Tuesday, June 02, 2009

Crisis of Confidence

WARNING: this is a post about childbirth, and the aftermath. I am tired of pregnancy, birth, and what comes after being a taboo and humiliating experience, especially when every single person on this planet has been involved. C'mon, people- you may not have given birth, but you were certainly born. So I need advice, but YOU may not choose to read about it. I do not want to force you to, either: this is your warning to just navigate away from the page if you do not want to be involved in the conversation.

So here's the bottom line.

Natural childbirth (read- no pain meds) was very important to me, as is the idea that birth is a very natural occurrence, and should be treated as such. With this in mind, I have been seeing a certified nurse midwife for all my well woman and pregnancy care for years. I was very pleased with my labor experience with Owen, which involved an induced labor lasting six hours (on pitocin, a contraction enhancing drug), no pain medication, no episiotomy. My midwife was with me almost the whole time, except in the earlier parts when I told her I didn't need her there, so if she had something to do we'd let her know when we were ready for her again. There was some serious tearing involved when Owen was born, but I do not fault anyone for that. (Also- I couldn't even feel it ladies- don't freak if you haven't had a baby yet). I waited an extra 11 days to give birth to a child who ended up being 8 lbs 14 oz. That was my choice as well. The healing did not go super smoothly, and I am not pleased with the quality of workmanship of subsequent repairs, which were performed by an ob-gyn who told me this would have been easier if I had had a c-section.

My mother (and most women of her generation) believe that an episiotomy would have negated most of the problems I had post-partum, but in speaking with many people (anectodally, other midwives, ob-gyns) I have learned that the episiotomy is no longer standard procedure and is indeed frowned upon in most practices today. So with 8 more weeks to go until the birth of my second child, I may be considering going about his differently. Here is what I want to know, and here's where I need your help.

If you have given birth in the last 10 years or so, and any of the following situations apply, please respond- and feel free to do so anonymously.

a) Has anyone switched from midwife to ob-gyn, or vice versa? If so, what were your reasons, and were you pleased with the choice you made?
b) Has anyone had a natural (epidural free) birth with an ob-gyn? (I am not opposed to pitocin, and handled labor fine last time, so pain management is not a concern for me)
c) Has anyone had an episiotomy? Have you had one, then not had one, or vice versa?
d) Anyone in the medical profession care to jump in, whether you have given birth or not?
e) Actually, any insight at all to second childbirth would be great. Feel free to make any comments.

I feel comfortable writing about this in a public sphere because many women I have asked have similar stories about the post-partum experience, so I know I am not alone. Nor do I want anyone to feel that I am critiquing her choices in giving birth- actually, I would love to hear about it from another perspective. Tell me your experiences, with first or second or third child. Feel free to do so anonymously.


WendySue said...

Hi Meaghan,

Ok - my birth experience was before knowing about the benefits of doulas and midwives. Rainey will be 10 this month. I flew to Mass. 2 1/2 weeks before my due date THINKING I'd be home to deliver - nope. My water broke 3 days after flying north. Had her in a hospital there, no prior experience or much say so. No real progression in labor for 6 hours after I was admitted, so pitocin started at 1am - I was 2 cm dilated the whole time. At 5:30am (4 1/2 hours of hard labor) I was told I could have an epidural (which after no sleep all night, they thought best) but couldn't get it til 7:30am - got it, slept 2 hours and went to 10 cm dilated in 2 hours! Pushed for 2 hours... tore... baby was 6 lbs, 12 oz. Simple, good recovery.
I don't think an episiotomy is ever needed (via my doula training). I don't think Pitocin is necessary. Doctors and midwifes work for you, and unless it's MEDICALLY necessary, you don't have to do it. I like mom's being empowered!!

kimberlina said...

hey chickie, i shared your link on my facebook and a friend responded. check it out:

I don't have too much insight seeing how I have not actually given birth to my 2nd yet (due 8/5/09) but I would like to respond as best I can:
a) Had and currently have an obgyn. Wanted to go with a midwife this time but she was all booked up through the summer (lots of babies down here!) I'm not really into the hand holding part of it as much as ... Read Morethe emphasis they give to minimal intervention/medication
b) Had an epidural free birth with obgyn (with pitocin) I had an open mind going into it-not knowing what to expect as far as pain and after a great non-biased explanation of the epi by a nurse I decided to try without. Will try without for 2nd too
c) Didn't have an episiotomy with my 1st but my Dr said she should have in retropect b/c I ended up tearing This may sound crazy but I don't think I would want one next time either Yeah it hurt like heck but only for an instant and I heeled fine
In the grand scheme of things it's all over so quick

aly said...

Meaghan, I tore (3rd degree) with my first, and my ob (who was my ob for all 3 and is still my ob) never even suggested an episiotomy or said I should have had one. My children are huge with enormous heads. I had a stitch or two with babies 2 & 3, but nothing big. I had Henry with an epidural, Ceci with an epidural that didn't work (well, it numbed my leg), but my labor was under 4 hours, and she came out on the first push. So by Malcolm, I was like, forget the epidural. He was 10 days late, 10 pounds, and had a 15 inch head. I was induced, and the contractions were way more intense than either of my other labors. But he still came out on the first push. My dr. was okay with me not having an epidural, and she is pretty cool in general. A midwife I know told me that a lot of her patients who have to switch choose the ob I see. If you want her name, let me know. I don't think episiotomy is ever really needed either, but Pitocin... well, I don't think I would have wanted Malcolm to get any bigger. But I know I am not the norm when it comes to baby size. Let me know if you want to talk about this some more.

mb. said...

well my dear I have nothing to say about birth, human birth anyhow. But I can offer to make you any of the previous dinners you have enjoyed at my table for BC on Tuesday if you will just come. Let me know what you want by monday evening, though OKay?

Andrew thinks I should offer to babysit Owen to relieve some of the round-&-round in your head (he thought you were a little amped when he crashed BC last month). I have tried to explain no one in their right mind would give me a child they wanted back in one piece, but I actually do not mind Owen (sorry, this is as good as it gets with me & <8 year olds). Call me when he wants to chick-squish.

Michelle said...


I actually had both an obgyn and a midwife (though she was not a nurse midwife). As you may already know, my goal was to have our baby at home with no interventions, and that was how we started.
My water broke on Saturday morning, but no labor started. My midwife gave me all kinds of natural / homeopathic stuff to get labor going, I even had an acupuncturist come to the house, but by lunchtime on Sunday, my blood pressure was still rising and no labor, so it was time to go to the hospital.

The hospital was MUCH more encouraging of my desire for a natural birth than I could have hoped. (Of course, it didn't hurt that I told them my water broke Sunday morning, not Saturday morning... *ahem*). We went to the hospital about 2:30pm and they gave me until 9:00pm to go into labor on my own (of course, I couldn't get out of bed). When nothing had happened by then they started me on pitocin. By about 1:00am I was contracting, and I asked to not be given any higher levels of pitocin. I also specifically asked the nurse to not offer pain relieving measures - I knew what they were and if I wanted them, I would ask HER, not the other way around.

By 2:30pm, both my midwife and doula were at the hospital and walked with me through labor.

Maya was born at 8:06am with about 1/2 hour of pushing. She was caught by my obgyn with my midwife observing (remember, midwives are illegal in Alabama). There was some tearing for me, as well. I ended up with three or four stitches. My midwife was a bit frustrated because she felt she could have prevented the tearing. I had a bit of a painful recovery, especially when it came to sexual activity, but am doing great now (hey, you said this was a post to put it all out there). And I too, had some post-partum issues.

I don't think I would have wanted an episiotomy, nor would I have one with a second birth. My goal for a second birth (should we ever decide to have another biological child) would be to be at home, with a birthing pool and my own bed, with a midwife and doula (I would fly my doula to wherever I am - she's that great).

Having said ALL of that (boy, we can really tell those birth stories, can't we?), I think you need to make the best choices for you and what your body needs for a safe and healthy birth AND recovery.

I'll be thinking about you these next two months as you near the end of your pregnancy and get ready for Owen's new sister!

Amy said...


I am approacing my third birth and I am wondering what to expect.

With my first my water broke at 1 am in the morning when I got up to use the restroom for the tenth time that night lol. However, I didn't have any contractions. But since it was my first and I didn't really know much about childbirth my husband rushed me to the hospital. By the time we got there and I was in the triage room my contractions had started and they were 2 to 3 mins apart. They put me into a room and then around 10 or so they gave me and epidural and I had my 8lb 14 oz baby boy by 4:00 in the afternoon. I tore pretty bad without an episiotomy. It took awhile for me to heal. In fact I wasn't comfortable for awhile down there. But I guess it didn't stop us from getting pregnant with baby #2. I found out I was pregnant again when are oldest was 7 months old. With my second baby my water broke again when I got up to go to the bathroom but this time I knew better then to call the hospital. I didn't want to be confined to a bed and hooked up to all of the equipment so I went and laid back down. Got up in the morning took a shower. We took are oldest to the daycare lady and my hubby and I went to breakfast and then we went home and waited for the contractions to come. They never came so finanally we went to the hospital and told them my water broke and my stupid husband told them it had been at least ten hours ago so they quickly put me on Pitocin. 28 painful hours later, with no epidural, contractions harder then anything I could imagine the nurse had the nerve to tell me I was only 4cm dialated. I told her to check again because I could feel the head. She rolled her eyes and took a look and sure enough here came baby. It was a very scary birth because the baby's heartrate dropped, he got stuck and nurses had to come push on my belly and then the cord was wrapped around his neck three times. Baby #2 weighed 8lbs which was less then baby #1.
From my experience I have nothing good to say about Petocin because it didn't really work very good and it made the contractions 100 times worse for me. I tore with my second less then I did with my first so the healing time wasn't so bad. However, by the time I had my second I was beyond exhausted.

I am just hoping for a better delivery this time around. I don't know if I will go for an epidural or not even thought I know how horrible the pain is. I also know I will be able to manage it.

Good luck with your delivery. I am due July 17th with baby boy #3. Can't wait to share birth stories.