The follow up to No One Told Me It Would Be This Hard: Part I . . .
The day of the induction and delivery of my baby was not at all what I thought it would be like. I had Pitocin administered through an IV at 6:00am the next day and by 11:00am my water broke and all hell broke loose in my body. I went from feeling like I could handle labor and the level of pain I was experiencing to having my husband and Doula take turns jamming their fists into my back. I was one of the unfortunate women who have posterior babies (the baby’s skull is in the back of the pelvis). It was the most incredible back pain I have ever experienced and I needed the counter pressure of their fists to get through each contraction. Once I reached 8 centimeters I asked for something to slow the contractions down and give me a break! They gave me a small amount of pain medication but it didn’t do much to help me. I eventually got to 10 centimeters and started pushing. Everyone kept telling me to grab my legs and thought to myself, they want ME to grab my legs?
I am normally very modest and well-mannered but at this point I didn’t care what was showing or coming out of me, and I was swearing like a sailor. I always hear women say that they are nervous they might poop. When you reach the point of no return, you don’t care what is going on, you just want that baby out of you. I was placed in all kinds of squatting positions and nothing worked. Two hours later, my bladder was swelling and there was no head in sight. I was in a lot of pain and the decision was made to have a C-section before it turned into an emergency C-section. It was the worst case scenario for me, but I knew I didn’t have a choice. I had a spinal block/epidural and by 6:41pm, I had a baby. It wasn’t what I envisioned but I had a healthy baby and eventually came to terms with the outcome. Many women experience a range of emotions and go through a grieving process when they have an undesirable birth experience. Information and resources for women who have had cesareans can be found at the International Cesarean Awareness Network.
According to the National Center for Health Statistics, 1 in 3 babies in the United States are delivered by C-section. Over the past 10-15 years the rate of Cesarean births has increased dramatically. As cited in USA Today, between 2002 and 2009, the number of Cesarean deliveries rose significantly, from 27 percent of births to 34 percent. Some Cesarean sections (C-sections) are performed because they are medically necessary due to complications that may affect the mother or baby; sometimes they are used to prevent a medical issue from occurring; and sometimes they are voluntary. According to a report from the March of Dimes and the American Pregnancy Association the following are the most common reasons C-sections are performed in the United States:
- Some women request them because they don’t want to have the baby vaginally.
- The timing of the delivery is more convenient for the doctor or the mother.
- Women now give birth later in life and are considered to be at higher risk for complications during pregnancy and delivery.
- Medical issues such as high blood pressure, diabetes, obesity, preeclampsia, etc.
- During labor and delivery there could be issues with the placenta, umbilical cord, the baby could be breech or in distress, the mother could have an infection, etc.
- If the women is delivering multiple babies.
- Some women may not have any education on the procedure and opt for it right away when they believe there could be a potential complication.
- Fear of malpractice.
- Some suggest that inducing labor or using epidural drugs may increase the likelihood of having a C-section.
Why would you want to prevent a C-section, anyway? A C-section, like other major surgical procedures, can have serious potential short-term and long-term effects. There can be risks and complications to both mother AND baby. Unfortunately, because the procedure has become so common, many women do not educate themselves on why they should or shouldn’t have the surgery (and we understand that women sometimes don’t have the choice).
What Can You Do to Try to Prevent a C-Section?
- Locate a medical provider with a low rate of intervention.
- Ask your medical provider about their rates and how they feel about performing C-sections.
- Create a birth plan and ask your medical provider what research they have on how to reduce the risk of having a C-section.
- Do your research: find out if your community hospital and/or birth centers in your area provide childbirth classes, read books on the topic, check out the March of Dimes website, and prepare questions to ask at each prenatal appointment. The information learned through these sources will also help you to become more familiar with labor and pushing positions.
- Look into labor support from a doula and involve your family member or support person when you attend the classes. According to the American Pregnancy Association, women with continuous labor support are 26% less likely to have a C-section.
- Find non-medical pain management techniques that will work for you (such as meditation and relaxation techniques, stretching, walking, music, etc.)
- Make sure your support person, doctor and/or midwife knows ahead of time how you feel about C-sections. You will probably not feel like yourself during labor and may need your support person to be your voice.
- Ask your medical provider how long you can labor at home. A common reason for Cesareans is prolonged labor at the hospital.
- Do not have a voluntary induction.
Stay tuned for next month’s blog post, which will give additional information about what occurs during and after the procedure.
Many of us have heard of the ring of fire that engulfs the vulva when the baby’s head is crowning and stretching your vagina in ways you never imagined possible.
Massaging your perineum can sometimes help prevent some of the discomfort, tearing or ripping and, possibly, the need (in some cases) to have an episiotomy during the delivery of a baby. An episiotomy is an incision made by a medical provider when they feel: the labor is not progressing; serious tearing seems very likely to occur; or the baby needs to be delivered quickly because of a medical condition (i.e., the umbilical cord is wrapped around the baby’s neck). According to the American College of Nurse-Midwives, 40-85% of women who have vaginal deliveries will tear and about two-thirds of those women will need stitches. For those who are unclear where their perineum is, it is the area between the bottom of your vagina and the anus. This area is sometimes referred to as “the taint.”
Some women are encouraged by their doctors or midwives to massage this area, starting approximately 4-6 weeks before their due date, to help the skin become more pliable for the incredible amount of stretching it will endure during delivery. If you are interested in performing this type of massage you should consult with your healthcare provider on how to properly perform the procedure. They may prescribe a specific lubricant, like KY Jelly or natural oils like vitamin E or olive oil.
Bottom line: The jury is still out if whether perineal massage significantly reduces tearing or the need for an episiotomy. Midwifes and women who have performed the massage prior to delivery state that it greatly reduces vaginal trauma. The midwives in the practice I’m going to swear by it, which is good enough for me. If it doesn’t work then there was no harm done, and if it does then I will be extremely thankful that my precious perineum does not have stitches in it for 6-8 weeks after delivery. Ouch!!