Self-study, self-doubt, skeptical husband... long, sorry.

mangomimosa · December 2014

Hi ladies. I'm so sorry if this is the same stuff you guys hear all the time - I truly appreciate any thoughts or advice for my situation.

TLDR: I need recommendations for a self-study med-free birth prep course. HypnoBabies, GentleBirth -- other options? I need something that's relatively affordable, and would *love* something I can listen to during labor. I want a low intervention birth because I'm a... science person...? So anything that's super fluffy/flowery/new-agey is not going to work for me. I can get on board with relaxation/meditation - but the idea of "hypnosis" makes me shudder. Not sure if that means HypnoBabies is truly out - advice/ideas??

I also need recommendations on how to prepare my skeptical hubby for supporting me during labor. He cannot go to a class & thinks a lot of labor stuff is cheesy, but is also a sweet guy who will support me as best he can. What helped your hubby, if you didn't go to a class? Are there good, non-cheesy books about labor support techniques?

----full story - thanks for reading, if you do ----

I'm a women's health NP who originally wanted to do midwifery, so I've read/watched a ton of NCB-oriented material. I consider myself well-versed in the physiology of birth and the risks/benefits of common interventions. I realized my personality meant I'd be an anxious "med-wife" instead of the easy-going midwife I wanted to be, so I ultimately decided not to catch babies. It made me sad to step away from this dream... so I pretty much stopped reading/thinking about birth ~4 yrs ago.

Now I'm pregnant, and trying to figure out how to prepare for birth. I am very wary of getting myself 100% geared up for a med-free birth, because I know I'll be extremely disappointed in myself if I "fail". I'm already at high risk for PPD/PPA and I think "failing" will be a huge trigger for me. So I think it's best for me to focus on goals of a safe, vaginal, low-intervention birth -- and to mentally give myself the freedom to use the epidural if I am not coping well. (I am aware this means I will probably get one. But we'll see.)

That said, I would love to experience a med-free birth. My plan is to prepare for one, to labor at home as long as possible, labor in water at the hospital, and delay an epidural as long as possible/never get one. I have chosen a midwife practice that is very much geared toward low-intervention birth.

Barriers that I'm worried about are

1) Me: I have always believed I could do this, after reading a ton of med-free birth stories, watching DVDs, and even being present for a few. But then, I got an IUD. The pain so intense that I passed out. It was absolutely the worst pain I've ever experienced. My first thought was - I'll never be able to have a med-free birth. Then, last weekend, I had a PTL scare and had very painful contractions for 3 hours. I was so exhausted, I wanted to die. The thought "I WANT AN EPIDURAL" totally crossed my mind (whereas "I should call the midwife" did NOT cross my mind, which is ridiculous... thankfully all is well now.) Now, I did have a virus that triggered this (and lovely GI symptoms with it!), but still -- the "I'll never be able to have a med-free birth" thought is still stuck in my mind.

2) My husband: He's supportive, but he's a doctor. He's been fully immersed in OB culture. And he's an emergency doctor, so he's very much geared toward symptom relief / watching for life-threatening situations. I'm going to have to work really hard to prepare him for this - probably harder than I'll have to work on myself. He wants to be supportive & says, "My role is to be your cheerleader!" but I can already see him trying to take over. I can also see him rolling his eyes when he sees the Bradley book I just ordered. But dammit, I'm going to make us read it together. I just don't know how to get him to step out of the King of Everything role that he embraces as a doctor. He thinks he knows the solution to everything. (I love him. But he's in residency, so he works 6 days/wk, and it's hard for him to get out of that role right now.) I know that I'll need him to be firmly in a support person role & need to find a way to get him to offer suggestions instead of give orders.

3) We can't do a birth class. It just doesn't fit in his schedule, no matter what - and I'm not going alone. I'd rather spend the money on a home study course, given my background knowledge. I'm looking for some recommendations on a home study course that isn't too... fluffy/cheesy. I just can't handle that kind of stuff & my H will *not* be on board! I've got the Bradley book coming in the mail, and I'm interested in finding some books (or DVDs??!) about labor positions/support person techniques.

:::phew::: if you made it through that, thanks. Sorry to make such a long post. I really appreciate any thoughts/experience/ideas!!

SidraJedi · December 2014

Active Birth was a good read and not too hippy dippy. It was mostly about laboring and birthing positions. It would be a good book for your h to skim through so he could refer you to some labor positions if you forget all you've read when you're in the zone.

I really loved birthing from within. It made me feel more confident but it is way new agey so you may not like it.

KateLouise · December 2014

Hi and welcome. I don't have any course or book recommendations, I just wanted to make a couple of comments.

1) I know lots of people say that if you leave yourself open to an epidural then you will end up getting one. That wasn't my experience. I wanted a natural birth, but was open to the epidural if needed. As it is I had a fairly straight forward, 7 hours of active labour with an hour and a half of pushing.

I think a lot of it is exhaustion and not knowing how much further you have to go, rather than the pain itself. If you knew you had 10 contractions to get through, then just about all of us could through it no problems by just working through each contraction. Yes it's painful, but it is pain from your body working hard.

So I would look at strategies to help keep your energy up. Sleeping when you can in early labour, eating well, having things like juice on hand to keep energy up but easy to consume etc.

2) For DH he was all about using the epidural. He saw no purpose in putting up with pain. But once he heard about the potential risks he was totally on board with a natural birth, and saw that his role was about being my cheerleader and providing what physical comfort he could.

The epidural is an amazing tool when it's needed. But if your body was in pain from climbing a mountain the most useful thing wouldn't necessarily be to give you drugs that take away your sensation and muscle control. The most useful thing would be to keep you relaxed, hydrated, nourished, and to provide relief to your muscles whether through massage or warm water.

The epidural comes into its own when your body is so tired it is no longer working effectively, and it gives you the break your body needs.

So although your husband has a wealth of medical experience, maybe talk to him about what he can do to support you in, "climbing a mountain" whilst also appreciating that he might be able to spot when you are at the wall.

Anyway that's my experience. I can honestly say that as hard as childbirth is, because it is hard work, I also truly love giving birth. The medical tools are wonderful and I am fortunate that I didn't need any of them. For me a big thing was just working on one contraction at a time.

Best wishes to you for a wonderful birth!

mangomimosa · December 2014

@KateLouise‌ thank you, that is so incredibly helpful!!

And I will definitely check out Active Birth.

pblge · December 2014

I'm in a relatively similar position as you, so I'm reading to learn more than anything, but I do have two thoughts to add. First, try reading the Ina May Gaskin birthing book if you haven't already. It's very interesting in terms of her thoughts about how the mind can get in the way of birth, and about how anxiety and ambivalence (and interventions) can actually make the pain worse. Might be worth considering in your case. Second, I'll bet that your husband will get on board with a natural birth if he reads more of the science. A lot of people say that obstetrics in the US today isn't "evidence-based," meaning that there's actually evidence suggesting that the way things are typically done is bad, but it's still how they're done. I'm a professor and researcher and went into my reading on birth thinking pretty much how your DH does, but it didn't take me long to realize that the best outcomes for me and my baby would likely come from a low- or no intervention med-free birth.

HTH. Good luck!

mangomimosa · December 2014

pblge said: I'm in a relatively similar position as you, so I'm reading to learn more than anything, but I do have two thoughts to add. First, try reading the Ina May Gaskin birthing book if you haven't already. It's very interesting in terms of her thoughts about how the mind can get in the way of birth, and about how anxiety and ambivalence (and interventions) can actually make the pain worse. Might be worth considering in your case. Second, I'll bet that your husband will get on board with a natural birth if he reads more of the science. A lot of people say that obstetrics in the US today isn't "evidence-based," meaning that there's actually evidence suggesting that the way things are typically done is bad, but it's still how they're done. I'm a professor and researcher and went into my reading on birth thinking pretty much how your DH does, but it didn't take me long to realize that the best outcomes for me and my baby would likely come from a low- or no intervention med-free birth.

HTH. Good luck!
Oh perfect -- I just picked that book up from the library. I've just been staring at it because Spiritual Midwifery was super trippy for me (I suppose it...just...is super trippy) but you're right- I need to just open up to her ideas. I have this voice in the back of my mind that says these self-doubt issues will become major stumbling blocks if I don't address them now.

And for my H...I've tried so hard. He's a huge science person, too. He's aware of the evidence but also, having been trained in medicine, cannot just throw everything OBs do out the window. Even in his own field there are things they do that aren't totally evidence based, but experience-based, or just practical, or whatever - and he will often just side with ACOG because of this doctor allegiance thing. You should have seen us go at it when the ACOG position on water birth came out this year... He just has a different philosophy about birth & has seen some really scary things.

Plus re: avoiding epidural - Cochrane says it doesn't increase risk of c/s, so I can't make a strong case of why I want to avoid one except I just would be totally jazzed to bring my son into the world without pain meds, if possible. I have to decide when if/when the tool is needed, and I think that's a point to discuss with him. The trick will be figuring out how to get him be supportive of med-free/not suggest epidural until I make the call.

I know I'm being super long-winded here & I don't need anyone to read all this babble. It's really helping me to think about this "out loud" though.

pblge · December 2014

Perhaps you and your DH can meet halfway on some of this stuff. Unless you feel strongly, maybe you can agree not to deliver in water, but that he would accept that maybe you could labor in water (per ACOG recommendations).

C/s aren't the only bad possible outcomes, and epidurals definitely increase the risks of other things. For me, my interest plummeted the second I read that the medicine in epidurals crosses the placenta, and that there's not a lot known about how that affects babies. There's some evidence that they have more trouble breastfeeding, for example (first pubmed ref that came up, there are others). There's also evidence that epidurals cause more fetal distress and more forcep/instrument use in labor, both of which are risky.

If you really want to do this without medication, and he's not going to support you, you might try having the conversation about whether he should be in the room with you. It wouldn't be crazy not to, as there are broad swaths of history in which having not men present was normal. If you really feel strongly about a natural birth, he needs to either accept this and support you 100%, or get out of the way.

Hope that doesn't sound harsh. It's possible that talking with him about it this way will help him see how strongly you feel about it.

Ducktale · December 2014

Is a doula an option?

I'm also not in to the flowery new age stuff. I know everyone recommends the Ina May books but they were a little hippy for me. I really really liked Natural Hospital Birth - The Best of Both Worlds. The Bradley book is also good, I'm taking a Bradley class though. Something I'm learning is how important it is to practice relaxing. That might sound silly but I think it will really help for relaxing to be an automatic thing.

massiejs09 · December 2014

mangomimosa said:

pblge said:

I'm in a relatively similar position as you, so I'm reading to learn more than anything, but I do have two thoughts to add. First, try reading the Ina May Gaskin birthing book if you haven't already. It's very interesting in terms of her thoughts about how the mind can get in the way of birth, and about how anxiety and ambivalence (and interventions) can actually make the pain worse. Might be worth considering in your case. Second, I'll bet that your husband will get on board with a natural birth if he reads more of the science. A lot of people say that obstetrics in the US today isn't "evidence-based," meaning that there's actually evidence suggesting that the way things are typically done is bad, but it's still how they're done. I'm a professor and researcher and went into my reading on birth thinking pretty much how your DH does, but it didn't take me long to realize that the best outcomes for me and my baby would likely come from a low- or no intervention med-free birth.

HTH. Good luck!

Oh perfect -- I just picked that book up from the library. I've just been staring at it because Spiritual Midwifery was super trippy for me (I suppose it...just...is super trippy) but you're right- I need to just open up to her ideas. I have this voice in the back of my mind that says these self-doubt issues will become major stumbling blocks if I don't address them now.

And for my H...I've tried so hard. He's a huge science person, too. He's aware of the evidence but also, having been trained in medicine, cannot just throw everything OBs do out the window. Even in his own field there are things they do that aren't totally evidence based, but experience-based, or just practical, or whatever - and he will often just side with ACOG because of this doctor allegiance thing. You should have seen us go at it when the ACOG position on water birth came out this year... He just has a different philosophy about birth & has seen some really scary things.

Plus re: avoiding epidural - Cochrane says it doesn't increase risk of c/s, so I can't make a strong case of why I want to avoid one except I just would be totally jazzed to bring my son into the world without pain meds, if possible. I have to decide when if/when the tool is needed, and I think that's a point to discuss with him. The trick will be figuring out how to get him be supportive of med-free/not suggest epidural until I make the call.

I know I'm being super long-winded here & I don't need anyone to read all this babble. It's really helping me to think about this "out loud" though.

I'm reading Ina May's book now and I love it. I feel like the message is really about working with your body (not against it) and having trust in yourself. She stresses that relaxation is key.

I am also planning to labor at home for as long as possible before going to the hospital. Being in my home environment is where I know I will be able to be the most relaxed. I told my H he has to be on board and supportive even if some of the things I might ask him to do seem strange or weird. And above all else he has to remain calm.

While it is impossible to know how everything is going to play out when it is actually time, at the very least I can educate myself enough to gain more confidence in my ability to have the birth experience I want.

painttheair14 · December 2014

You mentioned that you "can't make a strong case" against an epidural.

I just thought I'd share some reasons you may want to avoid one:

-It restricts your movement and confines you to bed (the worst pushing position)

-Often, it helps move labor along to move positions and you can't with an epidural

-You can't feel contractions, so you have to rely on others to tell you when to push instead of listening to your body.

My personal experience is that I had one birth with an epidural and one without. The one without had a much better pushing stage and resulted in far less perineum damage. Now, that could be due to many things and not just the epidural, but I credit a lot to being able to listen to my body and move around.

Of course, either way (epidural or not) is a completely valid choice. I just thought I would give you some more facts.

MitoRachel · December 2014

I've always gone into birth with the idea that if I need an epidural that's okay. I've never even considered it while in labor, and I'm a pretty big wimp. You're labor may be different, but that's okay too.

Before I gave birth to my first I was pretty limited as to what positions I could have sex in without pain because everything was so tight and I thought pap smears were rather traumatic, and yet I was able to birth a 9lb. bobblehead without any crazy difficulty. Are bodies are pretty amazing like that.

I had a PTL scare with my second. Those contractions hurt more because you are totally freaked out. "What's going on? What am I supposed to do? Make it stop!" I wasn't even sick at the time! If I had been, I'm sure I would have been a total basket case.

All to say, people aren't being silly when they talk about how our bodies are made to do this.

jennypolkadots · December 2014

We've really liked reading through "Natural Birth the Bradley Way" together. We took private classes, but I had already read the book at that point and found it very useful. Aside from this, I would try to get out there and connect with other women in your area that are planning or have had a natural birth. Classes are the easiest way to do this and many classes are not that expensive, there is nothing wrong with going alone or bringing a friend. I have found many women though prenatal yoga, la leche league meetings, cloth diaper meetings, and through my midwife. I also have several women in my family that have had a natural birth and only have positive things to say. I find that talking to real people helps more than anything to let me know that I definitely can do this, barring any emergencies outside of my control. I tune out all the naysayers, as there are plenty!

I don't think you can compare labor pains to the pain of getting an IUD removed. Labor is natural pain with a purpose and usually described as "clean pain" similar to bad menstrual cramps. Just the thought of an IUD removal makes me incredibly squeamish/light headed.

It's important for your husband to open his eyes and realize that childbirth isn't an illness. It is something totally different than what he is likely being taught and the vast majority of labors require no intervention to end with a healthy mom and baby. I think he will like the Bradley Method, it gives a lot of useful information and I didn't find it hippy dippy at all. Hypnobirthing and Ina May's books both were very Hippy Dippy to me, although I still enjoyed them. Good luck on your journey! You can do this!

jess9802 · December 2014

Years before having a baby I thought I'd want to have a natural birth. I was fairly immersed in the idea of it, which is why I have long lurked on this board and occasionally post here.

Ultimately, though, due to chronic hypertension I had a high-risk pregnancy, and at some point realized I was likely to be induced. At that point I decided I was going to just go with the flow and not try to worry about controlling the outcome of a process that can be wild and unpredictable. I trusted my OB (who has a 5% primary C-section rate). I read up on epidurals and their safety, and read reliable information. There is a wonderful blog (now mostly defunct) published by a Canadian anesthesiologist, The Adequate Mother. You can read her posts on epidurals here: https://theadequatemother.wordpress.com/category/epidurals/ Caveat: she is not terribly sympathetic to the NCB movement, especially the misinformation that is often disseminated regarding epidurals (some of which has been repeated in this thread).

My personal experience: I was induced. I walked around with my portable IV and telemetry monitoring. Eh, it was okay. I tried the birthing ball. Hated it. Tried the jacuzzi. Loved it - but at a certain point, it was no longer helpful with the pain. I was in terrible pain. Worst pain of my life. Honestly, it did not feel like pain with a purpose. It just hurt, unlike anything I've ever experienced before. (My son was thought to be OP.) I requested an epidural, dutifully waiting until I was 4cm. H.E.A.V.E.N. Of course, I dilated so rapidly thereafter that I didn't get as much rest as I'd wanted, so I was pretty pissed when it was time to push a mere three hours later. The epidural was turned down when I was complete so that I could feel when to push. I started pushing spontaneously which freaked me out. So obviously I could feel when to push (which I didn't really like; it hurt and it was hard work. So very hard). I pushed for about 40 minutes before my son was born. He was alert after the birth. It took us a while to get the hang of breastfeeding - not related to the epidural - but I did end up BF for 19 months.

I don't think there's anything wrong with natural childbirth or even striving to have one. A good friend of mine had one with her second baby and loved the experience. When it goes well, it can be very exhilarating. That being said, I also don't think there's anything wrong with wanting or having an intervention-heavy, highly medicalized childbirth. What I do think is regrettable is setting your hopes on a certain outcome over which you ultimately may have little to no control, especially if you think you may be at risk for PPD.

I guess I'm posting a response to you on the NCB board because while I'm fairly neutral on the idea of pursuing NCB if that's what you want, I am very much in favor of giving yourself permission to want something else, no matter what your past interests might have been. I think finding alternate ways of coping with pain is great because epidurals don't always work, or the anesthesiologist may be delayed. But ultimately, if you decide during labor that you've had quite enough of the pain and want the epidural STAT, then you should feel zero guilt over making that decision, and you should absolutely not feel like you failed or harmed your baby or anything of that nature.

Good luck, and congratulations.

MommyAtty · December 2014

I've had 2 natural births. Both times I went into it willing to have an epidural if I felt I needed it. If I hadn't given myself that permission, I know I would have ended up with the epidural. It's just the way I'm built. I think the idea that if you're open to it, you'll take the out is bunk. Your DH needs to realize this delivery is about you, not about medicine. I happen to agree with him that OBs are knowledgeable and definitely have their place. Mine was instrumental in helping me have a med-free birth. And both times, DH and I did a one-day prep course. That's it. No Hypnobabies. No Bradley. No Hypnobirthing. No Ina May. Just me trying to relax and listening to my body and my birthing team.

thenaturalrn · January 2015

Ina May's guide to childbirth was so empowering. It's a book of all different experiences and methods the women used during. I went through the bradley method childbirth classes and didn't remember a darned thing, but those stories I read did and my husband still talks about my horse lips (blowing air out closed lips) during contractions. It really helped though!

My husband was a true skeptic at my wish to deliver at a birthing center (paramedic), but his experience was SO POWERFUL! He said he can't imagine having our second at the hospital

Best of luck!!

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Self-study, self-doubt, skeptical husband... long, sorry.

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