Advocating Natural Childbirth

The more I learn about unmedicated childbirth, the more of an advocate I’m becoming for it.  Evidently, just calling it “natural childbirth” isn’t enough; too many women call a vaginal birth “natural” even though they’ve been prepped with Cervidil/Cytotec, induced with Pitocin, been given IV narcotics (Nubain) to “take the edge off,” and then are numbed with an opiate-cocaine anesthesia cocktail called a “walking” epidural.  Call me a purist...but that last scenario is probably the LAST thing that I envision when someone says “natural childbirth.”  Even if that woman delivered her child out the birth canal instead of having her baby pulled out via C-section, very little about that scene says “natural” to me.  But then again, everyone’s perspective, focus, and ability to handle pain is a little bit different.  I understand and respect that.

When I say “natural childbirth,” I mean an unmedicated vaginal birth.  That’s my goal for my daughter.  If medically necessary (and sometimes medications ARE warranted for very valid reasons), I will have an intervention...but only at the lowest possible dosage and as a last resort.  And even then, I won’t call my birth experience a “natural birth.”  I’ll call it what it is:  a vaginal birth.

The more I learn, the more amazed I become with the whole process.  It’s a beautiful, MIRACULOUS thing...and there’s so much going on that the medical profession is only just now beginning to scratch the surface of understanding it all.  We’ve come a long way from the “woman’s deliverance from the sin of childbirth” attitude of WWI and WWII.  Practices that doctors considered “safe” at that time have since proven to be detrimental - even deadly - for mother and baby.  With all the knowledge we have now with our past medical procedures/interventions, which modern ones will be proven to be detrimental in the future?  Some of them?  All of them?  It’s an exciting time to be giving birth, that’s for sure.  I truly believe that we’re at the cusp of an age of enlightenment and empowerment.  

Until I know for sure, I don’t want any of it.  No interventions, no augmentations, no drugs.  I’m even leery of “all-natural” options like tinctures, oils, teas, and supplements.  The only ones I truly trust to be completely safe are the tried-and-true:  patience, walking, more patience, baths and showers, rocking, relaxing, exercising, and finally a healthy dose of more patience.  Baby will come when she’s ready, and not a minute before. Yes, it's a personal choice. Yes, I know that every woman's birth experience is different. Yes, I know that unmedicated birth options are not the right choice for everyone. And yes, I know that not everything in birthing goes according to plan.

I only wish that more women were informed about the effects of what these drugs are doing to their babies and their bodies.  If you think that information won’t have any effect on the population of fertile women, I offer the growth of the organic industry as an example:  Organics existed on the fringe of the market until some very clever people in the 1990s thought to encourage pregnant and nursing women to make the switch from conventional to organic “for the health of their babies.”  Just a few years later, the industry was experiencing explosive growth in that sector, with the growth spilling outward into other demographics.  Today, not all women will eat organically during pregnancy and breastfeeding...but most will at least make the effort to buy a few organic items like produce, juice, or milk for their children.  It proves one powerful thing:  women will not change their behavior for their own health, but they will bend over backward for the chance (not even a guarantee!) that their children will be healthier than they are.  This is a powerful motivational tool that should be harnessed for the promotion of natural childbirth practices.

The thing that amazes me most about natural childbirth is its absolute perfection.  The design is flawless.  Baby (being head-down and hopefully in the Occiput Anterior position with her nose toward Mom’s tailbone) gets a signal that it’s time to be born, and the uterine muscles begin contracting.  Prior to the birth day, hormones in the cervix soften/ripen it to relax it from its normal closed state to one that can be stretched open.  Without the hormone Prostaglandin softening the cervix, birth cannot happen.  Uterine contractions can roll over each other all day, but if the cervix isn’t ripe, they’re not going to open it...come hell or high water.  

During the first stage of labor, this large and powerful muscle group of uterine muscle begins pulling the cervix wider and farther back (called Dilation and Effacement), allowing Baby’s head to fall through.  As the baby’s head sinks lower into the pelvis, called “Stationing,” the head will eventually hit a point to trigger the pushing reflex.  Once the uterine muscles have finished contracting as far as they can, making the cervical opening 10 cm in diameter (~4 in), they Transition into a new role:  expulsion.  After the Transition stage, the uterine muscles still contract, but their force is concentrated at the top of the uterus and the force is directed downward toward Mom’s pelvis.  Mom then works with the contractions and the pushing reflex to move Baby past the pelvic bones and out through the vaginal opening.

The interesting thing in all of this is that BABY is the navigator during birth, NOT Mom.  The reflexes that all babies are born with are there to help them survive birth and the first few months in their new environment:

• Babinski & Step:  when the baby’s foot is touched, the foot will pigeon-toe and flex to become flat.  The baby will then kick back at whatever is pushing against its foot as if “walking.”  In the case of contractions, Baby will actually kick against the contracting uterine muscles to help push herself down the birth canal.
• Moro/Startle:  when a loud sound or large change in the environment causes baby to throw back her head, cry out, and quickly extend her arms/feet.  In birth, this reflex allows Baby to lift her chin up and over Mom’s perineum (preventing severe tearing) and acts as a bellows to inflate the lungs for her first breath.
• Rooting, Sucking, and Grasping:  these reflexes aid in establishing feeding habits immediately after birth.  It’s hard work being born, and everybody deserves a snack!

Mom can assist Baby during birth by changing positions and using gravity to help the contractions be more efficient, but in the end...Baby has to find her own way out.  This is a complicated thing; it involves using the tailbone as a slide, turning this way and that to fit through the pelvic bones and pelvic opening, and finally lifting her chin up and over the perineum after crowning.

These reflexes are awesome.  Who knew that Baby could do all that without being taught?!?  But the problem with medicated childbirth is that drugs used during delivery prevent those reflexes from working.  When Mom is numb, fuzzy-feeling, or can’t communicate with her body...Baby has the same problem.  More so, even, because Baby doesn’t have a blood-brain barrier yet, doesn’t have a liver developed enough to detoxify foreign substances, and has a much smaller mass than Mom.  So basically, when drugged Mom is trying to birth Baby, she’s doing all the work to power the ship without having an engine to propel it forward and no captain at the helm.  

And in the case of Pitocin being a synthetic hormone, Mom’s innate hormonal system is completely thrown off when it’s administered into the bloodstream.  Pitocin is a synthetic form of Oxytocin, the love-hormone and trigger for uterine contractions.  This hormone is the one responsible for causing a flurry of Braxton-Hicks contractions after orgasm, as well as for causing bonding between Mom and Baby after birth.  It’s also pretty handy for causing the uterus to shrink to half-size after birth and thus sloughing off the placenta in preparation for its own delivery.  In the case of any artificial hormone, once the synthetic is released into your bloodstream, your body stops producing the natural equivalent on its own.  And why should it?  The concentration of that hormone is already detected in the bloodstream; too much hormone is just as detrimental as not having enough.  So your body uses the synthetic hormone as a proxy for its own stores.  This very principle is how the Rhogam shot is protecting me from developing antibodies that fight Aria’s d-protein if she’s rH-positive while I’m rH-negative.  

Our bodies don’t do steady, continual release of hormones.  It’s more like a timed release system on a dam; hormone is released when it’s needed, and the concentration is backed off when it’s not.  Then, when the concentration of whichever hormone is needed gets too low, more hormone gets released.  It’s a wave...which is good during labor, because it means that you ALWAYS get a break between contractions.  It might not be much of one (as is the case in Transition), but there is always enough of a break in the hormone flood enough to catch your breath and get those uterine muscles to rest.  Pitocin doesn’t allow for that; it’s a continual release at a constant concentration...resulting in longer contractions and no breaks between them.  This of course, leads to fatigue, and doctors then need to administer an epidural or IV narcotic to slow down the contractions and counteract Pitocin’s effects on the body.  It also creates an increased perception of pain because of the duration and lack of break between contractions.  

Notice I said PERCEPTION of pain and not actual pain level.  Some people erroneously believe that Pitocin causes longer, stronger, more painful contractions.  This is not true; the drug cannot physically force a contraction stronger than any your body already produces on its own.  The drug is a trigger for movement, not the movement itself.  The difference is the duration of the trigger and lack of rest between releases.  Think about it this way:  running a mile all at once sounds a whole lot more exhausting and painful than “I’m running to that light pole, then walking for a minute, then running to the next pole down the street.”

Epidurals, of course, are specialized cocktails of opiates and cocaines (a central nervous system stimulant).  The exact concentration and mix of drugs is variable upon the hospital, level of anesthesia desired, and the anesthesiologist...so the epidural you get at Ball Memorial is different than one that you would get at Anderson Community or St. Vincent’s Anderson.  Of course, there’s always risk involved with epidurals:  allergic reactions, side effects like itching or severe headache, nerve damage, infection, and then the flat-out chance that it doesn’t take.  Worse, the epidural placement and pain relief does take...but only in certain places.  This is called a “hot spot.”  Not pleasant.

In the end, you’ve got a baby whose survival reflexes are impaired, a mother who physically cannot communicate with her body, a hormonal system that isn’t functioning properly, and for what?  A few hours’ worth of something akin to comfort, but isn’t really because you can still feel that something big is going on down there, and you can’t move around to go to the bathroom or get more comfortable?  The effects of epidurals and Pitocin and IV narcotics last for hours in Mom’s system; for days in the baby.  Is a few hours’ discomfort REALLY worth impairing Baby’s function for the first few days of her life?

Most interventions at birth (vacuum delivery, sucking mucus out of the nose & mouth, correcting respiratory distress and poor circulation issues) exist because Baby is drugged.  She doesn’t have the coordination or strength to do it on her own.  In addition to being tired, she can’t feel her body enough to even clear her own lungs.  

I can’t do that to Aria.  I just can’t.  Maybe if I were completely ignorant about the effects that drugs have on her system, I could.  But I’m not ignorant anymore.  I can’t knowingly subject her to the effects of narcotics, stimulants, opiates, steroids, and synthetic hormones.  Not when I’ve worked so hard to keep synthetics out of my system and fueled my body with organic food for so long; it would be hypocritical of me.  I haven’t even hit Aria’s system with overdoses of caffeine, sugar, or heavy metals during my pregnancy or in the many months (and years) before.  I feel bad enough about having taken hydrocortisone cream for a short time on my skin.  So why would all that change now, when I’m so close to the end?  I can’t just toss all my beliefs and past practices aside because “this is the way we do it here,” or “everyone does it this way, so you will too.”

The sad thing is that there are so few out there like me; that I’m the exception rather than the rule.  I don’t blame the nurses, the doctors, the insurance companies, the pharmaceutical representatives, the drug manufacturers, or the hospitals for making drugs and interventions so easily accessible.  I don’t blame the media for showing (and therefore promoting) intervention-heavy labor and delivery plot lines.  In all cases, they’re just doing what consumers expect and request.  Interventions sell movies, insurance policies, and erode women's self-confidence.  What needs to change is consumer attitudes toward pregnancy, birth, and delivery.  

Childbirth is not an illness from which we women must be “delivered.”  This is not a coercive guilt tactic we should lord over the male sex to incite their pity or bolster our superiority.  We are stronger and smarter than we think, and need to be encouraged to take advantage of that.  The more we demand natural childbirth practices and birth education, the more widespread they will become.  And the more we advocate for our own rights and desires in the nation’s birthing rooms, the more positive our attitudes toward our birth experiences will become.  Women with positive birth experiences must become louder voices than those women with “horror stories” spreading their fear and distaste for the experience with everyone they meet.  I have faith that we can do this.  Truly.  We shouldn’t be made to feel ashamed for our birth choices, unmedicated or otherwise.  But we should share the positive aspects of them with others.  Knowledge is power, and power is utilized best when it’s shared with others.