Birth plans & drug-free birth - how much do you want it?

[Lil_Pearl]

Yes, in my opinion (based on what is considered a reasonable, safe and achievable statistic by good places to birth (such as the farm - Ina May's that is), and history, etc) I think a c-section rate of anything higher than 3-4% is too much...that anything above that really says one is not in the right hands.

I know, people seem to experience 2nd stage in so many different ways. Some get the break, most don't, some lose most of the pain, others have greater pain, etc. For me, 2nd stage was the same as 1st, just with everything happening constantly. The pain was the same, but added to it was the extra pain of the baby going through (I had a tear in the ouchiest place possible, I was told). But my sencond stage was quite fast, when I think of the fact that it was the first time I'd pushed a baby out, which of course can make things a little more intense. But I can't wait for next time! When one can say that, you know it's been an empowering experience. After each birth (even having the c-section), I have felt more confident, more powerful, more self-assured, and more demanding of respect...I think birth is just the greatest thing...I mean, it's the only thing, really....without it...???

[Smoke Jaguar]

Put it this way:
In our AN classes just about every other woman there seemed to have a panicked look on her face, especially in the birth class. This is at a birth centre! I mean, they were there because they were having normal pregnancies and expected to have normal births, yet all were asking what drugs for pain relief and what interventions were on offer there. We were all first timers, yet I knew infinitely more about what to expect and how I wanted things to go than all of them combined. It was really sad how disempowered they were because they hadn't been proactive about what they were about to go through and didn't seem to know how to access sources of information.

[angelfish]

This is a really interesting thread. Re birth plans, I think Kelly is right that it might be helpful for them to be more detailed and specific. You could even write down exactly what you want to happen if you change your mind, eg epi as soon as you request it, or alternatives such as wait until you have asked several times in half an hour, only after trying change of position, wait another 5 ctx and see whether you still feel you need it etc.

IMO one of the biggest problems is women getting confused between pain RELIEF and techniques for working with or coping with pain. If you have some aromatherapy and a CD of your favourite songs, and you expect that they will make the pain disappear, you are bound to be disappointed!

Personally, I thought that this was one of the best reasons to opt for a home birth. If I wanted an epi, I would have had to actually transfer to the hospital. Kind of like not filling your house with junk food when you're on a diet.

BTW, the most servere pain I ever experienced was my breast abscess. I found this much more painful than anything in labour. (Although this could be psychological?)

[Lil_Pearl]

IK - yes, that was true for my AN class (at a birth centre). Women have such mixed emotions - they are in a birth centre because they FEEL that natural birth will be the way to go, it's an instinctive feeling that that would be the best thing....yet they still have the fear, and so there is such conflicting emotions happening, they're confused about what they want, because they don't have the knowledge to feel empowered....they don't trust themselves as much as the back-ups that will be available.

angelfish - I agree with what you said about the pain of childbirth. Childbirth education needs to include (and go into great depth about) education on the pain of childbirth, the normalcy of it, the goodness of it, the fact that it has many different purposes, from physically letting one know how close they are to delivery, through to the empowerment one experiences after winning what seems like a life-and-death battle. It is huge, it is a right-of-passage, not something to fight. If women understood pain in childbirth as a positive thing, something to work with, then they would find the strength they need to go beyond their 'limits', their hormonal interplay will lead to them having LESS pain, and they will have shorter, safer births in general.

[chocolatecatty]

Ah, you're all so very helpful! I'm trying to prepare DH for his support role; have started reading 'New Active Birth' to him at nights which is a great start. He'll have to read this thread too! I guess it's a good idea to sit down with him a write my birth plan together so he understands it all...
Ach, how I love Bellybelly!

[Lil_Pearl]

chocolatecatty: Good luck!! I had my sister and her partner over for dinner last night, and my sister is pregnant. Anyway, I was so glad to have the chance to explain the basics with her partner, as he even asked, in relation to c-section, "does it even really matter"...meaning, "does it matter how the baby gets out?" !!! That was really a matter of having to start at the beginning! haha...at least she's only 8 weeks, we have a bit of time to educate him!

[Smoke Jaguar]

One thing I did fall for was thinking that the pain I'd be breathing through would be predominantly in the birthing phase...the 'surges' were a bit underrated in both HypnoBirthing and AN classes! These I found the most challenging to cope with. I did manage to remember the mantra "each surge brings me closer to my child".
Choco - sorry for shortening your name but this is a one handed job! New Active Birth is brilliant. Try also Waterbirth by Balaskas. Even if you don't plan to birth in water - it applies to labouring using water - water rocks!!
Liana - I feel that one of the biggest factors that goes unaddressed in AN classes is the fear-tension-pain scenario. Classes should aim at eliminating the fear rather than emphasising pain relief and 'complications'. At no stage was I scared or fearful about what was happening to me or what would happen. I decided early in my pregnancy that I was looking forward to the birth itself and savour my child's entry. This made a huge difference to my attitude throughout the pregnancy. People tried to scare me but probably out of some sense that I needed to be much more worried about it than I obviously was! I was too relaxed for many mothers' liking, as if they thought I was too naive and needed a dose of reality. I almost feel guilty telling the same people now that my first birth experience was great and that it was as 'zen' as I had half-joked it would be. How sad.

[Astrid]

Interesting topic. We did not have a written birth plan, as I was at the family birth centre, so it was already known the type of birth I was after. Also the education we received did discuss transition etc we were shown videos and many photos of women during a contraction and in between contractions. Given all that though, I was not really prepared for the pain, every contraction was in my lower back and making me throw up. Not something I really expected.

The midwives in the birth center were great, they knew just when to change my position, get me in the shower, offer gas etc. Gas was offered once I started the "epidural chant". As discussed above, I really did not expect that much pain, DH, as supportive as he was of I wanted, was not the best support. His way of dealing with me was to say in a hard voice "no you bloody well don't!" which just made me clamp up. I needed a different type of support. Also I was mentally struggling with the concept of actually becoming a mother, so I believe that was not letting me work with the pain, oh and the worry about DH as he was falling asleep! Anyway I ended up with an emergency c-section.

So really in my situation a written birth plan would not have helped or more education on labour, but I believe a doula would have. I needed someone there who was there for me, who I did not have to worry
about and would know what to say and not yell.

ETA: forgot to put in the major bit, yes I did really want it, but I admit there was a small doubt. As has been said in other threads, people laugh when you state it is something that you want and comments like that over time do have an effect. Wanting a natural birth should be seen as being the norm, not something that you are mad for even trying.

[Smoke Jaguar]

Hmmm, I'm just thinking of my birth plan and what it had for alternative scenarios. In it I had provisions for how I wanted to be treated in the case of transfer to the ward and drug interventions. I stipulated that I wanted things to occur naturally unless there was a genuine medical necessity to do so (read: not just cos it's the way the doctors prefer it to happen, just in case!). I asked that drugs not be offered to me, that I would request them if required. But I avoided a lot of potential labour delay etc by labouring at home where there are no drugs, just a very supportive partner and a bath! The fact that I knew what was happening in my body every step of the way helped me accept and embrace every sensation, even though I didn't enjoy the surges part of the whole deal. I had total freedom from fear and I was telling my brain to release endorphins, knowing that if endorphins are being released it is physically impossible to simultaneously release adrenaline, which kicks in fight or flight...the notorious labour delayer!

[Rouge]

I definitely think my birth plan helped me to ensure that I got the birth I wanted. Nearly everything went according to plan (within reason). I think things like how you want to deliver the placenta, if you want vit. k oral/injection etc are important to be put into a birth plan (if its important to you) as that sort of thing can often be forgotten in the rush and euphoria of what is happening!

I felt as though my birth plan allowed my ob and my birth support and the staff and my husband to know my intentions, as for me that was all my birth plan ever was... my intentions for birth providing all went well. And luckily for me it did. The midwives did read my birth plan and did follow it pretty spot on and because it had been openly discussed with my support/dh/ob everyone knew what I wanted. I truly believe my Ob stalled in getting to me as he knew ultimately I wanted a drug free birth. At the time I wanted to kill him, but now I am eternally greaful To him and to my wonderful birth support! I also think a birth plan allows women to become empowered, yes its just a piece of paper but I know alot of women who go to great lengths to arm themselves with education and choice when researching for their birth plan. So if anything even if it doesn't get followed to a tee I think it can be a great tool for the birthing woman and her support team.

*hugs*
Cailin

[BellyBelly]

I feel that one of the biggest factors that goes unaddressed in AN classes is the fear-tension-pain scenario. Classes should aim at eliminating the fear rather than emphasising pain relief and 'complications'.

1. Often they just don't know this stuff - they get taught medical things at uni
2. Like I said earlier, hospitals aren't there to create a warm and fuzzy process for you but to control a process. So I see them running these classes the way they do for a reason, which is why I promote private, independent childbirth classes. Birth is a life event, not a medical one. Seems to be the wrong way around at the moment though, big time...

[Liz]

People tried to scare me but probably out of some sense that I needed to be much more worried about it than I obviously was! I was too relaxed for many mothers' liking, as if they thought I was too naive and needed a dose of reality. I almost feel guilty telling the same people now that my first birth experience was great and that it was as 'zen' as I had half-joked it would be. How sad.

LOL.. I'm the same! Altho I wouldn't describe mine as 'zen' I'm almost tempted tho to tell other pregnant women that it really isn't that bad! LOL. I quite enjoyed it

[Lil_Pearl]

IK - Exactly, fear = tension = pain = intervention, longer labour, cascade of events that leave a woman feeling bewildered, and it can all follow through into motherhood, too. It really says something when women think your naive for choosing normal, everyday birth, doesn't it? The naivety of it. The media has a lot to answer for, I think. Not only in scaring women, but in showing birth as something that takes a couple of minutes, something you swear through, talk all through, puff and pant through, and have green sheets draped around you, with the doctor in mask and all, and that this is all okay, and, see, it only takes a couple of minutes, and then the doctor has 'delivered' your baby, and you can sit back and smile. Television shows and movies have a birth "scene", and that is the information women grow up with....that medical is good, that birth hurts but is over quickly, that a lit-up room and strangers are conducive to a healthy labour. No pre-labour, or two or more hours of pushing and working with your body, no dark rooms, no closed eyes and peaceful music, no 'zoning out' to get in the swing of the labour flow...no reality.

Most women don't have a knowledge of the whoole adrealin vs. endorphins thing. Most women don't realise that the smallest thing can hinder endorphin release and bring about a flood of adrenalin.....smells, sights, the trip to the hospital, booking in, being watched, being spoken to, being expected to answer questions, bright lights...the list is huge. Hospital situations, un-known or disrespectful staff, a support person who isn't educated in the art of birth, it can all lead to ones birth going "off track". Often, instead of partners and staff taking away the fear trigger (or even realising it exists!), allowing hormonal balance to return in time, they offer epidural, or say "oh, you labour is not progressing", hook you up to the drip, or, worse, rush you in for an emergency c-section. Staff need further education in a lot of cases. I think, Kelly, you've mentioned somewhere that you think medical staff (obs, midwives, etc) should be trained in natural birth first (such as a doula course), before all the medical stuff. So true, I think that should be a whole year of education in itself.

[DoulaRelle]

Reading through all of these posts, I realise that for my 2nd birth I had a wonderful hospital based team around me. I was induced and I had my DH and a support person as well as a fantastic midwife. After an extremely intense 1st labour, I was utterly exhausted and ended up asking for an epidural just the once and was given it.

I found that having been through No 1 and the experience that it entailed gave me the added strength to cope with the pain far more effectively for no 2. I also believe that as I only had DH as support (that was how he wanted it) and I have to be honest, he was not really that vocal in helping me.

KNowing this I asked a very close friend to be my support person and discussed all of my dissappointments/fears/wants and things I didn't want in detail with her on several occasions. She knew there was no way I wanted an epidural again, and as little pain relief as possible. She was by far the most fantastic support I could have chosen. She was the one who was supporting me through every contraction and telling me I was doing well and the one who was vocal for me when required. I don't even remember where DH was in the room!.

I was also able to work with the contractions ie: That is one contraction closer to seeing my baby, which I was definately not able to do with No 1. I was also very lucky to have a fantastic midwife who took on board my requests re pain relief. I can distinctly remember going through transistion and my crisis of confidence, and it was the midwife and my Obs who were telling me I didn't need the epidural or the dreaded forceps!!! (Can you believe I was asking for the forceps!!!).

I know by reading on this website that many hospital based midwives and Obs are very quick to give you pain relief, but I can honestly say that they were both instrumental in me delivering with minimal pain relief (gas) and I was actually using the mouthpiece of the gas more as a focal point that anything. They were the ones telling me I could do it and I didn't need anything else. The midwife with me had actually finished her shift just before I started pushing, but she stayed with me right through till he was born, just as she had promised to do that morning.

Now having had a much better experience, I would be more likely to want to go into natural labour again and try and cope with the whole labour with zero pain relief, I have much more faith in my body and it's ability to birth a baby now. But this has only been able to come with experience.

After feeling gutted with No 1 as far as my birth experience went, I can honestly say that although No 2 was more painful - it was a productive pain, and the sense of achievement at having pushed your baby into the world - well nothing else compares!

[Smoke Jaguar]

Good one, Relle It makes such a difference when your caregivers are on your wavelength! My birth centre pretty much operates the way most of my plan read, so I wrote it as a formality and more to confirm to myself what I wanted - and they made me stick to it, for the labouring at home bit, and I'm so glad they did! The bits that did not line up with BC policy were only there in the case of transfer and I asterisked those with a note to say as much (i.e. annotated with "in the case of transfer to the ward").
I can't believe that I missed the transition cues - I was underestimating where I was the whole time and must have thought that I was still dilating and that as a first timer that's why it was so intense - duh!

[DoulaRelle]

IK - I underestimated myself re transition also, when I did start asking for an epidural they were telling me I was about to push, and I had it stuck in my head that I was only 6 cm dilated (As at last internal) and that I couldn't possible be ready to push, even as they were wheeling the baby trolley in and my Obs arrived I was still fixated on the 6 cm!!!!!!! hehehehe

[Smoke Jaguar]

Relle - that's funny! it was only when I was walking over from the toilet to the bath and realised that there was a head in my cervix that the whole labour caper was over. I just wonder why women emphasise the 'pain' of the birth itself over the labour, because I found myself thinking, during the breathing down phase, that I would rather do that ten times over rather than the labour part!
But now that I've done it, it feels very rewarding - the labour really is working towards something, it's working towards something so lovely it can't really be sufficiently articulated, huh? So, yep, I'd now do labour again the same way - drug free and at home with no-one giving me internals and stats. One other thought process that got me through the labour was "my body is not going to put me through more than I can handle". That was really helpful

[kahmanya]

I have just read all the awesome info on here. But being honest i think there is nothing that can prepare a women the pain their about to go through as i believe each pregnancy is different. Me for example i had a fantastic first birth, although induced (14 days late) i was able to cope with the pain eventhough contractions were 2mins apart i could take abreather and my son was delivered with in 3.5hours!!!
For my second well i thought that this was going to be okay because i knew what to expect WRONG!!! Induced again (due to a pituitary tumor which i could not release oxytocin) The pain was UNBELIEVABLE MY contraction started at 2mins apart then to 1 minute apart!!! I couldn't breathe between contractions and the pain was soooooo unbearable, i was getting so upset with myself and felt like a failure that i couldn't cope!!
After 3.5 hours of this amazing pain i kept saying to the midwife there is something quite not right!!!! She said no everything is fine, i said i want an epidural they kept refusing me!!! Till the 10th time when she examined me again i was only 2cms dilated and said finally i'll get the anesthesiest!!! Well as soon as he put the epidural in, he was still standing there!! I fully dilated to 10cm's they were all in shock, the midwife was dumbfounded!!! I was examined and she said oh you poor thing no wonder you were in excrucitating pain Jayden was posterior!! He was delivered with in 10 minutes. My pain was soosososososos Bad that my body was tensing so much that i couldn't open up!!!! I tried massage, sitting on the toilet the gas nothing worked!!!! Where that all worked with James, I sat on the toilet with him and with in 20 minutes i had to push!!!!

That is why with this pregnancy i have taken the casual approach as Kelly mentioned that i will take it as it comes. But i would really love a natural birth (not being induced) which my Obs is supporting me, Due to haveing a really bad 2nd birth experience, as Relle said i may be able to cope with the next one!! This is hopeing that i can come naturally unless that damned tumour is back which i think highly unlikely!!!!!!
I am going to go to a chinese massagest to help bring on labour the day i'm due and do heaps of walking!!

Kelly is there anything you can suggest to bring on labour, knowing my situation it's not that i want be induced it's a matter i have to be induced.

P.S I do have to say that the staff at Cabrini are really into the natural drug free birth, as you can see they were totally resilient in giving me an epidural!

Thanks, awesome thread!!!!!

Kelly maybe you should hold a get together?