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What bothers me most after 'normal' births!

7/8/2010

7 Comments

 
Ok, so I could probably write a whole range of feelings I have after leaving the 'normal' births I have attended so far.  (FYI, by 'normal', I basically mean very low medical management if any, and baby coming out vaginally with no assistance.)  I feel elated for the mom mostly.  Happy that I had some part in helping this birth experience turn out 'normal' and more of what she had hoped for.  It is a special day. 

So two things bother me after these lovely births.  One - I usually feel a little sad oddly.  Yes, sad.  I cannot help but think of the moms I've worked with and labored with for hours on end only to have their births not turn out 'normal' for whatever the reason.  Some because of interventions that she made an un- or under-informed choice on thanks to some nurse, midwife, OB who just wanted her to follow the standard because it was easier for THEM, NOT better for the mom, some because of interventions she was not given ANY choice on, and some FOR NO REASON AT ALL.  But regardless of the reason why some births didn't turn out 'normal', I still think back on them and feel sad that they didn't go better.  And I tell myself that as long as the mom was happy with her birth or was able to make peace with it, then it is a success.  Things happen for a reason, I tell myself.  She needed that experience for some reason I'll never know.  And I take a deep breath and accept the differences in my clients' births, hoping that I did all I could.  

Two - The MOST frustrating part seems to be after the birth.  It more than bothers me when a CNM who just supported this amazing woman through an unmedicated normal delivery handles this new life like he or she is a piece of meat - not even a person.  I cringe the way they grab and hold the little baby, without even welcoming he or she to the world, never speaking to the baby at all, and talking loudly to other staff (about the next thing that bothers me).  Here goes.  Immediately after the baby is out, they are only concerned with getting the tools to clamp and cut the cord - literally within seconds after the birth.  Then the cord is cut without mom even being asked or noticing (she's usually a little consumed at the time, go figure!) And then they put the baby on mom's chest for skin to skin (this is a newer standard apparently - yay!) and then almost immediately start creating a nervous energy about the placenta needing to come out.  And so far, I have yet to see a placenta not pulled out.  They called it a 'gentle tug' at my last three births when the mom says, "OW, WHAT ARE YOU DOING, that HURTS!". JEEZ!  I am always stupidly surprised each time this comes true again and again.  What happened to that patience you showed through the labor?  I almost cannot watch it happen, it is so disturbing to me.  I just want to reach out and stop her hand from pulling on the cord.  Or yell, "STOP!"  I feel this is very wrong.  It is never gentle, it is hard - that has always been a lie in my experience.  It is more dangerous, very unnatural, and totally unnecessary.  It is only done to 'wrap things up' with one mom and move onto the next.  Time and convenience. They all want to DO something finally.  Like after not having the chance to DO anything to speed up the mom's labor with any intervention and now that this baby finally came, and mom doesn't seem to care anymore, they can do to her whatever they want to FINISH things.  And honestly, the last two that were pulled out had long trailing membranes that seemed to just come and come.  Not a fan.  I am particularly sensitive when I hear "It should be out by now" or answering a mom's question of "how long should it take?", with "oh, within 10 minutes."  Well, with my second baby - born at home, my placenta took it's time... a little over 1 hour.  At that time, I was getting uncomfortable laying there through the contractions still coming. Eventually, I started feeling like I wanted to do something to get it out.  So, in order to get into a squat, I decided to finally cut his cord and let someone hold him while I squatted and pushed the placenta out.  My midwife never pulled on the cord or suggested that anything was abnormal or being rushed. 

Ok, I got it off my chest.  I have to figure out a way to accept this kind of care happening once in a while, but overall, I think I have learned to make it a point to discuss these 'after birth issues' with each mom at our last prenatal visit.  They may not be equally important to the care throughout labor and birth, but nonetheless - it is something the mom should also be aware of and have a CHOICE about.  If I know it is fine with her and she's informed about the why's and why not's, I think I can watch a cord being cut immediately and a placenta being pulled out with less anxiety. 
7 Comments
doula los angeles link
7/9/2010 10:20:57 am

I am going to try to have a kid probably early next year but decided to started research. I did not realized so much to considered from type of birth to the minute matters of diapers. I want to have natural birth but undecided if I want epidural and hire a doula. Thanks for the post it has given me some clarity.
Leslie

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Knitted in the Womb link
7/11/2010 07:53:44 am

I COMPLETELY agree with you! After my most recent birth, it took 75 minutes for the placenta to come out, and all was fine. In fact, better than fine. After hemorrhaging at my first 3 births, it was finally at my 4th birth where I insisted on leaving the cord unclamped until the placenta delivered (30 minutes after my son was born) that I had virtually no blood loss at all, and significantly less lochia. Ditto with my 5th birth--the one with the 75 minute placenta.

The most troubling thing I see about this is that I'm seeing much more aggressive pulling of late, and EVERY time I see the placenta being pulled out, I then later am the uncomfortable witness to the mom "needing" to have clots cleared out of her lower uterine segment--an EXTREMELY painful procedure.

BTW, I also really hate how care providers pull on the baby's head to birth the body. Let the body deliver naturally folks! How that must hurt the baby! I'm just waiting for a few lawsuits from doctors actually severing the spinal cord. :-(

Reply
Jen S
7/12/2010 01:57:36 pm

I agree with everything you said. When I was pregnant with my son I read WAY too much according to my doctors/family/friends. I knew exactly what I wanted and did not want. I expressed my desires with my OB and heard varying responses. Once my due date became close they began to force the idea of being induced on me...I told them not to bother bringing Pitocin anywhere near my room as it was NOT to be put into my IV and not to bother performing the unnecessary cutting procedure. My biggest fear was that I would become yet another C-Section statistic because they forced my labor to progress. 7 days overdue, the doctors were "scheduling" my inducement date but I had no plan to appear. Thankfully, two nights before I was scheduled I felt the pain! Luckily, my labor moved extremely fast..I had my first contraction at 8.57 pm and my son was born at 12:44am! Completely Natural! When I called my doctor, I was told to just hang at home, but I knew it was time...these 3 minute apart contractions were not like any other pains I had felt. Overall, my hospital experience was okay...things moved so quickly there was not much time for debate. There was a point when another nurse came to see how long the doctor would be and she held a personal conversation with some staff member. The placenta delivery situation was horrible...since it was not allowed to move along naturally it actually hurt more than my son being born.

After my first experience, and having gone completely natural I am considering a doula for my next pregnancy. I am not convinced of the water birth yet, but anything would be better than the almost completely unnecessary time I spent in the hospital being poked and prodded. I wish that more women would prepare for their labors and understand that their doctor is not the end-all of the situation. Women do have choices and should be able to give their baby the best first moments possible.

Reply
Mandy
7/13/2010 03:01:57 am

i'm glad you posted that- i need to add "not pulling the placenta out" to my birth plan. i can't believe i didn't include that. especially since i have a friend who needed surgery after her son's birth because of the placenta being pulled out.

Reply
sara
8/17/2010 04:52:25 am

I feel extrememly fortunate to have had such a fast labor and birth that basically nothing could be done to me.

I showed up at the hospital pushing after 4 hours of labor and my daughter was born into MY hands 15 minutes later. Even though he had only been there a few minutes, the doc immediately wanted to clamp the cord and get the placenta out. We made sure that he did not cut the cord, but he still acted like he was in a hurry to get out. Umm...hello? You just got here, why the hurry to leave?! He did gently tug on the cord and everything was fine, but next time I will just be birthing at home. They billed 2800$ for a room that I spent 1 hour total in...geez.

Reply
emily
8/21/2010 05:59:23 am

Thank you so much for writing this. I took a natural childbirth class, wrote a birth plan that was followed to the letter, but was still unsatisfied by one aspect of my experience that I was not prepared for... the management of the skin-to-skin time. The hospital I delivered at boasts that they do skin-to-skin with everyone for an entire hour after birth and talks about how wonderful it is, but what they fail to mention is that the midwife will be pummeling you in the uterus during that time. It was EXTREMELY painful! After I asked her if that needed to happen "right NOW", she let up and began suturing my tears instead... not any less painful, for sure... even though local anesthetic was used, getting the anesthetic injected still really hurt. And the whole time I was holding my newborn baby and trying not to squeeze her through the pain... all I could focus on was being careful to hold her gently even though I was in pain. There was no reason that my midwife could not have waited for our one hour of skin-to-skin to be over. My bleeding was well within normal limits, I was breastfeeding my baby within moments of birth, and I still had IV Pitocin going (I consented to induction at 15 days past my EDD).
Anyway, if I decide to have a second child, I think that will be the one thing I will want to do differently. During our skin-to-skin time, do not cause me pain unless there is some sort of medical emergency going on!

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air max 2009 link
3/28/2011 01:15:17 pm

The article is worth reading, I like it very much. I will keep your new articles.

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