Andi Stracner's Doula Blog

A blog about natural childbirth and being a doula in Little Rock, Arkansas.

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Andi Stracner, Doula
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Email: Andi@doula1.com


Tuesday, September 02, 2003

A paper about giving birth

Here is a paper I wrote a while back for a composition class that explains a little about my views on birth.




The United States spends more money on child birth than any other developed country. You would think this would mean that it would be safe to have a baby in a U.S. hospital. This is not necessarily true. Unfortunately we have one of the highest rates of infant mortality and lowest apgar scores of all the developed countries. This could be because the technology that we have been spending so much money on is the very thing that causes complication in labor. The safest way to have a baby is to have it completely natural. The best way for many people to do this is in their own home.

When a woman becomes pregnant many things run through her mind. Will I have a healthy baby? Will I miscarry? Will it have all its fingers and toes? One of the most frequently thought of things during pregnancy is what will labor be like. Our society makes a certain image of child birth. We have all seen television shows where the woman seems to be in so much pain that she cannot possibly handle it physically or mentally. She is doing everything except spitting green stuff and spinning her head around. A woman will constantly hear horror stories from other people about child birth. This basically scares the hell out of any normal woman. Many women will just opt for the drugs after hearing the terrible things that they have heard without researching the consequences of doing such. Just listening to your doctor and keeping your mouth shut, thinking that they must know best could be very dangerous. Just because your doctor went to medical school does not mean that he knows best. Doctors are constantly giving drugs, performing surgery, or doing other medical procedures such as episiotomies (a cut in the vaginal area that requires many stitches at times) when it is not necessary. More than ninety percent of births do not need medical intervention at all. Not to mention the things that they do to a woman and the baby mentally in hospitals. They do things such as take the baby away to the nursery right after it is born. This is an important time for mother and baby to bond. Many times they do not even ask you if you are planning to breast feed the baby and just shove a bottle in its mouth making it very hard for the baby to get adjusted to feeding on the breast.

Many times when a woman is pregnant her doctor will ask her to schedule in a time to induce her labor. This to a woman who has not educated herself in child birth may seem appealing. She may like the idea of knowing exactly the day and time her baby will be born. She thinks that many arrangements can be made that might not be possible if she leaves the date of birth up in the air. This is a big mistake that women make with their doctors pushing them right into it. You see doctors don't really like to get called to the hospital in the middle of the night to deliver babies. This is why they try to schedule births in, not leaving it for nature to decide. Some doctors want to have total control of the situation. When a doctor decides to induce labor a medicine called pitocin is given intravenously causing the uterus to contract. This makes contractions come on at there highest intensity all at once. When labor starts naturally contractions do not start off at the highest intensity and remain this way throughout the contraction. A contraction slowly grows more painful and then slowly goes away. Obviously pitocin makes the pain of giving birth more unbearable. Then a nurse comes by every five minutes asking if your ready for your epidural. (An epidural is given with a needle that goes in to your back kind of like a spinal tap. The epidural makes a woman numb from the waste down.). The woman is going to think this is the way birth it is suppose to be done if she has not educated herself. She will be in a great deal of pain from the drug induced contractions and more than likely decide to take the epidural that has been offered to her many times. The epidural causes its own set of complications. Babies that are born with an epidural or other drugs usually have a lower apgar score ( An apgar is a score given to determine the health of the child based on tests given.). The epidural can also cause back problems for the mother for the rest of her life. Also, an epidural may slow down the labor. Many times after the epidural is given the mother will feel very much relief, but since she cannot feel her body from the waste down she has a harder time working the muscles from the waste down as well. As a result from this she may have a problem with pushing the baby out when the time comes. This is when a cesarean is performed. The woman can not deliver the baby vaginally so the doctors must perform major abdominal surgery on the woman to get the baby out. All of this possibly could have been avoided by the woman educating herself and not just letting the doctors and hospitals have control of her body. Remember you are a consumer not just a patient you have the right to refuse anything that they are planning to tack on to your bill.

A midwife may be a good alternative for many women. A healthy woman who is not at high risk for complications can deliver her baby at home. There have been studies done showing that there is a home court advantage. When a mouse goes in to labor in its own environment and is then put in a cage ,the flow of oxytocin slows down. Oxytocin is a hormone that causes the uterus to contract naturally. The flow of oxytocin slows down or stops because the mouse does not feel comfortable. It's body has a natural survival mechanism that stops the labor because it knows that it is not in a safe place to have its baby or babies. Also a veterinarian once told of a story about a dog pregnant with eight puppies. The dog delivered four puppies with no complications at a location that she picked out. The owner of the dog decided to move the dog to another location. The dog's labor slowed down and the other four puppies almost had to be delivered by cesarean. The veterinarian and the owner of the dog tried one last thing. They moved the dog back to the original place that it was laboring. The dog delivered the other four puppies quickly with no problems after it was moved back. You can see the obvious advantage you have at home from the dog, and the mice studied. We are mammals just like them. Many times labor is shorter at home than it would be in a hospital. The length of labor many times is the reason that doctors feel the need to intervene with pitocin, which leads to many other interventions. There are also other advantages to giving birth at home like you are not forced to labor on your back. This can be the most uncomfortable position to be in while laboring. A midwife will tell you that it will make the labor much faster if you get up and move. If you are up and moving the baby will be able to work with gravity moving the baby on down. Midwives also know many all natural drug free pain coping techniques such as breath awareness, aromatherapy, and water labor. Some midwives are even trained in hypnotherapy. Just knowing and trusting the person that is going to be helping deliver your baby can make your comfort level much better. An average check up with a midwife last 45 minutes. Compared to the average of 6 minutes for obstetricians. Mothers at home can relax knowing they will not have to fight against doctors and nurses to have their babies naturally. They are able to let go of all tension and direct all physical, mental, and spiritual strength into bringing life into the world.

People in the United states should look to home birth for a solution to its problem of high infant mortality rates. In 1991 the infant mortality rate was 8.9 deaths per 1,000 live births. The worst state was Delaware at 11.8, with the District of Columbia even worse at 21.0. The best state was Vermont with only 5.8. Vermont also has one of the highest rates of home birth in the country as well as a larger portion of midwife-attended births than most states. The International standing of the U.S. ( in terms of infant mortality rates) did not really begin to fall until the 1950s. this correlates with the time that the hospitals secured the monopoly on birth. Prior to then the U.S. always ranked 10th place or better. Since the 1950s the U.S. has consistently ranked below 12th place and has not been above 16th place since 1975. In 1993 the U.S. ranked 22nd place. You can see that there is a problem in the United States. Doctors need to step back and take a good look at what they are doing and think about if they are really helping. Women also need to take the initiative and educate themselves. Go to child birth classes. Not just the ones that the hospitals give you. You can find other child birth resources out there.

You can find a nurse midwife by searching on the internet, or even looking in the yellow pages. You will want to make sure that she has had the necessary training and licensing that your state requires. You can also ask around. If you talk to several people that have had a good experience with a particular midwife you may want to meet with her. A good midwife needs to know how to distinguish between problem and non problem cases. You will visit with her many times she will help you learn about your body and what happens during labor. She will also give you nutrition tips for a healthy pregnancy. An average visit with a midwife lasts for about 45 minutes. An obstetrician visit usually only last 6 minutes. she will know everything about you. She will know you physically. She will also know you as a person not just a patient. She will know your hopes for the birth and the fears for the birth. One midwife here in Little Rock has been known to go over to women's homes when they call at three in the morning just to comfort a scared emotional pregnant woman. She may not be in labor but just need emotional support, calling the one person who she knows understands her. One time this same midwife watched cartoons with a mother all night until she felt better emotionally. I don't think you can get that from any doctor around here.

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