The Business of Being Born has sufficiently scared me...

ebilbao · August 2014

...into trying to prepare for a natural childbirth. I searched the forums for some good recs, but couldn't find any consistent info. What worked for you STMs who have had natural births? Bradley? Ina May? Hypnobabies? Good old Lamaze? Biting down on a piece of bark?

TIA!

ebilbao · August 2014

Perhaps I could practice an "F U" mantra, then. Maybe we could write a book.

drpayne · August 2014

Bradley method here. The natural birth board is helpful!

Cheekers2010 · August 2014

Bradley is a LOT of prep but great if you have a strong partner that wants to be really involved. I love reading Ina May. I've always thought combining whatever methods you think might work is best. And, of course, I recommend having a doula (obligatory professional plug).

ebilbao · August 2014

Oh, duh - there's a whole board? Thank you @drpayne!

mrsrroberson · August 2014

Two CS with me but now my sister, had her first with epidural and her last two all natural. She progressed so fast it was too late for anything. Definitely a lot of "eff bombs". Oh and a lot of "STFU" to her husband. Lol

soulcupcake · August 2014

I have pretty easy labors and births without meds. The ring of fire and massive pressure prior to birth is intense, more so than my contractions ever were. My contractions were like moderate menstrual cramps coupled with a continuous low dull backache. That's how they felt with induced with pitocin (with #1 and 3). With #2, natural contractions (not artificially stimulated and unnatural), they felt like waves of pressure/tightening. And with #4, well, I didn't "labor" at all. I had maybe 4-5 contractions inside a minute, and they were accompanied by intense, massive, pressure. And then he was born.

I don't even remember the ring of fire with it. It was much too fast to process much of anything. If I didn't have freakishly easy and fast births I would absolutely commit to Hypnobabies because I'm a big fan of the philosophy and the hypnoanesthesia works. I did the homestudy with #2 thinking, convinced, I wouldn't get the luxury of an easy labor/birth again, and I didn't use the techniques. I was prepared to, but it wasn't necessary.

Part of me wants to do the study this time simply because I actually really like the scripts and techniques.

MaineMama · August 2014

Although my births have all been csections, it wasn't planned that way I did Bradley with my first (section was due to cord prolapse, no classes can change that outcome, lol!)

My sister also did Bradley method, and was successful with a non-medicated birth. And Bradley allows for F-bombs

marriedinaugust · August 2014

We did Bradley to prep for DS and it prepared both of us. DH was such a great support! I also read Ina May and many other books. Doing the same this time. We aren't taking a refresher course but I will be reviewing our workbook with DH.

MegsTactical · August 2014

Second-time mom here (although it's been 12 years since #1). I have found the show, "one born every minute", on YouTube, to be the most helpful. You get to see pretty much all labor and birthing methods, and see all different birth scenarios. It's like studying to me. The more information I have, the more I feel prepared.

saltsandwater · August 2014

What is a ring of fire?! Obviously, I'm a FTM. I couldn't finish the Business of Being Born. Stressed me out and husband decided it was time to watch something else. I found something called the Miles Circuit https://www.milescircuit.com/ so I'll be doing that as I near labor time. It looks good for our bodies and for baby positioning. Besides that, my plan so far is to bite on bark. Glad to get the info here from other ladies' suggestions.

BayCamp · August 2014

It definitely influenced me in to researching and deciding on a birth center birth. I watched it a couple years ago. I felt like when I got pregnant I was much more if an "informed consumer" than I would have been otherwise. I've been reading Ina May and seriously considering hypnobabies

Eora3 · August 2014

Hypnobabies was very helpful for me when my epi failed to work. I didn't have a "normal" labor experience at all. I was dealing with cronic nerve pain during my pregnancy (do to pregnancy) and so I had an induction at 38 weeks to try to limit potential nerve damage.

I was in some serious pain to start with and then had non-stop overlapping pitocin mega-contractions. The epi didn't do a darn thing accept make me lose muscle control in my legs (pretty sure the anesthesiologist placed it wrong).

The Hypnobabies techniques kept me from panicking and helped me feel a little more in control. It didn't take the pain away but it helped me feel less overwhelmed by it.

Meether · August 2014

For me, I didn't want an epidural due to the method of application...so I just kept telling myself the pain was temporary

I thought it helped to labor in my home and then head to the hospital once my water broke. For me, having my freedom helps and being away from a hospital setting is great! GL!

mc0113 · August 2014

FTM and starting Bradley Method classes on Monday evening! I've had a few friends who highly recommend it so we'll see how we like it. Oh and reading Ina Mays Guide to Natural childbirth and also reading/watching as much as I can on other laboring methods to prepare as much as I can.

esr9435 · August 2014

FTM and also planning a drug free birth due to previous back problems. Epi is off the table for me ( per my OB) due to the risk involved, so that helps knowing that I don't have an option

My mom had a natural birth with my sister and myself (I was breach as well), so I pretty much consider her a rockstar. Her advice has been to stay home as long as possible, take baths, and remind yourself the whole time that your body was made to do this. Another friend told me no matter what, just remember the pain is temporary.

bombe4 · August 2014

We did Bradley with DD. It was great and so informative. My instructor was awesome and has now become a good friend of mine. She is always available to past and present mom's she has had in her class and offers refresher courses for free. I'll be taking a few once my due date gets closer.

TaJplus7 · August 2014

I tried to not make this a novel but I am passionate about helping others that want an unmedicated birth so this post is kind of lengthy. It will not hurt my feelings at all if anyone skips over this because they do not want to read it all.

I have given birth 4 times unmedicated and these are the things I found to be most helpful. I read the Bradley method book. I did not follow all the prep, so I cannot say that I fully followed the method, but I found the ideas to be helpful. I read the Ina May book... she is a little out there for my taste, but I did find the information helpful. Here is what I did that helped the most:

1. The thing I find gives me the most relief and helps the pain be dramatically less is relaxing completely during a contraction. I know that sounds crazy but if you tense up and fight against the contraction it makes the pain so much more. I found that I needed to "practice" relaxing my entire body up until time of birth and I still "practice" while pregnant up until birth. Relaxing during a contraction is the exact opposite of what you will want to do, so it really takes concentration to fully relax. When I fully relax through a contraction, it takes the pre-transition contractions down to little or no pain. It make the transition contractions very tolerable for me.

2. For me music was essential! I listened to calming music (Christian worship music for me) and focused on the music during contractions. This was especially helpful during the worst part of contractions (transition).

3. Remember it is temporary pain. There will be an end to the pain. Even the most painful contraction WILL go away. If the contraction got crazy intense then I would focus on the clock and watched the seconds tick away knowing that every movement of the clock would bring me closer to relief.

4. This last thing might not be for everyone... but my faith is very important to me. Prayer and scripture were also very instrumental in the success of my unmedicated births.

I am not sure what tips to give you for the pushing part of it. My pushing stage has always been really short so I always focus on knowing that if I am pushing it means that I am about to hold my baby in my arms. For me, the moment the baby is born is this rush of complete relief, extreme excitement, complete exhaustion, and an indescribable amount of joy. I still get emotional any time I think about that exact moment my babies were born. I can say that I did not experience the same type of emotions when I had epidurals with my first two. Although I was still elated they were here, it was not such an intense moment.

If you have your heart set on an unmedicated birth, I feel it is also important to have support from the people around you. The last thing you need is for someone to start talking to you about an epidural while you are in the midst of a powerful contraction. Because even after having several unmedicated births, I still find myself thinking about an epidural towards the end. I would be a complete liar if I told you that unmedicated birth is not painful. It is painful but it is pain with a purpose. I have a very low pain tolerance (I have cried just because my hubby pinched me) but even I made it through...so I am convinced that anyone that has their heart set on it can do it.

CandaceC1020 · August 2014

Definitely visit the Natural Birth board. There are some super helpful ladies on there.

I'm hoping to go natural. I've been watching every birth documentary that I can get my hands on. The Business of Being Born has a secondary series that is worth watching (More Business of Being Born).

Start reading Ina May Gaskin's books. I just finished Guide to Childbirth which I found to be very helpful and I feel like I took away some really great information. I'm planning to read Spiritual Midwifery and her Guide to Breastfeeding too.

I'm in the process of researching local doulas. I'm not convinced that I need one, but I'm worried because I'm a FTM. My area also has a natural birth group that meets on the First Friday of every month. I'm going to my first meeting next month.

majoraimers · August 2014

I read Birthing From Within and took a birthing class based on this method to prep for baby #1. It was a good book and course, lots of tangible techniques for managing pain. However, if someone had told me how to breath during labor i would have told them to 'shut the fuck up,'. The book and class empowered me to birth my way and to find what that way is. I did, twice, at home and have had two amazing birthing experiences. In fact I can't wait for labor and delivery with this surprise baby #3. My best advice:
Pick a good, safe, and trusted team of people to be around you when you labor. This is a primal and intense experience you need to be focused and centered not worried about those around you.
Have them read the book The Birthing Partner.
Go into labor with confidence that your body can and will do this and that you might just come out on the otherside stronger.
Lastly, look forward to natural delivery and feeling the slither of your baby being born and getting your body back after 10 months of it being hijacked. I LOVE the slither!

soulcupcake · August 2014

OP, are you planning a hospital birth? If so, it is strongly encouraged by low intervention birth advocates to wait as long as possible before going in. Between 6-8 cm, or when you know you're in active labor and possibly transition. This gives the hospital less time to meddle and manage your labor. It can be very difficult to have a low intervention or natural birth in a hospital. Some may luck out with supportive and understanding staff, but many don't have that, or they're led to believe they're supportive and soon find out something different once they arrive.

So, for a hospital birth, these practices play a *huge* role in how the labor and birth process go. If these interventions are avoided, hence the recommendation to do the majority of laboring at home, then you have a greater chance of having a successful natural (or vaginal) birth.

I wrote the following out some years back in response to a similar question:

- Interventions have a cascading effect. All evidence shows there are many negative effects associated with unnecessary interventions. Interventions can lead to not so great outcomes, including "life-saving" measures to remedy the previous interventions.

- Reprogram your mindset about childbirth. For many generations, we have been programmed with negative ideas and connotations about childbirth.

- Speak up. Not everything doctors say or do is gold.

- Don't back down. Some medical professionals can be intimidating and regurgitate false information.

All sorts of interventions that are often unnecessary:

- The IV. It is unnecessary in low risk pregnant women. They can be refused. Some request saline or hep locks. Sticking a plastic tube in one's vein isn't natural and can do more harm than good. It's often said to "keep you hydrated," but this is moot when simply drinking water takes care of that. It is actually done to give medical attendants easier access should a complication arise -- usually due to interventions gone awry. (avoid the interventions, avoid the complications)

When you remove the underlying causes, you lessen the risk of needing medication delivered through an IV during an emergency.

Some nurses can start an IV on any part of the body in no time if you have an ounce of blood in your veins.

- Continuous fetal monitoring. (opt for intermittent monitoring) It's unnecessary. Strapping a laboring mom to the bed can make for a more uncomfortable labor. Lack of movement contributes to more pain. Gravity is your friend. If you get up and move around, it works to aid in the baby's descent. Studies show intermittent monitoring is safe and is not related to a high risk of complications.

- AROM. This one can lead to a ton of unnecessary interventions. The membranes cushion the cervix which lessens the intensity of contractions. Breaking membranes is a favorite for many doctors and midwives. Rupturing membranes is not necessary to "speed up" labor. Hospital births function on a time clock. If mom is 4 cm dilated for two hours, AROM is the course of action to be taken.

The outcome can be that mom starts having contractions soon after, but they're very painful than had they been left intact. Mom can't deal with the pain and requests medication. Epidural anesthesia can slow down labor where it becomes an invitation for pitocin.

Or, the medical attendants watch the clock for an hour or so hoping mom has progressed. If not, they administer pitocin because the body isn't "working."

Also, once membranes are ruptured, you're on a clock, and you'll be watched and receive more interventions to get you to birth in a timely manner to avoid the risk of infection. The membranes protect the baby and allow him/her to move freely during labor, and this can facilitate an optimal position for the second stage. Keeping them intact also protects the cord from possible compression and the effects of the contractions when they become stronger and closer together. It also helps prevent cord prolapse in the event of rupture and your baby isn't low enough in the pelvis to block the cord from presenting before the head.

Ambulation - Maintaining mobility and being upright is key in the earlier stages of labor. This helps with the baby's descent and progression of labor. Gravity is your friend, use it. Walking, using the birthing ball, laboring in the shower, sitting on the loo or birth stool, help with aiding the baby's descent. The gravity and pressure from being in upright positions helps to apply pressure on the cervix and bag of waters. Pressure can help with dilation and effacement, and this whole process aids in allowing the labor to progress efficiently. Lying on your back, as the majority of women do when laboring in the hospital, ignores these important facts and, well, common sense. How is gravity assisting if you're lying in the supine position? Gravity isn't doing squat in that situation.

Pitocin - It's a synthetic oxytocin hormone. It often produces very unnatural and painful contractions. Pitocin can lead to hyperstimulation of the uterus and fetal distress - fetal bradycardia. It has statistically shown to make labors harder and more painful, even more so with membranes ruptured. It often leads mothers into begging for the epidural or other analgesics because they are so intense.

What makes that worse, when you're tense, things just plain old HURT more, and your body has more difficulty mustering up its own natural pain-combating resources. So a woman who is tense and fearful is going to have a more difficult labor and potentially need pharmaceutical pain relief, even if she started out not wanting any -- than a woman who is calm and relaxed.

Important note on the body during childbirth - The body is smart. We don't give it enough credit.

There are three layers of muscles in the uterus. The strongest layer, the outer layer, is the one which contracts during contractions to open the cervix. The middle layer regulates blood perfusion through the uterine muscles, and should be allowing quite a generous amount of blood flow to the uterus during labor to supply the muscles for their work. Lastly, the inner layer keeps the cervix closed and maintains uterine shape. This muscle SHOULD be inactive during childbirth, but in the presence of stress hormones, it's not.

When the body is forced into labor when it is not ready, it can signal a response to tell the inner layer to close up, but it becomes a stressful ordeal on the body when a synthetic hormone is trying to force it open. The different parts of the uterus working against each other. It's crucial that it not be forced. AROM often leads to these sort of problems.

Cervidil and Cytotec - Both are used to induce labor. Cytotec is widely considered to be the devil's brother, pitocin being the devil. Cytotec is not approved by the FDA for use during pregnancy or labor, but is still used in some hospitals. It is not safe.

Routine episiotomy - Unnecessary except in emergencies. All evidence shows it is better to tear than be cut. One of the midwives with Eve brought up an episiotomoy if she was "big." I asked for evidence stating it was necessary. She had none. An experience or routine practice doesn't make for evidence.

The second stage - Pushing in the lithotomy position (on the back) is the worst position for pushing. It completely ignores gravity's role in pushing. Changing positions or pushing in a position that widens the pelvis is far more effective because the pelvis opens up and gravity is assisting.

The lithotomy position is only widely-practiced for the "benefit" of the birth attendant (OB), as it gives them a view and a better way to intervene, er, work. It is unnecessary and inefficient.

Morther-directed pushing is far more efficient than waiting to push when you're told. Pushing as soon as you're complete can make for a much longer second stage. "Complete" does not mean the baby has descended enough for pushing to be effective. Push when you feel you're ready, not when others tell you. According to studies, trying different positions than the lithotomy and mother-directed leads to a decrease in the length of the second stage.

The average labor for a primipara has long been touted to be 12-15 hours with pushing lasting 3 hours or more for some, average being 90 minutes. The "averages" might reflect differently if childbirth, as a whole, was managed better.

Other risks to induction is fetal malposition. This is where the body is forced into labor before the baby has worked itself into the prime position for birth. Fetal malposition accounts for more cases of needing a c-section than the baby being "too big." When baby is in the optimal position for birth, LOA, this allows for a more efficient labor and second stage. Baby's and mother's position during labor and birth play a huge role in the progression of labor and the second stage.

Inducing and augmenting labor before the baby is ready and in position can have serious drawbacks, such as malpositioning, and this can complicate the laboring process and lead to issues like "failure to progress" and "arrest of descent." These situations are seldom seen in labors that are not heavily managed with unnecessarily interventions. The moment routine interventions enter the picture, even if they seem benign, it invites in more interventions.

If your goal is to have a low intervention or natural hospital birth, these are the routine practices you need to keep in mind, and try to avoid. Going in prepared with a natural birth method is great, but being familiar with the routine practices, their drawbacks and risks, make you armed and informed.

JennaRaek · August 2014

This is my birth story I wrote after DS was born. I plan on going med free with this one too! You CAN do it! Good luck!!

https://forums.thebump.com/discussion/12291005/our-story#latest

DoctorWorm222 · August 2014

The Business of Being Born scared me into planning a natural birth with #1. Then the contractions scared me directly back into the arms of the anesthesiologist - ha!

Honestly, I don't regret the epidural but I do wish I'd held out longer. The documentary was 100% accurate in my experience. They pushed me *hard* for that epidural, and once I caved it was one thing after the next after the next. They did the epi, then labor stalled, then pit. They had to stop the pit b/c baby's heart rate dropped. Then they broke my water. Then they thought they were going to have to put fluid back in b/c baby's heart rate dropped. Ultimately, I did end up with a vaginal birth. But I don't think it would have taken nearly so long (24+h) or been nearly so dramatic if I would have let things proceed as they should have.

I think one key factor is a supportive partner. DH was absolutely NOT on board with a natural birth. All the nurses were really pushy about the epidural, but it was DH's "don't be a hero" speech that really broke me down. Make sure your partner is on board with your plan if natural is what you really want.

JennaRaek · August 2014

DoctorWorm222 said:

Then the I think one key factor is a supportive partner. DH was absolutely NOT on board with a natural birth. All the nurses were really pushy about the epidural, but it was DH's "don't be a hero" speech that really broke me down. Make sure your partner is on board with your plan if natural is what you really want.

This is very true!! I think it helped me soo much that my DH, OB and nurses were all on board with me and were very encouraging!

BayCamp · August 2014

@aeonlux‌ you're awesome

JaymeeLH · August 2014

@aeonlux that was a beautiful break down! I already knew most of that, but it's nice to see it laid out so plainly

DoctorWorm222 · August 2014

Ainslie325 said:

It's worth mentioning that like all documentaries, The Business of Being Born is not the unbiased truth; it's an argument for one particular position in an issue. It's a very compelling one that makes excellent use of the three rhetorical appeals--including the evocation of emotion from viewers and the use of expert testimony--in order to sway viewers to a certain point of view supported by the filmmaker. I only make this point to share that a person need not be any more scared of a medicated hospital birth than an unmediated birth. Both are safe, valid choices with pros and cons that tip based on the specific wants and needs of the individual. Good luck, OP! It looks like you've gotten some good info here from moms with unmediated birth experience!

Agreed!

RayRay007 · August 2014

I took a 8 week natural birth class that was Bradley-esque but also incorporated some Lamaze-inspired stuff and a lot of info about the stages and sign posts of labour. I also read a lot of books including Ina May. I think it is important to get several different perspectives/ideas so you have some different things to try.

turkeyleg5 · August 2014

Also doing Bradley and I love it. FTM, so not sure how it will actually work out (and I'm open to the fact that things definitely do not always go as planned), but I can say...

I've known for a while that I wanted to have a natural childbirth, but I have been terrified. Three weeks into Bradley classes and I'm not terrified any more. I'm actually getting excited. It is really building my confidence. At first I didn't get the point of practicing relaxation, but after only three weeks (granted, not in labor), I've already noticed how much better I am at getting my body to relax (which is also helping me sleep better at night). I can't believe how bad I was at relaxing my muscles before, without even knowing it.

Also, a couple of people mentioned how pushy they can be about drugs in the hospital, and I've heard that when they are constantly asking, it's much easier to want to give in and convince yourself that you aren't strong enough. My sister was worried about this and put a sign on her door, and another above her bed, that said something like "Please do not offer me any drugs that are not absolutely medically necessary. I will ask if I need them or more information." She also had her husband make sure the nurses saw the signs, and to approach him first, and not her, if they did want to discuss interventions. And not a single person asked her. I'm planning on doing the same.

edit: There was a post about this earlier that might have some more helpful responses:

https://forums.thebump.com/discussion/comment/83522741#Comment_83522741

soulcupcake · August 2014

Ainslie325 said:

It's worth mentioning that like all documentaries, The Business of Being Born is not the unbiased truth; it's an argument for one particular position in an issue. It's a very compelling one that makes excellent use of the three rhetorical appeals--including the evocation of emotion from viewers and the use of expert testimony--in order to sway viewers to a certain point of view supported by the filmmaker. I only make this point to share that a person need not be any more scared of a medicated hospital birth than an unmediated birth. Both are safe, valid choices with pros and cons that tip based on the specific wants and needs of the individual. Good luck, OP! It looks like you've gotten some good info here from moms with unmediated birth experience!

It isn't necessarily about being "scared" of a medicated hospital birth (if it's medicated there are often many other interventions part of the equation). It's about wanting to take a different approach to what is routine practice. Also, a lot of cognitive biases appeal to our emotions. Heck, there are a host of logical fallacies used and relied on in support of a great deal of practices and routines. Presenting evidence for X side with the available data is showing adequate support, and it would behoove anyone to actually research and read the literature no matter what they choose.

There are those who are "mainstream" minded who rely on their own cognitive biases and some physicians with a narrow and limited scope of practice are guilty of such. Only when we're exposed to other practices and we weigh them against evidence-based data do we really see a practice or method for what it truly is. Telling women "Your baby will die!!!!!!" if you don't do X or if you do X is an emotional response and appeal, a common scare tactic, and one used often to browbeat women into consenting to a host of practices. When people rely on outdated information and misconceptions it distorts reality.

Various practices and interventions have risks. It makes sense to know what those risks are. When people falsely argue "Well, my cousin's hairdresser's friend's sister's baby would have died if she wasn't in the hospital!!!! Birthing at a birth center or at home is dangerous!!!" ignores one major thing. Context. In what context did this situation play out? It is extremely rare for *true* emergent situations to arise in an undisturbed (not heavily managed) labor of a low risk pregnant woman.

Emergencies that necessitate immediate action:

Placental abruption

Cord compression

Cord prolapse

Amniotic fluid embolism

Uterine rupture

Uterine inversion

Postpartum:

Postpartum hemorrhage

The risks of some of these go up a lot when interventions are added to the mix. Cord compression is associated with amniotomy, which is the most commonly practiced intervention during labor. Is there really any reason to rupture membranes, other than the birth attendant's wish to "speed up" the laboring process? There's no evidence to support its routine practice. And it's just common sense that a baby moves more freely and the cord is better protected in an aquatic environment than without.

So, that being the case, why is this practice so routinely performed, and the vast majority of women who are induced or augmented have their membranes ruptured. I know very, very few women who managed to keep their membranes intact throughout most of their hospital labor/birth. It's practically unheard of.

And, we know from the evidence that uterine stimulants can and often do create unnatural and very strong contractions, often leading to uterine hyperstimulation and fetal distress. If nonreassuring fetal heart tones, late decelerations are noticed, a c-section eventually becomes necessary due to the distress... due to hyperstimulation as a result of the pitocin or misoprostol. Here is a chart that lays out what is done when decelerations are observed.

Oftentimes, when people regurgitate "X isn't safe" they're basing it off anecdotal evidence while ignoring the very real issues that played into the complication and emergency situation. Would mom or baby have needed that emergency c-section if other interventions weren't part of the equation. Likely not.

Also, for most hospital protocol, once a c-section is declared an emergency or necessary during labor they have 30-40 minutes between declaring it and having baby delivered. This is the guideline. Very, very few cases of obstetric complications result in near immediate or immediate loss of life.

"What is already known on this topic Many national bodies recommend that when a decision is made to deliver a baby by caesarean section because of fetal distress, the baby should be delivered within 30 minutes

There are no clear classifications of what is urgent nor any evidence that this standard is achievable in routine practice"

and:

"What this study adds Delivery within 30 minutes is achievable in only two out of three cases; 88% will be delivered in 40 minutes; up to 4% of women will remain undelivered at 50 minutes

Delay in delivery made no difference to the rate of admission to special care for babies over 36 weeks' gestation."

Source

What the above says, is the attitude and scare tactics of "Your baby is going to die NOW!" or "What if something goes wrong and you're not at the hospital to receive life-saving procedures"... you mean the life-saving procedures that take 30-40 minutes to remedy via c-section? If they were truly "mom or baby are going to die now!" emergent, the majority would be stat c-sections, in way under 30-40 minutes.

The sort of "what if" situations and emotional appeals that many use to argue against out-of-hospital birth very rarely happen, and when they do happen, they often occur *before* the onset of labor or at the very beginning of labor, before mom can be admitted. Like, for instance, mom's membranes rupture and the cord is presenting -- cord prolapse. This is an emergency situation, but one that can happen spontaneously at any point, and one that can occur more often when membranes are ruptured to induce or augment labor when the baby is not well-seated or engaged in the pelvis.

Cord compression is another serious situation, and the risks of compression increase when membranes are ruptured, as they're often done in the hospital. So, when a complication arises, is it *really* a case of "birth gone wrong" or "birth can be dangerous so better safe than not" or is it "X intervention was introduced and it led to x, y z." Based on the available and current, critical evidence, it's the latter. Very rarely does a uterus become hyperstimulated when uterine stimulants are not part of the equation, and the same for decelerations and fetal distress.

The process of logical deduction, analyzing the situation, the context in relation to the events/practices, the current data/literature, makes it quite clear that the basis for better management of labor/birth for low risk women is not about mere "opinion" on a bed of fluffy and fuzzy emotional appeals for blissful birth experiences for the sake of going "au naturel." It's about evidence-based practice.

In the end, you and everyone else are free to labor and birth however and wherever you please. Your baby, your body, your choice. But the decision to opt for low intervention or natural birth (no matter the location) is not about some flowery, whimsical, fluffy, or as some believe, unrealistic fantasy of a "perfect birth." It's simply desiring a labor and birth that follows evidence-based approaches.

(Oh, and before anyone attempts to claim this position "ignores" the usefulness of technology and medicine, I'll save you the time and state I'm very familiar with the situations that require and necessitate immediate response and action. C-section saves lives in emergent situations. Obstetrics is a surgical specialty. It absolutely has its place.)

AllTheTeaInChina · August 2014

I didn't really have a method, just kinda winged it. I did take a "generic" childbirth class and learned some relaxation techniques. I was determined to go drug free and did. I delivered in a hospital but was never pressured into an epidural. No one even mentioned it after intake. I didn't get an IV but did have constant fetal monitoring. The belt didn't really stay in place though, I was standing, sitting on a birthing ball, etc. I was able to use the shower too. My water didn't brake after 12 hours of labor and 1 hour of pushing and DD was stuck. The nurse asked if I wanted the dr to come in a break it. I agreed because I was so tired and ready to be done. Things moved much faster after that.

I read about hospitals not being natural birth friendly and wanting to speed things up but my experience was nothing like that. I was prepared to put up a fight but didn't need to. The hospital was busy too, they actually "closed" and stopped admitting new patients because all the L&D rooms were full. I was never pressured into anything. My L&D nurse was great though, I'm sure that makes a big difference.

BankerBSN · August 2014

aeonlux said:

Ainslie325 said:

It's worth mentioning that like all documentaries, The Business of Being Born is not the unbiased truth; it's an argument for one particular position in an issue. It's a very compelling one that makes excellent use of the three rhetorical appeals--including the evocation of emotion from viewers and the use of expert testimony--in order to sway viewers to a certain point of view supported by the filmmaker. I only make this point to share that a person need not be any more scared of a medicated hospital birth than an unmediated birth. Both are safe, valid choices with pros and cons that tip based on the specific wants and needs of the individual. Good luck, OP! It looks like you've gotten some good info here from moms with unmediated birth experience!

It isn't necessarily about being "scared" of a medicated hospital birth (if it's medicated there are often many other interventions part of the equation). It's about wanting to take a different approach to what is routine practice. Also, a lot of cognitive biases appeal to our emotions. Heck, there are a host of logical fallacies used and relied on in support of a great deal of practices and routines. Presenting evidence for X side with the available data is showing adequate support, and it would behoove anyone to actually research and read the literature no matter what they choose.

There are those who are "mainstream" minded who rely on their own cognitive biases and some physicians with a narrow and limited scope of practice are guilty of such. Only when we're exposed to other practices and we weigh them against evidence-based data do we really see a practice or method for what it truly is. Telling women "Your baby will die!!!!!!" if you don't do X or if you do X is an emotional response and appeal, a common scare tactic, and one used often to browbeat women into consenting to a host of practices. When people rely on outdated information and misconceptions it distorts reality.

Various practices and interventions have risks. It makes sense to know what those risks are. When people falsely argue "Well, my cousin's hairdresser's friend's sister's baby would have died if she wasn't in the hospital!!!! Birthing at a birth center or at home is dangerous!!!" ignores one major thing. Context. In what context did this situation play out? It is extremely rare for *true* emergent situations to arise in an undisturbed (not heavily managed) labor of a low risk pregnant woman.

Emergencies that necessitate immediate action:

Placental abruption

Cord compression

Cord prolapse

Amniotic fluid embolism

Uterine rupture

Uterine inversion

Postpartum:

Postpartum hemorrhage

The risks of some of these go up a lot when interventions are added to the mix. Cord compression is associated with amniotomy, which is the most commonly practiced intervention during labor. Is there really any reason to rupture membranes, other than the birth attendant's wish to "speed up" the laboring process? There's no evidence to support its routine practice. And it's just common sense that a baby moves more freely and the cord is better protected in an aquatic environment than without.

So, that being the case, why is this practice so routinely performed, and the vast majority of women who are induced or augmented have their membranes ruptured. I know very, very few women who managed to keep their membranes intact throughout most of their hospital labor/birth. It's practically unheard of.

And, we know from the evidence that uterine stimulants can and often do create unnatural and very strong contractions, often leading to uterine hyperstimulation and fetal distress. If nonreassuring fetal heart tones, late decelerations are noticed, a c-section eventually becomes necessary due to the distress... due to hyperstimulation as a result of the pitocin or misoprostol. Here is a chart that lays out what is done when decelerations are observed.

Oftentimes, when people regurgitate "X isn't safe" they're basing it off anecdotal evidence while ignoring the very real issues that played into the complication and emergency situation. Would mom or baby have needed that emergency c-section if other interventions weren't part of the equation. Likely not.

Also, for most hospital protocol, once a c-section is declared an emergency or necessary during labor they have 30-40 minutes between declaring it and having baby delivered. This is the guideline. Very, very few cases of obstetric complications result in near immediate or immediate loss of life.

"What is already known on this topic Many national bodies recommend that when a decision is made to deliver a baby by caesarean section because of fetal distress, the baby should be delivered within 30 minutes

There are no clear classifications of what is urgent nor any evidence that this standard is achievable in routine practice"

and:

"What this study adds Delivery within 30 minutes is achievable in only two out of three cases; 88% will be delivered in 40 minutes; up to 4% of women will remain undelivered at 50 minutes

Delay in delivery made no difference to the rate of admission to special care for babies over 36 weeks' gestation."

Source

What the above says, is the attitude and scare tactics of "Your baby is going to die NOW!" or "What if something goes wrong and you're not at the hospital to receive life-saving procedures"... you mean the life-saving procedures that take 30-40 minutes to remedy via c-section? If they were truly "mom or baby are going to die now!" emergent, the majority would be stat c-sections, in way under 30-40 minutes.

The sort of "what if" situations and emotional appeals that many use to argue against out-of-hospital birth very rarely happen, and when they do happen, they often occur *before* the onset of labor or at the very beginning of labor, before mom can be admitted. Like, for instance, mom's membranes rupture and the cord is presenting -- cord prolapse. This is an emergency situation, but one that can happen spontaneously at any point, and one that can occur more often when membranes are ruptured to induce or augment labor when the baby is not well-seated or engaged in the pelvis.

Cord compression is another serious situation, and the risks of compression increase when membranes are ruptured, as they're often done in the hospital. So, when a complication arises, is it *really* a case of "birth gone wrong" or "birth can be dangerous so better safe than not" or is it "X intervention was introduced and it led to x, y z." Based on the available and current, critical evidence, it's the latter. Very rarely does a uterus become hyperstimulated when uterine stimulants are not part of the equation, and the same for decelerations and fetal distress.

The process of logical deduction, analyzing the situation, the context in relation to the events/practices, the current data/literature, makes it quite clear that the basis for better management of labor/birth for low risk women is not about mere "opinion" on a bed of fluffy and fuzzy emotional appeals for blissful birth experiences for the sake of going "au naturel." It's about evidence-based practice.

In the end, you and everyone else are free to labor and birth however and wherever you please. Your baby, your body, your choice. But the decision to opt for low intervention or natural birth (no matter the location) is not about some flowery, whimsical, fluffy, or as some believe, unrealistic fantasy of a "perfect birth." It's simply desiring a labor and birth that follows evidence-based approaches.

(Oh, and before anyone attempts to claim this position "ignores" the usefulness of technology and medicine, I'll save you the time and state I'm very familiar with the situations that require and necessitate immediate response and action. C-section saves lives in emergent situations. Obstetrics is a surgical specialty. It absolutely has its place.)

You appear to have done quite a bit if research. May I ask where you are getting these statistics and research from?

soulcupcake · August 2014

@BankerBSN - A Guide to Effective Care in Pregnancy and Childbirth, a medical publication, was one of the first books I purchased when I became interested in the management of labor and birth. It is pretty much the "Bible" of evidence-based practice.

Abstract:

"This resource summarizes the most authoritative evidence available on the effects of care practices carried out during pregnancy, childbirth, and immediately after birth, and in addition to the details provided, the book concludes with six valuable tables that list the practices which are beneficial, those of unknown effectiveness, and those likely to be ineffective or harmful."

I also became familiar with publications by Marsden Wagner, a world renown perinatologist and neonatologist, and former WHO director of Women's and Children's Health. Michel Odent is another huge advocate for evidence-based practice.

And there's the Cochrane Library where procedures and practices can be looked up. This site is good because much of the topics/procedures are listed and linked directly to the studies that can be found on Cochrane. It's all in one place. Another good place is here.

haleyusf · August 2014

Ina May's books/resources have been hugely helpful for me so far in making me feel confident about approaching a natural birth.

JaymeeLH · August 2014

@aeonlux I seriously have a huge bump crush on you right now

docfizzle · August 2014

Talk to your doctor or midwife before you get too freaked out. Depending on where you live A LOT has changed in the way births are handled in hospitals since that documentary, maybe in part because of the film, if you have a good doctor who is low-intervention. For instance, there is more awareness about the whole epidural pitocin cycle, less routine episiotomies, more freedom to walk around. Nothing wrong with natural childbirth, but best not to be freaked out.

soulcupcake · August 2014

docfizzle said:

Talk to your doctor or midwife before you get too freaked out. Depending on where you live A LOT has changed in the way births are handled in hospitals since that documentary, maybe in part because of the film, if you have a good doctor who is low-intervention. For instance, there is more awareness about the whole epidural pitocin cycle, less routine episiotomies, more freedom to walk around. Nothing wrong with natural childbirth, but best not to be freaked out.

It very much is dependent on region/location. The PNW and other progressive areas may have more hospitals and physicians that follow a low intervention approach, but there are still many that haven't quite caught on. I live in Nor Cal, but in my county there are very few OB practices that favor low intervention approaches. UC Davis has a birth center that offers waterbirth, and there's a hospital near me that just opened suites with birth tubs. So, there are only a few that truly promote low intervention birth.

But the hospital closest to me, yeah, its protocols are far from low intervention. It has the highest c-section rate, and it assuredly not what most call "baby/birth-friendly." Certain areas are seeing progress, but it's slow progress, and one's options are still dependent on the individual's insurance and where they can be seen.

dianeg1017 · August 2014

STM here with DD I was forced into a no med natural birth after 2 days of labor and 3 trips to the hospital and kept getting sent home then got there the 3rd time and was too far along to have any meds. I don't think anything prepares you for the pain that you will experience but after watching the business of being born with my second one I'm actually choosing to go completely natural I figure hey I did it once I can do it again.

ebilbao · August 2014

OP here-thank you to everyone for such thoughtful replies. As I was writing my original post, I hesitated at using the word "scared". Perhaps I should have used the word "convinced" or "motivated". Either way, it's great to hear that so many of you have had low to no intervention births and have lived to tell the tale. Thank you especially @aeonlux‌ for such detailed info.

ebigelow8979 · August 2014

My husband and I just finished our hypnobirthing classes. I can say I officially have no fear attached with the pain of labor. I personally know women who have been hypno birthing mothers and it has been a wonderful peaceful experience for them. We switched from our OB and found an experienced midwife who will be delivering our baby, as well as a doula who will be going over and writing up our birth plan for us. I personally feel so much more comfortable with our new team, and new birth plan. Good luck and a peaceful birth to you.

Cryssteen · August 2014

Naked Ricki Lake was more than I bargained for. But it was a propaganda (anti-hospital) documentary, so other than that, it was pretty much what I expected. When I ignored the judgement about hospital births it was very informative about other stuff.

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