Natural Birth?

[Shahaku]

I debated putting this in the debate thread, but I figure unless it really does evolve there, this is as good a place as any.

I've done a lot of reading in the last year or so (long before getting pregnant) on the natural birth movement. And some of the statistics they toss out there for USA births are pretty frightening. Double the recommended C-section rate. Higher mortality rates than in most of the countries in the developed world. Worse than some countries that are still developing. Doctors using drugs and whatnot to put your labor on a timetable that works for them. And standard procedures that are supposed to make labor "safer" but really don't, and at times make it much more dangerous.

Because of all the reading I've done, I really want to have a natural birth if at all possible. And the fact that I have to have my baby in a hospital, because I can't afford a midwife, is becoming kind of scary. I'm really not afraid of labor and delivery itself. I expect it to be intense and at times painful, but I know it's a natural process and so I'm not afraid of it. What I'm afraid of is all the hospital interventions.

But I have to wonder, does the natural birth movement exaggerate? Is it reasonable? Is it really based all on facts or are they drawing these out of their hat? The more extreme sides say, "Don't have any ultrasounds, don't let them do anything more than occasional fetal monitoring and checking dilation every few hours at most, stay healthy and don't let the docs interfere otherwise, etc." And they have stats to back these up. Studies done, mostly in Europe, etc. Is that side of things really safe either, though? Where should you draw the line, what's a good balance, etc?

[lillywolf]

Re: Natural Birth?

My favorite topic YAY! Ok so my first child I had with only gas and air (not through choice, it was a quick labour of only 1 hour) I was in hospital and the midwives were horrible ( I had all my kids in the UK) all I remember is pain. I had to have alot of stitching.

With my second I had a water birth in a birthing center and it was the best experience I have ever had. I was calm and relaxed and I could get in to what ever position I wanted that was comfy and my labour was only 28 minutes and no stitches at all. I do not remember much pain due to the water keeping my lower back relaxed.

I wanted my third to be a water birth but I had gestational diabetes and I was huge so they induced me 2 weeks early so I would avoid a c section. I was in hospital but I used essential oils for my pain relief with gas and air (not that I used much of it) They did give me an injection near the end to take the edge off but it kicked in after he was born and then it just made me vomit.

If I have another one I hope to have a combination of water and the essential oils because they were very effective and I felt so much more alert with them. I am very pro natural birthing, it is a fantastic experience if you go in to it knowing it is going to be painful at times. If you fight the contractions, like I id with my first, it HURTS, but if you go with the flow and just relax it still hurts but no where near as much as it would if you fight it.

Oh listening to music and meditation helps some people too. Just to throw it in so people can't say that it might have been easy because the babies were small, my first and second both weighed 8lbs 12oz and my third was 10lbs 2oz!(at 2 weeks early).

[thalassa]

Re: Natural Birth?

But I have to wonder, does the natural birth movement exaggerate? Is it reasonable? Is it really based all on facts or are they drawing these out of their hat? The more extreme sides say, "Don't have any ultrasounds, don't let them do anything more than occasional fetal monitoring and checking dilation every few hours at most, stay healthy and don't let the docs interfere otherwise, etc." And they have stats to back these up. Studies done, mostly in Europe, etc. Is that side of things really safe either, though? Where should you draw the line, what's a good balance, etc?

I think there is a problem with the science here...and I think some of the claims here are a bit inflated/misguided (mostly by privilege).

Comparing statistics in the US to those in Europe are somewhat misleading for a couple reasons. Most European studies are done in one country, sometimes a couple, but almost always in countries with excellent, socialized health care that includes a full range of prenatal care, guaranteed (paid) medical leave during the pregnancy if something is wrong, etc. Also, because access to birth control and abortion is better than that in most of the US, women there that have children are probably more likely to be having a child that they have at least chosen to have, and probably planned on. Just looking at the infant mortality map, if you included all 47 independent nations that make up Europe, you will find that there are countries with better and worse rates that ourselves (compare, for example, Serbia and Norway)--I'd guess that if you would actually take the time to crunch the numbers, their overall rate would be similar to ours (and probably similar for maternal mortality). Much like Europe, here in the US we have 50 different standards for health care, and far more companies that decide what they will pay for...in some areas of the country women have almost no access to prenatal care or education, and people that are forced to forgo medical treatment that they can't afford. Also here in the US we have higher numbers of teen pregnancy (which is another risk factor for infant or maternal mortality), AND higher rates of obesity and other medical conditions that complicate pregnancy and make them more likely to deliver preterm or low weight, which are more likely reasons for high mortality than differences in delivery. The statistical comparisons are pretty much based on an assumption that doesn't exist--that one birth in one health care system is equal to another, except for the methods of delivery...even here in the US that isn't true--just your race alone makes a difference in the statistical outcome for mother and child. There are ways to overcoming the statistical differences for a more fair comparison, but I've not seen a good one.

If you have a normal, uncomplicated pregnancy, natural birth can be great. The military in the US runs a socialized medical care system, and has a guaranteed income that is well over the poverty line, it includes duty limitations for pregnancy service women, free medications (including prenatal vitamins, etc), and universal health care for service members and dependents....when I was first working as a corpsman, I remember reading a study comparing the difference in racial disparity in infant mortality rates--not only did it halve infant mortality rates for African American women, it also improved the statistics for white and Hispanic woman. And, while the military does encourage natural birth (as in limited intervention--it saves them money after all), they aren't hidebound to the idea either. Which is good---I wanted a natural birth, but...#1 and I would have been dead leaving #2 to never be born (by the way, I had a vaginal delivery with my stillbirth and 2 c-sections, and I thought the 2 c-sections were hella sweet, I was up and at it immediately without any complication...but I was also in the military and in really good shape). And (my other problem with natural birth nazis) in the real world...like the one that women in this world have lived in for millennia, natural birth is still and had been historically a good way to die. Its less likely here in the US, because we have better and more immediate access to medical care---but THIS is the reality for most women that are forced into having "natural childbirth", all around the world, without that luxury of medical care...the sort of "natural childbirth" that natural childbirth advocates are advocating are a product of economic and social privilege, they are not the norm.

I absolutely believe that women should be able to have whatever intervention is medically necessary and should be able to refuse any intervention that is medically unnecessary that they do not want. If you want a natural birth, have one. I have no problem with the idea of a birth with minimal intervention, and I certainly have no problem with advocating for it (a birth plan is a beautiful thing, and if you can get a doula, do!)--there is not doubt in my mind that there are hospitals and doctors, for a myriad of reasons (mainly not wanting to be sued if something goes wrong) press women to accept interventions that are probably borderline on whether or not they are necessary. But I do have a problem with the way that natural birth advocacy by some of the individuals and groups is actually carried out...I have this problem with a lot of the big Pharma and anti-conventional health care stuff I see too.

[Optimistic discord]

Re: Natural Birth?

I debated putting this in the debate thread, but I figure unless it really does evolve there, this is as good a place as any.

I've done a lot of reading in the last year or so (long before getting pregnant) on the natural birth movement. And some of the statistics they toss out there for USA births are pretty frightening. Double the recommended C-section rate. Higher mortality rates than in most of the countries in the developed world. Worse than some countries that are still developing. Doctors using drugs and whatnot to put your labor on a timetable that works for them. And standard procedures that are supposed to make labor "safer" but really don't, and at times make it much more dangerous.

Because of all the reading I've done, I really want to have a natural birth if at all possible. And the fact that I have to have my baby in a hospital, because I can't afford a midwife, is becoming kind of scary. I'm really not afraid of labor and delivery itself. I expect it to be intense and at times painful, but I know it's a natural process and so I'm not afraid of it. What I'm afraid of is all the hospital interventions.

But I have to wonder, does the natural birth movement exaggerate? Is it reasonable? Is it really based all on facts or are they drawing these out of their hat? The more extreme sides say, "Don't have any ultrasounds, don't let them do anything more than occasional fetal monitoring and checking dilation every few hours at most, stay healthy and don't let the docs interfere otherwise, etc." And they have stats to back these up. Studies done, mostly in Europe, etc. Is that side of things really safe either, though? Where should you draw the line, what's a good balance, etc?

If there is one thing I took away from all the prep work we did for our baby its this:

Nothing is more controversial or divisive than pregnancy. Everyone is an expert, and everyone takes even a benign comment as an aggressive attack.

I've seen close friends turn into frothing toxic demon trolls during conversations about breast feeding and natural birthing..

Things I picked up:

1: Almost everyone takes it all personally.
2: A lot of information you encounter is going to be published or written by people or groups with political/social goals and agendas, and like all good "internet warriors" they have mastered the art of having memorized quotes and references to back their arguments, and countering anything you say with "reason" and "science".
3: Pregnancy and mother support forums are becoming media recognized for their culture of peer pressure, bullying, sexism and general toxicity that puts even 4chan to shame.
A very vocal element use fear and extreme situations to push their agendas and key to this is pushing the "Drs are evil" agenda often backed with some story or study.

In the UK we are quite lucky in that we still have some form of national health service, even more so in that mid-wives are placed center stage in the support process, and generally the mothers choices are taken into account ( you get to design your birthing plan, as well as talk through all possibilities and eventualities).

Ultrasounds are benign. Sure there are studies that show extreme cavitations can occur and cause cellular damage, but these were using extreme dosage in mice and rats (much like the studies for lethal dosage of sugar and water ).

[Hawkfeathers]

Re: Natural Birth?

Ultrasounds are benign.

Wish I could project 50 years into the future and see what the thinking is on that!

[Optimistic discord]

Re: Natural Birth?

Wish I could project 50 years into the future and see what the thinking is on that!

I'd be willing to put money on it being the same
The metadata is still good.
But there is always the possibility that something may turn up to change the accepted stance on that, thats why science is awesome, its open to change

[thalassa]

Wish I could project 50 years into the future and see what the thinking is on that!

Its been in use for at least that long already (ultrasound has been used in pregnancy since the 1960's, and its been in use in general since WWII)...if there were problems, we'd already know about them.

1: Almost everyone takes it all personally.
2: A lot of information you encounter is going to be published or written by people or groups with political/social goals and agendas, and like all good "internet warriors" they have mastered the art of having memorized quotes and references to back their arguments, and countering anything you say with "reason" and "science".
3: Pregnancy and mother support forums are becoming media recognized for their culture of peer pressure, bullying, sexism and general toxicity that puts even 4chan to shame.
A very vocal element use fear and extreme situations to push their agendas and key to this is pushing the "Drs are evil" agenda often backed with some story or study.

THIS!! Omg, this...there is nothing worse than mom forums. Ugh...what I bunch of judgmental nonsense. When it comes to parenting, people take your choice to do something different as a personal attack on what they have chosen for their family. And, I'll be quite honest, it can be a knee jerk reaction that happens even when you are aware of it. Parenting is cultural, and its individual--every family and every child is different and what works for them will be different. Statistics are just information--they are CORRELATION, not CAUSATION, and if one is not careful they can and will use them (whether intentionally or not) to support their personal bias...and really, stats can be made to say just about anything when its not controlled for.

[Hawkfeathers]

Re: Natural Birth?

Its been in use for at least that long already (ultrasound has been used in pregnancy since the 1960's, and its been in use in general since WWII)...if there were problems, we'd already know about them.

With all due respect.....NO.

Vaccines, mammograms, airport screenings, plastic water bottles, mammograms, bc pills, GMO foods, etc., etc. It's all just beginning.

[Shahaku]

Re: Natural Birth?

When it comes to the Ethiopian thing, Thal, aren't a lot of the problems many of these women have cause by FGM? I mean, the scarring from that prevents the baby from coming out so it dies and rots causing a fistula? I mean, I know it can happen in an uncut woman as well, but isn't it much more rare?

Also, is the autism, adhd, etc rate really getting that much worse? And is there a possibility it is caused by changes in certain chemicals becoming more common or being present in higher levels? I mean, I know the vaccine thing is pretty much not supported, but otherwise?

[B. de Corbin]

Re: Natural Birth?

As far as the autism thing goes, I have a statement around here somewhere from the editor of the last DSM (which I can't access right now) stating that the increase in the autism rate came about because they (the DSM) redefined autism to include marginal cases, such as Aspergerer's, under the autism spectrum. I wouldn't be too surprised to find that the increase in the various attention disorders came about in the same manner.

[thalassa]

Re: Natural Birth?

When it comes to the Ethiopian thing, Thal, aren't a lot of the problems many of these women have cause by FGM? I mean, the scarring from that prevents the baby from coming out so it dies and rots causing a fistula? I mean, I know it can happen in an uncut woman as well, but isn't it much more rare?

Rectovaginal fistulas are caused by the prolonged labor of a complicated delivery, when the perineum tears and then doesn't heal correctly--in a hospital setting, those women would likely get a c-section long before their labor has been going on for a week and they deliver a dead baby and are almost dead themselves...and they'd have proper after care. Access to a cesarean section in low income countries plays looks like it plays a sizable role in reducing fetal and maternal mortality. Yes, FGM makes a complicated delivery more likely...but so does age, undernourishment (particularly the pervasive long-term undernourishment found in Ethiopia which has contributed to a smaller adult stature), lack of pre-natal care, lack of care after the birth, etc. I don't know enough about how the data was analyzed to say that FSM alone is the problem in the pregnancies. But, whether or not those women have had FGM or are 12 or whatever, access to a hospital would have led to an earlier intervention and proper after delivery care, probably preventing nearly all off these cases. I used that as an example that is still occurring today, but 200 years ago, this was pretty much the standard of care for all women...

One of my biggest problems with the "natural childbirth" movement is this idea that women have been squatting out babied forever without proper medical attention, and everything is just peaches about that. The idea that a home birth without medical intervention is preferable to a hospital birth is a position of socio-economic and cultural privilege. In colonial America, there was a 1.5% chance of dying in childbirth for the mother...considering most women had 5-8 children, women had about a 1 in 8 chance of dying in childbirth. From the 19th century to the first third of the 20th century there were 4-5 (Britain) or more (depending on the country) maternal deaths occurring per 1,000 deliveries...today, GB has 12 maternal deaths per 100,000 birth (the US has 21, Norway as 3, Estonia has the lowest rate at 2, and about 25 countries have rates comparable or worse that the historical GB rates (Ethiopia comes in slightly below those). The reality of childbirth historically is that more women die, more children die, and more women and children have lifelong problems when there isn't adequate medical care (the real "change" in maternal mortality rates came in 1935 when antibiotics and transfusions were introduced...within 10 years, rates were pretty much cut to where they are today). Maternal mortality is the easier topic to discuss because the method by which the statistics are determined are less complicated--data for fetal and perinatal deaths aren't standardized, particular for fetal deaths (some use birthweight, others use how many weeks of development...some count 22, 24, 28 ect weeks...this is an interesting read on the subject, with some historical and modern numbers and statistics).

Natural childbirth isn't a big deal in a developed country because by and large it occurs in or near a hospital, and usually in the care of a professional. Most midwives practice with or under a doctor and most of them will only accommodate a home birth in an uncomplicated delivery with a woman without any additional medical issues. Add to that the extra expense (which may or may not be covered by insurance), you are talking about a population of people that have the money to do this. Money is one of the best predictors of health incomes in general (and the income disparity between low and high income in this country is as great as that between developed and developing countries)...and since (with one exception) the highest rates of fetal and perinatial death in the US are are associated with a lower socio-economic status groups--unmarried women, black women, pregnant teens (the exception would be women over 35--in which increased age plays a role), I wouldn't be surprised to see a study that talks about the differences in income and maternal/fetal/perinatal fatalities. I just think that the data on the matter isn't as strong as natural birth proponents claim...not that I've sat around and done tons of research on the matter in the past few years...since I ain't plannin' to do that again.

With that being said, I think that a woman should pretty much be able to have any birth that she wants to (within reason--insisting on gold-plated surgical implements for a c-section or marble tiles for one's birthing pool might be a bit excessive)...I just think the rhetoric should be toned down a bit because its a misleading simplicity to a very complicated issue and IMO has the possibility of leading to a very slippery slope in terms of women's access to reproductive health care and to what makes a "good" mother, etc.

Also, is the autism, adhd, etc rate really getting that much worse? And is there a possibility it is caused by changes in certain chemicals becoming more common or being present in higher levels? I mean, I know the vaccine thing is pretty much not supported, but otherwise?

ADHD has a genetic component, as does autism. There is also likely an environmental component that determines whether or not an individual with the genetic predisposition for both autism and ADHD. But, like Corbin mentioned, changes in diagnostic criteria has played a part in the increase in cases as well...not just with autism, but also in ADHD. I would think that maybe a society that is more open about these things also has something to do with it--at least in terms of perception if not actual numbers. Although, I tend to think (in a negative way) over diagnosis can be about perception too (here's a counterpoint to that article that articulates some of the changes to the diagnostic criteria)--because there is no black and white test, people see minor and mild behaviors that have been associated with a disorder as indicative of it.

Also, there can be other reasons for those behaviors--(I'm referencing this from memory rather than double checking, so I could be a little bit off, but...) something like 3-5% of ADHD diagnosis are later found to be food allergies and intolerance, and another 7-10% have been found to be sleep disorders (also though, sleep disorders can be found in kids that do have ADHD and make them worse, behaviorally). There are a lot of parents that diagnose their children themselves (and a lot of pediatricians that will go off a parent's description of behavior without doing the detailed studies that they should do), rather than go to a specialist--and by a specialist, I don't mean a regular pediatrician, but a pediatrician that specializes in neurology and development.

[Jillian]

Re: Natural Birth?

All I can say here, as a Doula in training, is that it is no ones job to judge a mother for how she chooses to give birth. I am a HUGE advocate for home birth, but at the end of the day, my clients will receive nothing but love and support from me no matter what they choose. A Doula's job is to make mommy's experience the best it can be, and make sure she is never afraid or unnecessarily uncomfortable. I had a great experience having my daughter with a midwife, she is beautiful and healthy and amazing!

[Rae'ya]

Re: Natural Birth?

I haven't had children, so I have no personal experience with this, but I have opinions (as we all do), based on my knowledge of reproduction and birthing.

I'm all for a natural birth if you are able. What I'm NOT for is anti-doctor, anti-medical-intervention-even-when-it's-warranted stuff. My sister has had two children... my nephew would be dead if she didn't have medical intervention, while my niece was a completely natural birth that occurred in a hospital room. I wasn't present for the birth of my nephew, but I was present every minute of the process for my niece. She didn't need any intervention for my niece... and she didn't get it... no gas, no injections, no cutting, no pain relief... nothing. Contrary to what some of the militant natural-birth adherents would have you believe, it's possible to have a natural birth in a hospital, with doctors and midwifes in attendance. Just because they are there, doesn't mean that they are going to interfere, at least here in Australia.

I would never personally be induced early if there wasn't reason for it, or have a caeser if there wasn't good reason for it. But if it's warranted then it's warranted, in my opinion. And I plan to stay away from pregnancy and birthing forums and groups for the most part (I've heard so many horror stories from friends and families that I don't expect that it's worth it). But I plan to have at least a midwife in attendance when I have kids, preferably inside a hospital room. Because I want the peace of mind knowing that if something were to go wrong, they'd be on hand to save my life and the life of my baby.

Yes, women have been giving birth for hundreds of thousands of years. But women have also been dying in childbirth for hundreds of thousands of years. Not from medical intervention, but from the natural birthing process. Having said that, modern medical interventions mean that women are able to give birth who would have otherwise died, which means that we are passing on a wider genetic pool in terms of fertility and ease of birthing. There are some women who aren't able to safely give birth without intervention, and some of them experience a great deal of guilt about that because of the militant natural birth adherents.

I think that our decision about how to give birth is ours, and should only be ours. Research and education is a good thing, so that we can make informed decisions about our choices. There is obviously more than one way to safely give birth... and I think that it's up to us as to which way we want to go. I don't think that we should be forced or coerced one way or the other. There is propaganda on both sides of the debate, and there are very good arguments on both sides. I don't think that the answer for me personally lies to either extreme, but somewhere in the middle.

[Rowanwood]

Re: Natural Birth?

I just wish some of the judgmental "this way or you suck" folks could experience a situation where thing don't go as planned and if it wasn't for the medical intervention, things would go wrong.

My sis-in-law was very home birth and so forth, but after 18 hours of labor and no progress, she ended up having an emergency c-section just in time and found her pelvic canal is shaped abnormally and she cannot have a vaginal birth ever.

My daughter was wrapped in her cord with her legs next to her face in the breech position.

Both of us and our children would be dead without medical intervention.

I wanted to breast feed, but I could not. Even with 3 consultants and much effort. I cannot make milk. Without formula (that some scream is "poison") my daughter would be dead. But not only is she healthy and alive, but she's 3 and meeting all listed milestones for being 4, except for alternating feet on the stairs and that's because she's still too short.

Assuming that anything medical is bad leads to this: http://www.today.com/moms/home-birth...irth-1C7397929

Certainly, women die in hospitals birthing too -- its a dangerous thing to do. But we don't need scare mongering without proof to make things worse.

I'm all about being minimally invasive, but its not always practical.

[Shahaku]

Re: Natural Birth?

I'm pretty sure I mentioned it, but I ended up having to have a C-section. I had my baby in the hospital, and my cervix wasn't descending. It was dilating, but not descending, so it was kind of up behind the baby's head. This was at 7am, and I had been in labor since 4 the afternoon before. The doctors told me if I couldn't relax, it wasn't going to, so I got the epidural, hoping that would help things. My cervix finally started to descend, but my dilating slowed down.. I was dilating like 1cm every two hours. I started to spike a fever at 9 or 10 that night, and I was still a little short of the full 10cm. They pushed me the rest of the way and I tried pushing a few times, but I kept going back down to just under 10cm. So, 10:45, they said I had to have a C-section. I'd been on IV antibiotics the whole time because I was Group B Strep positive. And I'd been on Pitocin since sometime that afternoon to try and get my dilating to speed up.

After the C-section the doc told me she was never coming out on her own. Even without the infection to spur the C-section, I could have pushed as long as I wanted and she wouldn't have come out on her own. She was almost 9lbs, and her forehead was presenting, the biggest part of her head wanted to come out first. She hadn't even been able to get her head anywhere near going through my pelvis, which is why I wasn't dilating all the way.

I'm sure if I'd had a homebirth, I would have ended up going to the hospital anyway. It all may have happened quicker, because if I hadn't had the epidural when I did I would have gotten to the point where I was stuck a lot sooner. I dilated from next to nothing to five in about four hours before having the epidural. So if I'd been at home with a midwife I probably would have held off on getting that longer, might not have had to have the Pitocin, and might have gone straight in to having the C-section when I got to the hospital... but a midwife probably would have made me go to the hospital for labor anyway because of the Group B Strep...

Anyway, it all worked out for a healthy, happy baby.