Wednesday, August 15, 2012

Birth Days and Craze

Aidan should be two today.  It's his two year 'due date anniversary', which isn't a day you celebrate or really even think about when your child is born alive and healthy, but somehow seems significant when your baby didn't make it home.

Two.  Wow.

I know other people feel sad on these 'anniversary' days that are related to their dead child, but over two years later, I sort of look forward to them.  His birthday, his due date, the anniversary of the day we found out I was pregnant...these are days when the veil between the time we spent with him and now seems somehow thinner.  Even though he never actually lived to SEE an August 15th, it will forever be the day that is branded into my mind as the day our family of two was suppose to grow to include a small, squishy, bouncing baby boy.

A cousin of mine (the one who we had the shower for back in April), is due tomorrow.  As her pregnancy has progressed I've been able to mentally keep track of exactly how far along she was as I can easily compare to my pregnancy with Aidan.  In late April, when I saw her at the baby shower, I mentally did this equation because it was about a week after Aidan died (so 23 weeks + 3 days + 1 more week than we got with Aidan = mid 24 weeks).  I'll probably always be able to do this with her child (Aidan's suppose to be age - 2 years exactly = cousin's baby's age).

I've been thinking about this particular cousin a lot right now because she lives in the States and is planning on having a home delivery with a midwife.  As I mentioned in an earlier post, we've recently cancelled our cable and got Netflix so when Kaia's napping in the afternoon I've been watching documentaries.  I've watched two recently that were about the state of maternity care in the States and the sky high intervention (induction, epidural, forceps, vacuum) and C-section (30%) rates.  Both documentaries were by film makers who had planned or had home deliveries with midwives and heavily slanted in favour of reducing C-section rates, and encouraging and supporting more women in having medication free, vaginal deliveries.

The talking heads in the movies (medically trained outspoken advocates for natural birth) cite many studies that show home deliveries are as safe as hospital deliveries (for healthy moms and babies, of course).  One documentary film maker even goes to Holland where 80% of babies are born at home.  In Holland deliveries are CHEAP (about $800 for the attendant) and women's attitudes towards birth seem to be "why wouldn't I want to have my baby at home? I'm not sick, so why should I have to go to the hospital?".  How novel!

Both documentaries talk about how C-sections in the States may be done for the convenience of doctors (ie: the highest rates of C-sections are at 4 pm and 10 pm. The first so the doctor can be home for dinner, the second so the doctor can be home to go to bed).  Also, they both go into how inductions are now so common (mostly done on a Monday-Friday, again for convenience sake) and around 50% of the time, result in a C-section.  The induction flow chart often looks like this (especially in cases when babies are being induced with no signs of impending labor): induction > contractions very strong, very quickly > epidural as woman is very uncomfortable > labour slows down due to epidural effects and because woman no longer able to move around > increase pitocin for 'stalled' labour > contractions increase in size and strength > baby begins having decels due to very (too?) strong contractions > physician jumps in and says "your baby is in distress I think it's time for a C-section in the interest of your baby" > baby is born via C-section and everyone says "whew, glad doctor was there to get baby out in time".  That this occurs is not at all a surprise to me.  In one of my women's studies courses in university I did an entire paper on the history of midwifery in continental Europe, and it was fascinating to see exactly how medicine (read: male physicians) took over birth as a way to increase revenue and appropriate knowledge that had always been in the realm of women, touting it as "science".  That insurance companies, time management strategies, technology and pharmacology has made things even more complex and heavily weighted in favour of hospitals and doctors doesn't surprise me in the least.

I generally agree with a more natural approach to delivery, and less intervention versus more.  People seem to have lost sight of the fact that having a baby is a natural process.  Like digesting food, or recovering from a cold, or learning to walk, things humans do every day with very little incident.  Women's bodies are MADE to deliver and carry a baby.  We were doing it for THOUSANDS of years before epidurals, and C-sections and fetal monitoring showed up and somehow the species survived.  Not to mention that all other mammals except humans seem to do just fine with very little or no 'scientific' intervention. These documentaries portray the delivery that I would have loved to have had.

Of course, my experience was a little bit different.

At her baby shower, my cousin was talking about her decision to have a midwife and how she planned to deliver at home.  She stated that of course, if there was a problem, she would obviously want to be transferred to a hospital and then said "in those cases, I think a woman knows if something is going wrong.  You just have to listen to your body".  And while I want to agree...I know from experience, and from reading many of your stories, that no, in most cases you DON'T know that something is going wrong.  You might worry about it, or wonder about it, or feel off, or feel anxious or question if something is normal or not...but rarely do you know in a way that allows you to act.  In my case, I was a nurse, with contractions every two minutes at 23 weeks pregnant with a pregnancy that I KNEW was in danger...and it took until I was minutes away from delivery and they were announcing that I was 6 cm dilated before I really GOT that I was going to have a baby and he was going to die.  I was in so much pain that any decision making at that point was out the window. I knew 5 hours earlier when I started having bad back pain that this was likely 'it', but I didn't want to let myself believe.  It's that ever helpful/harmful human state called 'denial'. 

The natural birth advocates in the documentary, who talk about the flow of hormones that are released after a woman delivers naturally without meds (which they say are impeded with an epidural), talk about it being such a 'high' and so 'critical' for the mother-baby bond.  Maybe so, but after I delivered Aidan naturally, without meds (who was all of 1lb 4 oz and less than a foot long), all I wanted to do was pass blood pressure was in the tank and I felt woozy and exhausted.  This probably has more to do with having a death to deal with rather than a 'birth' and my heart condition, but in the weeks after having Aidan, thinking of the physical pain of giving birth I remember saying to Brian "don't ever let me do that again without an epidural". much for my 'elated high'.  It also puts down the many many women who have epidurals and also give birth 'naturally'.  Did they not push out a baby too.  What exactly was 'unnatural' about that?  And if it was any other condition where someone was in pain, you'd think it barbarous NOT to have pain medication.  Take out my appendix with out anesthesia? Um, no thanks. Yank out a tooth without freezing?  Not going to happen.  I fell and broke my leg in three places...holy hell, where's the drugs??!!  Who am I to say how much is too much pain for someone else?  Should proper preparation, support and other more natural pain relievers/modifiers be available for labouring women so they feel confident and comfortable saying 'no thanks, I'll work through these contractions on my own".  Of course.  (As an aside, I wonder what the cost benefit ratio would be of employing an army of doulas/midwives and/or better trained nurses, comfortable birth suites, and other pain reducing/coping methods of child birth compared to C-sections, anesthesiology time and medical supplies?)  However, I wouldn't want to put down anyone who says "nope, I'm done, where's my epidural?".

The documentary talked about the evils of C-sections and how they aren't the panacea of awesomeness that modern hospitals would have you believe. From an NICU nurse's stand-point this is obviously true. Babies are designed to endure labour, in fact, labour often helps to 'ready' them for the outside world.  Passing through the birth canal helps to squeeze out fluid in their lungs and the stress hormones set off by labour help ready their bodies for the transition to breathing air.  It's no coincidence that babies who are delivered by C-section (especially via a 'cold C-section' where no labour has occurred) have higher rates of breathing problems at birth.  Breathing problems that keep them in hospitals for many more days then they might have been if they hadn't been delivered via C-section (cha-ching $$$).  But, C-sections can save babies lives (and sometimes moms lives) too.  They can also be mental life savers for women who have had previous losses or other traumatic birth complications.  I had a C-section, and wasn't that bad.  I had no complications and my scar healed fact, it's probably the prettiest scar I have (and I have many).  I have no idea if it impacted my future fertility (if we even see fit to use my uterus again), but I wouldn't DREAD having another C-section (under much different, healthier, happier, higher gestational circumstances of course).

It's also probably a no brain-er that most babies could be born at home, just fine.  Another cousin of mine had a midwife for her third baby.  She planned a hospital delivery, but did most of her labouring at home.  She met the midwife at the hospital *just* in time, and had her daughter.  She spent a day or so in hospital and came home with her healthy, full term, baby girl.  My cousin told me, "what they did for me in the hospital wasn't anything that I couldn't have done for myself at home".  This is probably true in most healthy, normal deliveries.  Anything that humans have been accomplishing in fields and huts, in snow and in desserts, with attendants or all alone for thousands of years can probably be done just fine in a modern, lighted, comfortable home, with a trained, knowledgeable attendant, complete with running water, towels, a comfortable mattress and strategically placed pillows. the small percentage of cases...what if being in a hospital is the difference between life and death? Or the difference between health and disability?  Or maybe less dramatically, and more likely...the difference between FEELING 'safe' and feeling 'nervous'. That most of us wear a seat belt all our lives and never need them doesn't make it smarter to not wear one or anyone less grateful that they exist. This is obviously why most people deliver in hospital...on the off chance (hopefully not CREATED by the medical establishment) that an intervention might be necessary.  It's also why the doctor who delivers babies in Holland at home says he's generally within 15 minutes of a hospital, for safety (a feat more easily accomplished in a country only 33,889 km in size, compared with say, oh, my country Canada which is 9,093,507 square km).  It's also why, my heart condition and previous birth history aside, I would probably never opt for a home delivery, even if I could have one.  I'm a worry-wart by nature.  I just couldn't be comfortable having my baby at home, no matter how 'natural' and 'low-tech' I wanted or felt I was capable of.

In any event, I'm anxiously awaiting the arrival of my cousin's baby. Hoping she has the midwife attended, medication-free, uncomplicated natural birth I always wanted, and the alive and healthy August baby I never had.  Wish that it could be that way for all of us.

What do you think of the state of birth in your country?  Hospital or home, midwife or doctor for you? Would you ever consider a home based birth?  What does your loss make you think of these types of practices?


  1. I think in the U.S that it is sad that there is such a high rate of c-sections. Many of these women were probably induced before their bodies where ready and didn't progress quickly enough for their doctors or the baby didn't react to the pit as they should have resulting in the c-section. When I was first pregnant back in 2009 I watched "The Business of Being Born" probably one of the flicks you watched on Netflix. I was very adamant that I would have a natural labor/delivery but that I would be at the hospital. After 36 hours of labor (28 without an epidural), pit on, pit off, d-cels in the heartrate, and not progressing I ended up with a c-section. There was no way I was going to have a baby naturally. I am unfortunately not made to. I ended having a c-section with my second child as well. I thought about doing a vbac but was scared of the possible uterine rupture. I'm glad I chose the decision of a repeat section because I went into labor early, had severe pain and found out my uterus was really thin and could have ruptured. My doctor potentially saved my life and my baby's life. I am forever grateful that she listened to me and my body. Not being naive any longer I would never have a birth at home. I know how quickly things can go from perfect to emergency. Sorry for the long post, that is just my experiences and how they effected me and my decisions. :-)

  2. I pretty much agree with every word of this. A very sensible post. I'm very pro natural delivery, though I have had two elective caesareans (god I hate that term). The reason being, my ob who is also very pro natural birth, refused to induce me early when my body wasn't ready, as she didn't want me to end up with an emergency c-section. And given I lost hope at 40+ weeks, mentally speaking I couldn't stand to be pregnant a second longer than 36 weeks. I held out til 38 weeks, begging to be induced but I just wasn't ready. So a c-section it was (then again two years later for rainbow baby number two). I have no regrets, I have two healthy, living children. I will always wonder what it is like to push out a live baby, but I did push out Hope. And that's the experience that makes me realise none of it matters - just get them out! I think the idea of home birth is lovely, IF it goes well. And that's the thing, there is no way of knowing. People bang on about being low risk. I WAS LOW RISK AND SHE DIED. Bad stuff happens, it happens fast, it happens when you have no idea it is happening, so why anyone would want to be at home and not where immediate help is at hand is beyond me, but that's just me.
    Great post.

  3. I really enjoyed this post. I understand so much of what you wrote and being an American and living the costs of health care here, it's insane. I don't feel the push pressure from my OB and living in the loss world, we perhaps see this whole labor process a bit differently. I totally believe we are meant to deliver babies naturally and wherever, like you said. But being in the loss world, I want the drugs and induction and expensive bills if that means a live child. I don't want the percentage chance it won't work out, even if there are 10 scars on my abdomen. Because, somehow my natural, ready-to-make-and-deliver-bodies somehow failed me and I didn't get the memo. You're supposed to know. But I didn't. I may have had a feeling on the way to the hospital that something wasn't right, but never did I think I'd have a stillbirth to show for nearly 10 months of gestating my son.

    Above it all, I'm just jealous I can't feel comfortable and happy to deliver a baby past its due date in my own home without pain meds or worry or any of that.

    Not going to happen for me, though.

  4. I appreciate a lot of things about this post. For one, your comments about denial rang so true, sadly, for me. I hope you don't mind me saying this, but I beat myself up on a daily basis still that I waited so long to go to the hospital when I was in labor at 23 weeks with my son, Liam. Mentally, my defense is that labor at 23 weeks feels nothing like labor when you are full term so it is a helluva lot easier to write it off as sciatic pain or weird back pain. While it's a fairly good defense, I still find myself placing an incredible amount of blame, thinking that had I listened to my body, maybe just maybe the doctors would've done something (alas I know this not to be true since I had been in the hospital at 22 weeks and they were adamant to not intervene with a baby this young...but that's another story). Sorry, I'm getting sidetracked...

    Anyway, this is why blogs are so incredibly helpful to me. Here I am, sitting at home in the States, and I read your blog in Canada and your truth and honesty about your own experiences with denial ring so true and help me to realize that sadly I'm human and not alone in what I went through. That I need to try every day to let myself off the hook a bit because I'm human and it was a tragedy and it could happen to anyone.

    But, back to home births, yes, when your child has died and you thought that you were completely healthy and able to give birth the way women have been giving birth for eternity, you look at home births very differently. I'm glad and eternally grateful I was induced at 38 weeks with my daughter. I couldn't endure going "full term" for fear that I would again be on the wrong side of statistics. I was induced, had an epidural like I planned and completely avoided a c-section or scary dcels. Since I was contracting pretty regularly, I'm sure that helped. But, as everyone knows, every induction doesn't end in a section.


  5. I loved this post and often think about this topic and how my views have changed. When we were pregnant with Caleb we were all about "all natural." Took the 12 week classes and everything. We never wanted a home birth, but lots of people we knew had them and turned out fine. Then when he died just 10 days before his due date and I realized I still had to get him out somehow, I wanted all the drugs in the world! I didnt care about anything at that point.

    With our rainbow baby I was induced just like with Caleb but at 37 weeks. Both inductions ended in easy, medicated, vaginal deliveries. The thing that bothers me is that while we were taking all our "natural" classes I felt like they made inductions sound like the worst possible thing. Now after losing a baby I know that is the worst thing. Inductions are not bad, they usually end in live babies and live moms.

    Its hard to watch friends and family be so "carefree" about childbirth. I get mad that I don't have that luxury anymore and there is a part of me that wants to remind others that they are wrong-something could go wrong. I believe its almost selfish to have the baby at home. You risk your life and your babies. Sure people did it for hundreds of years, but they also died. My view now is what I assume all babyloss moms' view is -just get the baby out alive.

  6. Personally I thin it's all just a case by case situation. My first was an emergency C due to HELLP at 36 weeks. My very pro VBAC OB at the time felt I was not a candidate for one with #2.. and obviously not beyond that. I have given birth to 6 children but I have never been in labor- and I don't think I missed out on a single thing other than the ability to parent all 6 of those children.

  7. I live in Holland. I had a home birth with my first baby after a healthy and happy pregnancy. He was even born on his due date. My son came out alive and beautiful, but he didn't start breathing. It turned out he had suffered from severe oxygen deficiency. A week later he died in my arms.
    You would think I curse home births, but I don't. Things would not have gone differently had I delivered in hospital. Here in Holland, if you choose to deliver in hospital, but there is no medical indication to do so (like health problems with baby or mother, prior c-section or loss, etc), you just pay for a hospital room and get the midwife you would have had at home. The only difference for me would have been that in hospital my not breathing baby would have been taken away from me immediately. Here at home I sat beside him, talked to him, held his hand, while the paramedics treated him before we were rushed off to hospital. And oh yeah, it would have made a difference if I had chosen to have an epidural, because then they do monitor the baby's heartbeat the whole time. I chose not to have an epidural, because I had read about the possible risks they have for babies. So yes, epidurals are a touchy subject with me and I wish I would have chosen not to have pain myself, because in hindsight that would have been the best choice for my baby.
    I don't know if the Dutch system is insane. There is certainly a lot of discussion about it here in the media. I think that in a system like the U.S. you still have babies dying (well, obviously...). They're just different babies dying from different complications. By the way, I do not believe 80% of Dutch babies are born at home. Most women I know delivered in hospital, because midwives send you to hospital if there seems to be the slightest chance that something is going wrong. What happened to me is apparently very, very, véry rare.
    I do believe delivering babies is the most natural thing, but I also believe that mothers and babies dying in the process is unfortunately very natural too. It's a miracle that nowadays in many countries most mothers and babies survive.
    I'm sure your cousin is a very nice person, but I find it very hard when people say they would 'know' when things were going wrong. It's probably just very naive, but it sounds a bit arrogant to claim that you would know what many people obviously do not know. So many people lose their baby without knowing that it is happening. Your cousins remark kind of implies that our babies died because of our own stupidity. I've always had the weird, ominous feeling that my son would die and I was worried during labor, but I did not know what was happening. I feel like I failed him. That's probably why it's so painful to hear other mothers claim that they would be able to protect their child in such a situation.

  8. With my daughter I had a very medical pregnancy and birth. After my son died I got a medical indication for ever pregnancy that would follow, even though expectations were that a next baby would be born without complications, since what happened to my son was just what they call bad luck. After having an ectopic pregnancy in between, I became pregnant with my daughter who was born four months ago. At 20 weeks it was discovered that she has a heart condition and a cleft lip and palate. It's all treatable, but we didn't kow that for sure during pregnancy. I was hospitalised a lot, had to take heart medication for my daughter, had over 50 ultrasounds and eventually had a c-section at 35 weeks, because they needed to treat my baby's heart outside of me. There was hardly anything natural about it, but my daughter is alive and well and hopefully she's here to stay.
    Having had the all-natural pregnancy and birth, ending in death and then the complete opposite of that with my rainbow baby, I have a lot of thoughts on his subject, but I do not know what to think about it exactly. I cherish the memory of my first pregnancy and of delivering my son. I just wish it would have ended with a healthy, living baby. Having lost a baby I do not want to nag about c-sections, but I was slightly disappointed that I could not have a vaginal delivery with my daughter (also because I am not happy that now there is something more to worry about, if I ever become pregnant again). Things happened the way they did. I can blame the Dutch medical system, but in many countries I would have bled to death myself, my son would have died right away, instead of being with us for a week and my daughter (who actually would not have been born, if I had died delivering my son, but hey...) would have a cleft lip and palate for the rest of her life and god only knows what would have happened with her heart.
    Sorry for this ridiculously elaborate comment, that wasn't even accepted in one go. I guess your post really struck a chord.

  9. I finally got around to reading this post, and it was a good post. You probably already know how I feel toward c-sections and pregnancy in general but I'll share it anyway. First off I have always been against home deliveries and midwives and all of that. Not that they aren't great for some, and people have had them for hundreds of years, but I too am a worry wart and wanted to be with an OB and have my baby in a hospital so I was as close as possible to good medical care if it was needed. Too bad it couldn't have ended up that all my worry was for nothing though. I also always wanted to do it the all natural route; vaginal delivery and tough it out without drugs. When I got pregnant with my son and had learned of his spina bifida, whether I was going to be doing fetal surgery or not, I knew that I was going to need a c-section. I was told that a vaginal delivery would make his spina bifida worse and I was okay giving up the chance for a natural delivery if it was in the best interest of my son. With my daughter then, since I had the fetal surgery I knew again that I had to always have a c-section which again I was okay with. Things didn't work, again, but I could've easily bled to death without an emergency c-section and fast acting doctors. Since I also had a uterine rupture I am also now a huge fan of c-sections after a vaginal delivery as well. I have met more people that have been told to do a VBAC and how safe they are and ruptured and loss there baby. I know the numbers are low but I just feel the c-section was a safer route. On the other side if this though if I had never had the fetal surgery/c-section I most likely would've never had a uterine rupture. Okay I feel all over the place with this and probably made no sense how I truly feel about c-sections, but I guess its because both times I have had surgery it has ended badly.

    Thank you also for all of the comments you have left on my blog. You always leave the best comments and I appreciate all you have to say. I do still read your blog on occassion. Although lately I don't tend to read many blogs at all except for a couple which involve gestational surrogacy or have experienced multiple stillbirth and newborn losses like myself. I barely feel like I want to even write on my own blog these days. So much I want to say and yet have to force myself to even go to it. It just doesn't have the same appeal as it once did. I miss so many of you all though as you all became like family to me this past year and half. Most peoples blogs I can no longer read as they are too painful. Yours I can handle reading a lot more than others. I think it may be because I already new kaia long before I lost Evelynn. I guess its just different in a way. Anyway, thank you for being so supportive.