Last weekend, when discussing childbirth among women at my husband's firehouse, mostly girlfriends and wives, I was shocked when most of the women discussed wanting a natural birth. It was a pleasant change:one that I have been working so hard toward!I started doing some research after my discussion and came across a quote on natural childbirth in The Official Lamaze Guide that really struck a chord:"In spite of evidence, U.S. maternity care continues to sabotage normal birth rather than support it. In 2002, the Listening to Mothers survey learned that among nearly 1,600 new mothers across the U.S., 44% had labor induced, 71% did not move freely during labor, 93% had electronic fetal monitoring, 86% had intravenous lines, 74% gave birth on their backs, and almost 50% of their babies spent the first hours after birth with hospital staff. Only 1% of the women experienced all six care practices that promote normal birth, and none of these women gave birth in a hospital."Lots of alarming statistics in there. This first-ever national survey of U.S. women's childbearing experiences gives us a look into the way women are giving birth today in spite of evidence showing that these practices are outdated, unfounded, or harmful rather than helpful. Let's take a closer look into each of the statistics listed and learn ways you can try to avoid becoming "one of the statistics" when birthing in a hospital:44% of women had their labor induced. (!!)That is a huge number for labor induction, especially since labor should only be induced for necessary medical reasons. Letting labor begin on its own is key for a healthy birth experience for women. It is also the way our bodies are meant to work in the natural stages of pregnancy. Labor induction is not a procedure that is risk free:it can increase the risk of premature birth, cesarean section, abnormal fetal heart rate, fetal distress, shoulder dystocia, and increase the risk of your baby needing to be admitted to the NICU. To reduce the incidence of unnecessary induction, find a provider with a low labor induction rate, and research the policies of the facility where you plan to give birth. This may be tricky, as many hospitals do not publicly advertise their rate of induction, cesarean surgery or other interventions. You might be lucky enough to find it on your hospital's Web site. Or perhaps your hospital's rating and feedback is listed on The Birth Survey. If not, take a hospital tour and be sure to ask LOTS of questions. Knowing information ahead of time gives you the opportunity to change your place of birth if you're uncomfortable with their practices.71% of women did not move freely during labor.Being confined to a bed while laboring is not ideal by any means. Not only does it decrease the size of your pelvis, but it also can cause lowered blood pressure and fetal distress. Better positions to give birth in and labor in include:
- Hands and Knees
- Side Lying
- Knees to Chest
- The Sitting Position
93% had continuous electronic fetal monitoring.This is a high number despite the fact that several studies have shown no improved outcome to mothers and babies with continuous electronic fetal monitoring. Also, recently, there has been a number of controversial articles about fetal monitoring and how medical professionals are reading the fetal heart tones. Many think that the over-analyzing of small decelerations in fetal heart tones is leading to a higher rate of unnecessary cesarean births. There are situations where monitoring may be a beneficial procedure, but in most birth situations, intermittent monitoring is safe. 86% had IV Lines. Having an IV line in place in a laboring mother means that hospital staff has easier access to administering fluid and medications if needed. However, being attached to an IV line also restricts a laboring mother's movement, interfering with her ability to change positions. Something that may help is requesting a "hep lock" in place of an IV line. A hep lock is a device that is inserted into a mother's hand or arm so it is ready in case an IV line needs to be hooked up. Also, drinking and eating during labor will help to eliminate the risk of needing any kind of IV fluids during labor.74% gave birth on their backs.Laboring and giving birth on your back is pretty much the worst position. I recently wrote about this in two posts, Positions You Should Be Giving Birth In Part 1 and Part 2. Decreased pelvis size, blood pressure complications, lack of gravity to help with the birth itself are all huge factors in the supine (back-lying) position.50% of babies spent the first hours of life with hospital staff. (!!)Many mothers are not familiar with the benefits of skin-to-skin contact with your baby after they are born. The first few hours are critical for mother-infant bonding. Unless your baby is experiencing complications or needs NICU care, babies should be kept with their mother in the first few hours -- baths, weighing and measuring, etc. can all wait. Babies who have skin-to-skin contact after birth:
- Cry less
- Have more stable temperatures
- Have more stable blood sugars (with the lack of skin-to-skin contact with my second son, because of my cesarean, made a change in his blood sugar which resulted in a 30-hour NICU stay)
- Breastfeed sooner, longer, and more easily
- Are exposed to normal bacteria on the mother, which can protect them from getting sick from unhealthy, or other types of bacteria, especially if birthing in a hospital
- Have lower levels of stress hormones
Only 1% of these women experiences all 6 Lamaze Healthy Birth Practices.Having a birth plan, and being an advocate for yourself and what you want for your birth experience in a hospital is key here. Communicate with your care provider and create a written birth plan to share with your care provider as well as the hospital staff when you arrive for baby's birth. Make sure your partner knows about your birth preferences so he/she is comfortable talking with and reiterating to your provider and hospital staff on the big day.When it comes to birthing in a hospital, being an empowered patient is critical to having a healthy and happy birth experience. Read, do research, take a Lamaze class, interview care providers and hospital settings -- learn all that you can to be informed and make the best choices for you and your baby.
Photo from Inexplicable Ways.