The Best Birth

With my giant list of 'must read' pregnancy, birthing, and parenting books I figure I should attempt to write reviews of some of them. Then maybe I won't forget everything I've read when I need it, right?

Before I start, let me say that I am fully aware that this subject is one of the many 'hot topic' sensitive issues out there in the world of pregnancy and delivery. I have my opinions but believe everyone is entitled to theirs as well. And I mostly just want to reiterate what this book states, knowing it is not the end-all book out there. No judgment here, no matter what you believe about labor and delivery, okay? We as women need to do a better job of supporting each other in these circumstances instead of judging or putting each other down. Let's all hold hands and sing, shall we? :)

A lot of people have heard of Ricki Lake's book called 'Your Best Birth' and I still have that one on my list, too. But Hannah recommended 'The Best Birth' by Sarah McMoyler and I wanted to read this one first. It is kind of like the 'light' version of Ricki's book and I highly, highly recommend it to you if you are interested.

The author is a Labor and Delivery nurse with twenty-plus years of experience. She is very realistic, encouraging, and straight-forward. The McMoyler philosophy goes something like this: "healthy mom, healthy baby, however you get there". She is NOT anti-hospital, since she (like me!) is a healthcare professional herself. However, she is also encourages moms to try for a low to no intervention birth if possible. Basically she is not an extremist who pushes an 'all or none' theory at us. I really enjoy a realistic, middle of the road book every now and then:)

A few thought provoking points to consider:

1. The McMoyler method makes Dad a major player during labor and delivery, believing that as you give birth to his child he should NOT simply be a spectator. Many years ago, Dads weren't even in the delivery room with the mom (but then again, many years ago women were totally unconscious during delivery.....talk about creepy!).

She even goes so far to say that although some doulas are wonderful and helpful, most of them are unlicensed with no medical training. Although they may have your best intentions in mind, sometimes they will go up against the medical staff to fight for your 'birth plan' even when it puts the baby at risk. As a medical professional myself, I plan on taking advice from my OB--the one who went through years of medical schooling and formal testing and who is required by the state to stay up-to-date on her licensing. McMoyler suggests that you already have the best doula you can get in your husband. He knows you better and loves you more than anyone else, knowing your fears and desires, with a big stake in the outcome. She puts dad front and center as your primary support person and wrote an entire chapter just for dad. Nate is reading it right now and likes it for the specific techniques she lists to help me through the pain of labor.

2. McMoyler also proposes that the medical team at the hospital are NOT the bad guys. They aren't out to get you, ready to slice you open for a c-section and rush you through the biggest day in your life. Sure, there are some bad apples out there in the medical world just like any other profession. But the vast majority of doctors and nurses involved in labor and delivery love what they do and are committed to providing the best and safest care possible. She says that if you want a low-to-no-intervention birth they will support you any way they can. But if something happens that jeopardizes your or the baby's healthy, they will do whatever is necessary to keep you both safe.

And as a side note, as someone who works in a hospital myself, it NEVER hurts to do a little butt kissing to your nurses (I do it all the time and it works!) Be respectful of them, be kind, and a few compliments here and there go a long way. They will be a huge part of your day and you want them to be on your good side. Rolling through the door and saying, 'Don't touch me, I don't want you people to do anything because I'm going all natural' is a good way to put the nurses on the defensive. Not good. Another well-kept secret in the hospital world? We love food. Bring us some cookies or treats and we'll go the extra mile for you. We're pretty easy to please:)

I'm not going to go into all of the details here, but in chapter five the author goes through common myths about hospitals and interventions provided there. The two big ones for me (that I had heard before, and was a little worried about) were the idea that epidurals slow down labor and lead to many complications with the baby, and that hospitals intervene and do c-sections even when there is no medical need just because they make more money/it's more convenient.

For the Big E (epidural) dilemma, I'm of the group that would definitely like to try and avoid one but I'm not going to completely rule it out, either. You get no gold medal for going drug free and it's not a competition, so if I've been pushing for 15 hours and I'm only 3 cm dilated you better believe I'll consider an epidural. Sometimes, as the author states, an epidural lets your body relax and possibly even get some sleep which sometimes allows you to further dilate. A good epidural will let you feel pressure, not pain, so that you can still time your pushing without being completely numb. And in some hospitals you can even get a 'walking epidural' so you aren't totally bed bound afterward, since lying on your back is really not the best position for birthing. Epidurals sometimes spread out contractions but not always. Yes, if you have one you will probably need IV fluids, a catheter, and possibly Picotin. But I just think there is no way to plan whether or not you will need an epidural or not.

For the big C-section dilemma, obviously I want to avoid one at all costs. I do not believe that c-sections are more convenient for docs since they take a ton more time and delay the doctor getting out the door to another patient. I do think that some doctors might be more inclined to push for a c-section if there is ANY chance of fetal distress because of the fear of liability. And honestly, if my baby's heart rate is dropping with each contraction leading the medical team to think the baby is not tolerating a vaginal birth well I will not mess around with continuing to push for a vaginal delivery. The author also points out other valid reasons for a c-section (breech or transverse positioning, placenta or umbilical cord issues, and maternal indications) although she agrees that they should be used as a last resort. In the end, I just want my baby to be healthy and if something goes wrong I will trust my doctor to make the right decision.

3. Which brings me to an AWESOME point made by this book: no regrets. I think especially us women tend to get down on ourselves when plans fail, when things don't go the way they are 'supposed' to go. Although it's VERY tempting for me to write out a detailed birth plan of what my ideal scenario would be, I know that for me (and many others) putting ideas down on paper is like carving them in stone. And even though I've never been through labor and delivery before, I'm not naive enough to think that things go according to plan when you are pushing out a human being from your nether regions. If I hand over a piece of paper to my doc that says 'absolutely NO epidural, and NO c-section' I know I'm setting myself up for failure in the case that something does not go according to plan. As the author talks extensively about in the book, she has seen many women go in with the 'natural or nothing' mindset who end up having complications, needing an epidural and or a c-section. What is really sad is that these women end up regretting their birth experience, feeling negative and depressed and like a failure because they had to have drugs/interventions. I mean really, having a healthy newborn baby is a HUGE reason for celebration. Why would you waste one second feeling bad about yourself or your birth experience when you have an adorable new baby to care for? Throw in a little sleep deprivation, your whole world being turned upside down, and feelings of inadequacies and you are a shoe in for hard core baby blues, right?

So no regrets. Yes, you should spend time discussing your ideal situation and hoping for a low to no intervention birth is a fabulous goal (and mine!). But flexibility is key here and remember there are no gold medals for going all natural. The biggest reward is that little bundle of joy no matter how they got there. And at the end of the day, I want to be able to look over at Nate and say 'We did it!' because I fully expect him to be a major player pushing me through contractions and supporting me during one of the most intense moments of my life. He proved himself to be a great coach during my marathon and I know that he will be a lifesaver during this other type of endurance sport:)

Basically, I think that every single woman is different and each birthing experience is unique. I think it's great if you want a home birth, a doula, no interventions, etc. Maybe you're of the camp that prefers to be hooked up to an epidural immediately to avoid as much pain as possible, which is totally fine by me, too. But I just hope that whatever your 'plan' you know that sometimes the unexpected happens. And as long as a healthy baby enters into the world after delivery, the event was a success in my eyes.

I'm so grateful that I will be giving birth in a medically advanced time with so many options out there. And of course, I intend to read a zillion more books about this subject not because it gives me more control, or prepares me for every little thing about delivery, but because it's so freaking awesome to think that in about 4 months I'll have my own birth experience. GAH!

18 comments:

  1. I've never commented on your blog, and have always been a lurker, but I felt like this was an appropriate post to break my tradition. I'm a labor and delivery nurse in St. Louis, and most importantly, I just want to say THANK YOU for this post!!! Except for the few rare exceptions, all of us in the L&D world work with you for one thing- a safe and happy mom, baby, and delivery. While most people do opt for an medicated birth in this day, women wanting to go naturally are completely supported by all of us! We love to do whatever we can to make this the day you've dreamed of. And you don't need a birth plan to tell us what those dreams are. As long as you're capable of talking, we are more than happy to listen to what you want out of this experience- especially when you understand that we will ultimately do whatever is safest for you and the baby. So, thanks again for putting that middle of the road opinion out there.

    And one more thing... a little food for us nurses does go a LONG way!

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  2. This is the best thing that I have read in a long time! GREAT JOB, JULIA! I 100% agree with EVERYTHING you just said. I don't think I have ever had someone have the same attitude as me on this subject before. It was almost like you were reading my mind. I definitely will need to remember this book when my pregnant time comes! Seriously, awesome job!

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  3. I do agree with a lot that you said. For one, you HAVE TO be flexible in your plan because well, shit happens. You cannot predict what will happen. i know from working with kids w/ developmental disabilites, things can go wrong so you best believe if that happens, i want whatever is going to be safest for him!

    My mom really pushed the natural birth on me for a while, but im not comfortable with it at this point. If i didn't have back problems, i might consider it but knowing that i am calm and out of pain will be best for me-which means best for baby!

    I think the best thing a woman can do is research and decide what is best for her. Childbirth is just the beginning of judgement women get when it comes to raising a child (hell i learned ppl judge you since the day we told ppl we were prego!)

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  4. Between this post and Blue Eyed Bride's post about mothers taking sides on SAH vs. Working, this has been a FABULOUS 48 hours for Pro-Women Blogging! That sounds so crunchy granola, but like I commented to Erin yesterday, I am SO SICK of women taking sides and attacking each other!

    Fabulous post and very refreshing point of view!

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  5. Great review. You can never be too informed when it comes to these things.

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  6. This was fabulous! I wish you had a baby first, so I could read this and feel more assured.

    Also, I can't wait for the breastfeeding post, whenever we get there! :)

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  7. Obviously never being pregnant before, I have never thought twice about a birth plan. I have heard my friend's POVs get attacked when talking about their birth plans. I think the best thing to take away from this (very informative!) post is that women should support eachother and not critize. I love reading all the details of pregnancy you've already confronted. GREAT post!

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  8. Great post, Julia! I especially liked the part about the "no guilt." I had to have a c-section to do fetal distress, lack of amniotic fluid and Avery was breech. I didn't feel bad b/c the most important thing to me was getting AVery out safely. And when you're in shape, they really aren't that bad to recover from. I had a difficult time nursing for lots of reasons, but I had a really low milk supply. I could only nurse/pump for 3 months. Don't let anyone make you feel bad about your decision in this area. I let the guilt drive me crazy for a while, but again, the most important thing was for Avery to gain weight and thrive. Everyone has a different path and it's what's right for them. I loved your post!

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  9. Not to add to your list to do... but I'd highly recommend that you and Nate take Husband-Coached or Bradley Methold child birth classes. just google Bradley birth and you'll be able to find teachers in your area.

    Andy and I took classes to prepare for our little one. They are AWESOME! I read all the birthing books and felt ready to have this baby naturally. But I needed my support system to be ready. By going to the classes Andy learned a lot - I know he is prepared to handle anything that goes on during my labor and the birth of our child. Having a birth team assembled with your goals in mind is very important. I know my birth team is ready to get me the birth I invision. I really want to go all natural. But if I can't then I know that there are options and we'll discuss them at the right time. 90% of Bradley trained moms have natural deliveries.

    During class you'll have to read the student workbook (with lots of photos and quick reference for "go time") and Dr. Bradley's book, Husband-Coached Methold. I read Natural Childbirth the Bradley Way before the class. It was helpful to understand what we were going to learn in the class. Bradley classes are taught by an independent person from the hospital. So you get a lot more from the class than just hospital procedures.

    good luck and let me know if you have additional questions about Bradley!

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  10. Agree 100%....and I love how you mentioned "every birthing experience is unique"...so true. I had both of my babies naturally and people will say "oh, you are one of those women." Uhhhh...no. I started out thinking "I would like to do it as naturally as possible"....got to the hospital and said "give me drugs and epidurals and whatever you got" BUT because I spent so much time at home in contractions I was almost fully dialated and it was too late. I tried to bribe and beg and said I would sign something that says I give you permission to drug me even though it could be harmful...yeah, I got a little crazy. In the end all of our experiences are different and instead of judge each other we should be listening to each other's stories and be proud of each other. Great post.

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  11. Thanks! I feel better about my birth plan after reading your post. I did read "Your Best Birth" and I'm currently reading: "Ina May's Guide to Childbirth." They both focus on home births and not so much on hospitals, which can be a bad thing.

    I'm also reading: The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions.

    This book is VERY helpful! It has pictures and everything.

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  12. What an AWESOME post! I feel exactly the same way you do 100% but would never have been able to express my thoughts as elequently as you did. There are a few girls I know who are prego and going all natural, and I'm not into that at all. It's everything you said, about trusting true physicians over doulas, etc., believing they are looking out for my welfare and not just money etc. Wonderfully said!

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  13. Julia, great post! I have a friend who was studying to be a midwife, and friends who have covered the bases of childbirth, from completely natural home births to C-sections, and everything in between. In each and every scenario, they have all been blessed with beautiful, healthy babies--which, I agree with you, is really the only thing that matters. I haven't had children of my own yet, but truly believe that this is one life experience that really IS about the destination, not the road you take to get there. You have an awesome take on this--you are well on your way to becoming an awesome mom! Congrats!

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  14. I just wanted to say that was a really well written post! I really enjoy reading your blog. My husband and I are trying right now to get pregnant and it is great to read about your progress through your pregnancy. This is my first comment on your blog but I thought it was an appropriate first time to write!

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  15. Geez, I wish I would have read that book while pregnant with Emma! I had my perfectly planned birth all lined out. We did the 8 week childbirth classes, the breastfeeding classes, the hospital tours, etc, etc, etc. I was so prepared!! UNTIL IT HAPPENED. My water broke (GUSHED) suddenly one night and my plan immediately went down the drain. Emma turned out to be breech, needed an emergency C-section and there was no plan to follow. Afterwards, I felt a tremendous let down, guilt, and feelings of failure that my plan didn't happen. Those feelings eventually went away and it was a great learning experience for Baby #2! With Chase I said, I'll just wing it!

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  16. I love your approach. I don't feel the need to be anti-doula, as one can simply chose a doula who is actually trained and certified by an organization that one trusts. But I do agree that it is downright silly to ignore the importance of a woman's partner.

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  17. Hi Julia! I've never commented on your blog either but have been a religious reader for a long time now. I grew up with Erin Nevicosi and used to read her blog and needed a new blog to follow when she decided to stop blogging! Anyways, I am a labor and delivery nurse here in Milwaukee. I just had to tell you that I think this post is AWESOME. So many people have unrealistic expectations about labor and delivery. It sound like this book hit the nail on the head in every way. You are right, you must keep an open mind. The labor and delivery process is something you can not plan, unexpected events happen all of the time. Congratulations on your pregnancy!!

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  18. Hi! I can't find a way to email you, so I hope you get this comment. I just wanted to thank you for this post! I have been looking for a moderate approach to labor and this book is a lifesaver. I am excited to share it with my husband and know that it will be invaluable for our experience. Such a breath of fresh air compared to the other resources out there.

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