SHIFT NC

Belly Bump: Birthing Choices

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Note: In May 2015, the Adolescent Pregnancy Prevention Campaign of North Carolina (APPCNC) became SHIFT NC (Sexual Health Initiatives For Teens). 


Belly Bump is a series where we compare the pregnancy experiences of two women: Delsie, a prevention advocate and UNC student who became a mom at age 17, and Mary, APPCNC’s Community Programs Manager who decided to have a baby with her husband Anthony.  See previous Belly Bump entries.

Delsie

The cat was out of the bag and with it came a new sense of relief but also a whole new world of worries.  Once I got past the fear of revealing my unplanned pregnancy to those closest to me, I was now able to worry about the actual pregnancy.  A pregnancy carries with it the possibility of many complications and the fact that I was teen only increased the possibility of complications. I soon realized that my anxieties, which I thought would have been vanquished with my confession, shifted towards  the unborn child that I was carrying. The bundle that I was a carrying, which had once presented itself as a tremendous source of stress, soon transformed into a bundle of joy, one which I would give my life to protect. The motherly instincts had begun to kick in, and when it came to my child, I wanted the best for my baby. My world soon became consumed with decisions as to what would be best for my child. Which doctor would I go to? Which hospital would I deliver?  More importantly, what were my delivery plans? I must admit that there were many things that didn’t go quite as planned upon the conception of my daughter. The visions that I had prior to my pregnancy had slowly began to fade, but there was one thing that was still within reach; I would still be able to decide how I would deliver my baby- and I was set on a natural birth.

Women have been having babies since the world began and it would have been foolish for me to believe that I was the first. I was simply one among many and there was sure to be many more. This presented with it a sense of comfort and provided the assurance that I could do this as well and with that came the decision to have a natural birth.

I am one of four children belonging to my mother, all of which were natural births. All of her mother’s children were the same and I didn’t see why mine should be any different. As I would soon realize with other aspects of my pregnancy, opinions were freely offered, even when they were not necessarily invited. When it came to my birthing decision, most people advised me to consider taking an epidural. All of these suggestions were complimented with a reminder of the immense amount of pain that child birth would bring (as if I didn’t take that into consideration myself). But despite the prodding of others, my mind was made up. I was going to deliver my baby naturally-no medicine, no epidural.

Child birth is a beautiful thing. It is the product of nine months of development, bonding, and an immense amount of anticipation, and this is an experience that I did not want to miss. My desire was to feel every ounce of pain and experience every contraction. Sounds kind of crazy, but that’s what I wanted. I didn’t want to simply go through the motions of child birth; I wanted to be an active participant. After all, millions of women had done it before me—couldn’t be that bad…right???

Mary

“A woman dies every 90 seconds from complications of pregnancy.  90% of these deaths are preventable.”

I got this statistic from everymothercounts.org, an amazing campaign started by Christy Turlington Burns (yes, the supermodel).  She’s working to prevent maternal mortality across the world, which, unless you’ve been living under a rock, you know is a HUGE issue.  Maternal mortality is a big deal not just in underdeveloped countries, but in more industrialized countries as well.  The MMR or Maternal Mortality Ratio is used to describe number of maternal deaths per  100,000 live births.  The country with the lowest MMR is Italy with a ratio of 3.9.  The country with the highest MMR is Afghanistan with a MMR of 1575.1.  Using 2009 ratios, the United States is ranked as having the 39th lowest ratio in the world with an MMR of 16.7.  Compared to Afghanistan, we’re doing pretty good, to have the 39th lowest MMR, however, with American women having access to some of the best medical care the world can offer this ranking is indicative of deeper problems.

Our ratio numbers  could be due to lots of factors, more women given birth at an older age when complications are more likely, lack of access to those top notch medical resources for lower income women could be another, and many advocates and medical professionals cite an increase in medical intervention during birth and a rise of elective cesarean sections as another.  According to the Centers for Disease Control, “the cesarean rate rose by 53% from 1996 to 2007, reaching 32%, the highest rate ever reported in the United States”.  This statistic terrifies me, as there is nothing scarier in my mind than being awake while someone digs about in my stomach to pull out a baby. 

Knowing nothing about pregnancy at all, several years ago I took it upon myself to learn all that I could about pregnancy and birth.  I started off by reading an amazing book by Tina Cassidy called “Birth:  The Surprising History of How We Are Born”.  This book really brings to light the medicalization of birth that our culture has experienced over the past several decades along with the injustices many pregnant women have been forced to experience in their births.  I soon became obsessed with the idea of being a doula, and read every book on birth I could, reading more and more about birth and learning about birth outcomes associated with medicalized births versus birth outcomes associated with natural births facilitated by a midwife.  Soon, the literature and data convinced me that natural birth was the safest way to go and I became a natural birth advocate.  And then I got pregnant.

Upon learning that I was pregnant, I felt it necessary to find medical care as soon as possible.  I called the only free-standing birth center in North Carolina, only to realize that there is a screening process to become a patient, as well as a possible wait list.  Also, the birth center does not provide epidurals, which even though I knew could lead to negative birth outcomes, I had started to think I might want…because birthing is associated with pain and pain is scary.  I became disheartened and immediately called a local hospitals system and became a patient there after spiraling into a mommy vortex, concerned I was murdering my baby by not immediately seeking medical care.  A few days later, they scheduled my first appointment.  I can only describe this experience as climbing mountains of paperwork and being subjected to all kinds of medical tests.  The experience sent me into a panic.  I was just a number to them, and all of sudden, I felt completely disempowered.   One more pregnant gal.  Is this how all of my appointments would be?  Logistics?  Blood work?  Tests?  I’m a healthy woman, was all of this really necessary? 

After researching the hospital’s birthing facilities, I realized several policies that bothered me as well:   I could not eat or drink ever while in birth, I could not move around at all if I was to use an epidural, and time in a birth tub would be limited.    Most of these policies were in place due to the assumption that I would receive an epidural or that I would be a high risk birth and would ultimately need a cesarean section.    Again, I spun into a spiral of panic.  5 weeks pregnant and I was already constantly worrying about birth.   Would there be students there?  Would I actually be able to dictate the level of pain medication I wanted?  Did I even want pain medication?  All of my doula reading had convinced me that epidurals often slow down labor and making pushing nearly impossible, increasing a mother’s chances of  episiotomy or forceps/vacuum extraction, both things I am desperate to avoid.  What would be easier, being at a birth center with no access to an epidural and just dealing with the pain, or worrying that in a hospital setting I would be unable to resist temptation and receive an epidural and the subsequent interventions?  I didn’t know what would be worse.

After talking to my partner, my family, and friends, all signs seemed to point to the birth center, so my partner and I took a tour and I began the screening process.  Because the birth center uses so few medical interventions (as they believe a low risk pregnancy is healthy and normal), they only accept low risk patients.  After a week or so, I received the news that I was accepted as a patient and felt immediate relief.  My first appointment was wonderful.  No tests, no interventions.  My midwives focus more on having a low stress pregnancy, healthy eating, and lots of patient education.  I never feel like a number, and I always leave feeling a little bit more empowered.

The initial shock of pregnancy and other women’s horror stories made me doubt all of the research that I had done ahead of time about natural birth, but having the initial experience of a hospital system made me only more confident in my choice to birth naturally at a birth center.  When my time comes to give birth, I will have a midwife and a doula at my side.  No bright hospital lights and interventions, just a quiet room and loving people.  As the time gets closer, sure, I think about being in pain and it scares me, but I also know that that pain in birth is normal and that it will end.  I also know that a little bit of pain can have some pretty solid birth outcomes, both for me and my child. 

I see it as my first lesson of motherhood:  Very often, the best thing to do for your child is the thing that hurts you the most.

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