Tales From the Crib: From the Tales Inbox: Natural Birth Questions

Thursday, February 28, 2008

From the Tales Inbox: Natural Birth Questions

Deep in the comments of Kage's recent pregnancy Q & A post were a couple of good questions regarding natural birth that we thought deserved a post of their own. All you experienced natural-birthers out there it's time to share your knowledge.

Kristine N would like to know:

One thing I've been curious about is alternate positions for giving birth. Everyone I know gave birth supine, and most with an epidural. I'd much rather squat and go natural (my mom reacted badly to an epidural and so far I react exactly like she does to medications) and I've heard it's easier that way, but also difficult to convince a doctor to let you. Any thoughts on whether squatting/other non-laying down positions are (relatively) more comfortable and effective, and how have doctors reacted to the alternative positions? If you want to try something like that is it advantageous to have a doula?

And a semi-related question from Katrina

What I'd like to know is what techniques any natural birthers used during labor? I'm exploring the options and would really love to hear some specifics of how women got through natural labor.

42 Comments:

I'll go first. I have done 1 birth with pitocin, nubane and epidural, and one natural...both vaginal deliveries (obviously).

1. The first time you do it, it is very difficult to achieve natural birth because of the unknown. If you do not decide ahead of time that absolutely nothing will deter you from naturally birthing this child, I am guessing the chances of you achieving it the first time are pretty slim (many factors considering). The only thing that might help with this is watching some graphic videos on birthing. Youtube has some good ones of the actual birth part...maybe you can find some good position ideas there.

2. A midwife is essential for success in natural birthing. They are with you the entire time and they can coach you in a variety of ways. They are far more flexible with exploring birthing positions and they make your chances of success raise significantly over doctors, in my opinion. You might want to think about a doula too, but I am not into doulas, I want to do the work myself and it seems like a doula might give you the misperception that someone else is going to do this for you....I have no idea...anyone out there use a doula?

3. Practice positions while you're not in labor. Spend time squatting or laying on your side or sitting on the toilet and just finding comfort and familiarity with those positions, ahead of time....I can't imagine pushing a baby out in a position I had never even attempted before hand.

4. Read Books! Birthing from Within, Ina May's book, Husband-Coached Child Birthing, The Bradley Method. Not all of these books are exactly dead right for you, but you can take bits and pieces and compose your own birthing ideas from them. I found the Bradley book in particular to be very good in teaching me about the mechanics of birth and why my body needed to do what it was doing...helped me embrace the pain instead of trying to distract myself from it.

I highly recommend naturally birthing for the following reasons:

1. Recovery is much quicker
2. Chances of stitches is less.
3. Energizing, Raw, Gut-wrenching in a good way.
4. Completely Empowering, I felt like a transformed person after doing it, like truly I can do ANYTHING.
5. My natural birth baby cried when she came out and was a much better newborn...my medicated-birth baby whimpered and seemed a bit weak and was a harder newborn. Not sure if there is a correlation or not, but just stating differences.
posted by Kage at 2/28/2008 09:05:00 AM
I *highly* recommend the book Birthing from Within. It helped me prepare mentally for what would be ahead, and also helped me prepare for not really knowing what would be ahead. It also gives lots of excellent ideas for pain management.

I've had three natural births. They were all relatively easy births. My first was born in a hospital after laboring at home and the baby was born with me on my back. The pushing was by far the worst part of everything. I just had no energy or motivation at that point to "fight the establishment" for another position and honestly at that moment nothing sounded much more appealing. The next two were born in birthing centers with midwives in tubs so it was much easier to be in other positions. The were born with me sort of squating/reclining. The water supporting me in that position was the best part of a waterbirth for me. It is the rare hospital that allows you to birth in a tub, however. (Although we do have one in Dayton, so it's worth checking).

The most helpful thing I did to prepare was to reflect how I react to difficult physical situations like long distance hiking or yoga. It helped me realize how I might react in a painful birth.

My biggest advice about natural birth is to just go with it and don't put lots of pressure on yourself to make it an amazing, spiritual experience. It might be that for you, but it might not. Everyone's bodies are different, and every birth is different. Things rarely go as you expect or plan. Just honestly experience and rise to each moment; don't make yourself experience the fear of how much worse it might get. If at some point you feel unable to meet what you are actually experiencing, allow yourself options. This is especially true if your labors are very long and exhausting. Sometimes labors are worse than you expect, sometimes better. Shortly before my first son was born they asked me to rate my pain on a scale of 1 to 10. I said 5, fully expecting my labor was just beginning. He was born 45 minutes later. So for me, things were better than I anticipated. Your birth might not be like that, so don't compare your experience with others.

Good luck!
posted by Gina at 2/28/2008 09:50:00 AM
I had my first natural, I was ultra-informed and motivated. The next two I opted for hospital midwives with epidurals, and those were my healthier babies and happiest, easiest births with faster recoveries.

I support natural birth. really. I just hate the lack-and-white thinking about it, like so many other parenting decisions that can get so argumentative.

anyway, kristine. there is no sense convincing a Dr to "let you" do a certain position or skip a certain intervention. when the rubber meets the road, that won't be the way he wants to do things. that won't be what he's used to working with. you don't want the guy who agrees to "let you", you want the one who sees that day in and day out, who expects that, who can guide you through it, and who knows what success looks like. that's a VERY rare Dr but most midwives. you can have a CNM (nurse midwife) for prenatal care and attend birth in hospitals or birth centers, it doesn't have to be at home, and my insurance paid every penny.

You do have to get educated, because it goes against the usual American medical system. read Naomi Wolf's book about birth. Read Ina May Gaskin's work. Rent "the business of being born". Take a Bradley childbirth class. READ. The statistical outcomes are WAY better. No time to cover them here, but if you read up, you'll see that.

PS- about vertical positions, it actually opens up your pelvic bones and increases the space so baby can come out! plus, gravity helps. logically, flat on your back or reclined sitting is simply dumb. classic hospital reclined sitting with legs up actually makes baby go *uphill* near the end.
posted by Anonymous at 2/28/2008 09:58:00 AM
I want to second Gina's advice:

"My biggest advice about natural birth is to just go with it and don't put lots of pressure on yourself to make it an amazing, spiritual experience. It might be that for you, but it might not. Everyone's bodies are different, and every birth is different. Things rarely go as you expect or plan."

As for me? I'm the odd one out when it comes to unmedicated childbirth because I just do it. I didn't read any books and I didn't go to any classes. I didn't have a doula, although I did have a midwife with me.

I labored in bed, I labored in a chair, I labored standing up. I eventually chose the back position because I could open my legs better that way --also, pushing was easier for me with support underneath me. But I know it's different for everyone.

I also didn't try undmedicated childbirth until my third child. I'm glad I waited because then I had experience to show me what I was capable of --but I'll never go back to meds. Mostly because I now know I can do it (and I've done it twice).

And the only reason I made it through all of it was because of my husband. He was a fabulous coach and kept reminding over and over that I could do it. He was patient and kind and did exactly what I said. Man, I love him.

[On a side note, the term "Natural Birth" is offensive to all women who either cannot (or choose not) to have unmedicated childbirth. To quote my midwife: "It doesn't matter if the baby arrives by c-section or vaginally, with meds or without. All birth is natural."]
posted by Cheryl at 2/28/2008 10:04:00 AM
I have another question. I just had my first baby - well 9 months ago. I was not sure about epidural or natural before, but leaning towards natural. But then my water broke and I didn't go into labor, so like 12 hours later or so, they started the pitocin and it was HORRIBLE, but basically unavoidable. I tried for many hours to do without an epidural, but contractions with pitocin (especially when the level got way too high and my body started kicking in) were unbelievable painful. Do people do "natural" (i.e. no drugs) while on pitocin? Or should you just take an epidural right away? And I also pushed for 4 hours (which was NO fun). Anyway to avoid that??? I am still kind of bitter about the experience.
posted by Amanda at 2/28/2008 10:26:00 AM
Great advice here! My first baby was breech when I went in to labor, ending up with an "emergency" c-section (me knocked out cold for the whole thing).

7 months ago I birthed my second daughter at home (obviously no meds!)

I second the recommondation of "Birthing from Within" and "Husband Coached Childbirth" + Bradley classes. Also, the comparison to how you deal with hard physical activity to prepare yourself is excellent. Listen to people describe the physical/emotional experience of running a marathon.

I recommend laboring in a tub (very rarely will you have the option of delivering in a tub at a hospital) I didn't plan on birthing in the water. However, during labor I found the water to be SO comforting and soothing that come pushing time, I believe my actual quote was "HAH! No way in he* am I gettin' out of here!!" Luckily my midwife was prepared for that. ;) I pushed for 15 minutes leaning back/sitting against the side of the tub.

Also, make sure your labor attendant (doctor/midwife) is not only aware but supportive of your ideas for laboring/pushing. I agree that it is pointless go in to a situation where you are "fighting" the Dr. or doing something they are against or not "approving" of. That will affect your ability to birth.

Talk about it at your appointments. If your care provider is not interested or uncomfortable with the thought of you birthing in different positions, "shop around" for a provider with more experience in "natural" (drug free) childbirth.

Oh! One more book (in addition to all of the others mentioned above)

Creating Your Birth Plan- Dr. Marsden Wagner

Happy Pushing!!
posted by Guileless Mom at 2/28/2008 10:29:00 AM
Cheryl,

I don't think all women are offended by the term natural birth. I have never had an unmedicated birth experience and don't mind the phrase at all.

But the first person to be offended and comment as such gets to decide what we should call it and I will happily go back and change the wording in the post. We can use quotations or use the term "unmedicated" or whatever. Just let me know.
posted by This is Carrie at 2/28/2008 10:33:00 AM
I wanted unmedicated births for my two kids, but kind of like Cheryl, I didn't do much in the way of preparation for it. The biggest motivation to keep off the pain meds was my doctor telling me that it would be over a lot sooner if I could stick it out!

My nurse for #2(who was studying to be a midwife, so I lucked out there), helped me try some different positions but nothing was more comfortable than being on my back. Maybe, like Kage suggested, if I had practiced the others and been more familiar with them, it would have been different. She also put me in a shower and it was not relaxing or helpful in the slightest.

Bottom line: Everyone reacts to labor differently. Do the preparation you need to have the birth you want, but don't rule anything out (including the possibility of needing an epideral or a c-section)...and just see what happens.
posted by Jen at 2/28/2008 10:45:00 AM
For the first time preggo, I think the most important thing is to go with a midwife if that is an option. They are very geared toward natural labor and more open to different positions while laboring and pushing than traditional OBs. I think the second most important thing if you want a natural labor is to read all you can on it, prepare for it, but keep an open mind and just go with what feels right when you are in labor. It's one thing to read about labor but a whole different thing to actually experience it. And, even with drugs, it is still a natural process and your body is still doing all the work, so an open mind is key.

I have had 2 great labors/deliveries so far and was able to do them witout an epidural, but I don't know if I could do it if my labors weren't so short and if I had big babies that took lots of pushing. The best thing, though, about "natural" labor is the adrenaline rush you get after the baby is born - amazing!

Amanda, I have given birth without an epidural with both of my kids. First one, water broke, labor started right away, baby born a few hours later. Second birth, water broke, no contractions on my own, so I had pitocin. It was about 4 hours from getting the pitocin to having the baby. The contractions were pretty intense right away as opposed to building up in intensity like with my first labor, but it was manageable. Had it been my first birth, however, I don't know if I would have gone without an epidural.
posted by Mary at 2/28/2008 12:01:00 PM
I have to give a shout out that you can have a healthy baby either way... really. I have had two medicated births (one for the same reasons Amanda said- water broke, 12 hrs later, no contractions, pit started... I lasted 6 hours on the pit before I was exhauted and in so much pain I asked for the epi)

That said, I labored naturally with that first baby- I walked, I used a birth ball, I used water- all with an OB. He knew what I wanted, so did the nurses,and they respected it. You don't have to have a doula or a midwife to get what you want. I know that might increase your odds of success, but I just wanted to be the voice saying doctors are not ALL gung-ho for medicated births.

I had baby #3 all natural, but with the same OB as my other births- and I labored on my hands and knees for a bit, but she came very, very quickly- when transition started, all I wanted to do was lay down- it worked for me, and she was born quickly, easily and healthy.

I didn't see any difference in the health or vibrancy of any of my three chilren based on their methods of getting out. Natural birth can be awesome, and I support women doing what they choose, but like cchrissy, I hate the "black and white" nature so many people take.
posted by Anonymous at 2/28/2008 12:02:00 PM
All three of my labors/deliveries were unmedicated. I was in a semi-back position for two, where I helped hold back my legs and my husband supported me from behind. The third one, I was basically sitting up, right on the edge of the bed-the baby sort of slid out.
By way of preparation, I took a Lamaze class with my husband the first time through. I remember reading a book called Mind Over Labor, but I don't know the author (I let someone borrow it and never got it back!)
The second time, I had a friend who was becoming a certified childbirth educator, so we took classes with her.
The third time, I just practiced everything I'd learned.
I used a labor tub with the 2nd and 3rd--I loved it. It completely took the pressure off the contractions.
I've also labored standing, on a ball, using a sqaut bar, and in a rocking chair. I found all those positions helpful. All my labors were pretty straightforward, and the longest I ever pushed was 45 minutes with my first. The other two I pushed for maybe 15 minutes.
I really believe in the power of knowledge, prayer and breathing! I was amazed at what my body could do. But in my mind, I also prepared for being able to do whatever I needed to have a healthy baby- so I never ruled out a c-section.
I talked to my doctors early on in my pregnancies and found them all supportive. What made the biggest difference for me was my husband's support. He really acted as my advocate and coach so I could focus on what I needed to do.
My recoveries were great! I did have episiotomies, but they healed well and I didn't have any complications.
I loved my birth experiences (as much as you can love that kind of pain and discomfort...) I think learning all you can, practicing what you learn and talking to your health care professionals will help you have a successful experience no matter what.
posted by Normal Mom at 2/28/2008 12:18:00 PM
Thanks so much for getting the discussion going on this! I really appreciate everyone's input. I've been reading a lot about hypnobirthing. Anyone out there tried that?
posted by Katrina at 2/28/2008 12:21:00 PM
I don't get offended by the term "natural," but I did get a little miffed when a friend informed me (at a book group in front of 10 other women) that I couldn't possibly feel for my child what she felt for hers because she did hers naturally. She also was somewhat appalled when I turned down her offer to breastfeed my daughter because I was having trouble. Surprisingly, we are still good friends and no longer discuss birthing and breastfeeding.

Luckily there is room for all kinds of mothers. Better living through chemistry is my motto.
posted by jlk at 2/28/2008 12:22:00 PM
Our first baby is due in 5 weeks so I'm not really qualified to comment, but since katrina asked about hypnobirthing I just want to throw out there...hub and I are taking a hypnobirthing class right now and I LOVE it. I know, I know, I'm still naive and the hard part's coming so we'll see how it actually goes in action, but emotionally and mentally it has been enormously helpful, and I feel much more informed/prepared/comfortable with the whole thing now than I did a month ago. Some of the stuff's a little "out there" (I get the giggles listening to some of the relaxation techniques about visualizing your body humming green with nature or your breath filling a "magnificent" balloon) but a lot of it I'm finding surprisingly soothing and helpful.
posted by gurrbonzo at 2/28/2008 12:41:00 PM
Amanda-
It's so different for everyone! Some women don't do well without the epidural (somehow, their bodies just freeze during pain), and others (like me) slow down with an epidural.

I did it "Natural" (that was for you, carrie) with pitocin both times. And yes, it hurt like a mother! But I already knew that epidurals slowed me down, so I was able to push through it.
posted by Cheryl at 2/28/2008 12:43:00 PM
I have a funny story about the term "natural birth." My brother had mentioned a few times that his wife delivered all four of their children naturally. We simply marvelled at her stamina, but she wasn't one to tell birthing stories so we never got the details. When I got pregnant, I was curious about birth experiences and I asked her what it was like to deliver naturally. She gave me a very funny look and said she'd had epidurals with three of her kids, and the fourth one was born without an epidural only because they'd gotten to the hospital so late.

I told her that her husband said all her kids were born naturally. She called him over. We eventually figured out that her husband thought "natural birth" meant "vaginal birth" and since she hadn't had a C-section with any of them, they were all natural births. She set him straight.

Now back to your informative and interesting discussion.
posted by Melinda at 2/28/2008 12:49:00 PM
i had an emergency c-section with my first, even though i was hoping for an unmedicated birth. she was born at only 31 weeks. with my second, i was able to have an unmedicated VBAC (vaginal birth after cesearan) and it was a fabulous experience. i used a doula and would highly recommend it. i'm now pregnant with my third and i'm planning for another unmedicated one!

a book i would recommend is A Thinking Woman's Guide to a Better Birth. loved it.
posted by merathon at 2/28/2008 12:57:00 PM
I had back labor when I delivered my first. I was all about the epidural, but unfortunately walked into the hospital at 9 cm dilated! So the "window had closed!" It helped A LOT to labor and push on my hands and knees. The bed moved so that the lower half supported my knees and I was leaning over the top half. My husband pushed on my lower back to counter pressure the back labor. I can't tell you how helpful that was. Once the baby had crowned they had me move to my back and the nurse and my DH held my legs so I could push. For someone who was so set on having meds, I am totally thinking about going "natural" again for our next child. Just remember....they don't hand out awards for doing it natural...so be open to anything!
posted by Anonymous at 2/28/2008 01:48:00 PM
amanda, I think pitocin is hard to do without an epidural. If you aren't progressing on your own (or even with pitocin), sometimes the epidural is the only thing that will help you relax into it and open up...also you get so fatigued doing contractions for so many hours with no relief and no progress. For me it was so mentally draining, I had to get the epi.
posted by Kage at 2/28/2008 01:55:00 PM
Melinda - I have actually heard people use the term "natural birth" for "vaginal birth" quite often. Come to think of it, it may have been mostly men.

I'm also curious about Amanda's question. With T I was induced and pitocin kicked my butt. The contractions were so intense and there was absolutely no break or recovery time between them. I am hoping with this baby to have labor come on naturally and last a little longer before using an epidural. Are contractions a little easier to manage when they come on naturally, and opposed to being induced? (Sorry if that question is off topic of "natural birthing").
posted by Beth at 2/28/2008 01:56:00 PM
also, as for positions.

With #1 I delivered on my side with one leg on the bed and the other up in the air and held back. This was the only position where the baby's heart rate didn't dangerously dip during a contraction. I feel very strongly that having a midwife on duty that day saved me from a C-section. My second one I pushed/labored in every position imaginable. I hated the tub....I first started pushing while squatting on the floor...it was the only way I could feel where I needed to push. I then pushed while on my hands and knees and then I also ended up delivering sitting up right on the edge of the bed, the midwife was on the side of the bed near the head of the bed...so being able to move around is really important especially during TRANSITION....when you feel like you might just jump out the window.
posted by Kage at 2/28/2008 02:01:00 PM
Do people do "natural" (i.e. no drugs) while on pitocin?

I don't like saying pitocin without saying epidural in the same sentence. :) Going from 0 to 60 with pitocin doesn't give you the gradual build up. Having done a pitocin-induced birth without an epidural for hours, vs. feeling all the intensity of transition (twice my epidurals didn't take), I think the two are different because of that buildup. But they both hurt like crazy, so just be ready for that. :)

I personally think that a woman should be open to anything, especially for their first (but really, each birth can be so different). Be prayerful; I know of situations where the mom was listening to the Spirit and that saved her baby's life. Had she predecided what 'should' happen, she might have put herself and baby at risk. All the best laid plans can change with something like giving birth, so just plan the best you can but don't set things in stone.

It took me two children to understand my body and realize how I labor. Not all women can do non-medicated births, and I really, really think we ought not hold that up as somehow the better option. For some women it is, for some it's not.

BTW, I had absolutely no problem pushing on my back -- none took more than 30 minutes, the last took 10.

There is simply no set answer to any of these questions.
posted by Anonymous at 2/28/2008 02:06:00 PM
I have no experience personally with a nonmedicated birth as I got epi's on both kids. But I did make it until I was dialated to an 8 with #2, and at that point did not feel confident that I would not faint or pass out from the pain, and so I begged for an epidural, and he was born quickly and easily after that.

I have 3 sisters that have birthed every way imaginable. One fully INTENDED, prepared for and wanted a nonmedicated birth. She was the most physically fit of all of us, and I figued her birth experience would be easy because of that. But it was LONG, hard, and they nearly had to have an emergency C-section because they couldn't get the baby out. It was very difficult for her.

Another sister labored nearly all at home, and then went to the hopital (natural birth room) and had a seamless and easy water birth. Baby was out in only two pushes! It was a dream scenario. She now swears by the water birth- although yes there are very FEW hospitals that have it as an option.

I also have had several friends do hypno-birthing and SWEAR by it!Worth checking out, for sure.

I am due with baby #3 in June, and so far are not planning anything different that what I have already done. I have had fairly quick births, and have recovered quickly enough that I am happy with the results. I am just not interested in PROVING to myself that I am TOUGH enough to survive natural(nonmedicated) birth. Epidurals make me happy. =)
posted by Rachel H at 2/28/2008 02:33:00 PM
I love all this stuff about natural birthing. I have nothing against people who use an epidural, pitocin or anything because sometimes it is necessary, but if you can avoid it at all, and you feel prepared, totally go natural. Your body knows what it is doing.

I am pregnant with #2 and I did the first natural birth. While I was having contractions (before getting to the hospital), I walked around, up and down stairs, trying to get fresh air outside, etc. While in the hospital, I felt shaky, so I didn't want to walk, but I knelt, kind of upright leaning on the head portion of the hospital bed for support (it was fully elevated). I had a midwife in the hospital and wouldn't have had it any other way. my MIL had 5 of her 6 kids at home with a midwife, then later became an apprentice to that same midwife, so she was like my birthing coach (along with my husband and mom). That's another thing, you can read all these books (I add my support to "Birthing from Within," I'm reading it right now), but if you don't have other people on the same page while you're in labor, you might not be as confident and comfortable as you could be. My husband really had no idea what was going on; he held my hand and supported me, but really, how could he be prepared for something like that. My mother hadn't had a child in 26 years, and she only had 2. The midwife sees this stuff everyday, so she was a good support, and my MIL kept me focused when no one else could (kind of almost like hypnobirthing). She kept reminding me to listen only to her voice.

Anyhow, my comment is so low on the list, I don't know if anyone will have time to read it. But whoever wants to squat, sit, lie on their side, or on all fours, DO IT! I was sitting up, so not really on my back, and it worked. This time I am doing a home birth with a midwife and there will be that much more freedom.

Also, don't let anyone intimidate you and act like it is impossible to birth naturally. I really hated that. I only got a few comments while I was pregnant when I was I wasn't going to take an epidural, like "well, don't try to be a hero," or "well, you just might have to be flexible if you need one." Have your mind made up, and if you don't want drugs, tell the medical staff not to persistently offer them and that if for some reason you change your mind, you will ask.
posted by Sarah at 2/28/2008 02:33:00 PM
I just had a lovely natural birth a few months ago for my first birth. Some thoughts -

1. Regarding pushing: It was a 30+ hour labor, ending with me pushing on my side. I started pushing on the toilet and that was the ONE place the midwifes would NOT let me push. I tried squatting, but honestly, I was exhausted and things were all of a sudden going really fast. So, laying down seemed better. I tried my back - hurt quite a bit. Midwife suggested left side - didn't do much. Rolled over to my right and all of a sudden each push was super productive - baby was there in less than 30 minutes. I tell the above because while I thought I would like squatting (and with a slightly posterior baby, it should have been easiest), you never know.

2. I labored everywhere - at home, walking in the halls, in the tub, on the ball, lunging, everywhere. But that was something that appealed to me about natural labor - the ability to move. It was great to have a doula to help remind me to change things up given my complaint of the hour.

3. Find a midwife if possible. I had a lovely hospital midwife team who truly believed I could birth any baby naturally. They also did not pressure at all for induction and would not do so until after 42 weeks (which decreases the pitocin quandary - not quite Amanda's situation, but a slippery slope to needing pain relief at any rate). If you find you have to have a Dr, ask how many natural births they have attended. Some haven't ever attended amazingly enough. You don't want them to just "let you" in theory but when the rubber meets the road be pushing for what they know best. Also, when checking into the hospital, ask for a nurse who is comfortable with natural birth and then ask her not to offer you pain meds unless you bring it up.

4. Doulas are so worth it. She helped my husband be a most amazing support. I'm not sure we could have done it the first timewithout her.

5. I walked a ton during pregnancy - 2 to 4 miles a day. I think that really helped keep my body in shape for the whole process.

The birth was hard work, but so worth it. The hormonal surge afterwards was amazing - immediately forgot how much it hurt only minutes before. Baby was super alert - he was placed on my bare chest and was wiggling/rooting to nurse within the first few minutes. Absolutely amazing. Recovery was simple and relatively easy, even with a few stitches: I was eating within a half hour, walking within an hour and home 24 hours later.

I know that everyone can't have a drug free labor and I don't have anything to compare it to, but it was the most empowering thing I have ever done. I'll do it again, but at home next time.

And Amanda - I know we aren't real close (we are extended family), but if you want to discuss for next time around, track me down. I'd be happy to speak frankly with you.
posted by Nicole at 2/28/2008 02:57:00 PM
For those who asked about hypnobirthing:

I took hypnobirthing classes with my husband and found them inspiring. I believe that some women can labor virtually pain free. I was not one of those women nor did I expect to be. Maybe I'm ultra-cynical but I just expected there to be a lot of discomfort. Luckily, this attitude probably helped me out in the long run because my labor was 21 hrs., I pushed for 3 hrs. and my son was 10 lbs.

I appreciated hypnobirthing because it emphasized the fact that birth is a completely natural process and our bodies are meant to do it. I went into labor fully confident of my ability to birth my baby. In a lot of ways, my birth experience was completely self-directed because my midwife didn't want to intervene in my process. I gave birth on my back but I'll probably try another position if it looks like I'm going to have a big baby again.

The best part of birthing naturally is the overwhelming sense of power. I never doubt my ability to do anything anymore because I birthed a 10 lb. baby without medication.
posted by mraynes at 2/28/2008 03:04:00 PM
just noticed this related link on the FMH sideblog

Modern Childbirth: Failure to Progress
posted by Anonymous at 2/28/2008 03:08:00 PM
Oh, and to answer one of the original questions - I relied heavily on breathing. Because I've danced and done yoga for the past 15+ years, that is what seemed most natural.
posted by Nicole at 2/28/2008 03:08:00 PM
Wow! Thank you all for the great information and advice. Since this is my first pregnancy and I'm obviously not sure what to expect, so it's wonderful to hear what you all experienced. Given my question, thank you especially to those who said positive things about epidurals--I'm not totally opposed to one, it's mostly that the thought of having a needle in my back grosses me out, and I'm just not a big user of pain killers in general, unless it's necessary (which it definitely sometimes is!). Again, thank you for sharing what you've learned--I've been pouring over every comment.
posted by kristine N at 2/28/2008 04:13:00 PM
Re: OP (positions) - Yes, in general, upright or gravity-neutral positions are generally easier, but you have to have a care provider who knows how "catch" the baby in those positions.

I am a birth doula, and I just attended a birth where the woman wanted to avoid giving birth on her back. She pushed lying on her side and asked to stay that way; the nurse and I lifted her top leg so she could push the baby out; and the doctor said, "I do not deliver that way!" (Translation: "I do not know how to deliver that way.") So she gave birth on her back.

With my second baby, as I was pushing, I told my midwife I wanted to squat. She said, "That puts a lot of pressure on the perineum. . ." (Translation: "I don't really like doing it that way.") She didn't tell me no, but she subtly used her authority to undermine my confidence in my choice. So I gave birth on my back.

With my third baby, as I was pushing, I told my midwife I wanted to squat. She said, "Go ahead!" So I did!

In order to find out if a provider is supportive of using upright or gravity-neutral positions, it is helpful to ask them specific questions such as: "What percentage of women in your practice give birth in upright positions/ squatting/ sidelying/ etc.?" "Under what circumstances do you recommend that a woman give birth lying on her back?" and "Have you ever caught/ delivered a baby birthed in the squatting/ all-fours/ etc. position?"

I think a doula can be helpful if your care provider supports you using upright positions in the first place, but if your care provider (or his/her colleagues who may be on call when you give birth) are unsupportive, having a doula won't make a difference.

Re: OP (techniques) - I second the many suggestions that have been posted already, especially about laboring in a labor pool/ jacuzzi (ideally one big enough that you can move around, with enough water that you float a little). They call this the "midwives' epidural" and in my personal experience, it cuts the intensity of your contractions in half.

The other thing that really helps is the "3 Rs" - relaxation, rhythm, and ritual. "Relaxation" means relaxing during and between contractions for as long as you can. Once it's difficult to relax during contractions, just relax in between them (this helps you conserve your energy). "Ritual" means the thing that you do over and over again during contractions to cope with them (moaning, vocalization, breathing, movement, visual focus, etc.) "Rhythm" means that no matter what ritual you use, you use it in a rhythmic way.

Doulas look for the 3 Rs to assess how well a woman is coping with her labor. If they see them, great. If not, they try and guide a woman to use them.

Re: Books - I second the many books already suggested, and would add "Active Birth" by Janet Balaskas, "The Birth Partner" by Penny Simkin, and "Journey into Motherhood" by Sheri Menelli.

Re: "Natural birth" - I agree that this term means different things to different people. In the interest of enhancing communication and reducing offense-giving, I try to use the term "medication-free vaginal birth" if that is what I am describing. I also like the term "physiologically normal birth." Although it is a mouthful, it accurately refers to a birth that begins, proceeds, and finishes spontaneously (i.e. under the mother's own steam).

Beth - Re: contractions during spontaneous labor vs. contractions during induced labor. Yes, contractions during spontaneous labor are, in general, much easier to manage. To understand why, it's helpful to differentiate between labors induced with Pitocin, and labors induced in other ways.

In spontaneous labors, the mother's brain secretes the hormone oxytocin, which causes uterine contractions. The oxytocin also signals the brain to produce endorphins, which are the body's natural painkillers.

In methods of labor induction such as prostaglandin induction, nipple stimulation, artificial rupture of membranes, etc., the mother's brain is stimulated in some way to produce oxytocin, which triggers contractions and endorphin production.

Pitocin is a synthetic form of oxytocin, but it has different physiological effects than oxytocin does. It acts directly on the uterine cells to produce contractions. These contractions are, in general, longer, more intense, and more frequent than contractions caused by oxytocin. They also have a shorter time from the onset to the peak of the contraction. In addition, Pitocin cannot cross the blood-brain barrier, so it does not stimulate the mother's brain to produce endorphins.

(That's a somewhat simplified explanation, which doesn't do justice to the beauty of the oxytocin production cycle, but it will have to do for now!)

Having said that, though, I have experienced one labor induced with prostaglandin induction, one labor induced with nipple stimlation, and two labors that began spontaneously. Even though the two induced labors involved my own oxytocin and endorphins, the two spontaneous labors were MUCH easier. I believe this is because with spontaneous labor, my cervix was actually ready to respond to the contractions, while with induced labor, it was forced to respond.

Hope this helps!
posted by Anonymous at 2/28/2008 04:32:00 PM
I had #1 and #4 with epidurals and #2 and #3 without--every time induced.

With #2 the lack of medication was accidental. We actually had the anaesthesiologist in the room asking the prep questions when the baby started coming. Recovery was awesome, though. My energy returned much faster--I felt great. With #3 I figured I had already done it with #2, so I should be able to do it again. But on hour 3 I chickened out and asked for the drugs. I could barely hold still long enough for them to finish the epidural--I had fully transitioned in those few minutes and they barely had enough time to flip me over when the baby came out. A total waste of drugs--they didn't kick in until after everything was over. I wished I had either hung on a few more minutes or gotten the epidural when they asked if I wanted one 2 hours before.

By the time #4 came along I thought if there could somehow be a guarantee that my total labor time would be 2-3 hours, I would skip the drugs. But I didn't want to risk the possibility of several hours of painful contractions (because I'm wimpy like that) and I got the drugs.

I think I had to be on oxygen or antibiotic IVs for every birth, so I did not have a lot of options for positions. When I was able to get up and walk around that did seem to help speed things along quite a bit.

From all this I can say my experience was not any more or less enjoyable with or without the drugs. I think if I had had any kind of history that put me at greater risk with the epidural, I probably would have tried to avoid it every time (because I'm paranoid like that). But since my labors ranged from 2-5 hours from start of induction to finish, I'm probably not a fair judge.
posted by Anonymous at 2/28/2008 06:03:00 PM
Kristine and Katrina--

I agree with what a lot of women have said--I don't think I could have done it without a midwife. I know there are doctors open to natural birth, but you take your chances. That would be my biggest recommendation. (I was also in a hospital and insurance covered everything). As far as positions you just have to be open to whatever--I felt more comfortable on the birthing stool, but the baby's heart dropped, so she had me back on the bed on my back. So I just had to do it that way. Not what I wanted, but it worked...and I was really looking forward to the tub in our room, but it did nothing for me. I was back out in 2 seconds.

I also read Ina May's Guide to Childbirth. I think it just gave me a good idea of what to expect...which was basically "be prepared for anything." Some women labor easy, some labor hard...I think that will make a huge difference in weather you end up with an epi.

Also, as someone mentioned above the pushing was the hardest, hardest part...since I labored for 2 nights previous I barely slept and was SO tired. Rest as much as you can before the tough part kicks in. And I agree that it was a very empowering experience. However in the minutes after birth I thought "well, I'm never doing that again..." but in the days to follow I replayed the experience over and over in my head--I felt very triumphant.

With all that said, I'm also not sure I will go natural every time. I think you really have to take each birth individually. Good luck and just remember your ultimate goal is a healthy baby. :)
posted by Miggy at 2/28/2008 07:10:00 PM
My Natural was only supposed to be natural till I aked for drugs. I wanted to see how tough I was- made it to him crowning before screaming for them. LOL! So, no advice, I didn't squat, did the breathing, and focused on getting him out.

I must say, if it ever happens again (unlikely, but I'm hopeful it will) I'll do it natural if possible- I healed so wonderfully!
posted by Melzie at 2/28/2008 09:05:00 PM
I think it's funny how childbirth is such an emotional thing that no matter what happens, it's very therapeutic to talk about it to other people!
I read a book about hypno birthing and I was 2 weeks overdue. The day contractions started I was so thrilled/excited I just let it happen...I guess I had no fear. I did all my normal stuff, went to church, made smoothies, played with my daughter and husband. At night I told my hubby to go to bed because I was probably going to have the baby soon and he better get sleep plus I kinda liked the quietness of just relaxing. I wrote in my journal, and then It started to feel strong. So then I took a bath and did like some breathing/hypno stuff. My mom sent my dad to my house to watch the kids....I made him a bed. I started to really feel it I guess and we took off at about 11:30. At about 1:00 am. my 9 lb daughter was born at the hospital in a birthing tub. IT was just amazing and wonderful and I'd totally do it again. I think the best part of a totally natural birth vers. med. is you can just focus on YOU not on what other people want you to do, ie. vaginal exams, IVs, needles, eat when you want, and listen to your body. You just relax and let it happen. BUT at the same time, I know it can go down differently (my first daughter I had an epidural) and it's just a pure blessing when you have an easy birth and I don't take the credit.
posted by Amelia at 2/29/2008 07:44:00 AM
Up front, I do not want to offend anyone. I also don't want to make new mothers feel anxious.

However, I have noticed people saying a number of times recently something like: delivering a healthy baby is your goal.

However, your choice of how to labor and deliver your baby actually has little connection to whether your baby is born healthy.

Unless you do all the screening and are willing to abort a baby with a chance of a birth defect (assuming a birth defect was even detected before birth) you have little to no control over whether you have a healthy baby. These things sometimes just happen with no advance warning. Most birth defects are never connected to anything the parents did.

Be very thankful if your child is healthy. Most babies are. Only about one out of 100 babies are born with a problem. Be thankful that you live in a time where maternal mortality is close to zero and if your baby has a problem it can usually be taken care of.

I just wanted to be clear that this discussion is about the mother and her experience and feeling empowered and not about whether the baby is healthy.
posted by Anonymous at 2/29/2008 08:32:00 AM
This is mostly in response to Amanda's question: "Do people do "natural" (i.e. no drugs) while on pitocin?"

I had my first (unmedicated) at Long Island College Hospital in Brooklyn at their now defunct birthing center. From beginning to end it was perfect, the midwife was there in the room the entire time but usually off to the side unless I needed her.

My second birth was also unmedicated but very different. I used a midwife again but there aren't any 'birthing center' type places here (NC). The midwife was more like an MD. She convinced me to be induced with pitocin and was there only at the end to catch the baby. I think I was able go natural even though I was on pitocin only because I had done it before and knew that I could do it. It was so intense. Going from a 6 to having the baby out in less then 15 minutes was excruciating! I remember thinking that I was being torn in half. Basically, I wouldn't recommend going natural with pitocin. I certainly wouldn't do it again!

As for positions, I have always wanted to squat or do the birthing tub but for some reason the way my body handles labor is to lay in the bed (on my side) and usually sleep between contractions. Practice as much as you can but when the time comes do what feels right to you.

and I would second (or third or fourth- there are a lot of comments here!) the recommendation for Husband Coached child birth- the Bradley Method. It is the only birthing book I have read. It really helps you to understand the process and to work with your body not against it.
posted by Erin at 2/29/2008 09:14:00 AM
I have five kids. My first three were natural. With the fourth and fifth I had epidurals. I sometimes joke that if I had epidurals with my first kids, I would have had more kids. I think a decision might be based on how good you are with pain. Think about things like if you ever had surgery or your wisdom teeth out and how you did. For me, the recovery has been so much easier without having to recover from the experience of all the pain.

I started off seeing midwives. I assumed I would be more comfortable with women. I had a very poor experience. They did not explain things. They did not show compassion and support. They did not diagnose a severe pregnancy complication.

Luckily we moved eight months into the pregnancy. I saw a midwife until our new health plan kicked in. Same experience. Our insurance (which saved our bacon by having no preexisting conditions clause) did not allow access to midwives. Our new OB group diagnosed my complication and carefully monitored the baby.

I have found male OBs to be every bit as compassionate and respectful and proper and supportive as women medical personnel.
posted by Anonymous at 2/29/2008 09:55:00 AM
Anon-- I was saying that because some women (myself included) felt a lot of pressure to do it naturally and I built it up so much that I realized I would be disappointed if I didn't do it natural. Then I thought, "disappointed? either way I have a beautiful baby." I realized I needed to shift my focus a little so that I wouldn't be disappointed in HOW the baby got here, but rather excited that she got here at all.
And there may not be a lot of complications with the birth itself it DOES happen. I know a few women whose baby had complications due to childbirth--sometimes there is an importance to getting the baby out quickly. But I understand your point. :)
posted by Miggy at 2/29/2008 11:50:00 AM
Again, thank you everyone for all the comments. It's really good to hear so many perspectives being a first-timer. I've been doing TONS of reading on natural birth methods and I've decided to go with hypnobirthing. There are several options out there and I'm leaning towards the Hypnobabies program. If anyone out there really wants to do a non-medicated birth, you should look into. They even have a home study course if there's not a class in your area.
posted by Katrina at 2/29/2008 11:58:00 AM
YAY FOR MIDWIVES!

I delivered a 10-lb boy while on pitocin and magnesium sulfate, flat on my back, and no epidural.

You can do it if you decide to do it. I wanted to prove that I could do it, and I did.

Practice relaxing. Whatever technique you want to use, practice it A LOT.
posted by Madame Coin at 2/29/2008 12:31:00 PM
I love birthing stories. I was able to be with my sister while she delivered her first baby "naturally" and it was so amazing it inspired me to do it also. (Also I happen to be way more afraid of the epidural than I am of just giving birth so that helps.)
I also decided to do the hypnobirthing and loved it. I really do believe that women can birth without pain, but when Carrie asked me right after I gave birth if it hurt I answered, "Yes and it still hurts!"
My hospital and midwife have been very willing to let me birth the way I wanted, but I did have to ask instead of just going along with what they expected me to do. With my first baby my water broke and since I was told I needed to go immediately to the hospital I wasn't having contractions yet. They wanted to start pitocin, but I asked if I could walk for awhile to try and induce labor and they let me. I also really love the tub. I cannot imagine laboring anywhere else. It was so relaxing for me that I would never want to deliver in a hospital that didn't have tubs in the birthing rooms. I was actually so relaxed in the tub that my husband couldn't tell when I was having contractions and was surprised that I was having any pain when I asked for an epidural. Yes, I did ask for an epidural, but I had a pretty good nurse who stalled and I was able to go without one.
My strongest advice is that when you start feeling like "I cannot do this!" Ask to be checked before you ask for an epidural. Chances are you are ready to start pushing and nearing the end. It was hard to change my mindset once I decided that I wanted the epidural to deciding that yes I can do this naturally.
My second birth I was induced. I actually didn't think the pitocin was too bad. It was when they broke my water that I had to basically run to the tub to get that relaxation.
As far as trying different positions my first baby was posterior so my midwife was having me try a lot of different positions on the bed so I was constantly turning from my back to my side to my knees (which I'm sure was not a pretty sight for the 8 people in the room for the birth.) It wasn't really much fun for me. I actually prefer to lay on my back and push against the stirrups. But I think it would be fun to try the squatting position if I had someone strong behind me holding me up!
Good luck with your births! I'm sure that no matter what happens when you are holding your baby it won't really matter how he/she got there you'll just be amazed at the miracle that you are holding.
posted by Anonymous at 2/29/2008 12:38:00 PM
Both of my babies were born at home into the hands of very competent midwives. It was brutal and messy, and both times there was a moment when I thought I wasn't going to make it, but if I had to do it again I wouldn't change a thing.

I labored in all sorts of positions - standing and walking, leaning over the couch or kitchen counter, sitting on a birth ball, etc. Name the position, I labored in it. Hands down, though, the winner is waterbirth. Laboring in ANY position is a million times easier in a pool of hot water. I had to get out of the tub a few times while I labored, and dry-land contractions seriously kicked my butt.

If you're interested in different positions or using water in your birth, and you are planning a hospital birth, your best course of action is to ask potential care providers UP FRONT how often their clients deliver in positions other than on their backs. Don't let him (or her) hedge with comments that they're willing to accommodate different pushing positions so long as . . . Those doctors will almost always find it necessary to put you on your back in the end.

A doula is a must. If I were to plan a hospital birth there's no way I'd consider it without hiring a competent doula. When you're in transition and the pain is unbearable and your husband is willing to do or say ANYTHING to make the pain you're feeling go away, your doula will advocate for you, calmly and with a level head.

When asked, my #1 bit of birthing wisdom is this: You *can* do it. It is hard, and brutally painful, but the pain will end. I hate the way birth is portrayed in the media as a HUGE FREAKING EMERGENCY all the time. It's not. It's natural and normal, and you can do it. The baby *will* come out.
posted by Miss Shelly at 2/29/2008 07:41:00 PM

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