So, I have lots of opinions on this topic. L.O.T.S! With my first, I went the usual way. I used an OB who I loved and trusted. I asked to be induced when I had reached 40 weeks with no 'signs' of progress. He agreed, though he did warn me of an increased c-section rate. I ignored him and went ahead and in less than 8 hours, I had my first daughter. I wasn't a fan of the episiotomy that he gave me (I knew I didn't want one) but he insisted I needed it or I would tear badly, so I agreed. Overall, the delivery wasn't too bad. I wanted to try to avoid pain meds to 'see what I could do' but I needed them with the pitocin and it wasn't as bad as some anti-med people had made me believe.
Fast forward almost two years. I was pregnant again and again went past my due date. I was going to be patient this time though. I was going to wait this little one out in hopes of having a med-free birth. I really wanted to see what my body could do. At 41 weeks, when my doctor told me that he had been generous the week before when he said I was 2cm and that now I was too closed to even try stripping membranes I was devastated and asked if I could be induced again. So, at 9 days past my 'due date' I was induced again. Again, I couldn't handle the pitocin contractions and had an epidural - though less of one so I could still feel the 'ring of fire' and the pressure. It hurt, but not too badly and I wondered if I had been patient if I could have avoided the induction and had a natural childbirth.
Up to this point, I was seriously doubting my body's ability to actually give birth on its own. Maybe I was just one of those women for whom labor doesn't work. I was glad to have missed a c-section twice and my second labor took only the first drip of pit to get me going and it was less than 4 hours start to finish. Still, I couldn't help but wonder what was wrong with me. Was I ever going to get to have that empowering experience that my friends talked about?
My third pregnancy was going to be different. Before I even conceived, I was reading books about how modern medicine can interfere with the natural labor progress. I learned how the interventions often lead to other interventions and rob women of the chance to experience 'real' labor. I wasn't entirely convinced that labor could be 'pain free' as some women reported (I had felt the labors for an hour or two each before I got the epidural and they HURT), but I wondered if I had what it took to do it - to actually give birth without medical interventions or 'helps'.
I chose to go with the midwives this time and had them note in my file to NOT induce me - even if I begged. I knew I was far more clear-headed in the early stages of pregnancy than I would be at the end. I read everything I could on how to get through labor naturally. I read books that told me to 'do nothing', 'relax', 'don't do anything extra' and I latched onto those ideas. As my pregnancy due date approached, I was patient this time. I knew that it didn't matter how many cm I was. It didn't matter that my 'due date' came and went. My body would do this on its own. I had my birthplan written with instructions to avoid as much intervention as possible. I especially wanted to avoid the IV. It symbolized everything I wanted to avoid this time around - being stuck in a bed, poked, prodded, and treated like a patient instead of a strong woman doing what her body was made to do. I had countless conversations with my midwife who was very supportive of me and let me know that she knew I could do it. I called my homebirthing friend who talked me through those last weeks when I was starting to get worried that my baby would be too big and that I was setting myself up for a c-section or that I wouldn't ever go into labor and would end up being induced anyways in spite of my patience.
My due date came and went. My corrected due date came and went. My latest ultrasound 'due date' came and went. Four days past due, five days past due. I wasn't feeling pressure. I wasn't feeling contractions. I was starting to question whether I had what it took. Could I really do this? I decided I needed some help and went for a pregnancy massage. H-E-A-V-E-N. I had ankles instead of cankles, but still no baby. Six days past due - I needed another massage, so I scheduled one and then spent the afternoon painting with my kiddos - enjoying the time with my two little girls. Knowing that this would all change soon. I poured out my fears on my paper - could I do it? Could I give birth naturally? Could I manage the pain or would I wimp out again (as I saw it)? Was I ever going to give birth? All of these worries came out like a flood and I felt at peace. No longer was I worried that I could do it. I knew I could. And I knew it would happen - on its own. I still was worried that I would be giving birth on Christmas day or something, but I knew I could do it.
My massage that night was a little different - even more relaxing than before. Saturday morning I woke. I knew when I was at the midwife's office on Thursday that I was 3cm and had tried to remind myself that that didn't mean anything. I don't even know why we check anyway. I knew I could go from 3 to 10 in a matter or hours or stick around at 3 for another couple of weeks (if anyone would let me get that pregnant). I went to my niece's birthday party figuring there was no reason to sit around impatiently - nothing was happening. I was sure I was going to make it to Christmas week, so I went out shopping Saturday night. Nothing happened. I tried to remind myself of my recent peaceful state and that my baby would come when he/she was ready. I could wait - besides, I didn't want to miss the Christmas hymn sing :)
That night, I went into labor on my own - right in the shower. I started wondering if this was for real, but deep down I knew it was. There was no build up for me. The contractions started at 3 minutes apart and just got more and more intense. I focused on reminding myself to open and relax and let my body do the work. That was the mantra in my head as labor progressed...quickly. We made it to the hospital where my tension started to build. My nurse was chatty and focused on procedure. She asked an endless stream of questions while I puked and groaned. She insisted on making me get in the bed to check me and monitor me. I knew I had to comply so they could get a baseline, but the bed just made everything worse. She was annoyed that we insisted I stay on my side instead of my back. She checked me and told me I was 4cm. 4CM???? I started to worry that I really couldn't do this and then I pulled myself back together and reminded myself that the number didn't matter. These contractions were doing their job whether she could tell or not. I was just going to have to focus even more on relaxing during the contractions. That was when my midwife appeared.
Like a breath of fresh air she came in, got me up and off the monitor and started helping me to sway and move during the contractions. I started to relax and got my focus back. She got me in the tub - though things seemed to very quickly intensify there. B.J. couldn't push on my back there and the contractions were seemingly endless. It was all I could do to hold on and focus on doing nothing- relaxing. I was only in the tub for 15 to 20 minutes when I thought "I can't do this. I need an epidural". B.J. saw something change on my face and asked if I needed to push. I couldn't answer, so I just shook my head. The next thing I knew, my body was seized in a contraction and it was pushing. I yelled "My body's pushing! My body's pushing!" - petrified that my body was messing up. I just knew I couldn't be ready to push - I was only 4cm after all... thoughts of a swollen cervix and endless labor rushed into my mind as my midwife tried to get me to breathe through the contraction and not push. I panted, one, two, three and another contraction seized me and I bore down saying "I can't stop, I can't stop". B.J. pulled the cord to alert the desk as the midwife pulled the plug on the tub and water started rushing out. I instinctively sat up on my knees from my all fours position and reached just in time to feel the head crowning. My midwife saw what I did and saw my face and realized there was no time to get me out of the tub. She told the frantic nurses who had rushed in that there was no time and she and I guided my son's head out. One more push and he slipped out into her hands.
I had done it!! What a rush! What a relief!! I started trembling. I had done it. I couldn't believe I had done it! I had a son that I had birthed. My body wasn't defective. It DID know how to give birth, and it had done it wonderfully. I had never felt such an incredible sense of accomplishment. I felt strong and feminine. I hadn't needed anyone to 'help' me give birth - to convince my body to do something it knew how to do. I knew that any future births would be natural. I never wanted to have my birth 'stolen' again in an effort to 'help' me give birth. My body did what it was created to do, and it did it well.
Just today I heard another story of a young mom. She had been patient - she hadn't gotten induced and yet she still ended up with a c-section. I heard her talking and realized that something had been stolen from her birth experience. She may not realize it yet, but she talked about her body's 'failure' to progress, the way her contractions hadn't been the 'right' kind and my heart broke for her. Someday, I hope she will get to experience what birth should be like. I understand that c-sections are necessary, but I don't believe most of them are.
So, how can you avoid one? Or at least increase your chances? STAY HOME! No, you don't have to do a homebirth, but don't rush to the hospital just because your water broke. The hospital is going to want to see a labor that looks just the 'right' way and if yours doesn't, they will intervene. So, you get to the hospital and your contractions aren't regular or strong enough - now they will run pitocin - and keep cranking it up. Maybe the pitocin won't work and your contractions will still be the 'wrong' kind and the doctors will start to worry because they can't get your labor to look like it 'should'. Now you'll want an epidural because being tied to an IV pole and monitoring machine (at best that's all you'll be tied to) will hurt more, so the obliging hospital will 'rescue' you from your labor with a cocktail of drugs injected into your back. Now, you are completely confined to the bed so you may end up with a catheter, increasing your risk of a UTI or bladder infection. You'll be continuously monitored so that when your blood pressure starts to fall from the side effects of the epidural, they'll rush in with oxygen and more IV fluids. The falling blood pressure can cause your baby to show distress and now you're off to the ER. Or maybe you both handle the pit, IV, and monitoring just fine but you don't dilate fast enough - again, off to the ER. I know that doctors mean well and earnestly want the best outcome, but they aren't trained in normalicy - they are trained in complications and they want to manage the labor (not to mention the liability issues). They often fail to trust that a woman's body can do what it was made to do, so they rely on formulas and schedules in an attempt to have a positive outcome - failing to understand that it is the journey AND the destination, not just the destination, that build that positive outcome.
Do yourself a favor and stay home. Let your labor progress without a clock, a schedule, a minimum dialation to be considered 'progressing'. Enjoy the comforts of home and relax so that your body can do its job without the interference of adrenalin. Your body can do this. You need to trust it. I just wish that women knew what they were missing. I wish they knew what these interventions mean. I wish they would educate themselves about the hospital protocols that will dictate their labor once they arrive. Protocols that aren't necessarily in the best interest of the mom or baby - sometimes, they are just to 'be safe' aka - don't get sued. Lawyers shouldn't get to dictate your birth - you should. This is your birth - relax and let it happen.
If you want to read more, I recommend "Pushed", "Spiritual Midwifery", "Baby Catcher", "The Business of Being Born", and "Birthing Within".