Wednesday, April 16, 2008

Ten Things Learned In the Trenches

I think of laboring like parachuting. You can read about parachutes, take classes on parachutes, practice the correct way to put on your suit and the right way to pull the cord....but you won't really understand parachuting until you're falling through the air. Also, if you lined twenty people up and had them jump out of a plane, each of their experiences, while sharing common aspects, would be unique. The birthing process goes through the same stages for every woman but is at the same time highly individually. A woman in a naturally progressing birth process, for example, will labor differently than a woman in an induction or other situations. But there's something we all have to share with each other hopefully to make the process a little less scary.

In that thought, this is what I learned from my free-fall.

10) If you can, eat a really good meal at the beginning

When my childbirth instructor, Claudia, gave me advice for preparing for the induction, she told me to make sure I ate a high-protein breakfast. We're talking about three or four eggs and a bit of toast with juice....something to give energy and strength for the laboring process. Common medical knowledge encourages women to labor on an empty stomach but you're going to need fuel for the hard work of laboring. Eat whatever is comfortable for you. If you start labor naturally, you probably aren't going to plan a meal beforehand but you can, at the beginning of labor, eat something nutritious to help you build energy reserves. Listen to your body.

9) Bring a pillow or two and blankets.

Hospital rooms are even worse than hotels when it comes to comfort. The pillows are pathetic and the blankets are inadequate. Bring your own pillow-- one that is washable, no heirloom feather pillows please-- and use it to help you get into comfortable positions during labor and in recovery. You can also consider bringing a nursing pillow to ease the awkwardness of early nursings. The same rule goes for blankets-- it's good to have an extra one but make sure it's one that you can wash if necessary. I'd recommend one of the inexpensive fleece blankets you can buy for as little as $5....it keeps you and your little one warm and is very durable.

8) Don't be afraid to make noise when you labor.

Society loves the ideal of a placid, docile, passive birthing woman, one who doesn't make much noise and doesn't argue with the Doctors Who Know Best. It's one of the reasons why drugged labor is so popular; it's much quieter.
Real birth is noisy. Sound is a release, one that can help you deal with the pain of a contraction, but don't choose panicked, high-pitched sounds that will make you tense. I had a repetitive moan that I used during contractions--- actually I said "out, out, out" in a rhythm that I found soothing. In combination with breathing, the sound helped me stay calm and focused. Figure out what works for you and don't be afraid to use it, especially during pushing. You're pushing out a baby not taking tea.

7) Ask questions.

Along with preference for a quiet birth, society likes a docile birthing woman, one that goes along with whatever the doctors or nurses recommend. Your doctors are your birth partners, not birth generals. They are there to help you through the birthing process and, if necessary, step in the event of a crisis. You certainly can question or refuse any non-necessary intervention about which you feel uncomfortable.

6)Have someone who can say no for you.

This goes hand in hand with the previous tip. When you get going into labor, and especially when you get into transition, you aren't going to be the most rational you've ever been. It's usually at the point when you're tired and in pain that well-meaning individuals-- be they doctors, or nurses, or family members-- suggest pain medication or other interventions that may not be in your birth plan. Have your birth partner-- whether it's your husband or someone else-- designated to refuse things you don't want. Decide ahead of time what your criteria will be for interventions-- under what circumstances you would use them-- and have your partner stick up for you when you're immersed in birthing.

5) Limit the number of guests or observers.

My instructor Claudia said something to the effect that every additional observer you have, besides your partner and hospital staff, adds ten minutes to your labor. I don't know whether or not that's true for everyone, but you aren't a circus attraction. Labor is done best when it's as private as possible, and that may mean kindly telling friends and family to pace the halls. If you want family members or friends present, that's okay, but make your choices wisely.

4)
Have relief support lined up to give your husband a break.

While you don't want a crowded labor room, you do want to have someone lined up to support your husband while he's supporting you. This could be a professional doula or a family member or friend-- just as long as someone is designated to give him a chance to grab a soda and sandwich or a bathroom break. Also, some husbands have trouble with the messier parts of birth and there's nothing wrong with having someone who can step in if he gets overwhelmed.

3)
Remember that your birth plan is flexible and doesn't determine the success of your birth

We touched on this in the last post but I want to reiterate that the goal of birth is the baby in your arms not a perfectly executed birthing plan. Even a textbook natural labor may not be exactly as you planned. If circumstances require interventions that you would have preferred to avoid, such as induction, medication, or even a c-section, keep your focus on the destination-- your baby.

2) Keep your baby with you after

Some hospital staff get downright hostile to the thought of a mother actually keeping her baby with her after labor rather than letting the newborn spend hours in a hospital nursery. The hours after birth are important not only for bonding but for establishing milk flow, and both are accomplished by keeping the baby with you and allowing them to nurse on demand. A hospital does not have the right to take your baby to the nursery against your will. While you may concede to leave the baby in the bassinet when they are sleeping, since many hospitals have an aversion to co-sleeping, you can fully insist that the baby be left in your room. You will have to be vigilant; even after my husband and I made it clear that under no circumstances was our baby to be in the nursery, the nurses still tried to keep the baby on the grounds that they knew what I needed better than I did. My husband ended up accompanying our daughter to the nursery for any necessary procedures and then accompanying her back. Don't be afraid to be insistent.

1) Trust that God is in control

No matter how crazy your labor gets, God is directing your path and your that of your baby. You can cry out to him for strength at any time-- even if it's a wordless moan-- and He will come to give you strong and sure aid. When it came time to push in my labor, I couldn't feel much due to the epidural and subsequently couldn't use the pushing techniques I'd learned in class. At the final moment, my body and spirit were absolutely drained and I remember calling out to God, silently but with all my soul. At exactly that moment, a primal, indescribable strength filled me and I was able to deliver Ember. I am no mystic, but I do know that God is with us through our labor and is our greatest comfort. There are no atheists in foxholes and delivery rooms.

So there. That's what I've learned, and it may be totally irrelevant for your labor. But then, it may help you just a little, which is my hope.

Happy parachuting!

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