Friday, June 8, 2012

What's Your Favorite Position?

After my last post, I was asked to elaborate on why you should not give birth on your back, and to provide more information on better birthing positions. That is what this post will be about!

So as I mentioned in that last blog, birthing on your back is just not a good idea. I will say, some women are comfortable giving birth on their backs, and they feel in labor that it is the best position to be in. To that, I say more power to you! The point I want to make here is that there are much easier, more comfortable, and more ergonomic positions to be in; but by all means when you are in labor please do what is most comfortable for you. It is different for everyone, and hospitals requiring one position for all women is absurd.

So, let's look at why giving birth on your back can be so problematic.

1. For some reason, we picture our birth canal as being a straight line. While there are some positions that make the birth canal straighter, it isn't necessarily a straight line. When you are on your back with your feet in the air, it is far from being straight. It actually begins to resemble a "J". Because of this, you will end up having to push against gravity. When your baby nears the end of the birth canal, you will have to start pushing him uphill, just like the crook of the "J" if it were laying on its side. This picture shows a woman on her back giving birth, but is rotated to show the "J" effect.

2. When you lay on your back, you are putting pressure on your tail bone, which can close your pelvis slightly, as can putting your legs in the air, which folds your pelvis forward. Try it; lay flat on your back and put your feet in the air. It may make more sense if you actually feel it. If you aren't pregnant, imagine how uncomfortable it would be with that round baby belly, to boot. These things combined can close your pelvis up to 30%, making you and your baby have to work much harder to make it around your pelvic bones. This can also raise the risk of shoulder dystocia with your baby; a pretty serious complication in which the child's shoulder gets stuck behind the pubic bone. I won't go too much into that on this post (I will write a separate blog on labor complications if I see enough interest in one) but PLEASE look into it and know your options. Do NOT let your doctor pull on or twist the baby's head, EVER. Simply shifting your position will often free the shoulder and allow your baby to continue his decent. Discuss your options with your doctor, and ask how he or she typically deals with shoulder dystocia when if and when it becomes an issue. (It isn't extremely common, but it is always good to know your options.)

3. If you have been pregnant or you are pregnant now, you know that you are not supposed to lie on your back after the first trimester. The weight of the baby puts pressure on your nerves and arteries, and can slow your and your baby's heart rates. So why is it that it is all of the sudden okay in labor? Studies have shown that laying on your back in labor can reduce the baby's heart rate, and slow contractions due to a lack of oxygen flow to your uterus and your baby. This can lead to emergency interventions that in many cases could have been avoided. This is especially the case when you think of just how many factors begin to work against you; your pelvis is closed so you are pushing harder, but you have your feet in the air and you are having to push uphill. The pushing phase in this position can take a long time, meaning higher odds for slowing that baby's heart rate from being on your back for an extended period of time. Then all of the sudden, the doctors are telling you that you NEED to get the baby out because it's heart rate is dropping, which is every mothers nightmare while she is in labor.  (Scary example, I know. But it happens all too often.)

So, laying on your back can make labor last longer and be more uncomfortable, and it can lower the oxygen supply to your uterus and your baby which weakens contractions and can slow heart rates. Why is that our standard birthing position in hospitals??

Here are some birthing positions that are much better for mom and baby during labor:

1. Squatting: Many pregnant women know the squat pretty well; it is a great exercise in pregnancy and is recommended by most doctors and midwives alike. During labor, it not only opens your pelvis up an extra 15-20%, but it also can shorten the length of your birth canal, speeding up your birthing time. (Hooray!)

2. Hands and Knees: I couldn't handle this position in labor, only because I was just too exhausted to hold myself up. Many women swear by it, though. It also opens your pelvis wide to help the baby move down, and puts gravity on your side as it faces that "J" curve downward. This is another position that most pregnant women will know from their pregnancy exercises; cat/cow, anyone?

3. Standing/Squatting on a Birthing Stool: This is how I had my son! I know everyone is different in labor, but this was the ticket for me. I tried several different positions, I even tried laying on my back (which lasted all of 1.5 minutes, I hated it!) but the second my midwife suggested the birthing stool, all systems were go. It was so much more comfortable than the other positions I had tried, and I could tell that gravity was helping me out. I was able to sit and relax my body between pushes. I also felt like I had full control of my abdomen and uterine muscles while I was pushing; something that was severely lacking while I was on my back.

4. Birthing Tub/Pool: Again, this is one of those that didn't work for me, but oh how I wish it had! Everyone has seen the photos or heard the stories about how beautiful water births can be. The only reason I didn't like it was because I really needed to feel grounded, but even us big pregnant ladies float in a pool. The reason I didn't like it is the reason most women love it, though. Because our bodies are buoyant and float, the water takes a good amount of the weight off of our muscles and joints. Women who do enjoy the pool say that the water is a great pain reliever; I have even heard that it works better than an epidural for some women who have experienced both. You also have the freedom of movement; you can just sway in the warm water, sit on your hands and knees, squat, or recline. And trust me, it is better to move around than to sit still for too long.

I know most of us as women have been taught to be modest, and in some cases we even feel shameful of our bodies, which is extremely unfortunate. Reading these suggestions may make some women uncomfortable and worry about looking funny or strange while they are in labor. Believe me- when you are in your birthing time, you aren't going to give a rats ass what you look like, but to everyone around you, you will look like a goddess.

I hope this helps to any of you preggo ladies looking for advice, or to those who aren't pregnant yet and are just trying to get their fill of information beforehand (good for you!! Empower yourself with baby-birthin' know-how!).

If you have any questions or requests for a blog topic, or you just want more information, please don't hesitate to ask. I don't know everything, but I have learned a lot on my quest for information. If I don't know, I can find out for you! Thank you to my readers! Your support means the world to me.

Stay informed!

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Wednesday, June 6, 2012

Get the Hell Out of the Hospital (Or Learn to Own Your Birth)

This is something that has bothered me for a very long time now, but I have recently come to the point where my blood may start boiling over if I don't say something about it.

When exactly did women lose their respect for their bodies? And how is it that most of them don't give a damn?

Someone told me a story of their grandchild's birth recently, and it went like this:
"The baby was turned upside down in the birth canal, so every time she had a contraction, the little baby's nose was squished and she couldn't breathe! So the doctor had to save her, and he grabbed the forceps, turned her right side up, and pulled her out. Thank god he saved her life." 

Can anyone tell me just how many things are wrong with that story? 
1. Babies are supposed to be "upside down" or facing your back. It is the best position a baby can be in during labor. As the baby is born, he or she will slowly turn themselves to get their shoulders around the pelvic bone.
2. Babies don't breathe in the birth canal!! They are still receiving all of the oxygen and nutrient rich blood they need from the placenta. I couldn't believe the doctor told her that. 
3. The doctor wasn't "saving her", he was making the birth go faster, and making things easier on himself. He was more ready to injure the baby or the mother before he would just let her give birth in her own time. 

That last one is where my real problem comes in. Doctors and nurses in hospitals who scare women into believing something is wrong with their child, just so they can take over the drivers seat and control birth itself. How disgustingly sad is that? They absolutely know the maternal and neonatal death rates in this country are the 3rd highest in the developed world. They absolutely know that those numbers are mostly due to unnatural medical interventions during birth. Yet they carry on regardless, ignoring statistics, just so that they can make it home in time for dinner. If your labor is induced, your chance of needing an "emergency cesarean" go up 50%. The cesarean rate in this country is upwards of 30%! One in three women getting a c-section when their bodies are made to give birth is absolute insanity. Laying on your back during labor is the WORST position you could possibly be in for birth. Laying on your back closes your pelvis by a whopping 30%. This position not only makes pushing near impossible (the woman is pushing uphill, with the baby behind the pelvic bone), but it also increases the risk of an episiotomy and/or an emergency cesarean (because at some point in time, the doctors just don't want to wait anymore). The only reason the hospital requires you to be in that position during labor is so they can see your vagina, which is totally unnecessary most of the time (trust me, you can't really see anything down there until the last few minutes!), but when it is needed, they should be able to look no matter what position you are in. It isn't your job to make the doctor more comfortable. It is their job to allow you to be comfortable in a very uncomfortable time. Being in a squatting position, on your hands and knees, or in a tub free to move around can speed up your labor and pushing time! You'd think that is exactly what the doctors would want you to do, but they do everything by "the book" (which hasn't been updated since the 1900's, it seems) just to avoid liability.

The doctors also must know about the importance of skin-to-skin care after birth. The baby does NOT need to be measured, weighed, wiped off, and cleaned up before being given to the mom. That first hour (especially the first hour, but several hours and days, really) after birth are critical for mother & baby attachment. The baby needs to be with his mother. It is a necessity. The mother's beating heart is a comfort to the child (since he's been listening to it for 9 months), and helps to regulate his own heartbeat. Her body heat will raise or lower in order to help the child regulate his own body temperature. Sometime in that first hour, the baby will wiggle around and find the mother's nipple to begin his first feeding. All of this is facilitated by the hormone rush that happens for both mother and child directly after birth. If the child is taken away too soon and misses that time window his temperature will not regulate under the heat lamps and he will need to be swaddled. It is insanely hard for a newborn baby to eat without his hands. Because they can't see well, they have to use their arms and hands to help them feel around. Imagine trying to eat with your hands behind your back and a blindfold on. The baby will miss his first feeding, causing his blood sugar and heart rate can drop. Then he will take a trip to the nursery, which means MORE separation for mom and baby. Once all of that has happened, breastfeeding can be extremely complicated, as the baby was likely given formula in the nursery, or it has just been too long and he cannot figure out a good latch, be it from exhaustion or stress from the trauma of separation (and YES- it absolutely is traumatic for a newborn to be separated from the only person he knows in a brand new world).

I just recently learned about brachial plexus injuries. They occur in 5 in 1000 births, meaning they are more common than down syndrome or spina bifida, yet I had never heard of it. It occurs when the doctor pulls on the baby's head during labor. This snaps or tears the nerves running from the brain to one or both of the arms, leaving the child paralyzed in that limb, often for life. Shoulder dystocia is a contributing factor, which is when the baby's shoulder gets stuck behind the mother's pelvic bone. Although there are much safer ways of alleviating this problem (the Gaskin maneuver calls for simply rotating the mom's position, which opens up the pelvis and releases that shoulder. Remember what I said about laboring on your back?) doctors ignore the proven safe route and pull on the newborn's head. I don't see the sense in that. They know that it can cause severe birth injuries, yet they continue to do it, I assume to speed up the process.

Doctors know all of this, yet it happens every single day. 

And what is worse, is that most women just let it happen. I can't tell you how many women I know that don't want to know the facts about hospital birth in this country. They would rather just "get the epidural" or "choose a cesarean" than give birth naturally. The other thing is- pitocin makes birth more painful, causing unnatural contractions that your body was not built to handle. Yet women often take drugs in the first place thinking they make the whole process easier and smoother. So why are women so clueless, and why are they okay with being clueless?

I'm sick of hearing about how the media and society caused this lapse of reason in women's minds. I absolutely agree with it; birth on TV is nothing like birth in real life, and it is VERY scary on TV. But frankly I am just tired of excuses. TV shows should not be where women get their information about the kind of birth experience they can have. When I found out I was pregnant, all I wanted to do was research. I wanted to know the safest options for everything- from car seats to first foods, diapering to baby soap. More than anything else, I wanted to know about the safest and best options for the birth of my child. I can't help but (maybe naively) feel that every woman has that intuitive notion that birth is in fact important. The way you give birth and how you and your child are made to feel in that time will affect you and you child for the rest of your lives. A child's own life path is paved at birth. The brain is a very sensitive organ, and if it experiences trauma that early in life it will hold very deep scars, of which many scientists wonder if they will ever heal. So why is it that women still just take the drugs so easily? Or elect to have a major surgery as if they were getting a dental exam? It is preposterous to me.

Here's my thought on it; if you want to ignore the facts about what is safe or unsafe for your child, then you shouldn't be having children at all. If you can't grow up, educate yourself, and put your child's needs first, then you aren't doing your job as a parent. Period.

I wish I could get inside the heads of all of these women and really make them hear me. You absolutely have choices in birth, but if you just submit and do what is easiest for the doctors, things will never change in this country. If you don't educate yourself and take control of your birth, you are hurting yourself, your best friend, your sisters, and your daughters.

I can't tell you how confident and powerful I feel after giving birth at home, and all I had to do was let go, and allow my body take over. As women, we have these superpowers. We can create human beings in our bellies, nourish them with an organ that we build especially for them, give birth to them all on our own, then feed them with a milk designed specifically for their personal needs (it differs with every child and changes composition to suit them by age!), and help them grow and mature until they can fly on their own. Yet we give it all up; we hand over our powers to someone else. Most women hand over their powers to the doctors and nurses, and let them take control. Some women hand their powers over to their religion, instead of taking the credit for their own creation. Many women just ignore them altogether, and never feel just how powerful they really are. I absolutely believe that every woman on this planet (excluding the very few with serious medical issues) can give birth naturally. They can feel their bodies working, follow their own intuition, and birth their babies without the constant "coaching" of medical staff. If every woman did just that, can you imagine how powerful and confident women would be as a whole? Can you imagine the difference that would make in the world we live in? The things we would change, the things we could fix?

Birth is of absolute pivotal importance in this world, and it is about time we started acting like it.