On epidurals

I just found an interesting abstract on epidurals… I’d like to read the whole thing and may have to break down and buy the issue of Midwifery Today so that I can. It basically sums up epidurals as being given so much because a woman’s friends are doing it and likens anesthesiologists to drug pushers.

This year, about two million women will get an epidural legally, but hopefully not lethally, in the US. As a result, about eight of them will never walk unassisted again. In Westernized countries, roughly 50–70% of birthing women have epidurals for pain relief. Research on who gets an epidural and why draws a profile very similar to the people who were taking drugs in the ’70s. Most women are getting epidurals because their friends are doing it.(1) In a recent, large study of epidural users, the most often cited factor in deciding to have an epidural was having heard about positive experiences from friends and family. Having already had children and having fear of the side effects of an epidural each reduced the odds of choosing one by half. In other words, the older or wiser women get, the more they avoid the epidural trip. Overall, those who did not choose an epidural reported wanting to be in control and having more confidence in their ability to tolerate labor pain.(2)

Go here to read more of the abstract.

After having an epidural, I knew immediately I never wanted another. I didn’t appreciate not being able to feel anything at all during the experience. I did not like not being able to move. I didn’t like the feel of the nurse and my husband holding onto my legs in an effort to “help” me push the baby out. Above all, I didn’t care anything for the fact that, even since that epidural, I’ve had countless issues with my bladder. I would only learn after the fact that that’s a pretty common side effect of epidural.

Not to mention the obvious factors of risk to baby and the fact that, after a cesarean, it’s vitally important to not have an epidural because, in the rare event of a uterine rupture the woman will never know, thereby posing a much larger risk of death. Definitely a risk I do not care to take.

A tale of two births

All this talk about babies – okay, okay, I’ve been the one doing the talking – has got me thinking. Noah’s birth was so much more peaceful and calm than Elias’.

Prenatal care
With Elias:

  • I rotated through the three doctors in the practice
  • Appointments were quick, I spent more time with the nurse than the OB
  • I was told that I was in the minority for wanting to have a VBAC
  • I never felt as though I was taken seriously
  • I did not feel cared about, as though I was just a number
  • I felt like the doctors thought they knew my body better than I did
  • I really did not like the exams
  • The OBs freaked out when I went past the “due date”

With Noah:

  • Appointments were longer and spent with the midwife
  • I felt listened to and believed
  • I felt cared about
  • The vaginal exams were few and far between
  • It was made clear to me that I was not in the minority for wanting a VBAC, my choice was actually encouraged
  • No one freaked out when I went past the “due date,” we discussed things and they didn’t start to worry unless we approached 42 weeks

With Elias:

  • Went to hospital waaay too early – kind of got bullied into that
  • Labor was controlled and augmented with Pitocin that was not allowed to be turned off due to threat from the doctor that she would section me if it wasn’t turned back on

With Noah:

  • Went about my day, ate, drank, lived as normal
  • I waited to go to hospital until I was feeling the need to push
  • Mostly calm environment – once we got in the room

With Elias:

  • I was on my back with my legs being held up by my husband and a nurse
  • I felt very humiliated and embarrassed
  • The doctor told me to stop making noises when I was grunting as I tried to push
  • After I tore, Jon was shooed away from me while I was being sutured
  • The doctor sutured me up so tight that I had pain and tightness for months afterward
  • Elias was put on my chest momentarily before being whisked away

With Noah:

  • I laid on my side to push him out with Jon standing beside me
  • Noah was immediately put to my chest to feed where he stayed for some time
  • I was asked if it was okay to take him and weigh him, etc.

I attribute the difference between the two births to a number of things: The second time around I went to Nurse Midwives of Indianapolis where the Certified Nurse Midwives (CNMs) have views on birth that closely match my own, i.e. if it ain’t broke….

Also, we went to Methodist where the nurses are much more accustomed to seeing natural birth, unlike when we were at Clarian North. Clarian North would be later described to me as “perfect” for those moms who don’t want to mess their makeup.

I also read a lot. I re-read a lot of the books that I had read – or skimmed – before. I especially enjoyed reading Ina May Gaskin’s Guide to Childbirth and Penny Simkin’s The Birth Partner. I do firmly believe that both books played a large part in my having the natural birth I wanted.

If I do it again, I would like to consider a home birth. I definitely would want a water birth, regardless of where it would take place. But, of course, that all depends on whether or not we have another one. Now, I realize that realistically we don’t have space in our house for another person. I do get that. I have hopes – we both do – that we will be able to find some land within a few years and literally make a home for ourselves.

Noah’s grand entrance

Contractions began at about 3 am Monday morning. They continued off and on all day. We went to the scheduled appointment at the birth center where they did an NST. Once everything was confirmed to be okay with baby, she wanted to check to see how far dilated I was. I seemed to have surprised her when she discovered I was right about 4.5 – I don’t know if I was too calm or what. Next, I was told to go home, stay active, hydrated, and be certain to eat.

We began making arrangements to get the kids taken care of. My mother took our daughter with her. We then met Jon’s parents in Avon for supper and passed off the little guy to them. Contractions sped up to about 8-10 minutes apart during supper. We then proceeded to go home and try to get ready.

Contractions held pretty steady around ten minutes apart, after a bit of fluxuating to about 12-14 first. I started feeling a little chilled so I decided to jump in the tub. I stayed in for a while until I got bored. It was nice and very comfortable while it lasted, however. I got out and lounged on our bed with a book for awhile.

We watched Bones and Two and a Half Men that we had DVR’ed previously. I honestly don’t recall if this was before I got in the tub the first or the second time.

It wasn’t too long before things began to get harder to deal with. I felt like I just really had to poop. I sat on the toilet for awhile, frustrated because I couldn’t do anything. I kept peeing though. Every time I thought I was done peeing, I felt more coming out, which rather confused me as I sat there. Finally, I decided to get back into the tub. It didn’t help. I felt even more like I needed to poop. It was odd because I wanted to try to poop right there in the tub, which completely baffled me at the time!

Out of morbid curiousity, I inserted a finger inside to feel if anything was going on. I felt something very hard, which puzzled me. I could not figure out what on earth would be so hard that I could feel.

The heat of the water started making me feel sick, which helped even less. Jon started putting some cold water in to try to cool it off. It helped, but not much. The heat made me feel like I was going to vomit. Finally he got the water cooled down, all the while trying to get me to get out. At one point, I was half hanging out of the tub in much pain. He finally convinced me and helped me climb out.

I laid naked on the bed, miserable. He had already turned the ceiling fan on high. I asked him to open a window. I kept on with that constipated feeling as I was racked with pain. Finally, Jon phoned Barb (the CNM) who (I believe) suggested we get to the hospital. Andrea (another CNM) had already let her know we would almost definitely be phoning that same night.

He finally coerced me off of the bed, although I still stood leaning over the bed sort of swaying back and forth. I tried to reach down to get my pants on, but was unable to. He had to help me get my pants on. Bending over was just not possible at this point. Sitting was even more unimaginable, although there was not much other way to get to the hospital.

Once we got to the car, I laid the seat back as far as it would go. The Jimmy Buffet CD I had been listening to earlier was still playing. I was able to focus on that fairly well. You wouldn’t think Buffet would be terribly conducive to laboring but, oddly enough, it did help.

I won’t lie. The ride was fairly miserable. The pain became almost constant – no real reprieve at all. Finally, we got to the hospital. Jon told me he could either drop me off at the front or I could stay with him and walk from the garage. I opted for the latter. I was not about to be by myself at this point!!

We parked, Jon grabbed pretty much everything leaving me to grab my pillow and we began walking. And walking. Every once in awhile I had to stop, grab the wall, and hold on, all the while feeling that strange needing-to-poop feeling. After the pain would somewhat subside, I would then be able to continue walking. Finally we get into the lobby where Jon said something about a wheelchair. I wasn’t sure that I wanted to sit down, but I also wasn’t sure that I wanted to keep walking. I decided to sit down.

We went up to the third floor only to find that we were at the wrong doors – after 9 pm they get locked. We went to the other doors only to find out that we had to go back downstairs to another set of elevators entirely to come back up to the third floor.

Once we finally got in, the nurses immediately knew who we were. We went into the room that was waiting for us. I don’t recall a lot of what went on while I continued feeling miserable. At one point, the nurse asked me to use the toilet. I sat there, peed, and suddenly realized that I needed to poop so badly. I started bearing down, trying unsuccessfully. At this point, I knew something felt off. I reached down and touched my vulva to feel what was going on and felt something hard. It startled me and I snatched my hand back. It took me a moment to get it together and I felt again, only to feel nothing abnormal.

I had been bearing down off and on. At one point, the nurse asked me if I felt like pushing. I said I didn’t know. It was about this time that she came in and insisted I get off of the toilet. I would later learn that my grunting had alerted the nurse, who was calling frantically trying to get anyone to respond and come to help.

The nurse walked me to the bed. It wasn’t terribly easy since I was walking bowlegged at that point. She had me lie down on the bed in order to wrap the straps for the baby moniters around me. I really wanted to be doing anything but lying down. She kept trying to get me to lie flat and I kept telling her no. I wanted to be upright but she wouldn’t let me, telling me I couldn’t without the midwife or an OB there. I was so angry!! Finally I rolled over on my side and refused to lie on my back.

I kept bearing down – by this time I had figured out what was going on with the feeling to poop that I had been having – and I felt this odd burning sensation. I remember hearing “rimming” used twice by the nurse. It was then that I decided I wanted the baby out and I wanted him out right then!! At one point, Jon told me the baby was out. I yelled back, “No, he’s not because I can still feel him!!!!” It was about then that I felt almost a woosh and the burning was gone.

Finally, Barb rushed in. Jon would later tell me that she ran into the room, donned some gloves and got to me just in time to catch the baby.

Noah was born at 12:06 am on 21, April 2009. He was 8 lb 15 oz and 21 inches long. He’s so tiny!!!!!!