Thursday, October 18, 2007

the more you know

We're planning a home birth. And I'm really, really excited.

I know that we were leaning this direction, but meeting our new home birth midwives, Gail and Clare, really tipped the scales. We met with them a week ago, and they were just lovely. They spent an hour and a half with us, just talking about who we are, how we feel about birth, and what our goals are. The explained their work and their training, and we felt extremely comfortable with them.

That was the easy part. Now comes the more difficult stuff - telling family. Here's how I plan to phrase it:

We're planning a home birth! We are working with two certified midwives (one a certified nurse who has years of hospital birth experience, and one a traditional midwife who has been doing home births for almost 25 years). We have our back-up plan in place, and in case of any difficulty or changes, we will transport to Abbott Northwestern, an 5-10 minute drive from our house. There are many reasons that a woman will transport during labor, the most common being exhaustion and dehydration. We're planning to avoid these two things, but we know that we might end up in the hospital either way. If we do go, the midwives come with us. We also know that if the baby's vital signs or my vital signs look at all like they are in trouble, we will go to the hospital. We're not stupid, and we're not willing to put my life or the baby's life in danger.

There are a number of reasons that we're choosing this path, but they're personal and I don't want to go into them. If you have serious concerns about my safety or the baby's safety, please come with me to one of our prenatal appointments, meet the midwives, and talk to them yourself. We've done our research, we've talked to references, and we are excited and committed to this plan.

So there. I'm not sure how that will go. I had planned to lie to family, telling them that I'm going to deliver in the hospital. But you know what? I'm going to have to start putting my foot down. It's about time. And it seems good to start doing that now, before the baby is involved - because I think there will be a lot of things that I'm going to want to put my foot down about once the kid is actually here.

So I've got to find a way to tell them, and find a way to have them be okay with it. Dave and I had a long talk last night, and he kept repeating that I'm not in charge of how anyone else feels, I'm only in charge of how I feel. It's hard, and scary to think that my family might resent me, or disapprove, but this just feels like the right path. I've said before that I feel like my family disapproves of me in general, they think I'm just a little too far out of the mainstream. Even though I don't believe that I am - not watching television and eating organic, locally grown food does not make you a crazy person. This, however, is stepping way out of the mainstream, and I understand that.

I truly believe that one of the reasons that the United States has seen an increase in maternal mortality and a fairly high infant mortality rate at birth has more to do with the intervention of medical science than it does the lack of it. Bringing birth into the hospitals, increasing rates of induction, Cesarean, and medical intervention have all been contributing factors. I want to be part of that small group who fights back by taking the birth of my child into my own hands, and trusting that two experienced women can get us through without those interventions. Reading articles like this one and this one prove to me that it is the right thing for me to do. Learning about the hormones that are released during birth and knowing all of the ways that hospitals go about stopping that natural process, I want to try to do it this way.

Last night, Dave and I attended a meeting of the Minnesota childbirth collective. They do a series of parent topic nights, and it was neat to connect with other parents and a bunch of doulas. The topic for last night was preparing your mind and body for birth. There were a couple snippets of information that we gleaned that I found particularly helpful. The doula Karen covered a number of exercises that can be done in advance to prepare and tone the muscles groups needed during birth. Most important to me was squatting. While it's well known by many that women in other cultures squat during birth, I never considered the reasons why. To name a few, squatting shortens the birth canal, uses gravity to get the baby out, and opens the pelvis as wide as it will go. It makes sense to practice this ahead of time, especially as the weight of the baby in your belly makes balance a little more difficult.

Karen also gave a long talk about food and food choices, something that Dave and I have learned a lot about and spent a lot of time discussing. The thing that hit home, though, is hearing again how high the protein needs are for a pregnant woman. They talked about the Brewer Diet and the research Dr. Tom Brewer did during his lifetime. Sufficient levels of protein can prevent pre-eclampsia, a scary and often dangerous condition. Being a vegetarian, we've been worried that I wasn't getting enough protein, even though my blood levels were fine at 8 weeks (the last time we had lab work done). After meeting with the home birth midwives, I began to add hemp protein powder to my fruit shakes every day. But now, after looking through the Brewer diet, I'm going to try to do more. I plan to eat nuts every day, either peanuts or almonds. Peanut butter at breakfast, and a hard boiled egg. We will keep adding beans into means wherever we can, but I will try to snack on things like black bean and fava bean salads. I think these small changes will make a world of differences.

The last part of the evening that was sort of skipped over because of time, was practicing relaxation techniques with your birth partner. It makes sense that one would want to practice these things ahead of time, learning how to read each other's cues and be comfortable saying what is working and what isn't. Dave and I didn't get a chance to talk about this at all last night, but I'm hoping we will soon. Karen urged us to consider how to deal with a woman in labor who doesn't want to be touched or spoken to. What are you left with? Eye contact, music, scents, sounds - there are a ton of ways to continue to be helpful and supportive, even if that doesn't involve talking and touching. One of the most insightful things they said is that when you invite someone to your birth, you want to be sure you talk to them in advance about the possibility that you may want them to leave. Let them know that they shouldn't be offended, it's not personal, it's just the way that you feel right now, and feelings are all over the place during birth.

This was really our first forage into birthing classes, and while it was not the traditional hospital Lamaze class, I found it very valuable. I think I'll go back to the parent topic nights, to get to know people better and to connect with other pregnant couples. It was neat to go around the room and hear how and where other people planned to deliver (or had delivered) their babies. It's cool to be able to tell a room full of people that you're planning a home birth, and feel supported and proud of your decision.

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