Friday, January 16, 2009

The Needs of a Laboring Woman Are More Easily Achieved at Home

A woman is labor has specific needs. These include darkness, solitude, quiet, abdominal breathing, physical relaxation, the right to move around in different positions as she needs to, and support and encouragement from those around her. These are not in any particular order.

In "Orgasmic Birth", midwife Ina May Gaskin talked about how birth used to take place in a woman's bed, likely the same place the baby was conceived. When birth moved from the woman's bed to the hospital, everyone pretended that there was no sexual nature to birth. When a woman feels free to make laboring sounds, she sounds like she's having (great) sex. This makes people uncomfortable. The drugs used in childbirth take care of this "problem".

Some women are, what I call, silent birthers. Some are not. It really doesn't matter which category she falls into. What does matter is that women feel free to do whatever they need to during their labor and birth. Often, a woman who is vocal during labor is perceived as not handling labor well. This is not at all true. Deep, abdominal breathing and sounding it out as she exhales, is very beneficial for mom and baby. Baby is getting good oxygen and mom's vocal cords remain open and loose. It's very hard to tense up when she's breathing and sounding out her contractions in a low relaxed voice. I have a friend whose husband had kidney stones a few years ago. He found himself using some of the Bradley techniques they'd learned with the birth of one of their children. He said that he definitely learned that the low, controlled sounds were much more soothing and relaxing than the high-pitched sounds that created tension.

A woman no more wants to be watched in labor than she does when she's having sex. I'll return to a comment from Ina May (gotta love her!) that we have "shy sphincters". It's no wonder women are diagnosed with "failure to progress" so often. A woman really needs to be left alone to labor. It cannot be rushed. Adrenalin is the opposite hormone from what a woman needs to release in labor, which is oxytocin. If an animal is laboring, she will go off by herself, to her home where she feels safe and knows her surroundings well. If she suddenly feels threatened by a predator (in this case the doctor threatening a c-section), adrenalin kicks in and labor will stop. It will only resume once she feels safe again. In a hospital, this opportunity usually does not present itself again, as the baby was most likely surgically removed from its mother's body. Bottom line -- a woman needs to labor where she is comfortable and not rushed or watched.

Bright lights are not conducive to relaxation. Imagine if you dimmed the lights right now in your room. Wouldn't you automatically feel more relaxed and private? Bright hospital lights are often the first thing a new baby sees after its birth -- not very relaxing to the baby either.

A woman in labor is "in labor la-la land" when she doesn't have drugs in her body. She is listening to her body and focusing on controlled breathing, relaxing, imagining the baby coming down and her cervix opening up. When people are talking in the room, it is extremely distracting to most women. The fewer people in the room, often the better. But in the hospital, a woman has little or no control over who is in the room at her birth. At home, she has total control over this and will usually put a lot of thought into exactly who she would like to attend her birth. She is very comfortable with this group of people.

I have written quite a bit about EFM, or Electronic Fetal Monitoring, on this blog, but it must be mentioned here again. A woman must move around in labor. Not just for her labor to progress, but to help her baby out. When the uterus contracts, it tips forward. When a woman is laboring on her back in a hospital bed, it hurts. When you are chained to the bed by the EFM, you cannot move. This is bad for your labor and bad for your baby. This is not good medicine. It is a legal issue. End of story. When a woman labors and births at home, this is not a concern. Her midwife will monitor the baby at least once an hour, which evidence has proven to be adequate. A baby truly in distress will be picked up.

Birth is a natural process. When I say this, everyone agrees. But I think that there are very few people who believe in the natural process of birth and trust it. Women are missing out on this wonderful experience because they are afraid. They are not bonding with their babies as they should. They are not breastfeeding as often or as long as they should. What is wrong with us?

I hope this has been helpful to those who think that it is irresponsible to birth at home. When you understand the needs of a laboring woman, you can start to understand how the hospital is not set up to cater to these needs. If a woman wants to have a truly natural birth, free of interventions, the only place she can do that in America, is in her own home, in her own bed.


Scott and Hannah said...

When my sister was pregnant with her second baby, she read a book (can't remember the name) that talked about the ways to achieve the baby, pregnancy, and labor that you want. She prayed very specifically for what she wanted her body to do for her and the baby. She would often talk to the baby and her body.

Her labor with that baby this past August was about 3-4 hours long. She labored much on her own and didn't even wake her husband to let him know how she was feeling. She relaxed and rested in between contractions. Her husband awoke moments before her water broke. Shortly there after her baby was born at home with the assistance of a midwife who arrived only minutes before the baby was born.

After the birth, I asked my sister what she was experiencing during labor. She said she was not afraid to let her body do what it was designed to do and that she really deep down felt like she wanted to labor in private. Her experience was wonderful for her.

As a doula, of course, I am there to assist if a woman desires emotional and physical comfort. But, there are woman who, like you wrote, will progress well on there own when left in peace to allow their bodies to do what they were made to do.

Sorry to write the novel! ;)

Bella said...

Hey Donna! I love your blog and read it often...but no way am I planning a home birth! Although, I would be a great candidate because my labors and deliveries are awesome! I have been getting tons of information from your posts, some I agree with, some I don't! I still remember being prego with my first and calling you and asking you TONS of questions! We are doing good and living in Michigan now. We will be here for another year and a half and then we are hoping to move back to NM or somewhere closer to family. I can't believe I am having baby #4! I'm a little freaked but excited. So, keep up the good work and I will keep reading! I might even comment, even if I don't agree! haha Have a great day!

Eric Jorgensen said...

I was reading about the guy with the kidney stones and thought, "gosh that sounds like what happened to me." Then it dawned on me that it *was* me! Yep, I was in my office, naked from the waist up yelling my head off. I have no idea what other people thought about it, but I can say it's important to be able to do what you body says.

Donna Ryan said...

I just love kidney stone stories, Eric! I must be a sicko -- they just make me laugh so hard. I hope I never have one. That would be the worst payback.

Jessi said...

Love it. Very timely post. I've been pondering lately the many similarities between sex and birth and how the conditions which are conducive to each are quite similar (privacy, low lighting, changing positions, rhythm).

Another characteristic sex and birth share is the turning off of the thinking part of the brain and going within one's self to do what instinctually feels right without logically thinking it through.

Jessi said...

Whoops just realized the original date of the post. Well, very timely REMINDER of this great post! sorry!

chewymama said...

Kidney stones are the reason I got into natural birth. I had them with my second pregnancy at 24 weeks and while at the hospital I was left alone in a hallway, waiting for an xray. In my despair, I slipped away into my mind, thinking of who I'd call when I left, what my mom would say, etc. The pain was gone during this time. suddenly someone else walked into the room and I snapped out of it and burst into tears. I knew right then I could handle labor without drugs if I could handle that pain.

When I found hypnobirthing I knew thats essentially what Id done when I had kidney stones. Blocking everything out mentally, whether there are people there are not, has really worked for me the last 3 times. Its much easier out of the hospital - I hated being there for my 2nd birth. Way too many people day and night.