I think BOBB made things Worse (long)

phq2011 · May 2012

So I have been very uneasy about labor and delivery for a few weeks (which I am sure was obvious in my other posts), and so I was trying to learn more about it to get more comfortable. I have started taking birthing classes, trying to learn as much as I can about pregnancy and staying healthy, and not looking up stuff on Google. However, I had heard a lot about The Business of Being Born and so I watched it. I am now terrified to deliver. I am not doing a home birth because I don't feel my apartment has adequate space to set up and birthing centers are all out of pocket for me. I really do like the maternity unit at my hospital and it is one of the best hospitals/NICUs in the region. However, after watching the documentary, I am terrified. I knew in advance that c-section rates were high and induction is not uncommon, but now I don't know when to actually listen to the nurses and deliver other ways, when is induction necessary.... Also, the care I am with forces induction by 42 weeks, so if I haven't delivered, I have to be induced. I feel that these induction drugs make things worse, even from stories I have heard from friends who had to be induced. I really don't want an epidural, but it seems like a requirement with induction. Opinions, even a slap in the face, would be appreciated.

pepomntpat · May 2012

Propaganda like the BOBB should really not be watched by anyone who has anxiety. You should also stay away from things like A Baby Story. All of them are sensationalized to serve an agenda. They are one sided and meant to make money.

Most births are fine. I would suggest that you talk with your provider repeatedly about your concerns and have your questions answered. Knowledge, not fear mongering documentaries, will ease your fears.

I would also recommend a doula who can help remind you of your wishes and why you want them. In my Bradley class we were told to ask three questions when an intervention was suggested-Is Mom okay? Is baby okay? What happens if we wait? It really helped to know when an intervention was really necessary and gave me peace of mind. My doula reminded us of those things and also suggested things like sitting on the balance ball when I had to be monitored rather than being stuck in bed.

sosoph · May 2012

Any media advocating med-free birth tends to be alarmist. The reality is that ob practices evolve and many are much more moderate than the occasional extreme cases you read about or watch. Even Bradley proudly talks about routinely giving pressure episiotomies back in the day.

I recommend you make a list of questions and talk to your ob about them. You've done some broad research on med-free birth (watching BoBB), but you need to do local research on your ob's actual practices, and know what kind of dialogue you'll be having with your ob while you're in labor. A lot of things the Bradley course cautioned about were totally out of practice where I delivered, so I just crossed them off my list.

judahsmommy1 · May 2012

So a few questions to ask your care provider if they suggest an intervention. 1.) What happens (or could potentially happen) if we do this? 2.) What happens if we do not do this? 3.) What happens if we wait? You are looking for an assessment of the risks and benefits of whatever procedure they are suggesting. It would be a good idea to be aware of the risks of the most common procedures before you go to the hospital. Asking what happens if you don't agree to the intervention tells you how serious the situation is. If the doctor is suggesting an epidural and when you ask what happens if you don't he replies, "Well, you're going to be in a lot more pain and this will take a lot longer..." then you know that the intervention is not medically necessary. If he says, "Well, baby's heart rate is dropping with each contraction and I'm concerned that the amount of tension you are holding is impacting your baby's ability to cope. I'm hoping an epidural will help you relax and allow the baby to get in a better position to be able to handle contractions. If we don't and your baby's heart rate doesn't improve, we're looking at more invasive interventions." Do you see the difference in answers? You're looking for him to give you a specific concern that he thinks that the intervention will prevent or assist with in a medically necessary way. You can always ask for time to think about it.

About inducing at 42 weeks. My personally opinion is that inducing at 42 weeks (assuming that you have a very good gestational age for the baby) is a valid decision. Delivering after 42 weeks does put you at a higher risk for some very scary complications. If you go to 41 weeks, ask your doctor about natural methods of induction - stripping your membranes, nipple stimulation etc... They are much more likely to work after your due date than before. And ultimately, if you do need pitocin, no... it's not ideal, but it's doable.

caralck · May 2012

BOBB demonized births not done at home or in a birth center. And it was filmed in a city at a hospital with high c-section rates. If this is where you live, then it probably does represent what you may face. Every doctor is different and every midwife is different. I think having the frank discussion with your provider about induction methods (natural or medical) and your preferences are in order. A doula is an excellent suggestion PP have made. Make sure your husband is fully aware of your birth wishes so he can help advocate for you if you're unable to do so or having a hard time being successful. Thankfully I live in a city that has made a commitment to not allowing elective inductions before 39 wks in an effort to lower the hospital c-section rates. Delivering at a smaller community hospital is also nicer and there's usually less pressure to crank out the babies and move the ladies to the next stage (postpartum floor). We do have a number of "baby factory" hospitals where that is the case. In training, I had that same sense of "hurry up and move on, pour the pit in" and usually it was in those baby factories and ones with high level NICUs. Those nurses are so used to worst case scenario that they fail to see or rarely see a truly natural birth. They follow the Friedman curve religiously even though that curve is flawed (it was based off of deliveries done with "twilight birth" and medicated in other ways to augment labor). I personally do not feel comfortable going beyond 42 wks because of the possible risks and would like to hold off until 41.5 wks before induction. Prior to that, I'm starting acupuncture at 36 wks in an effort to encourage my body to get ready. Red Raspberry Leaf tea is also supposed to help as well as evening primrose oil. There are many natural things you can do that are safe to help prepare your body. The key thing is to be as calm as possible. Fear about what they may or may not do to you or force you to do, will just serve as a barrier to your goal of delivering without forced induction. Though, even the most calmest of people may still need induction.

KateLouise · May 2012

Are you working with an OB or MW who you trust, and who respects your desire for a natural birth?

I think having staff who are on your side is a big part of it.

FWIW I know a number of people who have been induced and then gone on to birth naturally. Not saying it was easy, just saying that an induction doesn't have to mean lots of pain meds and other interventions.

I haven't seen BOBB, but the ladies here have lots of good ideas for working with the environment you will birth in, to achieve a natural birth.

footnotegirl · May 2012

I was induced.

I did not need an epidural. I delivered without painkillers.

So induction does not mean you MUST get an epidural, by far.

nosoup4u · May 2012

Don't worry about things until they present themselves. Remind yourself what you can contfol, let go of the rest.Epidurals aren't the end of the world, they come in hamdy whem women truly need them. Read "Birthing From Within".

LadyTyler · May 2012

As a number of women have pointed out, your experience will vary a lot depending on your doctor/hospital. The place I am giving birth does not even have a nursery for healthy babies because they want you to bond, automatically sends a lactation consultant to help with breastfeeding, and has a garden they encourage you to walk in during labor.

My OB doesn't believe in cervical checks if you don't want one, encourages ways to get labor started instead of induction, and he encouraged me to not check in to Labor & Delivery until I was between 5-7cm since I'm close to the hospital and he thinks laboring at home is more productive for most mothers. He has constantly encouraged me in my birth goals and takes the time to discuss his reasons for things.

Take the time to talk to your care providers about your concerns to get a feel for how they think/will react to situations. It might turn out that they are more aligned with you than you fear and if you have concerns about their views, see if it is possible to change providers. If nothing else, you will have a real idea of how they feel about things instead of just worrying about it

cyprissa · May 2012

If you are up for a book, I recommend Thinking Women's Guide to a Better Birth by Henci Goer. She gives a comprehensive explanation of possible interventions and their risks and benefits. She strongly comes down on the side of natural birth but helps to really educate you rather being alarmist.

pithikaki · May 2012

I just want to tell you as someone that is giving birth with a midwifery practice that's what you would expect from one (no usual meds, no internal exams, so non-standard sonos tests, etc.) vs an OBGYN practice, they don't let us go past 42 weeks either! I'm pretty sure most places handle it as a case by case basis if you go past your EDD nowadays - 2 weeks isn't as short as it seems when you get to 40w! If you love your practice otherwise and feel comfortable, ask them what happens IF you are in that position - it's very hard to find someplace you feel good and safe, don't stress over a "timeline" restraint just yet.

choppinbroccoli22 · May 2012

I watched the BOBB because I was afraid to give birth. I then realized, I was only afraid of unnecessary interventions, NOT labor pain.

I was the only person in my birthing class to put myself in the category of "very opposed to medication and will be disappointed in myself if I end up having any".

An aunt got me to realize that I was setting myself up to fail. I needed to be open to things not going according to plan, and open to the necessary interventions, and not take it as a personal failure on my part.

It's a good thing she did, because I had a 44 hr labor with midwives in a hospital. Even midwives have time lines, and this practice's comfort zone was to start pitocin after 24 hrs of water breaking. I had been so against it, and I cried, but accepted it. I then was able to realize when I hit a wall at 41 hours or so and asked for pain medication to help me relax so that I could get to 10 cm before the clock beat me entirely out of a vaginal birth. I was confident in this decision at the time, because I knew it was the right thing for the baby. Me, the one who had been vehemently opposed to it, was using it to our advantage to achieve a vaginal birth when things out of my control-- water breaking, and labor progressing slowly initially-- made it imperative to be open minded, not afraid, and to make better informed decisions together with my midwives.

Had I not watched BOBB, I would have stayed with my original OB practice, and things could have gone much differently. The OB on the hospital floor wanted me induced immediately, with 4x the amount of pitocin that I had at the PEAK of things with the way my midwives handled it, when he heard that my water had indeed broken. I can't even imagine that. I do know that being induced doesn't necessarily mean that you can't have something close to the birth plan you want, though. I'd discuss it with your practitioners and make sure your birth plan is clear. GL.

Edit: oops, posted before I was done

RissKay · May 2012

I feel like BOBB is a great tool for some women to learn from when it comes to questions about whether or not they want certain things done. If nothing else, it shows some of the not-so-commonly-talked-about practices of SOME hospitals/doctors.

Ultimately, your OB(or MW!) and team are there to honor your wishes. You shouldn't have an OB or MW you don't trust or ones you think would "force" something on you that you don't want unless necessary. Talk with your OB/MW about your concerns and find out from them exactly what they are for/against and make sure you are on the same page. If you aren't, it may be time to find another one (I have friends who fired their OB's up until all they way into delivery because of different reasons!) So, don't think that "it's too late" to find someone you can trust just because you are further along, but rather realize that it's your right to have the experience you want for your body and your baby. Also, this is where a doula comes in handy, as they understand a lot of the medical jargon most mothers don't understand, and can step in and help you either understand what is going on, or put their foot down for you against something you don't want/isn't necessary.

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I think BOBB made things Worse (long)

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