contractions, for example--is not available. That is seriously what got me through two labors. Warm water. Something so simple. Not asking for huge technological equipment. Access to a tub of water in labor took my pain from a level 8 (of 10) to a level 4-5 instantly. Very effective pain relief. Counter pressure. My husband stood behind me and I was standing for 95% of my 12-hour labor (not laying down, strapped to a bed) and shoved his fists into my hip sockets during contractions because I had such bad back labor (and sciatica) and that made my labor bearable (and his arms sore!)

Someone asked about eating in labor--the woman in the birth story shared in the link ate throughout almost her entire labor! I think the point is, that eating is NOT DANGEROUS in labor. The biggest risk is that you'll throw up. Many surgeon OBGYN's don't want you to because they are visualizing you going in for an emergency c-section and don't want to deal with vomit at that time either (which, can be a problem but not likely a fatal one--just need a suction hose). So, whether one eats or not depends on individual comfort level but there is a practical reason to keep fueling your body with easily digested food--to keep your strength and stamina--it's not a quick sprint, this labor thing, it's a marathon (or at least, it has been for me).

Now, for me, I would not enjoy eating so much in labor-after a certain point my tummy just shuts down. The woman in the birth story above threw up twice but there is a lot to be said for keeping up your strength. Like I said, I labored, standing for nearly 12 hours--you can't do that if you don't have fuel. In fact, toward the end, I was getting weak because I did all of that on a bowl of soup I had eaten as soon as I knew I was in real labor. If I had felt comfortable eating later on in labor (I spent 8 hours of my 12-hour labor at home) I may not have had to lay down on the bed at all. Laying on the bed made my labor pain spike off the charts. It was excruciating to lay down during labor--or sit down--the only thing that helped was standing and circling my hips.

 

[thanka2]

nb: birthing was a very neutral expereince for me. i dont remember much nor did i care about pregnancy / delivery. my single agenda the whole of those nine months was that my baby be safe and as healthy as God wills him to be. so we chose and still would whatever was the safest option presented to us and advised by a doctor we trusted. am not saying this is the ideal way to be. change comes because people question existing mindsets. am just putting accross another mindset to you on why women like me are not buying into birthing without interventions.

When I read about your experience I thought of what this author wrote. I respect that this was/is your own experience and viewpoint. I think the divergence is that when doctors/medical facilities, from the outset hold the same mindset and sort of thrust that upon the pregnant/birthing mother--that, in my opinion, is a problem. If the mother considers all things and has that mindset, it's a completely different thing. Although, I personally believe pregnancy and childbirth are important as they are all tied to the "end result" (baby). That's why we take the time to eat better, take multivitamins, get prenatal checkups, abstain from alcohol/drugs, get more rest etc. --because we do believe that what happens in the womb is important for the health of our child. So, I really can't see how there can be a disconnect.

 

[miran]

thanka - no disconnect there. ofcourse we did all we could to see the baby grew well in the womb. what i am saying is we did not have a preference for either normal or c-sec. we were very clear not to have an elective c-sec without genuine medical grounds. but apart from that we did and would in future go with sound well explanined advice from a doc we trust, for our particular circumstances.

i can completely see where you ladies arecoming from. if we did have a particular preference. and there were no medical grounds against it, i would be very annoyed if they were not even willing to listen to reason. just because of convention.

 

[thanka2]

thanka - no disconnect there. ofcourse we did all we could to see the baby grew well in the womb. what i am saying is we did not have a preference for either normal or c-sec.

But, not having a preference for a normal or c-section birth, to be seems like a disconnect to me. Because, in a c-section, the child is still in the womb and the child is exposed to heavy-duty drugs. Yes, they are in their final moments of being inside the mother but they are getting a large dose of chemicals via the mother.

So, while I'm pregnant I don't drink coffee, drink wine or eat tuna because it might have an effect on my child's development--and even if it doesn't it probably isn't going to be a healthy choice anyway. But, how can we say that there is basically no difference between a c-section and med-free birth? Now, in an emergency case, of course everyone wants to save the child's life but we also can't say it doesn't come at a cost. Those tough decisions have to be made at that time. But, to go into childbirth saying that one has no preference between a c-section or med-free birth seems to say that one believes there is no difference between them. Is this true in your case? Birth is a critical moment in a child's life--it's more than just "get the baby outta there"--birth can set the stage for that child's life in many ways.

i can completely see where you ladies arecoming from. if we did have a particular preference. and there were no medical grounds against it, i would be very annoyed if they were not even willing to listen to reason. just because of convention.

I think it goes beyond being "annoyed" for me. I would get annoyed at a restaurant if they only had orange juice but instead I wanted to drink apple juice. I feel almost to the point of being violated if I was forced to "perform" ("lay down, get strapped in, do as we say because we know best...") by the medicalized model when I am genuinely convinced it's not the best for me or baby and being spoken down to or worse treated like a bad mother because of my preferences--it's a lot to deal with in the throes of labor. And if one knows anything about med-free labor--it has to be tension-free labor as well--your whole body freezes up with the fight/flight response when you are harassed in those conditions--and the way many women are dealt with adds up to harassment. It's a power struggle that doesn't need to go on.

As far as going with sound well-explained advice--having a non-medicalized birth and listening to reason of medical professionals are not mutually exclusive. Meaning, there are well-trained doctors, nurses and midwives who simply operate by a different model (i.e. not seeing pregnancy and birth as having a root in pathology--something to be "managed" like a disease but instead as a natural thing that womens' bodies are designed and capable of going through). The problem is that very few of these types of professionals can be found in HK (if anyone knows of any, please let me know!) as the system majority is the way it is.

Finding a doctor who is not only "pro-natural childbirth" (med-free, intervention-free) in word but also is practically prepared to attend such a birth is truly a feat.--especially if one doesn't have a quick labor or goodness knows, if there are any minor complications--it's like there is a total panic if this happens. There are no other alternatives as there are no birth centers here and home-birth attended by midwives is forbidden.

 

[catan]

I support normal birth and believe that it's difficult in HK due to the way the medical system is set up. When I first got pregnant, I never gave childbirth much thought, but once I started doing research, I became determined to have a normal birth without interventions. I educated myself on all aspects of childbirth and tried to prepare myself as much as possible. My family thought I was too extreme, because what did it matter? We know a bunch of women who gave birth via elective c-section with healthy and happy babies.

During my pregnancy, I was always asked whether I planned to deliver naturally or via c-section. It surprised me that method of birthing is presented as a choice-- I always thought c-section should be reserved for absolute emergencies. And when I mentioned my plan of natural birth, I was asked why in the world would I choose to bear pain when I don't have to with today's medical technologies? Although my stance was why should I have to go through a major surgery (the idea which terrifies me) when I don't have to?

I feel very strongly about natural birth and do think that a lot of people are talked into unnecessary interventions and c-sections that have reasons not related to health and safety. The idea of it angers me. But then I find there are people out there who simply do not care about these issues. They put their trust in doctors and hospitals. It doesn't seem like such a big deal to do whatever.

I had a natural birth without interventions. But labor was awful and if my labor hadn't been as fast as it was, I'm not sure I could've endured without some form of anesthesia. My baby and I got off to a great start with breastfeeding, and she was so alert when she came out, which I attribute to the normal birth. That makes it all worth it, imo. Even though I sure don't blame anyone for wanting an epidural.