Childbirth

I had so many childbirth and labor questions before our first child Hana was born, and I got tired of everyone saying, “Every labor is different.” I wanted to know all the possibilities that could occur. I guess I was impatient!

I have had three natural childbirth labors and I want to tell you something very important for you to remember during childbirth. Here it is:

• Your body knows exactly what to do during childbirth.
• Your body is built for growing & delivering babies.
• Your body will only give you what you can handle.
• Trust your amazing body!

Remember that you are not alone. As you are going through childbirth, so are literally thousands of other amazing, strong women at the exact same time as you.

My Childbirth Experience

My kids’ childbirth was an amazing, positive experience for me, all three times. I am very fortunate, I know that I had a positive childbirth and labor and I realize that not everyone is as lucky as me. But I do believe that if you prepare yourself through childbirth and labor education (reading books, reading websites like this one, taking prenatal classes, etc) and taking good care of yourself while you are pregnant, you will have a far greater chance of a pleasant childbirth and labor experience.

There are many things you can do to increase your chances of an empowering childbirth and labor experience. These are the things I did:

• Pregnancy yoga classes
• Regular Chiropractic care
• Chose a Midwife instead of a doctor
• Hired a doula to be with me throughout the labor and childbirth
• Took vitamins, folic acid and natural iron supplements
• Took an 18 hour prenatal class from a former midwife (NOT at a hospital)
• Lastly, I believed, truly believed that my body knew what it was doing. I was not scared at all about childbirth. I knew in my heart of hearts that pregnancy is a healthy state of being, and that my body would know exactly what to do when the time came. And it did!

So many people seem to enjoy telling stories of excruciating pain during childbirth and labor. Others will tell you their labor was 87 hours long! I do not know why women do this to each other. Yes, I will grant you, labor is painful. But it is also powerful and incredible what your body can achieve!

One important note: I am Canadian, and our medical system is much different than the United States. But I am aware that most visitors to my website are American, so that is why I often try to include American statistics and information. One major difference between our two countries is that midwives in most parts of Canada have hospital privileges, i.e. they are allowed to deliver babies in hospitals. They perform essentially the same procedures as doctors, except they do not perform surgery.

CORRECTION: One of my website visitors recently wrote to me to let me know that in some states midwives do, in fact, deliver babies in hospitals. Nicole wrote to say that she delivered her baby in a Wisconsin hospital with the help of a midwife. She said it was a great experience for her and that her insurance covered it, which is wonderful! Thank you very much, Nicole, for writing to me and setting the record straight. I appreciate it very much.

Back to the article… Whereas doctors view childbirth labor in terms of what can go wrong, midwives see childbirth and labor as a natural process and medical intervention is only necessary in the event of an emergency.

Questions About Childbirth

These are some of the questions I had before I gave birth the first time, and my responses. Again, I am not a doctor, so please ask your own doctor for clarification or more information.

Question: When does the average woman give birth?

Answer: A woman’s due date is determined to be 40 weeks after her last menstrual period, which is about 280 days. Most women go into childbirth labor very near their due date, but anywhere from 38 weeks to 42 weeks is normal.

Question: How do you know when you are in labor?

Answer: Generally, when childbirth labor starts, you have strong (generally more painful than period cramps) contractions, five minutes apart, which last for a full minute. You will know you’re in labor when you are feeling pain stronger than cramps. This is NORMAL. No one ever tells you this, so most women start to panic when they feel pain. They think, “Is something wrong with me?” No, there is nothing wrong. It is painful, but your body can handle it.

Question: What are the three stages of childbirth labor?

Answer: The first stage of childbirth labor is the longest and that is when your cervix dilates from 0 to 10 centimeters and becomes thinned out (or “effaced”). The second stage of childbirth labor is the pushing stage, which begins after you are fully dilated. The third stage of childbirth labor is after your baby is born and you deliver the placenta.

Question: How will I know if my water breaks? Will it happen during childbirth?

Answer: The bag of water, (the membrane that surrounds the fetus and protects it during your whole pregnancy), contains amniotic fluid. It sometimes breaks at the beginning of childbirth labor (mine did the first time); however that only happens about 10% of the time. It does not hurt. You may not even know it has happened, but you may feel warm water on your legs. You feel a tiny “Pop!” and then a little fluid trickles out. It’s not a huge gush – this is because the baby’s head is acting like a cork on your cervix. If you are afraid that your water will break all over the supermarket, don’t worry; this would be very, very unlikely. And if it were to happen, just get back in your car and drive home. No one has to know. Most commonly, about 90% of the time, your water breaks when your cervix is fully dilated. Sometimes your midwife or doctor may break it. When that happens, prostaglandins are released, and contractions become stronger and more regular, and the progress of childbirth generally picks up.

Question: When should I go to the hospital? What will happen when I get there?

Answer: Your doctor or midwife will educate you about what they want you to do during childbirth labor. Some may want you to phone the hospital as soon as anything happens. Most want you to wait to see if childbirth labor is well established. A midwife usually comes to your house, so you don’t have to plan so much as you would with a doctor. When you get to the hospital, you will need to register at the Maternity Department. Usually you can do this a few months prior – call the hospital where you will deliver and find out. Depending, again, on whether you have a doctor or midwife, a lot of different scenarios can take place. Also what kind of doctor you have: is he or she someone who believes that your body knows what to do during childbirth labor? Or will he or she insist that you are given an IV and hooked up to a monitor constantly? You do NOT have to undergo childbirth labor this way, but you need to decide before you choose a doctor what is important to you and how you want your experience to be. (A birth plan would be a good option. If you present your birth plan to your doctor and he or she laughs at you – get another doctor!)

Question: How long will childbirth labor take?

Answer: That’s a hard one to answer, because every childbirth labor is so different. Generally speaking, first labors take about 12 to 24 hours. My first labor was about 12 hours but my midwife said that I was only in “active” labor for 5 hours, which I disagree with because the first 7 hours were not spent sitting around comfortably! My second childbirth took about 6 hours and my third childbirth was an hour and 45 minutes!

Question: What about the pain? Is it really that bad?

Answer: I am not going to lie about it, childbirth is painful, but your body is an amazing machine. I did not take anything for the pain during my labors, but I was very fortunate to have a wonderful doula and husband who supported me throughout. Studies have shown that continuous support during labor decreases the need for pain relief by 60%.

Question: What’s wrong with having an epidural? Why go through the pain in childbirth if you don’t have to?

Answer: (This is simply my opinion – I am not a doctor, but I have done the research) For me, I was not trying to be a martyr by having a natural childbirth. I just wanted my baby to have the very best chance of being healthy.

Generally, it is true to say that epidurals are a safe and effective method of relieving pain in labor, but safe does not mean risk free. There are risks; I would be lying to say there are none. (Source: Thorp, J.A. & Breedlove, G (1996) Epidural Analgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83.)

In terms of risks for your baby, epidurals during childbirth can cause maternal fever and this can potentially harm your baby. Newborns sometimes also exhibit poor nursing behavior for up to one month. Many newborns exposed to epidural anesthesia in childbirth labor are very sleepy and they would rather sleep than nurse, which can be problematic because the more you nurse at the beginning, the faster your milk will come in and the better your breastfeeding experience will be.

It’s shocking to me that most women take such exceptional care of their babies while they are pregnant, i.e. no alcohol, no Tylenol, etc., but they willingly expose their babies to drugs during childbirth without fully educating themselves of the risks.

Here’s something you may not want to know: Hospital-employed childbirth educators encourage epidurals because they WANT you to have an epidural. Hospitals make a lot of money from epidurals. The nurse often comes into your room and says, “Are you ready for your epidural now?” In the U.S.A, an epidural costs from $500 to $2500, depending on the hospital. The United States spends more money on birth ($50 Billion a year!) than any other nation in the world, without necessarily getting the best results.

The average hospital childbirth costs $8,000 – $10,000 and that doubles for caesareans, providing very nice profits for obstetricians, anesthesiologists and drug companies. Hospital policies are routinely set based on financial goals. This is a fact, and if you don’t believe it, you are being duped.

Just hear me out on this one: It makes sense, doesn’t it? Since midwifery care and doula care reduces the rates of intervention, they also reduce the profit for doctors and hospitals. Of course, they will try to convince you that midwives are dangerous. They want your money!!! That is why, in Canada, our government realized that by allowing midwives to deliver and encourage natural childbirth in hospitals, they are saving millions of dollars.

Ok, I am finished my rants now, I think. Back to epidurals (which I am NOT completely against, by the way! I hope it doesn’t come across that way. I was a childbirth coach at my sister-in-law’s childbirth and I thought it was the most civilized, beautiful childbirth, I kind of wanted to do it that way too… I can totally understand why women choose epidurals.) If you have an epidural during childbirth, you must also have a urinary catheter inserted to empty your bladder. Epidurals can cause your blood pressure to decrease, so a nurse will check your blood pressure very often. The nurse or doctor will also periodically rub your abdomen to make sure there is enough paralysis but not so much that your breathing becomes impaired.

There is also a domino effect that plays into it as well – once you have one intervention, you are more at risk for more and more. For example, a woman who has an epidural is FOUR times as likely to have to have a caesarean section. Sometimes it relaxes the pelvis so much that you cannot push out your baby, so the use of Vacuum and forceps are significantly increased. This means you also have to have an episiotomy (where they cut the skin from your vagina to your rectum) in order to get the forceps into your vagina. Sometimes there are complications from episiotomies, as you can well imagine, such as bowel incontinence and urinary incontinence.

Note: According to Childbirth practices researcher Katherine Hartmann, MD, PhD, close to 1 million unnecessary episiotomies are performed in the U.S. each year. She says episiotomies are probably medically warranted in fewer than 10% of cases. Currently 1 in 3 American women get episiotomies. (Hartmann is director of the Center for Women’s Health Research at the University of North Carolina in Chapel Hill.)

The biggest risk of epidural is death – if the anaesthesiologist injects the wrong dose, or makes a mistake, you’re in trouble. You can also be paralysed (in very rare cases, permanently) due to nerve damage. Let me repeat, MOST epidurals are safe, but these are some of the risks you need to be aware of. The evidence of epidural risks is well documented, but it is not readily available. No one wants you to know.

OK, here is my last rant on the topic (I promise!): Don’t you think it is easier for the doctor to be able to “control” their patient if they are lying still and quiet in the bed during childbirth, paralysed and unable to move around? Ask your doctor what percentage of their patients receive an epidural during childbirth. Can you go one step further and ask them how much money they make if they give an epidural? Or of it makes their job easier if their patient has an epidural during childbirth? I think that would be very interesting! If he or she has an alarming rate of epidurals, I would seriously consider changing doctors.

If you are still thinking, “I don’t care what anybody says, there is no way I am going to go through that pain like some freaky natural childbirth nut”, I am here to say that I thought exactly the same way when I was pregnant – at first. But once I did some reading, I thought, wait a second, maybe I could at least try to do childbirth labor naturally. In my birth plan I wrote that I wanted to try to do it naturally, but if I ask for an epidural, give me one. (Where we live, midwives can order epidurals.)

I also want to say that I do believe that in some cases, epidurals are a really good idea. For example, if you have been in childbirth and laboring a very long time and you need to rest a few hours so that you can gather your energy to push the baby out. I was present at my friend’s childbirth as her support person, and she was not making any progress after about 10 hours. We tried all sorts of positions and everything, but finally her doctor suggested an epidural and I agreed. She was able to rest, and relax her whole body, and then it wore off and she was able to push out her baby without any problems. It was beautiful. (Note: she did not experience any of the above complications.)

Please educate yourself by reading some of the books I recommend about childbirth labor. (See my suggestions left sidebar). You will feel much better about yourself knowing that you did your research and made the right decision for you. Finally, please take a GOOD childbirth education class and read as much as you can so that you are prepared and educated. It’s your body and your baby!