Posted by: sayamika, the killer bunny | 2008 March 23

The Birth Plan

I was happy to see a midwife doing deliveries in the Slightly-Larger-Regional-Hospital where I studied OB. In the past, I have generally appreciated some level of antipathy amongst midwives for birthing in-hospital.

Which blows my mind, I have to say. It’s not as though the vast majority of people giving birth need the services of a hospital, but quite often when trouble occurs it is unpredictable and needs the  immediate attention of an obstetrician and an OR team. I’d like to say I respect the choice of women who recognise the risks and choose to birth at home, but I have to say I just don’t get it.

Your “birthing experience” may be important, but in the end, the point is to have a healthy baby.

Childbirth is a natural event. This is true. Of course, so is death.

Women have done this outside hospitals for millennia. Also true. I’ve seen the aftermath of lots of these births… most go fine, when you start with a healthy mother and an experienced birth assistant. But when they go badly, they can go very badly. Cord prolapse in a hospital is a nightmare, but manageable. Cord prolapse at home is an unmitigated disaster.

Epidurals are unnecessary.  That is I suppose literally true, but really, that depends on your point of view. If it’s you having the baby, I guess you’re the one who gets a say in it. If you’re not giving birth…. mind your own business. That includes you, miss midwife, mister nurse, or granola gramma. This birth might involve you but it’s not about what you want.  Pain does not ennoble: it’s just pain.  I have never been so annoyed with another professional as I have been when I have seen OB nurses trying to talk women out of epidurals or pain control. If you have some biblical belief that women should give birth in pain, stay the hell away from my patient.

I don’t want a caesarean. Be sensible. Nobody wants a caesarean…. well, nobody sane anyhow. The doc doesn’t want to call in the OR staff. A vaginal delivery is so much easier and nicer. You’ll recover faster and take up a bed three fewer days. If they’re saying C-section, they’re saying it for one of three reasons: a. there is some pre-existing reason you can’t do a vaginal delivery, b. the baby isn’t coming even though you’ve been pushing well and the contractions are great, or c. the baby is not doing well and might not have the strength to withstand delivery. So get over yourself already.

No forceps. You know, if the forceps are coming out, it’s because they have to. For some reason, the baby has come down most of the way but you need help getting those last few centimetres, and the baby can’t take much more pushing. They’re interesting, but I don’t want to use them unless I absolutely have to.

No episiotomy. Older docs were taught that an episiotomy reduces tearing, so they did them. Younger docs have read the new studies that show minimal differences in tearing and better healing in tears that occur naturally. So, I won’t cut you. But I will try to prevent the tear, and I will sew you up carefully afterwards if you need it. 

Can I have my boyfriend/sister/mother’s lesbian lover present? You can bring the whole flag-football team if you want, just keep them away from my steriles. And let me know who you want cutting the cord. 

Most hospitals these days try and make sure you have a room with its own bathroom, lights that dim down, and a comfy chair. You can have whatever you want for music, from Brahms’ Lullaby to Killing in the Name Of. You can hang out in the tub. You can make the birthing partner bring you smoothies. You can push at your own pace. You can deliver in any position you like. You can swear at the doc, and they won’t hold it against you.

Medical people don’t want you to have all of the above. They want it available if you or your baby need it. Nothing more.

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Responses

  1. *Picturing how slightly-larger rural hospital would react if you really did show up with a Rage Against the Machine CD, your mother’s lesbian lover, and your flag football team. Laughing a little*.

    Miss ya.


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