Friday, December 31, 2010

The First Birth- No Do-Overs Currently Available


I think every person who supports women in having a great birth hates to hear these words:

"Well, with my next birth I will do XYZ differently, but with this one I can't......"

Deep breath.

Some other phrases that drive me mad (or just make me want to impress on the new mother-to-be how important these choices are) are these:

"Maybe for my next birth I will have a home birth, but with this one...."
"I would love to have a doula, but I just can't afford one...."
"I know that hospital has high c-section rates, but it is just so conveniently located..."
"I really don't feel comfortable with my care provider but it is too late to change...."
"Maybe next time I will have a midwife..."
"I really want to take a natural birth class, but my insurance doesn't cover it (doesn't fit in my schedule, maybe with the next one, etc)...."

You get my drift, right?

I am not saying that some people can't afford a home birth, doula, a birth class, or whatever. But it makes me really sad when these things are sacrificed when they COULD be afforded or fit in or made to happen and they are not.

Ladies- I know it is hard. The sad truth though is that you only get to birth THIS baby once.

Might you have other children? Probably! But you only get to give birth to this one once. I realize I just said that twice. I say it twice because it is so important.

You may very well have more children. I have seen plenty of women overcome horrible birth trauma and fear and go onto have a fantastic healing birth. It happens all the time. It is possible and totally worth the effort.

I have also seen women who only take the time to educate themselves AFTER the bad birth experience and then go into the next birth prepared and willing to drive, take a class, read, change care providers, etc. But that doesn't fix the first birth. And - despite all their preparation, fate sometimes steps in.

The sad truth is that there are lots of consequences to an unnecessary c-section or birth trauma that we don't often think of.

One- overcoming a traumatic birth is not easy. Women sometimes find it harder to heal emotionally from a traumatic experience than they had thought possible. How much easier it would have been to simply drive an extra half an hour with the FIRST baby in order to stack the cards in your favor?

Let me give you a tiny personal example (which is not really that traumatic at all, but is however descriptive.)

My first birth was fairly painless. I did however push for about four hours. This was exhausting. When it came time to push out my second (and third for that matter) I totally lost it. The truth is I was simply AFRAID of pushing because it had taken so long. That fear gave me an insane amount of physical pain. Not only that- I thought it was going to last FOREVER. Not rational thoughts for sure, but that first birth certainly impacts the next, and often in unseen emotional ways (either good or bad).

Two- Sometimes the physical consequences of a traumatic birth will also come back to haunt us. (PLEASE- don't get me wrong. VBAC, HBAC, etc are all awesome and can almost always be accomplished. But surgical procedures on women can have lasting consequences. I am absolutely NOT discouraging VBAC- I am encouraging doing everything you can to stack the cards in your favor for that first birth.)

I do not know how many women have a first unnecessary c-section, and then when attempting a VBAC must have a necessary c-section because of something that was altered in their body from the first surgery.

We are sold in our country on the safe effectiveness of surgery. We act like (and doctors sell this hard) there are no bad side effects from an invasive surgery unless you DIE. Death is not the only possibility. Talk to c-section moms. How many have scar pain? How many have other problems? You would be surprised how deep these cuts scar and how totally ignored these women are.

Let me give another personal example (and again, not that big of a deal, but illustrative):

With my first I had an episiotomy which resulted in a second degree tear past the initial cut. It was painful to heal from. I have had two more children since, one a water birth and one squatting at home. I have, with every single birth torn right along side my episiotomy scar. My midwives have told me both times that I would NOT have torn were it not for that first cut.
(Many women do however go on to deliver over an intact perineum after previous deep scar tissue- do you get my point though?)

Three- Negative words are hard to kill.
If your doctor or midwife says things like- "You are not big enough to birth this baby." or "Your pelvis is too small." or "We need to section you for failure to progress, CPD or XYZ" you will remember these words FOREVER.

Some women simply give up on their bodies then. I don't blame them. She has been told by a trained expert who went to school for many, many years, that she is incapable of normal birth. It takes a very strong person indeed to simply question authority that comes from one of our modern day prophets- a medical doctor.

But there are many amazing and powerful women who DO question this authority. But, once they have heard that from a medical person, it is still hard to get that nagging voice out of your head. The alternative: pick a care provider with your FIRST who doesn't talk to women this way, especially when they are at their most vulnerable, pregnant or laboring. If your care provider has already said something like this too you- remember- it is not too late to change until the baby has been BORN.

The End-
I want to be very clear- women can and DO go on to have fantastic healing births after an initial trauma or surgery. If that has already happened to you, you are powerful and you can do this.

My message is really for the first time mom who doesn't seem to realize the gravity of the situation. Women who have done this realize how powerful the birth experience is. IT WILL CHANGE YOU. That I can promise. How it changes you is partly up to you and the preparation you put in and the choices you make.

Can you control everything? NO! Absolutely not. I am not saying that you can. But I am saying that you should take the time to prepare and control what you CAN. Then, no matter what happens you can live it without regrets.

Blessings and joy on your journey into new motherhood. Every birth counts.

27 comments:

mamapoekie said...

Using this for sunday surf... This is so so very true...
I always had wanted a natural birth center birth for a first child. I had no home of my own at the time of my daughters birth (we came to stay with our parents in Belgium when it was time to birth) so homebirth wasn't in my realm of options, but my husband bullied me into having a hospital birth at the hospital where his mom worked because it was 'so much easier' which ended up in me having an induction and having the stranded beetle.
God this is so frustrating for me because I know all too much that I will never get to birth her again.
And it's so much worse because I knew... I knew all too well that I didn't want to birth in a hospital and that I didn't want to lay on my back. That I didn't want an induction. I cried throughout that pregnancy because they made me feel like shit and they said I had no options. I allowed myself to be bullied by my husband, my family and my doctors. And in the end i just got a 'don't complain, you're baby is perfect'. Such a cliché.
I know that I take this abused because I was abused as a child and it's hard to break the cycle, but actually knowing this simply makes it worse.

Yes I did feel powerful after having birthed my child, and I loved her at once and I would want to do it over and over again, despite all the things that didn't go my way... But the problem is that they shouldn't have gone that way. There were options.
I feel like I was this sheep being brought to the sacrifice beam...
And nobody stands up for me...

I told my husband everything I didn't want. Over and over again. EVen before I was pregnant, but he says he was overwhelmed. He never reacted.

OK, this is unleashing the beast. I think I'm going to sit here a while and cry about it.

Diana J. said...

You are spot on! I am going to link to this right now from my own blog. Thanks!!!

Mama Birth said...

Thanks ladies- and mamapoekie- I am so so sorry for your experience. I don't think husbands understand how important they are to the process. Wishing you strength and healing-

Jessie said...

So true! I would encourage any woman who *is* dealing with fears from previous births, things she's been told, or stories she's heard -- get some counseling, and maybe some hypnosis. We did a session in my Hypnobirthing class where we let go of our fears and previous experiences through hypnosis. It was wonderful! Can't hurt, right? :-)

Anonymous said...

The words you hear are SO powerful. Being spoken of and over like you are not there is unpleasant and the words can stay with you and impact you forever.

My first time, I was in hospital, classic stranded beetle. I remember the mws talking about me - my body parts- to dh, like I wasn't there. It made me self conscious and I know now that probably contributed to slowing the process.

The consultant who cut the episiotomy acted like she had done me this massive favour because I had a local and a cut I never felt the ring of fire. The way she described the ROF made me totally phobic about that part of birth. I know the fear was deep-seated and slowed my second birth a lot, altho on the whole I enjoyed it immensely, and will forever treasure the moment when she slipped out into my own hands...

Healing is wonderful, but not always easy or guaranteed. In any case, better to not be wounded in the first place....

Anonymous said...

I really would love a birth outside of a hospital, but I dont have a choice :(
Reading about women who do and advocate against such hospital births hurts my heart because I know I cant have one.

I currently have $359 in my bank account for a fortnight of food shopping and 1 phone bill (which wont be able to be fully paid)
This is the price we pay for keeping me as a stay at home Mother.

The cheapest Doula in my State is $800...
Birth center $2500...

So even though I dont feel so much "bullied" I feel trapped?

Unless my money starts having babies I cant buy the birth I want, I have to take whats being given.

Anonymous said...

I'm going through this with a friend - she knows homebirth is what she wants (and her mother had two which she witnessed, so she's not afraid of homebirth and has the right support to plan for one). But her husband is from a family where it's often said that the doctor is always right, and 'our children would have died without the hospital help.' I urged her gently to do whatever she feels in her HEART is right for her and her baby, but she's acquiesced to her husband's wishes for a hospital birth with OB care.

I can only stand back and quietly shake my head, because she's ALREADY saying, 'Well, the next birth will be different, because after he sees what birth is like, he'll be okay with a home birth.' Um, what??

Mama Birth said...

To the mamas who really can't afford an out of hospital birth I would say this- you can have a great hospital birth! I did. It is done all the time. The majority of my students birth in hospitals and have great natural births. Sometimes money is a limiting factor. I have never had a doula. I am still paying for my last home birth. Money is a huge factor and I get it. But don't give up on a good hospital birth either. Don't tell yourself it can't be done- it can! Some things that are helpful- getting midwives in hospital if you can- finding a doula in training (they MUST observe 3 births free to certify) if you feel you really need a doula, taking a class or reading good books like crazy and then PRACTICING the stuff in the books- going to the hospital later rather than earlier- advocating for yourself- even though it is a system, your attitude and confidince will have a big impact.
Good luck-

Elizabeth Walker said...

Thank you so much for this. I have definitely researched so much more since I had my first. The Dr. was concerned that I was leaking fluids (I wasn't as the ultrasound proved). When it was shown that fluid levels were fine, she decided to induce me as I was only a week away from my due date and she was on call the next day. I regret that I didn't fight more about it...I was just so excited to meet my baby! After about 17 hrs. labor, and puking non-stop from the drugs, they decided to do a c-section. At that point, I just wanted my baby.
With my second, who was a bit of a surprise, I had a scheduled c-section. From the information I was given at the dr.'s office, it sounded so dangerous to even attempt a VBAC. I regret that now. I wish I would have researched more. Again, a perfectly healthy baby, but still feel as if I "failed" at having a baby the "right" way.
Last time I was pg, I researched a ton, then lost that baby.
This time, I've already done the research. My hardest thing is figuring out the money. I would LOVE a Home birth/VBA2C. I don't think I'll be able to find someone for that within our budget. I've already decided that I will travel though to get the birth I want and this baby and myself deserve! If the first dr. isn't going to work with me, I've already talked to my husband about going elsewhere. Thankfully, he's supportive about travelling further. I just hope it will go as I want. I know I can deal with whatever birth I get though.
Anyways, thank you for this article.

Hannah Joy... said...

Loved this! And while I still say "with my next baby ..." it's after the fact of my HBAC there are still things I would like to do differently. But I learned a hard lesson with my first.

Anonymous said...

If there were one piece of information I could share with first time mothers this would be it. After an attempted HBA2C turned CBA2C with a complete uterine dehiscence discovered after incision. I am living proof- No matter how much you prepare for the next one to be different the physical damage can NEVER be undone.

Becky said...

While the physical results of not doing your first birth right are always with you, sometimes I think the emotional scars go deeper.
http://idahobecky.blogspot.com/2010/12/letter-to-bastard.html

Enjoy Birth said...

This is wonderful advice! I second the opinion you can have a great hospital birth, you just have to choose your care provider and your hospital carefully!

eulogos said...

Anonymous 1:26pm.....you could do what poor women used to do, and have a friend with you who has given birth naturally, and just have your baby!

You have to really study birth and prepare your self and your friend and your husband/partner if he is involved should do the same, and you need an alternative plan if something either before the birth or during it doesn't seem right.

I admit that there ARE dangers to this and you have to be willing to face that and take responsibility for the outcome. That is something that poor women in the past didn't have to do, because there were no other options they could have chosen, and people would pity rather than blame them if something went wrong.

But all that being true, the most likely outcome is that your baby will just get born, just fine.
My fourth through eighth were born medically unassisted. #4 and #5 with women who had been to a limited number of other births, and #'s 6,7, and 8 with just myself and my husband present. I did have a doctor who backed me up. I remember apologizing to him that I forgot to call him to tell him I was in labor with number 8, and he laughed at my lack of dependence on him. I felt very liberated that I didn't need anyone to "give" me a birth.

Susan Peterson

Anonymous said...

This is a great article. I have had two deliveries both of which I am not happy with. The first was scary as I was delivering preemies due to PROM. The second (my next time baby)my membranes ruptured at 38 wks, long before contractions started. I did everything in my power to make those start and they never did. Nothing. I ended up with pitocin and a very painful delivery and a dream crushed. A dream to have an unmedicated birth and to hold my baby immediatly after delivery. Sadly, I was still in such pain after he was out I waved my poor baby away.
After my son was born my DH decided that 3 children is enough. So I will never get yet another chance.

You never know what the future holds and you may never get another chance.

Sydney said...

So true. I have done a lot of research and reading on natural birth and I know what my birth preferences are going to be. I say "going" because I have not had kids yet. Sometimes I feel silly being such a natural birth advocate cause I don't have kids and I think that people just shrug me off and think "you say that now but you've never felt what its like." But I am very glad that I know what I do and that I'll be able to have a great birth experience even with my first baby.

Lyndsey said...

Following a link to your from Authentic Parenting. What a wonderful post! It's absolutely astonishing to me how many times I hear the exact phrases you mentioned! It always frustrates me to no end, because what if THIS birth is the very last child you are ever able to have? What if it's the only birth? Why are you not educating yourself and demanding the best for THIS birth.

I have certain things I WOULD like to change at my next birthing experience. I do plan to birth at home...this simply was not an option last go around although it was still carefully considered. I DO want a doula or close female friend at my birth...this was a surprising (and too late!) desire of mine from my first birth. I DO have lots of nitpicky ideas for my surroundings during my next birth that I simply would not have expected I would like...but as far as the actual major decisions that were made last time, I stand by them all! I treated that birth like it might be my only...and that child like it was the most important thing in the world. (as it should be!)

greenapril said...

Dear Anon. @ 1:26pm (and that goes for anyone else in a financial situation), doulas are very well connected and if you explain you situation will most likely be able to find someone (DIT or newer doula) who can support your labor, just ask!! If you don't find any other options out there e-mail me directly and I will do my best to find someone for you. Seriously, e-mail me. You are not alone!!!

Blessings!!
doula.kim@gmail.com

Terri said...

This is a wonderful post and I have shared it with friends and on my fb page. I have just been asked to share my natural birth experiences with some trainee midwives this week and I will be taking along this piece for them too.

For 'anonymous' or anyone who can not afford a non-hospital birth - yes you can still have a magical birth. Where I live (a small Caribbean island) there were NO midwives willing to deliver my baby at home for my first birth. I searched and was so disappointed. I even considered an unassisted birth but the family pressure was huge. So instead I wrote a 3 page birth plan, discussed it with my ob/gyn and a midwife in the hospital. I also was blessed to have the assistance of a medical student who had worked with her midwife mother in a birthing centre who gave me great support and advice (ask and you shall receive) She said something wonderful to me when I kept saying how I wanted my homebirth...'you will have a beautiful birth wherever you are because you choose to' So in the end I chose to labour at home, the Ob/Gyn and nurse midwife were frantic that I would not come to the hospital to be induced and refused to attend the birth! I arrived at the hospital with babies head engaged and gave birth within 30 minutes with no interventions and laughing in the labour room! So a good hospital birth is possible - it is a state of mind! Be very strong and clear, don't let anyone bully you.

Having said that I did get a homebirth for my second baby and it was extra magical because of the way I was able to relax more fully and do the full hypnobirth process with no interruptions. I'm glad I have both experiences because many people seek my advice when it comes to natural birthing and I can give them both sides and celebrate the beauty of each!

Cate said...

Great post. I feel so lucky that here in Western Australia we have the option of homebirth and it's government funded!!!

The sad thing is that even though homebirth is available to us at little or no cost, many women don't even know that it is an option.

This is my first pregnancy and bubs is due any day now. We are planning a waterbirth at home with a midwife and a birth photographer. I don't plan on having any vaginal exams and am confident that my body will know what to do and when to do it - I'm just there for the ride!

I am so proud of myself for doing the amount of research I have done and am amazed at how much I have learnt about natural birth. I feel like a birth junkie even though I haven't even given birth yet!

I can only hope that after this birth I will be saying "Next time I want to give birth on the deck overlooking the valley" :)

The Smiths said...

Hmm. I WAS educated and I did choose a home birth midwife, took a 12 week natural birthing class, and did my homework. I still ended up with a hospital birth after 42 hours of labor saying, "WHAT DID I DO WRONG?" My second birth, I again chose a home birth midwife, did more homework, struggled with my demons, drank LOTS of red raspberry tea. I had an absolutely triumphant UC after 17 hours of labor. I wish I had had DH turn on the video camera. I wish I had gotten into the position my body wanted to rather than following the midwife's directions on the phone. So I guess there are always after the fact wishes.

I have a friend who said, "Next time I'll have a birth center birth." I didn't say anything, but she DID choose the crunchiest OB within 300 miles. But I wish she could know how she may not have had a 3rd degree tear if she wasn't birthing on her back in a hospital bed and she may not have had to struggle with them keeping her baby away from her for observation. Oh well. This same doctor is opening his own birth center, so I think she will probably go there next time!

Coco Cana said...

Great post! I just wrote a story about my "do-over" home water birth where I spoke of how I wanted a completely different birth from my first! I wrote it for a contest with Ricki Lake and BlogHer called Journey To Motherhood. Enjoy! http://www.blogher.com/my-water-baby?page=0%2C0

Quantmlife said...

So true ~ IF YOU OR SOMEONE YOU LOVE IS AN EXPECTANT FIRST TIME MOM, PLEASE HEED THIS SAGE ADVICE.

Don't let it be "with the next one" or let $$ somehow hinder you... I know situations vary and it may feel impossible but it may not be as impossible as you, at first, may believe. At least try. You owe yourself that much.

I did everything I knew how to do to have a natural empowering birth and even though everything didn't go "perfectly" I still had my ten pound babe without drugs or surgery. I do wish some things were different and that I had hired a photographer (I didn't think I could afford) or at least commissioned someone close to me to take photos... thought I wanted a very private birth (which didn't end up happening either). *sigh*

Things that I can change for this one I have... best and blessings to all you moms.

The Beccinator said...

I know I'm too late to say this to you, but in case other moms in your situation read this, I just think it should be said.

Hopefully your hospital birth was beautiful! I don't think Sarah was trying to say they can't be for first time moms who don't have doulas. I think she's saying educate yourself so you can know your options, know your preferences, and then FIGHT for yourself.

Know that even in the hospital, you can say no. There is always some liability release form for everything. You can lock yourself in the bathroom for hours on end. You can demand a different doctor or nurse, if the ones on call really are not working for you.

Better yet, if you have access to prenatal care with a CNM, many personally attend all of their births (regardless of the time/day it occurs). That way, they may (hopefully) be more supportive of your natural desires and you will have time during pregnancy to talk to them about your birth plan.

Our library had several good books about birth. I did all of my research that way. READ positive birth stories (LOTS AND LOTS OF THEM) on the Internet (again, using the library, if needed). I benefited even more from watching birth videos. Even if the stories you read or videos you watch are not in the hospital, watch for things you like that you can incorporate into your hospital birth to make it more intimate.

Doulas working toward certification have to attend some births for part of their training. If you can find someone training to be a doula, they will probably gladly help you for free. Some also exchange services, so if you are able to provide something to exchange (several free haircuts, for example), that may be an option.

I think the real point of this post is to learn what it will take for you to have a good birth experience, learn the resources and providers (including hospitals) you have access to, and then MAKE it work. Never settle for an ok birth when you can make it amazing!

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