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Moms-to-be have more options for giving birth |
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Written by Pikachu
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Friday, 13 April 2007 |
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Forget knitting baby booties. When Angela Ganter found out she was pregnant, she immediately went to work on a more fruitful task: researching her childbirth options.
"I wanted to know all I could about the birthing process," says Ganter, 30, of St. Louis.
So she began to read extensively, particularly about home births.
"I read the pros and cons," she said. "I read people's birth stories, and it seemed the home birth was a more satisfying experience."
She saw two doctors while pregnant — one "hospital doctor" and one "home-birth doctor."
In the last month of her pregnancy, Ganter decided home birth was the way to go for her.
"I was just confident I could do this myself," she says.
She prepared by doing visualization techniques, art techniques, yoga and breathing, and, on the day of the birth, she was ready. She rented a birth pool from her doula and friend, Katie Mack, and gave birth to her son, Silas, in the water.
"It went better than I expected," Ganter said. "In the last two hours it was completely silent ... no one touched me, and I just reached down and pulled my baby up. It was very empowering. I was so glad I did it at home."
Ganter is part of a growing number of women who are looking for more out of their birthing experience. For many women, that means taking a greater role in the birthing process, perhaps including their families, using self-help techniques to get through the birth and choosing not to labor in a bed the entire time.
But for those who are fed up with medical interventions and doctors who perform C-sections too quickly because of malpractice concerns, the choices may be more extreme. Indeed, according to the latest report by the National Center for Health Statistics, the rate of C-sections went up 6 percent between 2003 and 2004 (the latest year for which figures were available), the rate of induced delivery doubled, and the rate of vaginal birth after Caesarean fell by 13 percent. The nonprofit group Childbirth Connection made public a study last year saying that 25 percent of the mothers who'd undergone a Caesarean had felt pressured to do so, and nearly 20 percent of those who'd been induced said they had felt pressure from a doctor to get their labor going.
Though the survey found that most women were satisfied with their birth experiences, many were not.
Some childbirth experts say they are seeing a trend toward women looking for more meaningful birth experiences.
"That doesn't necessarily mean home births and water births," says Mack, a doula from St. Louis. What it does mean, Mack says, is more education.
With the plethora of books and Internet sites dedicated to informing pregnant women, it's no wonder more are going into doctors offices armed with information.
"Women are much brighter, much savvier about what's available to them and what they should expect from their providers," says Sarah Boyer, a maternal child educator at St. Elizabeth's Hospital in Belleville, Ill. "It's not uncommon for women to research, read books and go in with insightful questions as to what kinds of tests they are having, what kind of care they are receiving."
Boyer says she's seen the trend really grow in the past four years. And with education, women are seeing more options.
"There are so many choices out there," says Cindi Hedrick, a nurse and owner of Labor of Love, a childbirth services company in Weldon Spring, Mo. "Now, in the Internet age, mothers are able to get more information about their options, and many are looking for more naturalistic approaches to birthing, or maybe they are just looking to understand the medical side better. I think 10 or 20 years ago childbirth was more seen as a medical procedure, and the empowerment was taken away from moms. Mothers in this day and age are so much smarter and looking for more for themselves and the babies. They are taking power back to birthing, and that's an awesome thing."
DOULAS
One of the ways women are doing that is by hiring doulas. The word "doula" comes from the Greek meaning "woman caregiver." A doula is an experienced companion who is certified by a doula organization but not necessarily medically trained. She provides women and their partners with emotional, physical and informational support throughout the different phases of her pregnancy and the postpartum period.
"A doula can be the glue that holds a woman's experience together," says Mack, who estimates she does 30 to 50 percent of her births at the mother's home.
"A woman is going to feel better if she has choices along the way. If she's in a state of fear and tension, the body doesn't work."
Mack says that doulas are there to act as an advocate for the mom and to help the dad.
Boyer helped start the doula program at St. Elizabeth's two years ago. The program provides doulas at no cost to moms in labor. In 2005, just 10 percent of patients took advantage of the program; in 2006, that number doubled.
"I think there is still a big misconception that if you are planning an epidural, you don't need a doula, and that couldn't be further from the truth," Boyer says. "Sometimes they almost need them more."
Research has shown that women who have a doula report having more enjoyable birth experiences, and they report breast-feeding for longer periods of time.
THE MEDICAL SIDE
For some women, an estimated 25,000 a year in the United States, returning the birth to its natural process means giving birth at home, as Ganter did.
But few doctors are willing to do home births or water births. There's a good reason for that: You never know what could go wrong.
Dr. Octavio Chirino, chairman of obstetrics and gynecology at St. John's Mercy Medical Center, put it this way: "The problem with home deliveries is that when it comes to delivering babies, it's 90 percent routine and 10 percent sheer terror, and while you can try to create a model for predicting high-risk and low-risk pregnancies, low risk can turn to high risk in a split second, and that could be dangerous for the mother and the baby."
Chirino says he understands the goals of a home birth ("natural") or a water birth ("where everything is serene and empowering") but says that the fear of things going badly keeps most doctors from doing them.
"If you lose a mother or a baby, it's going to affect you, it's going to affect the rest of your career, and also, unfortunately, we live in a litigious society."
Chirino says hospitals have made strides in recent years to listen to mothers' desire to make the birthing process more natural.
"It's important for hospitals to provide women with the things they want," says Chirino, whose hospital delivers 7,800 babies a year. "We've tried to create a more homelike environment," with beds for the dads, rooming in with the baby, breast-feeding immediately after birth and even a room-service food delivery.
"We have a tub for laboring, but for the delivery itself it's important to be outside the water," Chirino said He cites a report in the American Journal of Obstetrics and Gynecology in which water births were blamed for drowning and for infection from a waterborne disease.
"This is a gambling situation, and it's not a gamble I would take when it comes to my family," Chirino said. "Birth is a normal process, it's true, but you cannot predict when that normal process is going to turn into a disaster."
FAMILY-CENTERED CARE
These trends have even filtered into more traditional settings. At St. Luke's Hospital in Chesterfield, Mo., family-centered maternity care was implemented in January.
"We focus on the family as a whole," says Kelley Swinkels, associate head coordinator for family-centered maternity care at St. Luke's. "We realize it's not just a birth experience for the mother but for the whole family, and that family is defined however you define it."
Swinkels says the hospital realizes how many choices parents have when it comes to the birthing process and tries to be accommodating.
One of the unique aspects of St. Luke's is that the mom and baby get the same nurse.
"We encourage parents to take advantage of the time here," Swinkels says. "They can watch the nurse take care of the baby right in front of them, so the parents learn how to listen to the baby's heart, how to change a diaper; they can talk about the baby's stools, whatever."
Swinkels says that family-centered care is becoming more popular across the country but that the educational aspect of St. Luke's program makes it unique.
"This program is all about options," Swinkels says. "If you want to do aromatherapy or massage therapy, we'll help. You can bring in your own tub for water labor — just discuss it with your doctor."
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More information:
Doulas of Greater St. Louis: www.doulasofgreaterstlouis.com
International Childbirth Education Association: www.icea.org
Waterbirth International: www.waterbirth.org
Circle of Life Doula Services: www.circleoflifedoulaservices.com
www.childbirth.org
www.a-laboroflove.com
www.naturalchildbirth.org
www.babycenter.com
www.childbirthconnection.org
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Recommended reading resources:
"Birthing From Within," by Pam England and Rob Horowitz
"The Thinking Woman's Guide to a Better Birth," by Henci Goer and Rhonda Wheeler
"The Birth Partner," by Penny Simkin
"Journey Into Motherhood," by Sheri L. Menelli
"An Easier Childbirth: A Mother's Guide for Birthing Normally," by Gayle Peterson
"The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth," by Dr. William Sears and Martha Sears | Only registered users can write comments.
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