Personal Birth Choices

History

When our first child, Daniel Keith, was born, my wife Alice, and I were completely ignorant of the facts of safe and humane childbirth. We went along with all of the usual hospital protocols, some of which included EFHM, perineal massage, amniotomy, IV, and vaccinations. We were not then aware that we had an amount of personal choice in the birth procedure and we were easily (mis)led by the medical establishment. The announcement of our second pregnancy was quickly followed with the decision that this birth would be different than the first.

First of all, we decided to forego all of the usual prenatal care. A home pregnancy test (and a slight bit of "morning sickness") told us we were pregnant. During the pregnancy, Alice, like most women, had an instinctive awareness of the natural processess her body was experiencing. She knew nothing was wrong. She could feel the baby moving daily and the motion was strong. This baby was doing just fine.

Throughout the pregnancy, Alice read several books on childbirth, from unassissted homebirth to hospital labor and delivery experiences (comparing the two is recommended). After doing our homework, we decided that we would have a home birth. At 35 weeks gestation, we found a midwife who met our qualifications: she is a Christian, would do homebirth, was experienced, would allow us to make decisions about the birth process, would allow me to catch the baby, and promoted breastfeeding. The midwife began "prenatal care" which consisted of palpation to determine the baby's position, listening to the fetal heartbeat with a fetoscope, and taking Alice's pulse, temp., and BP. The birth kit was ordered after our second visit to the midwife's home and our first home visit was scheduled. The midwife came to our home on December 30, 1998 for the first time.

On December 31, we called our midwife with the news that Alice was in labor with regular contractions and that we would be in touch to let her know when we would need her to come. Since we had no birth kit, our midwife pulled together materials which would be necessary for the birth. When we knew that labor was progressing, we called our midwife again and told her to come.

Decision Making

After 24 hours of labor, we were forced to make some decisions contrary to our birth plan. Contractions were coming at a rate of 3 minutes with a duration of one minute. However, the 24 hours of continuous contracting took their toll on Alice. She was tired both mentally and physically. We were at 7 centimeters with a cervical lip. We were close, but not close enough. We decided to continue hoping that full dilation would be reached shortly. Herbs were administered with expectations that labor would speed up and second stage would be reached. At 32 hours, we still were not at second stage labor. Another exam showed full dilation but only partial effacement due to the cervical lip. By now, Alice needed to rest. The difficult decision was made to take her to the hospital.

Hospital Experience after Attempted Homebirth

Going to the hospital after attempting a homebirth does not mean the abandonment of your birth plan. Know what you may refuse and decide that you will not accept any interventions you do not want. When we arrived at the hospital, we were admitted to general labor (as opposed to the birthing center where Daniel was born). Here are some of the decisions we had to make, how we made them and why we decided the way we did.

IV or no IV

We informed the nurse that we did not want an IV done. She then sent the doctor in to talk to us. He spoke to Alice (who, of course, is under the pressure of labor) condescendingly, pointing out that without an IV they could not do a C-section if necessary. The key to the decision was that Alice needed something that would allow her to sleep between contractions for the much needed rest. They would not administer pain medication without an IV. We reluctantly aquiesced.

Sign the waiver

This one is the epitome of idiotic. We had to sign a waiver releasing the restraint of just about every horrific intervention devised including C-section, epesiotomy, vacuum extraction, and forceps extraction just so Alice could get 10cc of nubain. Incidentally, I read every word of the release and it said NOTHING about administration of medication.

Internal Exams

No choice here, they just did them - 4 different people. They apparently cannot ask the last person who jabbed their stubby nubs into my wife's body what they felt.

EFHR monitoring

Again, no choice here. They just strapped them on without concerning themselves with the mystery of what it does to a baby.

Amniotomy

The second OB who examined Alice declared that she was at full dilation and asked for "a hook". Knowing the amniotomy was coming next, we declined this excursion in pain (we had an AROM done with Daniel and the pain increased exponentially. Within 40 minutes of the procedure, Alice was begging for pain medication). The doctor, apparently clairvoyant and infinite in wisdom, informed us that Alice was ready to push. We told the goddess (oops, I mean doctor) that if Alice was ready to push, SHE would feel like it. Not to mention the fact that she was still under the influence of drugs and would not be able to push anyway. Disgusted, the OB left. The membranes ruptured naturally 45 minutes later when Alice felt like pushing.

Perineal Massage

We did not have to worry about this one. We simply took some of the labor room washcloths and put them in warm water to put on the perineum before Alice was transported to the delivery room. The perineum stretched nicely and there were no tears whatsoever.

Dad announces the baby's sex

The doctor said this was ok (probably because he doesn't charge a "gender announcement" fee), but a nurse blurted it out before I could say anything. Thankfully (and luckily for the nurse) Alice did not hear the announcement until I made it.

Umbilical cord stops pulsing before it's cut

The doctor was confounded by this one. Apparently they do not tell them in med school that fully 30%-40% of the baby's blood is tied up in the placenta and umbilicus after birth. Allowing the cord to stop pulsing will allow this needed blood to enter the baby's body. When Hannah Grace was born, the doctor almost immediately clamped the cord. I was not aware until Alice saw him do it. She told him to unclamp the cord. The doc quoted hospital protocol. I told him to unclamp the cord NOW. He did, but would not allow me to put the baby on Alice's chest until he could clamp the cord, stating that the blood could not run uphill through the umbilical cord. Apparently they also do not tell the doctor in med school that the heart is below the most important internal organ, the brain, but blood does still manage to reach the brain despite the effects of gravity (do you see why I am reluctant to trust the medical establishment?). The cord was clamped a short time later and the baby was placed on Mama's bare chest.

Do not pull the placenta

The knuckle-head did it anyway and even went so far as to put a metal rod through the cord to facilitate pulling. Apparently they do not tell doctors in med school that forced extraction of the placenta is a cause of uterine hemorrhage. By the time we realized that the doc was pulling out the placenta, it was fairly well delivered and required little more than removal from the vagina to deliver. The damage was already done. (You may, however, ask that third stage labor be allowed to progress naturally. The doctor can just wait an extra 30 minutes before watching the rest of his football game).

We give the bath

We told the nursing staff that we were going to bathe our child, not some stranger. Their argument was that 1) no one except hospital personnel may enter the newborn nursery and 2) no one on staff could touch the baby without gloves until she was washed. Not a problem, we replied. Either Dad goes to the nursery and washes her or you waste alot of gloves. I washed her 20 minutes later, taking care to massage in any remaining vernix and using very little soap.

The baby will not be out of our sight

After the bathing episode, the nusing staff decided that it would be easier to just let me go wherever the baby went. She was not out of my sight for more than 30 seconds at a time.

No vaccinations/medications

Controversy galore here. We rubbed more people the wrong way with this area than all of the others combined (4 doctors & more nurses than I could count). Immediately following birth, babies are given erythromycin to prevent viral infection of the eyes from gonorrhea. My wife and I are clean - no problem, no medicine. Vitamin K is given to promote clotting of the blood. Hannah Grace suffered no physical birth trauma, was not presently bleeding, nor would she be in a position to cause her to bleed. Her body will be in full vitamin K production mode 10-12 weeks from birth. We can wait. The Hep-B vaccine was refused because the vaccine causes more cases of Hepatitis than living life does. Pass. DPT (a 2 month vaccine) will be refused because of its link to SIDS and other vaccine-induced difficulties. Every doctor we told not to stick our baby with a needle had a problem with it. Social Services was called and we spent the better part of 90 minutes explaining to a social worker why we deferred traditional "preventative care" of our newborn.

You have the right, and the responsibility, to question any intervention suggested by your OB or pediatrician. If you don't know what effect a procedure will have on you or your baby, refuse to accept it until all risks and benefits are explained. Even then, be wary. Remember, the medical community is extremely biased on its own behalf. If it's going to make them money, they will do it, consequences not withstanding. Informed birth is better birth. We knew a lot of what the docs did not or were not willing to tell us. We will again try to have a home birth with our next child and we will stand upon the same staunch principles that we did with Hannah Grace. She is a beautiful, perfectly healthy little jewel and we are convinced, that we did the right thing.