Tuesday, September 29, 2009

Hospital Birth

It's no secret that my preference for place of birth to occur is home. I had three of my children in my own bedroom. I have worked at a home-like Birth Center and that is a good alternative. And I have come away from Lily's hospital birth with my place-of-birth beliefs only more firmly held.

Let me say right away that our nurses, especially the one you see there, were terrific. We were blessed with that woman as our nurse. She was incredibly kind and patient and hard-working and she knew what our philosophies were and she did everything in her power to make Lily's birth as un-intervened with as possible in the setting we were in. I wish she had delivered Lily's baby because I think she would have done a fantastic job of it. She, like we, believed that Dr. Brickler was the best and when he was on the floor, she always announced that with sweet smiles. "Thank-you Dr. A.D.," she would say when he left the room. And when Dr. B. went home and residents appeared, she assured us that the head nurse on duty had been a midwife in Iran and had delivered thousands of babies so that even if a fumbling just-got-his-white-coat doctor was in charge, there would be someone looking over the resident's shoulder to make sure all was well.

I wanted to take that nurse home and baptize her in the holy waters of the Church of The Batshit Crazy because I think she would have fit right in. She worked 7 a.m. 7 p.m. on Friday and was back again at 7 a.m. on Saturday and was with Lily up to and through the birth. She was our touchstone and our comfort. I would look at her and say, "Elizabeth, what do YOU think?" when we would get to places where decisions had to be made. And she would tell us and we trusted her.

BUT, BUT, BUT- although I would personally love to have that woman with me or any of my loved ones when they gave birth, I would so much rather that she do that in a place other than the hospital.

I think it is harder to give birth naturally in a hospital than it is for a camel to pass through the damn eye of a needle. Everything and I do mean EVERY thing, is set up against allowing a natural process to proceed on its own.

Now a lot of things have changed in a hospital when it comes to birth. The family is allowed to be present at all times. There is great respect for the family and that means more than anything. Countless times one of us would say, "Here, let me get out of your way," and the medical person would reply, "Nope. You're fine," and then figure out a way to do what he or she needed to do from another angle. I not only noticed this fact, I was impressed with it. Tremendously.
But my god, there was so much going on. Lily was in the hospital to be begin with because of her blood pressure. She was monitored for that no more than any other birthing mother would have been and it never got so high that any measures had to be taken to bring it down. A midwife could easily have done the same.

Owen's heart rate was monitored for twenty minutes every few hours, up until she got an epidural and pitocin at which point it had to be monitored continuously. And his little heart (bless it! bless it!) did exactly what it was supposed to do, going down during contractions, coming right back up. Again, a midwife could have monitored those heart tones with a doppler instead of those darn monitors which are strapped on and slip easily and cause great consternation when they do. Her contractions were also monitored. In the picture above, you can see Lily looking at the screen to see when one was coming. This was after her epidural and when she was pushing so the screen gave her the information she needed to use the power of the contraction which she would not have had at home or a birth center but there are no epidurals at a birth center or at home. Contractions in those places are monitored by the midwife's hand on the mother's belly, by the mother saying, "Here comes another one."

And the thing is- if Lily had been allowed to go into labor on her own, I think she would not have had to labor for so long. Although the ultrasound doctor was encouraging her strongly to get a C-section three weeks before the induction because he believed her baby was so big and although everyone involved (except Lily) was so damn worried to get him out before any more time had passed, Owen did not appear to be a post-dates baby. And his size- although hefty- was not anywhere near dangerous. I have seen fat babies and Owen is not a fat baby. If Lily had taken his advice, Owen would definitely have been born early and Lily would still be recovering from major surgery instead of walking around like a woman who's never given birth.
So all that technology, all those millions of dollars worth of machinery and scanners and devices were not as accurate, in the long run, as the midwife's hands and if we had just been allowed to let nature take its course, I think Lily would have been saved days of agonizingly slow labor.

Another thing- although the hospital encourages walking during labor, there is no place to walk except the hallway. We made loop after loop after loop of that hallway during the dead of night and not one nurse or tech looked up from what she was doing to smile encouragingly. Not one. In fact, they looked at her askance, if anything. We saw no other mothers walking, no doubt because they all had epidurals going and were asleep while their bodies labored. When dawn broke and Lily's uterus finally reached its limit and labor stalled completely, Lily had no desire to get back out there and walk. She didn't want to see those same people, and say what you will- walking down a hallway in a hospital gown and having contractions is not something you want to do in front of strangers. It just isn't.

Which brings me to another point- Ina May Gaskin says that labor is not unlike going to the bathroom in that you really need privacy and to feel safe to get the job done properly. And in the hospital, you have no idea who is going to walk through that door, introduce him or herself and stick their hand inside of you. You may like the person or you may not, but it's not up to you to decide. The stranger's vibe and touch may be great and inspire trust or may not be. And don't you laugh and call me a mad old hippie because I KNOW for a fact that touch and vibe have a lot to do with feeling safe. So do you. The mind-body connection in labor is strong and we can pretend that it's not but that doesn't make it so.

When Lily's labor stalled, I thought back to a home birth I'd been to once where the same thing happened. The mother had been in labor for a long, long day and then through an entire night and at dawn, she stalled. I listened to my gut (I was not the midwife, but an assistant) and realized that we needed to turn off the cozy lamps, open the curtains, open the windows, let the new day's light into the room, and get things moving that way. It worked. The baby was born soon thereafter.
Lily's room didn't even have a window in it. It was like Groundhog Day. Time passed like in a movie- theater. The clock on the wall gave the hour, but one wasn't sure whether it was the hour of the day or the night.

And again, I think that if Lily had been allowed to go into labor in her own time, I don't think her uterus would have reached that point of exhaustion, causing the need for the pitocin, the epidural. She was so vastly relieved by that epidural and so was I. I had reached the point where I couldn't stand to see my baby in pain anymore, especially knowing that although the contractions hurt horribly, she was too exhausted to deal with them properly and they really weren't doing much good. And then, because she had labored for so long and because she'd gotten pitocin, after the birth she bled A LOT. I always bleed a lot after I give birth, too but it's never been a life or death situation. By my third and fourth babies, the midwife knew what to expect and had a shot of methergine available and ready to give me. Lily required a huge dose of more pitocin to get her uterus to contract properly and it's so easy to say- well, if she hadn't been in the hospital, she might have bled to death. But perhaps, if she hadn't been medically interfered with to begin with, she wouldn't have had the complication.

Same with Owen. There was some meconium in the fluid and they had to suction him before his body was born and because Lily's water had broken early in the labor (which she reported but which never got noted or charted) he had that fever at birth. But- if the process had been on Lily and Owen's timeline, perhaps he wouldn't have had to go through such a prolonged and stressful labor.

And the waste- my god, the waste at a birth! The amount of disposable stuff. Everything is disposable now and several large bags of trash were collected and disposed of during and after the birth.

Here's another thing- although family is encouraged to be with the laboring mother, there is nothing done to provide for their comfort. AT ALL. No place to lay down and rest. No place to get food except for the machines or the cafeteria which was a very long walk away in another building. Mothers are encouraged to eat and drink during labor but Lily was offered nothing except for juice and water. We were expected to bring food in. Which we did. But still- that's ridiculous! How is a woman supposed to labor for three days without food? What if we hadn't been there to bring her food? And after she gave birth, there was no food offered to her. None. Again, we had to go out and get her some. Same in the family care unit- the mother gets a hospital meal, the father gets a long walk to the cafeteria.

I think it all boils down to this: birth in our country is still considered very much a medical event. Yes, they do give lip service to the needs of a woman to be able to walk, to eat, to be with people she loves and trust during labor but no real considerations are offered to make those things easy. The staff was indeed considerate of the family but our presence was more tolerated than encouraged. Lily was told to walk but there was no real place to do that except for the artificially lit hallways of the floor. Lily was told to eat to keep her strength up but no nourishment was offered.

It was a beautiful birth. Lily and Jason learned more about their strength than they ever could have imagined, which is the perfect preparation for being parents. But this happened because of Lily's will and desire to birth naturally. No one, from Dr. Brickler on down, believed that she could do it. And I have no idea why. She is a strong, young, healthy woman and her baby was a reasonable size. She had unending support from her family and from kind nurses. Without all of this, she would NOT have succeeded in having a vaginal birth.

I keep thinking of how every time Lily got a contraction, Jason would jump up and be with her, to hold her, let her lean on him. She wanted HIM. The rest of us were okay, but it was Jason she wanted. How could this be anything but the best lesson their relationship could ever have? He was her main support, both physically and emotionally. He knew she really needed him and she really wanted him to help her. He was an integral part of the success of Owen's birth. He was there for his wife and his baby throughout the entire process. If Lily had gotten a C-section or even an epidural during an earlier part of the labor, he would not have this information, he would not know how much she truly loves and depends on him. As they danced together during contractions, it felt holy in that room. The three of them working together to bring Owen out.

And that's what I'm thinking about this morning. My brain feels a bit less mush-like and I am have so much to do. My house and my yard need attention. My chickens need their morning scratch and their crazy-chicken-lady love. I need to start baking bread, a cake, and to make that delicious salad which is going to nourish my daughter and her beloved, strong husband. I just called Lily but her phone goes directly to voice mail. I hope this means they are sleeping. I hope they had a good night. It takes a lot of will power not to jump in my car and go over there RIGHT NOW to see how they are doing, but I'm going to leave them alone. They are doing something very, very important which is being alone together as a family in their own home.

And it occurs to me that nowhere in this long discussion did I talk about the actual delivery. It's hard for me to do that because the resident did deliver and I do think it was his first delivery. The real doctor stood over him and advised him but it was a lesson in how it is the mother who delivers the baby- the attendant only helps guide and catch. I was mostly at Lily's head during delivery but part of my attention was down there and I saw some fumbling. I think she would not have torn if there had been a more experienced attendant. I saw the resident pull on the cord so hard that it broke, and blood spattered all over his face. This is the second time in my life I have seen a cord break- the other time was also in a hospital. I think there is a sense of panic during a hospital birth I have never seen in a home or birth-center birth. As if the whole culmination of this medical event is something to be scared of. At the very end of the pushing stage, it is difficult to get the fetal heart tones of the baby because he is up under the pubic bone. The doctor recommended that they put the electronic leads which screw into the baby's head to keep track of his heart and I had to laugh because Jessie, Lily, and Jason all looked up with alarm at these words and said, "NO!"
And really- at this point with the birth so imminent, what good would they do? The nurse, bless her, assured him that if she kept having trouble hearing the baby's heart, she would do that. And it ended up being unnecessary and Owen was born without tiny wires screwed into his scalp.

Ah yah. Owen was born through the power of his mother's pushes, through the determination and strength of her. The man who caught Owen will never forget that birth, even if he goes on to deliver thousands and thousands of babies.

And that's nice, in a way. He will remember our crazy family, the joy, the tears, the happiness, the support. He will remember that strong mother, that hefty baby boy.
He will also remember the way a cord can break and spew blood when pulled too hard.

I am so grateful for the way everything turned out because everything turned out fine. I still believe, though, in my heart, that if Lily had been allowed to go into labor when her body was ready, things would have gone easier for her AND for Owen.
And I think we can safely say that about hundreds of thousands of other mothers and their births. But until things change in this country, we'll never really know.

Until then- we have to keep asking the questions. We have to keep questioning the experts. And we have to keep trusting our instincts.
And we have to remember to bring food to the hospital because they sure ain't gonna give you any there.
A sleeping bag wouldn't be a bad thing to bring either.

And we have to keep being grateful for the people who are part of the process who have faith, who have patience, who are the ones who truly help the mothers in this greatest of all transitions- the nurses with the tender touch, the knowing eyes, the smart brains, the beautiful faces. The ones who, in the very midst of this very much medicalized event, keep it real, keep it human, keep it holy.


  1. My Dear Ms. Moon,
    I think you are right. The body has its own wisdom. I think things would have gone better if nature wasn't fucked with, too.

    But what the hell. Owen is here. He is good and safe and well. God bless him. Lily did well. Very well.

    Love, SB.

  2. Yes, Ms. Moon. Hospitals are not conducive to holistic births. Were it not for the human kindness of some lovely nurses, I'm not sure I'd have gotten those babies out myself. I had a wonderful doctor the second go around, but the first sounds like Lily's experience- stalled labor, high anxiety liability management, pitocin plus I got the screws into my babies head, and I still feel guilty about those. I hope the resident apologized for breaking the cord, seems barbaric. It's all business and efficiency and not so much common sense these days in the hospitals. And oh, walking the halls, big as a house, contracting in front of strangers, it was horrible for both hubby and I, we're very shy people. I love how you captured the parent bonding experience perfectly. A new layer of trust got built for us, and I can't fathom the times when a husband or family was excluded from the birthing.

    I know it must be awfully hard to stay from your new family, and trust Lily will call you or you will know when she needs you, because she will. She's so lucky to have you so close, yet gracious enough to allow her new family time to bond.

    Best wishes to you and your family.

  3. I completely agree with you Ms Moon... and it saddens me that women are still sort of slaves to the system.

    Keep in mind though that a big factor in why they wanted to get Owen moving along was the issue of Lily's BP, which does make sense. (at least that was my impression) My feeling is that she would have probably been fine anyway, but..?

    I think it's been so long since we've allowed nature to take it's course there are so many unanswered questions about how mother nature may take care of certain maladies on her own time and her own way. I still don't think Harley's lungs needed sucking for instance. I think he's have been fine to work it out or at least TRY to on his own... but we'll never know that now.

    Love ya,

  4. Some couches in the waiting room wouldn't be a sin, either.

  5. Ms. Bastard Dear- I know. He is here. He is well. I just wonder how much trouble we create with our technology which we then use technology to deal with and call it progress?

    Mel- Exactly. When you're in labor, you do lose a certain amount of modesty but it's completely ridiculous to try and relax under those circumstances, let the body do what it needs to do. And I just talked to Lily and Little Man has nursed all night and she's worried that he's not getting "enough" although he has been frequently peeing and pooping. I assured her he is fine, he just likes to nurse.

    Ms. Fleur- Yep. They have to do "everything" no matter what.

    DTG- They don't have couches here for a reason and we know what that reason is.

  6. Yeah, so people can laugh at me when I sleep sitting upright.

  7. I think things are done very differently on this side of The Pond. I had 2 premmie births (26 weeks and 34 weeks) and was still delivered by a midwife both times. The only doctor present was a Neonatal consultant (not sure what you call them - top guy anyway!) I was seen by a doctor but only briefly - the midwives are generally in charge of births over here.
    I'm so glad everything turned out for the best but I totally agree with you about too much intervention.
    Sorry for the long comment!

  8. Unfortunately, I don't think that Dr. Resident really cared all that much about him breaking the cord and showering blood everywhere. I think it just amused him. I heard him say something like, "What? The cord was really soft." Now this might be true, but still... Do you know if the drugs that they gave Lily soften up the cords? Well, I was a bit bothered by him no matter if it was his fault or not.
    And it drives me nuts that Nurse Elizabeth did all that great work, and then the docs come in every few hours to ask Lil a few questions that the nurses already know the answers to. Then it was so weird at the very end when Lily was so close to pushing him out with Elizabeth coaching her and that's when the team of doctors rush in, just to catch him. It was strange, but I guess that's just how hospital births go.

    I will never forget how you kept whispering to Nurse Elizabeth as Lil was almost done, "You just do it. You deliver him. I know you can do it." You were smiling such a sweet smile as you told her that.

  9. Congratulations! I love birth stories.

    I had a horrible traumatic "natural" hospital birth, followed by a c-section that seemed very peaceful by comparison, followed by a really empowering hospital vbac. It was amazing, and was really the birth I always wanted. I hope Lily feels very proud of herself for Owen's delivery. How wonderful!

  10. I remember seeing a docu-movie (I think it was Ricki Lake's) about contemporary birthing practices. There was a scene where 2 third year OB residents were being interviewed and NEITHER had ever witnessed a completely natural birth. They were even stumped by the question. To them "natural" included either an epidural or pitocin, or both. THREE YEARS of "delivering babies" and not a single experience of a mother laboring without intervention. So NOT batshit crazy

  11. Belgian hospitals seem to be better at providing meals and places to sleep (only for one extra person). They're still very medical places, though.

  12. Penelope- See? We're not trying to invent the wheel over here. There is adequate proof of what really works and yet...we refuse to pay attention. That's the USA for ya. We can do it bigger and better. Unless we can't.

    HoneyLuna- The cord was fine. He pulled too hard in panic and that was what happened the first time I saw that. And you know? There was a LOT of bleeding in that birth, too. I think pulling the cord that hard is so ridiculous. Wait until it's time....
    Something we can't seem to manage here.
    And yes, I wish Elizabeth had delivered. I trusted her with all my heart and soul.

  13. Jen- I am so glad you finally got the birth you wanted. I am SO proud of Lily and how strong she was in every way.

    Mwa- Well. That's a start, at least. Food is what I'd call necessary but we don't seem to get that over here.

  14. Lily's labor/birth sounds a lot like Elizabeth's (my sister). I kept thinking they should've just let her do it on her own instead of filling her up with all that pitocin, then letting her rest, then doing it again, then telling her she'd need a c-section if she didn't dialate within an hour. Thank god for the nurses.

  15. oh c'mon, quit ya bitchin'; that's a healthy little baby

    Ya ever tried to clean afterbirth out of a couch?

  16. Ginger- Yes. But what do WE know? Harrumph.

    Magnum- No. But I have cleaned plenty of sheets with all kinds of afterbirth leavings in them. It ain't that hard.

    DTG- Haha! And Daddy, too. Y'all have a talent for sleeping sitting up. It serves you well.

    Michelle- Yep. That was the Ricki Lake movie. I remember it. It freaked me out!

  17. It's so wonderful when nature takes it's course and babies are born with no complications. I can tell by your description and pictures which hospital this is because I know it well. My daughter was up there for 10 days last year before my granddaughter was finally delivered by c-section at 33 weeks weighing 4 lbs 6 oz. My daughter's blood pressure started going up and she had protein in her urine when she went for a routine checkup. By the time she had the baby her blood pressure was up to 180/120, she had had an excruciating headache for 24 hours and was vomiting. I kept begging them to do something before she had a seizure and they finally decided to deliver the baby. I don't know why they waited so long, because she had the same thing happen with her first baby 4 years earlier at the same hospital. Thankfully my daughter and both of my grandchildren are fine now, but she has promised me no more pregnancies. They were very accommodating though and did allow both me and my son-in-law to be in the delivery room during both c-sections. I wish I had better memories of these births, but I was so stressed and worried about my daughter and the babies that I get upset just thinking about it. And seriously, would it be so hard to put some kind of eating establishment in that women's pavilion? I walked back and forth to that cafeteria so many times in those 10 days, I could do it in my sleep. At least they had wireless internet, but you had to call every day to get a new password. Can you tell I don't like that place?

  18. Amen to all of that. And I'm just shaking my head at everything "medical," -- I live that life, often and it's just so bullshit.

    I'm so happy that Lily and Owen are home and away from hospitals. I'm so happy that you can write so well about something so important. I hope your words reach many pregnant ears...

  19. I can't see anything else beyond 'they pulled on the cord so hard it broke'. you don't pull on the cord, it's insanely dangerous. What the FUCK?

    I hate it. The violence of it. Why do they think it has to be violent?

  20. Thanks for sharing the experience Ms. Moon. I am sorry I am late to the game to congratulate you on your wonderful new addition to the family. Owen looks beautiful and I am sure he might replace someone as the cutest baby ever but I understand. I am glad that everything turned out fine and congrats again on the new family member. Take care.

  21. Amen, to every single thing you said. I love birth stories and birth, and even though I had 2 very wonderful and powerful hospital births, I still mourn my lost home birth and believe home is the best place for birthing.

  22. I am just happy that Lily is fine and Owen is fine. Hospital births saved the lives of both of my children, so I can't knock them, but I understand your points about being bothered by medical interventions. Seriously, do they need to take your BP and temp every damn hour while you're trying to sleep after giving birth?

  23. Lois- I agree! Why can't they have a little place to buy sandwiches and salads, maybe a yogurt? It's ridiculous! I'm so glad your daughter and her babies are okay and healthy and I can see why she wouldn't want to go through that again. And I'm glad you don't have to either!

    Elizabeth- Dealing with the medical profession is a frustrating and surreal experience a lot of the time. But I am not telling you anything you don't know. I don't know how you do it. I am in awe of you.

    Ms. Jo- They have to react like it's a crisis that must be dealt with IMMEDIATELY. It's crazy.

    Mr. Shife- Well, we knew this day would happen- that Baby Shife would no longer be the cutest boy in the world. But he's a damn close second.
    Thanks for your good wishes. I do appreciate them.

    Lora- I wish you could have a home birth. I know you would love it so much and would be such a good candidate.

  24. Yes, yes, oh yes! Your wisdom amazes me. Where were you when I needed you?! This is supposed to be the most natural thing in the world, to give birth. Medical intervention definitely hinders. Sounds like Lily had a difficult time of it... all 3 days. But it sounds like she's got her mother's strength of spirit and determination. She's one strong and determined lady, and Owen is lucky to have her as his Mama and you for his Grandmama. Enjoy the love.... it started with you x

  25. I've never had any other sort of birth nor have I known any different. Wow. Thank you for sharing all your insights as I honestly never knew what we missed, not having experienced any of it. Someday I'll have to tell you what happens to a 16 yr old single mother without health insurance who goes into a hospital to have a baby...my story, but for now relish in the glow of your grandson.

  26. My Mama had natural childbirth with us kids and she thinks nothing of it.I think she's my hero. People look at her like she's crazy when she mentions it. She didn't want any drugs near her babies. And neither will I. I want a totally "Hippie" birth experience. Our bodies were created to bring life into the world. I have always felt strongly about this.Thanks for posting so eloquently about the subject.

  27. Lilacs- More women need to know the truth of things. I really believe that.
    Thank-you for your sweet words.

    Marsha- Whoa! That must be some story.

    Tiff- Have you seen The Business Of Being Born? You should. And hurray for your mama!


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