Many people are choosing to go "against the grain" when it comes to birthing their babies these days. What used to be normal or expected in birth has now become alternative, taboo, or even crazy to some people. After the invention of the epidural for childbirth in the '70s, the rate of its use has increased steadily to the current rate of 78% in South Carolina.
Before I go any further I want to be very clear that I'm not against epidural use when it's appropriate, or when needed. I think that what has happened though, is people are being conditioned to believe that they NEED it when in reality they just need more support, more space, more time, and more freedom. I support every person's right to choose when and what pain relief techniques to use. This is mostly for those who really want to push for an un-medicated birth, and want to prepare against this one particular thing.
Sometimes, a person will plan to have an epidural before they have even felt their first wave. This is due to the fact that we are flooded with fear of childbirth from the time we are young. We hear our mothers, aunts, sisters, and friends tell us their stories full of pain and suffering. We watch movies with birth scenes where the woman is out of control, screaming, and just overall miserable, and we are scared. Who in their right mind would want to do that ?!
We very rarely, or maybe even never heard of peaceful births, home births, gentle births, water births and the like. We were never told, "Hey birth is an amazing transformation, I am so happy that you will get to experience this miracle!" Or "Wow, what an exciting adventure you get to go on! I remember how strong I felt after giving birth, it was so beautiful and empowering!"
I have had many clients who tell me they plan on having an un-medicated birth, and then suddenly in the middle of labor, change their mind in a split second and decide to get an epidural. Things are going well, we are working through each wave, utilizing all of the awesome coping strategies we practiced at home a few weeks before.
Imagine with me for a moment: You are sitting on a birth ball, leaned over the bed. Each wave comes over you, and you are breathing through them. Someone is rubbing your back, and someone else is offering you a sip of water. You feel in control of yourself, you are on top of the contractions. You know when one is building, you sit with it in silence, and it passes. You have nice breaks in between where you can talk, laugh, and move. Things are going great and you feel confident. Then, it's time for a cervical exam. It's time to check and see how much progress has been made. Have you dilated enough to show that your body knows what it's doing? Has your cervix opened enough to appease the clock?
It's been 3 hours and your cervix has only dilated 1 centimeter.
This is it, this is the moment where it happens most often, in my limited experience of course. This is when the thus far med-free birther asks if they can get the epidural. They think "I've been working SO HARD, how could this be true? What's wrong with my body, why won't it just cooperate! I can't possibly do this for much longer!"
Disappointment, fear, and resentment cloud your mind. Cortisol (the stress hormone) and Adrenaline (fight or flight) flood your brain, you clench your jaw and furrow your brow. There is no more laughter in the room. You feel defeated.
I think this begs the question, "What can I do to avoid this feeling?" The answer lies in a more hands-off approach. Less cervical exams for laboring people. Fewer time limits, less use of the word "only" when it comes to anything you are doing. You are ONLY bringing an entire human being into the world! Good grief! Labor is different for everyone, some people have super fast precipitous births, and some labor for days or weeks before giving birth. I like to think of labor as a ladder, no one knows how long of a ladder they have. Each contraction is a rung on the ladder, you can only go up, so each wave you go through is one more you never have to do again. It's done and on to the next one. If we start bringing this simple tidbit of knowledge into the birth space I think people will care less about dilation. It's only one piece to the puzzle anyway. We also have to look at many other factors such as effacement or thinning of the cervix, intensity and duration of contractions, position of the baby in the pelvis and so on. In fact, you could be 10 centimeters and still hours away from birthing your baby!
So if you are planning to give birth without pain relief please consider limiting or declining as many cervical exams as you want. They are not required to give birth, and they are practically useless without the presence of the other factors mentioned, and they increase your risk of infection.
Make a solid plan of action when it comes to your labor. Maybe think about staying home for the early parts of labor (or the entire time and give birth there!). Discuss what your preferences are on cervical exams with your care provider before you go into labor, and during your labor with your nurses. Have them document your refusal, and ask them not to mention it anymore unless you ask for it yourself. Learn about the different ways you can set up your physical and mental space to cope with labor. Surround yourself with people who fully align with your choices and who will support you, and trust your judgment. People who will remind you about WHY you made your decisions and encourage you to really think about the things that are influencing your choices.
Always remember, YOU are the boss of you. YOU have autonomy over your own body. YOU hold the decision making power in the birth room. YOU can have whatever kind of birth you want to have, and I can help you achieve it!
If you or someone you know is seeking experienced, loving, compassionate Doula care in the Upstate South Carolina area please reach out!