Wednesday, April 7, 2010

Don't Tell Me How to Have My Baby!

"We didn't get into medicine because we want to screw with your lives, we got into medicine because we like mothers and babies and we want to help them."

While phrased in a strange way, I understood where she was coming from. The woman who said that was replying to a series of questions posed by audience members at a meet and greet I attended this week.

It was a chance for pregnant women to ask questions and talk with all of the OBs in our practice, plus the on-call OBs who could possible deliver us in the 30% chance we don't get our own.

My husband and I sat on the second row, eager to hear what women wanted to ask as well as what these obstetricians had to say. I wasn't sure what to expect when I arrived. I had pages of my Prego Planner twisted around my fingers, as I fumbled through my notes, thinking if I was brave enough to ask any of my questions in front of the room of around 40 couples.

I got some of my ideas for questions from the reading the outline of the Lamaze Healthy Birth Practices. Others, from friends like Emily Dicky, who recently had her baby by a cesarean she, and many others in the blogosphere say was unnecessary. I thought getting questions from her that she "would have asked" would be a great way to find the right OB for me.

All of the doctors introduced themselves, and told us about their background. My husband and I listened to their backgrounds and remarks, and found we liked the personalities and stories of my OB, and one other on the end the best... Coincidentally, those were both the women recommended by our family practitioner whom we love.
After their brief introductions they opened it up to questions. Of course, we were all a little hesitant at first, but one woman who appeared to be a little further along than I had the balls to throw out the first one.

"I want a natural labor," she said very matter of fact. "How open are you to allowing things to progress without medical interventions?"

Wow, well I could cross that question off of my list. A few of the doctors answered her question, including mine, stating they love for us to come in with plans, and if we'd like an unmedicated birth to be up front about it, let the hospital staff know when we get their because they make a special effort to pair certain labor and delivery nurses with women depending on the kind of birth we're going for. All of them said their first and foremost job is to get us our baby safe and sound, and secondly, they want us to have a good experience.

The series of questions that followed seemed to be all stolen out of my mouth. In fact, I began to wonder if some of the women in my room were women who've been coaching me online... Women on Twitter who are almost anti-hospital birth and would prefer to deliver at home.

There were questions about stalling in labor, and how long they'll let us go before recommending an intervention, letting the cord pulse for awhile after birth, what positions we can labor in, and if they'd let us walk around. I was honestly quite surprised at the amount of women who had the same questions I did. They each seemed very stern and attentive when listening to the responses.

Of course not everyone in the room had the same concerns, there was another group who wanted to know how a scheduled cesarean process would work, and wanted to know how soon, and how late they could get an epidural. But I was amazed at how knowledgeable and confidant so many of these woman were in their desires. I think sometimes we sell ourselves short in assuming women don't do their research... At least I know I have people telling me to do my research ALL the time, when sometimes I feel like saying: "I bet I've done WAY more research than you did when you were having your first baby."

I think, or at least I hope, in this day and age women are feeling more empowered, and learning more about labor, but they also aren't feeling the need to hide away in their homes simply because they feel like they can't get the level of care they desire from a hospital and doctor.

Speaking from my own experience... I know home birth isn't my thing. Nothing against it, I just don't want to do it. I'd prefer to take a little vacation to the hospital and have people take care of me for awhile. Plus, my insurance covers a hospital birth 100% whereas a home birth would end up costing me much more (not the usual case I know). But I also don't want to be cut open for convenience. I feel like I found a happy medium finding an OB group I really like with a great birthing philosophy, as well as a hospital with great accommodations.

As more questions were asked and answered, my husband and I talked about the responses and took notes. Some of the things I was happy to learn about:

-The baby is placed directly on the mother's belly right after birth and the cord isn't clamped right away.
-Husbands/partners are asked to cut the cord after the baby is born. If they don't want to cut it, that's fine too, but they give them the chance.
-They no longer do episiotomies.
-There's a new policy where women ARE allowed to eat during early labor (whatever they don't mind possibly seeing come back up). During active labor clear liquids/foods are allowed, like popsicles, ice chips, water, etc.
-During early and even active labor, without an epidural women are allowed, even encouraged to walk around to help their labor progress. There are showers in all of our rooms as well and they encourage us to use them.
-They have doula recommendations to help during labor (I'm not getting one, but I've heard some people say OBs don't like doulas... Either a lie, or my practice once again is cooler than most).
-They have other pain medication we can take if we don't want an epidural but want the "edge taken off." They did say it makes you woozy, but that you can still move around on a birthing ball etc, with assistance. I didn't catch the name of the drug but I'll ask at my next appointment.

I like the idea of moving around more, because if I get an epidural they pretty much said I'll have to stay in bed and labor there, on my side or slightly upright (if I can support myself/be supported). But I've also heard that some IV drugs are uncomfortable. So I guess we'll have to see how it goes, but I like knowing I have several options for pain if I decide I don't want to deal with it.

And last but not least, someone asked if we have to labor and deliver on our back or if we could be in a different position. This was something I was really eager to hear their answer too because it's #5 on Lamaze's healthy birth practices "Avoid giving birth on your back and follow your body's urges to push." I watched the video and the "pushing when you feel he urge to push" part seems a little common sense to me, and less complicated than the positions part. One thing it says to do is ask your practitioner during your pregnancy how they feel about different positions so you know if they'll support you during labor.

The doctors were all very nice in saying that they have birthing bars that we can use, and they'll position the bed in different ways if that's what we want to do. They said we can try whatever we want and they'll go with it if it's effective, but they may try suggesting something else if it's not working. They did point out though that the squatting position can to lead to more tearing, which sounds ouchy to me, but I'll have to learn more about other alternative labor positions like kneeling on all fours later, hopefully during our childbirth class, and find ways to avoid that.
(birthing/squatting bars)

Having read quite a bit about laboring in positions OTHER THAN your back, I know sitting up can has benefits like helping with gravity pulling the baby down, ease pain, and a shorter pushing stage of labor among other things. I'm totally happy with that answer for now. I would expect to be given a chance to try something and see how it works, and hey, if a different position works better cool.

And once she's out I'm going to have them put on one of these adorable trendy hospital hats from Tweedle Bug Boutique so she stands out from the crowd (I had to find a way to squeeze in a plug for her adorable first hats!!)

Overall after that experience, and then touring the hospital just after to see where I'll be having my daughter I feel a lot more confidant, trusting, empowered and even excited about labor, probably than every before.

Lately I feel like I've been bombarded with negativity towards obstetricians and hospitals which really was starting to push me into a corner of fear and anxiety about my birthing experience. Even while I tweeted during my #OBmeetandgreet I got responses that were negative, and seemingly trying to counter every positive comment I made about the meeting.

When I mentioned that I could labor [and push] in different positions some replied saying things like "OBs say a lot of vaginal-baby things up until it's time to give birth." Sorry, but what kind of BS is that? And I'm not going to say it was all of the "crunchy" people who were being pessimistic. A few commented saying "you say that now" in reference to my tweet about trying to deliver without an epidural... But honestly, I'd much rather hear things like that than remarks that scream "Your OB is trying to screw up your life."

I wish more of us supported each other in the decisions that we make, and helped each other to have the best experience going forward.

I'm having my baby at a hospital, with an OB. I've made my decision. That doesn't make me better or worse than anyone else, but it works for me, and just because it may not have worked for you doesn't mean I'm doomed.
***
**PS: For people who were offended by my "hide away at home" remark let me explain my meaning. I don't mean hide in a bad way. Some animals like cats prefer to birth in private places and "hide away." I think that's a more intimate experience and great for those who want that experience in their own personal space. But to me... Instead of compromising my feelings of wanting to have my birth in a hospital environment, I'd rather find a hospital and staff that has the same attitude towards birth that I do, and supports my choices. I'm APPLAUDING women for taking a stance and fighting for what they want. What's the point of telling women we need to be stand up for our rights but not face the issue directly? What's the point of having a list of questions to ask doctors their philosophy on birth if you're just going to say "well, they're lying?" when you happen to find the right one? To me, addressing the issue straight on, and confronting OBs about concerns you have with their practice is moving in a direction of change. If I didn't want to worry about "putting up a fight" and wanted to have a home birth experience with a midwife I'd do it, but I don't. So I'm dealing with the cards I'd dealt for myself.
PPS: My OB does practice evidence-based medicine, I talked to nurses at the hospital as well, and they are VERY big breastfeeding advocates... Contrary to what some have suggested.
PPPS: While I don't love un-supportive comments I DO love birth stories. If you have one you've posted about I'd love to read it. My birth story link up is here.**

This is a part of a blog carnival post about childbirth you can read more Lamaze's Healthy Birth Practices posts here.

56 comments:

  1. when my mom had her first baby, my brother, she positioned herself on all fours - because it didn't hurt as much (she didn't want medication) and it felt better. This was about 34 years ago (I keep forgetting how old he is - ha ha, and they forced her down on her back and gave her the meds. She was terrified, because she is very sensitive to meds - and these made her kind of numb, so she felt that she couldn't help get the baby out. She was only 19 and scared that something would happen to my brother if she couldn't get him out in time.

    Things have changed though - fortunately! Now they listen more to the women and there are so many alternatives, as you mentioned in the post.

    What I wanted to say is that I think she was on to soemthing with the position - why should lying on ones back be the best option for the mother and the baby?

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  2. I say forget what other people say. For me personally I would much rather have my baby in a hospital where I know the baby would be safe if something were to go wrong. I personally want to try for as natural as a birth as I can handle but if I can't handle the pain I will get pain meds. That being said I do have a pretty high tolerance for pain so I'm pretty confident that I will be able to get through it. I really don't want to have a cesarean section unless it is necessary. I think people come away from a hospital birth with bad experiences because they may not have planned for things to go the way they did. I think the more informed we are about our options and our choice of doctor can make a huge difference in the way we experience labor and delivery. I honestly believe that a lot of first timers don't know what to expect because it isn't always talked about. I know I found a lot of interesting things I didn't know by searching on the Internet and I am more informed for when we do have our first baby.

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  3. I made myself totally annoying to the hospital staff and my husband with wanting the bed as upright as it could go.

    I think it helped me to read birth stories from women of somewhere close to my mindset to help me build the confidence I needed to ask for what I wanted and refuse what I did not. Mine is on my blog (http://hardierlime.wordpress.com/2008/06/13/our-birth-story/) if you're interested. :)

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  4. If you can, avoid reading about others' birth experiences, especially if they are anti-hospital.

    It sounds like the OB you picked is in a progressive practice, and I am sure that the goal is a happy, healthy baby - and for you to have the positive experience you desire.

    That said, get used to the negative messages from others. This is just the first volley in the ongoing mommy wars. After the birth, there will be the breastmilk vs. formula, the family bed vs. crib, the cry it out vs. the comforting - and the one that has lasted forever: working moms vs. SAHM.

    You'll get used to it. But it still makes me sad that we women can't agree to disagree, and be respectful of each others' choices.

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  5. I'm now expecting baby #3 and maybe I'm a little biased in my opinion because my labor/delivery experiences have been almost by the book. When I was young, I knew I wanted to become an OB/Gyn...I was fascinated with the way the Lord brought spirits to this earth and started my researching as a teenager (I was 15 when I read "What to Expect"!). I have yet to make it to med school (marriage and kids were a little higher and my list of priorities) but I am supporting my husband through his ending journey through med school. I've read, heard, talked about all the possibilities, options, experiences, etc. that are possible when it comes to pregnancy and childbirth (I'm not claiming to be an expert, though, just someone who was curious like you and wanted to know all I could). And one thing I've learned through others and my own experiences as well is that no one labor/delivery is the same and even the same doctor will handle your situation differently than another's. I've had vaginal deliveries with both my girls (with only nubane to for the pain with my first and nothing but pitocin with my second!) No one pushed my to have an epidural or go into a c-section because I was so exhausted after 22 hours of labor and no sleep with my first in the middle of the night. You'll be seeing your doctor for 9 months...you'll have the opportunity to see how he/she works and ask questions so you have a good idea of you each other's expectations. DO WHAT FEELS GOOD TO YOU!!! If you want to have the baby at the hospital, do it! I know I had great experiences both times, at two different hospitals, with two different doctors, and this next baby will be again at a different hospital and with a different dr. Maybe I'm the ONLY one in the world who has, but know that it's possible to really enjoy the experience even in a hospital, for goodness sake! Good luck with everything and just remember no matter what you decide, it's your choice to make and I can tell you love that little one enough to do what you feel is best for her and you! Don't fear the unknown too much!

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  6. I actually had DOUBLE McDonald's regular meal (that's 2 burgers + 2 Pepsi + 2 fries + 1 choc sundae) about 6 hours before I gave birth... hahahaha... I didn't even realised I was already having contractions (cos we planned to admit to hospital for labor induce since my gynae earlier advised us to cos of my low amniotic fluid case)

    Thanks to my baby, he decided mummy should never go through labor induced and decided to start off mummy's contractions.

    In Malaysia, chances of natural childbirth and breastfeeding are higher if we deliver at government hospital. Because I wanted a natural delivery & breastfeeding, I chose to deliver at a semi private hospital (about 1 hr car ride from my home).

    As for pain relief method, I relied on Enthonox during my delivery and I'm glad I chose that hospital cos it has given me the best experience ever. No regrets despite ppl telling us how far it is from our home yada yada yada..

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  7. Not to be negative, because I know that isn't good for anybody, but remember that the hospital is a business. It is run like a business. I'm not saying it is good or bad. But when it comes down to the nitty gritty, they want to keep their employees safe (i.e., cover their butts so they don't get sued) and they want to move people through. They depend on a steady in and out to make money. A hospital can be a good place to have a baby...especially if you don't want to birth anywhere else! But, no matter how receptive the OBs seem to be toward your desires, be ready for things to change at the drop of a hat (or, rather, a tiny indicator in the pregnancy that things aren't going to be textbook!)

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  8. I don't think everyone who responds with a negative comment about what these OB's said is trying to scare you. I think you've done an amazing amount of research about labor and birth, and there is a chance that you are blessed to have some actual GOOD OB's where you live! I hope that is the case! As a registered nurse who has worked in labor and delivery, and as a mother who has given birth naturally to a baby (in a free standing birth center) I've seen both sides of the coin. I can only speak from the hospitals I have worked at. The doctors in my state have made me so negative toward hospital births, not to mention that I wouldn't trust the majority of them to work on my dog, much less me. I've heard so many lies come out of their mouths, heard them trash talk patients at the nurses desk, and seen so many unnecessary interventions and c-sections take place because of convenience that I have a hard time trusting anything they have to say. But, those are many of the OB's in my state. I live in NC, not TX, and the natural birth climate here is not pretty needless to say. I think you'll do just fine during labor with as much as you know! I'm glad that you've found a great OB to work with you.

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  9. I wish I would've tried to go without the epidural because it REALLY sucks being stuck in a hospital bed - especially when you're labor lasts for over 30 hours ;) I think it's great that your OB's office held a meet and greet. I think that's VERY rare.

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  10. My two cents:
    When I had my son, I was gung ho on a natural delivery, but it didn't work out that way. I was very disappointed and felt like a failure esp. when my friends are pushing out their babies no problem. But there were very good reasons to have a C-section and it worked out better for both of us and I learned I can't compare myself to others. Because where I couldn't vaginal delivery my kid, I did breastfeed for almost a year while some of them couldn't and that's ok too.
    What I'm trying to say it that it's different for everyone and knowing what you want is a good thing and don't worry about what others are saying. Because they are not birthing your baby, you are.

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  11. Well, every woman that commented so far will hate me because I was in hard labor with my first for two hours with only something to "take the edge off" and 45 minutes with my second and NOTHING!

    Look everybodies differnt--that's the way God made us! You're doing great by researching and LISTENING to other women who have ALL had different experiences. This will only make your jounery more memorable!

    I interviewed my first OB and he and his wife became good friends of ours. I chose my second because he and his wife were friends of ours from church. (I live in a small town!) This was best for my personality. Do what is best for you!

    If you want a good laugh, read my blog about how I found out I was having a second baby! It will show you that the ONLY person in control of your birthing situation is God himself!

    http://frugaltractormom.blogspot.com/2010/03/surprise-is-walking.html

    God Bless---

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  12. I recently wrote about the comments I've received when I've answered the question of "are you going natural?" I do plan on going natural, without any meds - if my body and baby allows! But I hate that people have rolled their eyes when I've said that, or said "yeah right" or questioned me. We need to support people in their decisions and recognize that we all handle things differently, and therefore our decisions will be different as well. I actually have started saying to people when I get a horrible comment, that I'd appreciate their support instead of their skepticism. It has effectively stopped some bad comments from continuing!

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  13. It's YOUR pregnancy and YOUR birth experience. If others wants to judge just ignore it. You have done your research and made your choices. Everyone has an opinion when it comes to child birth. Doesn't make them right. I wish you all the best when the time comes for a quick and easy delivery.

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  14. That sounds like a really awesome practice! That they bother with details like offering doula recommendations and pairing drugless birthers with L&D nurses who are supportive of that - in my opinion - speaks volumes to their commitment to ensuring a good birth for everyone. I mean, even that they opened themselves up to questions in a meet & greet forum impresses me. I hope they are everything you are wishing for!

    How many of them are mothers, did anyone ask? What are the c-secton rates for their practice? I'm curious!

    Congratulations on your baby!

    After you're done, make sure you fill out the birth survey - www.thebirthsurvey.com - so other women know about the support they can get from this practice!

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  15. This is your experience. Your big day. Your body, your labor, your birth. You know what's best for you. Don't let those other comments get to you. If you want that natural birth, set your mind to it. If you want to try different positions, do it. All you need to do is remember that this is your experience and use your voice to make it the birth you want it to be. I didn't find my voice until the birth of my 5 month old. I wish I'd found it with my other two.

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  16. Good post. As others have said - Do What is Best for You and Only You!!! This is your day and this is your experience so do it how you want to. I think sometimes we think only one way is right and that's not fair to others. Good luck with everything!!

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  17. I think how you choose to have your baby is really no one's business but your own. Because you chose to blog about your experience you will undoubtedly get criticism from "know it alls" but the fact of the matter is your doing what you feel is right in your heart. I don't feel there is one "right" way to go through this, what really matters at the end of the day, your baby being born healthy and safely or the way you birthed her, hospital or not?

    I can see where the "you say that now" crowd is coming from. Speaking from personal experience and being a person who said they would never do this or that with my child...only to find myself doing the exact thing I said I wouldn't. It's good you have a plan and that your OB practice is willing to work with you. Just be open to their advice and recommendation (which sounds like you are) because that is there job. I had a medicated birth, labored to 7 cm at home and that was the most painful, grossest, etc experience so by the time they finally admitted me I could not of imagined pushing any way but on my back. I was exhausted! If a different position works for you then great! It's good to be informed.

    The only thing I would caution you about the "take the edge off" meds is to think about how you react to medication. When they say they make you woozy, that's no joke. I was given those meds while waiting for my epidural and I hated that feeling, plus it didn't help pain at all for me. I was so out of it, I lost track of time, I couldn't hold a conversation and I was pretty dazed when I finally had my son. I knew that I didn't react well to pain meds in the past so I should of stayed away from them. Everyone reacts differently though so if you know you react strongly to certain meds you might want to stay away from them.

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  18. Beautifully written! I commend you on doing your research and making the decisions that are BEST for you & your family. What's best for one is not always best for others. Speaking as a home birthing L&D nurse, you can have what you want in a hospital setting too! Not all OBs & nurses are out to sabotage a woman's birth! Good luck!

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  19. I totally agree with your point of view - do what works for you and don't worry about what others may think. I believe if you're happy & safe then why comment otherwise!

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  20. (Your comment form disagrees with you, it said my comment was too long and I had to trim it to fit!)

    I did A LOT of research as a first-time pregnant mom, too, and was so annoyed at all the BAD advice and information I got from other women. And the "just wait, you'll want the drugs!" crap made me SO mad. Guess what? I wasn't begging for the epidural, even after 30+ hours of back labor. I still knew I didn't want to expose myself or my baby to those risks and confine myself to the bed. Eventually I pushed my son out while sitting on a squatting stool while my CNM stood by to help if needed.

    Those of us who are wary of OBs and the standard American hospital birth have very good reasons for those concerns. We are not trying to "hide away" by considering home birth, and I find that characterization to be insulting. Families choose home birth after much careful research and consideration. We are trying to help you avoid what we KNOW -- via personal experience AND statistical data -- happens in the vast majority of hospital births. We don't want to see you suffer through unnecessary interventions and disappointing experiences that so many of us have had.

    Yes, some OBs are better than others, but all OBs are *surgeons*. When all you have is a hammer, everything looks like a nail. OBs aren't trained to help you turn a persistent posterior-facing baby without a vacuum and/or forceps, both of which come with a HUGE episiotomy. As for pushing positions, they MIGHT let you push in "alternate" positions but virtually NO doctors are comfortable actually delivering a baby from a squatting position, much less all-fours!! They simply haven't practiced it. And the doctor's comment about squatting causing more/worse tears is a big alarm bell to me, because that's not backed up by research. And their defensive attitude ("we're not trying to mess up moms' lives") also raises a red flag. If they were practicing evidence-based care and had good outcomes (low c-section rate, high rate of intact perineums, low NICU transfers, high VBAC rate), they wouldn't have to feel defensive.

    Please realize, just because those doctors are "on board" with your plan now, doesn't mean they won't change their tune at 37 weeks or even during your labor. The birth bait-and-switch is REAL. Read more here: http://nursingbirth.com/2009/10/21/the-ol-bait-and-switch-or-finding-out-your-ob-has-been-leading-you-on

    For the sake of your physical and mental well-being, and for the sake of your baby, I really hope that your OBs are in the tiny percentage who practice evidence-based medicine and will not start playing the "your baby is too big" card at 37 weeks, or the "failure to wait" card during labor, or try to induce you at 40 weeks because you're "late".

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  21. (Sorry to double comment, but this was a long post and I have a lot of opinions on this subject!)

    If your doctors said they don't do episiotomies any more, they are lying. Maybe they don't do them ROUTINELY on every woman, but ask at your next appointment -- they will tell you that they only do them "when necessary" which is at their discretion, and they know you aren't going to argue when the moment arrives and your mind is on pushing out your baby.

    Finally, your perceptions of hospital birth are mistaken. A trip to the hospital is NOT a vacation. Would you choose to vacation somewhere that millions of people catch antibiotic-resistant infections every year? Where the food is truly awful and you aren't even allowed to eat it for hours on end, when you're doing the hardest work of your life? Where strangers are looking at you, touching you, and telling you what to do when you're at your most vulnerable? The nurses will not be waiting on you hand and foot, either. Some nurses are good and will be supportive, but it's totally luck of the draw. More importantly, have you found out if your hospital has lactation consultants on staff around the clock? Are breast pumps available? What is their rooming-in policy and policy on routine blood sugar checks and supplementation with artificial milk?

    I do understand the insurance issue, but midwives deliver in hospitals, not just at home, and the midwifery model of care is proven to result in a more satisfying birth. Medication is still available in a CNM birth, if you decide you want it, and backup from an OB will be available in an emergency. And insurance covers most CNMs. Based on everything you've written, you would be a perfect candidate to give birth with a certified nurse midwife (CNM), and it's definitely not too late to switch.

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  22. I have to say, I just had the BEST hospital birth experience. My doctor and the nurses really let me take the reigns and make most of the birthing decisions (until my placenta tore -- then it was time to get baby out!). In the end, I got my VBAC and although my recovery was rough, the nurses took great care of me and I healed quickly.

    I've found it's important to find a doctor who will listen to you. The rest seems to fall in place at that point. If they are a more hands-off kind of doctor, they will probably deliver at a hospital that is more hands-off/patient oriented, too. Seems like you've done your homework; good for you.

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  23. What people don't get is that every birth is different. Just ignore all the bad experiences. In hindsight, my birth experience really wasn't that bad. I loved my OB and did have him for the actual birth. For some reason this surprised me. I thought that maybe they'd just send somebody on the floor or something.

    I didn't plan on being induced and this is just the part that killed my "plan." It definitely wasn't horrible though. Only 18 hours total of labor with less than 30 min of pushing.

    Labor is a big part of your life but, to me, it's just something to get through in order to have your baby. There are going to be good and bad parts of it whether natural or not. It's not like pain is enjoyable, right?

    Don't let people get you down. Just because people are disappointed in their own birth experiences doesn't mean you have to approach yours with a bunch of doubt. Best wishes.

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  24. Huh, I thought I left a comment, but I'm not seeing it.

    Well, in case it doesn't show up, my most hospital delivery was great. My doctor DID attempt to manually turn my posterior baby several times before resorting to the vacuum, and I don't believe he would have if I hadn't had placental abruption. Plus, my episiotomy was TINY. Just a midline incision. It healed fine in a few days.

    Not every OB is going to cut you open at the first opportunity. Mine was very supportive of my VBAC and could have sectioned me at several points during my labor (when I stalled, when my placenta tore, when we discovered baby was posterior). But, he didn't. In the end, I had a successful VBAC. WITH an OB, an epidural, and augmented labor.

    Finding a hands-off, patient-oriented OB is a must. It's not easy but it's possible. Sounds like you've done your homework.

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  25. I planned from the very beginning to have an epidural. I knew I wanted to enjoy the labor experience and I didn't want to be out of control with the pain. I was extremely surprised with my first child that I didn't really need the epidural immediately. I labored for 32 hours with Pitocin without any pain relief. And you know what? It wasn't that bad, not at all. In fact, the only reason that I got the epidural at all was because I was about an hour away from having to have a c-section (water had been broken for well over 34 hours at that point)and my nurse said that I might dialate if I was able to relax. She was right. I went from stuck at a 4 to fully dialated less than 15 minutes after getting the epidural. But I really didn't need it for pain relief.

    Don't let anyone discourage you. This is your birth. They had their's. I wish you the best of luck!

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  26. i've never been to your blog before, and this is the first post i've read. a few quick thoughts...i only have a minute.

    my mom is a labor and delivery nurse and has seen a lot, not mentioned delivered quite a few babies on her own, and has had a few of her own (8 children, one set of twins).

    i'm pro hospital, pro o.b., and frankly pro epidural and pro episiotomy. but each woman is different, each pregnancy is different, and each delivery is different.

    one thing about going natural. if it is something you want to do, decide to do it now. if you don't decide and prepare, it most likely won't happen. For my first girl, i considered going natural and did some research and talked to people who had done both. i decided to go with the epidural, for reasons i won't give you because i don't want to throw my opinions in your face. ;) but i do know that if you want to go natural, the best thing to do is to decide that you are going to do it, and to prepare accordingly. (yoga is great, i'm a certified instructor, and if you have any questions, you can ask me.)

    of course, remember, things can happen during delivery where the doctor must intervene. If that happens, don't feel bad, and don't feel like a failure. Be happy that you have your beautiful baby!

    someone mentioned earlier that doctors just want to "cover their butts" and while that may be true, the best way to "cover their butts" is to make sure you and baby are as safe as possible. Doctors, nurses, and hospitals are not the bad guys.

    i applaud natural births (even though it is not for me) when the couple delivers in a hospital, there is an o.b. overseeing (at least), the couple is prepared, and they are nice to the hospital staff.

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  27. I don't think people who say "Sure, your OB says that now..." are trying to criticize you or judge your choices. They're simply sharing what may have happened to them or other women they know in order to encourage you to stay focused and informed from beginning to end. There are many anecdotes out there of OBs placating women and answering all of their questions fine in prenatals, but then really taking charge during birth and telling the woman s/he knows best, regardless of her preferences. It could happen, it could not happen, but that's no reason to write off another woman's experience/words of warning as an insult or criticism of your birthing choices. I hope that you DON'T encounter any bait-and-switch in the throes of labor... but it doesn't hurt to be prepared, just in case.

    After all, it is a fact -- not opinion -- that OBs are trained in the medical model of care, which focuses on the pathology of birth (i.e. birth is a disease or illness to be treated), rather than birth as a natural process, and that because of that, many OBs prefer to actively manage labor rather than let it progress on its own. This doesn't make them scary or awful or bad people; it just makes them a member of their profession.

    Personally, I hope your OBs are as awesome as they sound (who wouldn't?) and you have the birth experience you are hoping for.

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  28. I love that you know exactly what you want, and that you make no apologies for it! That's the perfect attitude to have! :-) As long as YOU feel good about YOUR birthing process, it's all that matters.

    My son came by Cesarean, out of necessity, and so now this 2nd baby will be a scheduled C - and I am soooo cool with that! My OB asked if I wanted to try a VBAC and I told her no-way Jose! I'm perfectly content having my tiny, 3" inch incision re-opened to take out Baby #2, and I too make no apologies for that. I just smile when folks raise their eyebrows at me for saying this!

    It's all about being confident in what YOU want. In the end, the birth process pales in comparison to all that comes afterward anyway so..... I say go with your heart and you wont ever feel bad or have regrets afterward! :-)

    ~Yakini

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  29. Good for you Jenn! Whatever choice you and your husband make is the right one for you. Go with your gut and how you feel about it. I think that having done the research you have done you should feel confident. Either choice probably would be just fine, but do what works best for you two.
    I'm on the thought that anything works, as long as people are comfortable with it. I am uncomfortable with home birth for myself, but I have lots of friends who have done them and loved them, but for me it wasn't a choice. I didn't feel comfortable with the idea of it. But that is me, and I don't push anything on anyone else. I just tell them how MY experience went. but that is my personality, I don't push my ideals, or criticize anyone for their choice.
    That probably is one of the biggest things for being in the spotlight like you are, you will get everyone's heated opinion in it.
    ( I just had an experience this week like that, someone didn't like my status on FB, disagreed with me and left a comment doing so, so I replied a rebuttal comment. Then that person gets all offended since that happens a lot to her. She ends up de-friended myself and a lot of other people from our old ward. My feeling is, you came onto MY site and disagreed. You searched ME out, I didn't search YOU out and call you out. I didn't have a problem with her opinion, I didn't think less of her for it, but SHE got all butt-hurt and frustrated. So I was more disappointed in her for acting all crazy over two points of view.) My philosophy is that I may not agree with your point, but I will respect it, listen to it, but I don't have to live it. I do what works for me, if I am right or wrong I will learn from it. I just wish I got more respect in the same manner instead of snide comments or actions like that.

    Internet is great but it is just a virtual world. Sometimes I think we get wrapped up into all of it, myself included.

    I had two hospital births, one with OB and one with Midwife. Each turned out fine, healthy babies who are adorable and I love dearly. But in my experience, it was just a birth, a day that is a distance memory but so precious to me. I don't dwell on what should haves, or could haves. I dwell on how adorable they are, how precious they are and how little they will only be. They grow up WAY TOO FREAKING FAST!!

    OH and I had one episotmy and one tear, and honestly I healed faster, less pain and more comfortable sex after the epsiotmy over the natural tear. Complete opposite of what you hear about episotmoies. So my own personal experience of natural birth experiences are now a bit questionable. But that is just for me, not to slam it for any one else experiences. I'm usually the odd one out. ;)

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  30. Your OB group sounds really good, and fairly progressive. I'm glad to see things trending that way. It would be great if you could have a similar meeting with the hospital staff. The thing I have found (3 hospital births, opting for home this time), is that you are mainly with the nurses at the hospital and only see your OB at the end of your labor (possibly sporadically through out). Often hospitals have a set routine they like to run women through, and it is hard to feel like you are trying to do things differently (particularly in the middle of labor). If your hospital is used to women who labor naturally, they may be really supportive of your decisions. The hospital I went to with my first, was not. They acted like I wouldn't be able to labor naturally, and preferred that I would just fall in line, and get the epidural and pitocin like everyone else. The second hospital was much better, but kind of left me alone most of the time since they didn't know what to do with me. My point in all of this is that your experience may have more to do with your nurses and hospital staff than your OB who is only present for a small part of the process.

    Way to get educated and ask lots of questions. Make sure your husband or other support person is prepared to go to bat for you, if things aren't going the way you want, because that isn't the time to have to fight for what you want.

    Good luck!

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  31. Go you! Everyone is different. I have a friend who has been pushing the at-home, natural birth as long as I have known her and it's worked for her and she's happy with it. I've only had two (she's had 5), but I'm happy with my hospital births. Did I like the on-call doctors? No. But I had PIH both times and needed the epidural to help bring my blood pressure back down. Not to mention I was in tears and begging for it by the time they brought it in. I do have to say that my second experience was WAY better than the first and I believe that is because women are taking control of their own birthing experiences and being proactive and assertive more and more. Yay! I hope we all can continue on with the trend. But, let's remember that there is more than one way to skin a cat (horrible, I know) and not judge. I heart epidurals!! So there.

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  32. LOL whoops on some spelling! I typed this out while tendng to my two young-ins! I stopped a lot and came back to it as I could. So I ended up overlooking some horrible spellings! LOL

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  33. Mallory and Rebecca M. are right on with what they said. I wrote a comment earlier but it didn't post, and it's probably better I waited because even though my comment wasn't rude I am highly offended by your statement that women aren't empowering themselves by going to the hospital and instead hiding away at home. The entire point of a home birth is exactly that women ARE empowering themselves and know that their body is capable of birthing a child on it's own! Fact: birth rapes happen every day in hospitals in America. Hospitals are a business and doctors are business men/women and the reality is that a hospital is a place for the sick. In developed countries where women are taught to trust their bodies when having a child and where they routinely birth at home with a midwife and not a hospital, they have higher success rates than here in America! That is a fact as well! You want others to respect your opinion, I say respect others' opinions as well. Do what you feel is best for you but and please, be informed about what you are saying of others instead of stating misguided assumptions about something you are clearly uniformed about.

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  34. All I can say is that I was really, really prejudiced against c-sections going into my first pregnancy. I wanted to do as much as I could at home, going to the hospital at the last possible moment and then staying for the shortest amount of time they'd let me. Then, the baby was late. We went in for an ultrasound and he was upside down and backwards and his heart rate had dropped dangerously. The doctors and nurses were all prepared to try and help turn him naturally but something just didn't feel right.

    I suggested the c-section and I'm very, very glad I did. My husband watched them untangle the cord from around his neck and the pediatrician confirmed my fear that, had we tried to turn him, we would have killed him.

    Going into everything, I was planning on as drug-free, natural experience as possible. But, when the time came, I had to make a very different decision for the safety of my baby and myself. To this day, I still have people who look down on me for my decision but all I can really say is, I made the best decision for myself and my baby, and I have a 6 year old running around to prove it.

    I'm currently looking into the stats about VBAC because I'm pregnant again, but my first inclination is to schedule that c-section. Am I right? Who really knows, but it's my decision. And your birth is your decision. Do what's right for you but do talk to your doctors. They don't know everything but they do do this an awful lot.

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  35. Oops UNinformed, or possibly MISinformed.

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  36. I don't have any children of my own so I am afraid I can't comment on hospital births vs home births but I do think it is a shame that women can't support each other instead of criticizing women who make a different decision than they did. It is your baby, your birth, your choice. I hope people will respect that for you!

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  37. The squatting leading to more tearing thing I have never heard before, and I don't see why it would. I tore horribly during my first delivery (stuck on my back) and only a tiny bit along the original scar line with my second (squatting in a birth pool) What I think *did* make a difference more than the position was that I had an epi the first time around so could not really feel what was going on properly. the second time I was unmedicated so I could really feel when he was crowning and was able to control how he came out to avoid ripping wide open again.. (sorry tmi) You want to push the head out slowly to avoid tearing and I don't see how the position would make a difference with that.

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  38. hey, like other people said, just get used to other women telling you you're doing things wrong right now. i once had a woman in my ward pull my blanket off while i was nursing, look at my son, and tell me i was holding him improperly. i was like, oh no you did NOT just do that.

    anyway, with my first delivery i had a full epidural a few hours after reaching the hospital, and it was a bad experience. it only worked on one side, so my left leg, buttcheek, and foot were completely numb and useless, but i could feel EVERYTHING on my right side. i tore really bad, had a large episiotomy, and my son had to be vacuumed out. needless to say, with my second son i wanted a different experience.

    my doctor is not an ob/gyn, and she has six kids, so she is very open to birthing plans and tries to work with her patients. i let her know that i wanted to try for no epidural, and that i absolutely did not want an episiotomy. she was fine with that.

    i ended up getting induced and went about 9 hours without an epidural, but i caved and had them give me a very small dose to help me relax (i wasn't progressing, had been at a 5.5 for about 3 hours, contractions every 30-45 seconds). as soon as i got the epidural, i dilated all the way and my son was born an hour later. it was the best decision i could have made.

    since it was a light dose of medication, i was able to get up and use the bathroom by myself right after i was stitched (small tear this time), and my recovery was so much faster than with my first. it was a wonderful experience.

    anyway, moral of this looong story is that you should do the research and make the decisions beforehand, but be flexible and willing to accept that the process is really not in your hands. being open to last-minute changes will make the labor and delivery experience a lot less tense and overwhelming.

    anyway, that's my two cents. i hope you're still awake. :)

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  39. FTR, when I said "they say that now" it's because having birthed two children being told I could birth in whichever position I wanted, I invariably ended up doing the actual pushing, not the laboring, but pushing, in the standard on your back position, despite desires to the contrary. They do say that they allow things which they DO allow, but you have to have an advocate when you actually are birthing, because you're going to be busy laboring, and generally a woman doesn't have much fight in her left for arguing with the white coats.

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  40. It's cool that you are becoming so educated. While I am not pregnant, I do want to have kids in the future. One of my fears, however, is the birthing process. It scares the crud out of me. This post was helpful because I didn't even know there were so many options to consider. Doing what you feel is best for you is definitely the way to go. Good luck!

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  41. Sounds like you'll be taken care of by a wonderful group of doctors! The advice they gave you about being up front about your desires and pairing you with a nurse who will help you work toward those desires is great advice! We did that when we checked in to the hospital, and it made for an incredible experience. The nurse helped us achieve a natural birth—with my husband acting as my doula! I also found that the doctors were surprisingly willing to listen, even in the throws of everything (I told him NO episiotomy mid-pushing, and he listened :)). We've decided to have a doula with us for this delivery and I'd love to have a home birth for my third, but if there's one thing that I've learned from doing it once, it's that your experience will be what it will be, and after it's all said and done, it will strengthen your knowledge and help shape your desires for any deliveries that may lie ahead. Hope you get your dream birth experience, though! :)

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  42. It always shocks me when people feel the nudge to harshly judge the birthing choices of others. I'm not a mom yet, but when the time comes? I'm going to go with the solution that fits best for me, my body, my baby, my life, etc. - and I wouldn't expect anything else of any*one* else. If one thing worked for everyone, there'd only be one way to have babies with no variants at all. Since that's not the case? We all get the chance to make the decision that's right for us, and I think that's AWESOME :)

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  43. Hi :)
    Following very late from the Friday follow! The list is sooooo long!!! You can follow me at http://savvycouponmommy.blogspot.com Best wishes with your new addtion! :-)
    ~Sarah

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  44. I have 3 kids. My first 2 are boys and I had them natural. No Epidural. I loved it. I had a girl for my last pregnancy. My little baby girl went into stress and I had to have a emergency cesarean. I hated it. I would go NATURAL anytime. I just wanted to say GOOD LUCK on your pregnancy and the birth of your child. Do what you feel is right for you. GOOD LUCK AGAIN!!!

    Gina
    Visit my blog at http://motherof1princessand2princes.blogspot.com

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  45. Jen, people are crazy. And mean. And heartless. The illusion of internet annonymity gives them the feeling they can say whatever they want. Who the heck cares what they think about your choices? They are YOUR choices and this is YOUR baby. Jerks.

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  46. Can't wait to come back and read these comments. I wrote a post about this. . . triggered by yours. Find it here:
    http://smotheredinmotherness.blogspot.com/2010/04/labor-train.html

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  47. Hello.
    Please read how IVF medications led to my breast cancer and how a breast cancer study using genetic testing to check estrogen metabolism is saving my life. Please share my story with all women who have used or are considering IVF, HRT and anyone with estrogen positive breast cancer.

    Thanks
    Stacia

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  48. Seriously I think when people sign up to become a blogger our brains and thoughts start to link up and we carry on some of the same themes. I JUST wrote a post on hospital vs home birth on my blog.

    And in a nutshell. I had my son in a hospital and it in fact was nothing like I wanted or envisioned. Even though my OB expressed over & over she would follow my birth plan, she didn't. I did end up with an episotomy and I STILL got over 100 stitches! The trauma of my labor (in labor 21 hrs with no drugs)even caused me to not produce as much milk as I needed because of all the stress and repair my body was going through.

    I do believe that women aren't as informed as they ought to be about birthing. We spend months and months researching and focusing on what not to do and eat and what not to put in our bodies, but not enough time thinking about what we shouldn't be doing and putting in our bodies in labor.

    But nevertheless every woman and birth experience is different. Some women loved the hospital experience and wouldn't have it any other way. When I had my first baby I too looked at the hospital as a "vacation" (which it is NOT. People coming in and out of the room all night to see if you've farted?!) and the best birth but after going through it I will never birth in a hospital again (if I can help it). It's just one of those things you'll never really know until you've been there.

    Whatever you decide good luck to you. My only advice is to make sure your support team (husband, mother, sister etc)that is going to be in the room with you is going to fight on your behalf and be YOUR advocate.

    Good luck

    My blog post: http://beforethebabywakes.blogspot.com/2010/04/learn-business-of-birth.html

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  49. Wow, there's lots of comments here so forgive me if someone has already answered. But when my son was born I was given a drug (a shot in the back- NOT a catheter in the back) called "L.I.A" that is similar to an epidural in the fact that it takes away A LOT of the pain, however you're still VERY conscious and you can still feel your limbs, I spent all of my labor except the pushing, standing up "dancing" with my husband. I was able to "push" correctly and knowledgably because the LIA doesn't take away sensation.
    I recommend it because it doesn't have any lasting side-effects and it wears off much quicker than an epidural.

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  50. Your hospital sounds like a place full of mother-friendly providers. Perhaps you could mention to them the website http://choicesinchildbirth.org/ - which provides a list of mother-friendly providers across America. It would be GREAT for other women to know where good OBs are located!

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  51. I loved this post! I think you're dead right, some people have a tendency to assume "If this woman is making a choice I don't like, it's because she hasn't done her research!" As you say, we're quick to criticise instead of support each other's decisions.

    Like you, I got a bit spooked from reading a lot of really negative anti-doctor things; I don't want a homebirth but I started to get really scared about a hospital birth too. And this post came at just the right time for me -- it inspired me to sit down and do some research and make some concrete decisions about the kind of birth I want, and I feel much better about the whole thing now. So thanks!

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  52. Wow - sounds like a great meet and greet! I wish more practices had things like this one. And it also covered a lot of territory. I think that the sheer fact that they are doing this has to speak volumes about the practice. Don't forget, after the birth to log them into http://thebirthsurvey.com so others can see how cool they are! Haven't seen you around Twitter in awhile, I'll catch up sometime soon! Be well.

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  53. Best advice I ever got on labor was from The Girlfriend's Guide to Pregnancy: When they say it's time to push, push as hard as you can. The harder you push the faster the pushing part is over. Seriously.

    Also, breastfeeding is hard for the first 2 weeks. Then it just magically clicks (for both baby and mommy) and it's the easiest thing in the world. If you really want to breastfeed, commit to stick with it for 2 weeks no matter what and you'll do great.

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  54. That's terrible advice from RainSplats. Pushing when you're told to push, and "as hard as you can" instead of listening to your body, is not a best practice for healthy birth and increases your risk of perineal damage and the chance your baby will have distress signs due to oxygen deprivation if you aren't breathing properly due to non-stop purple pushing.

    And breastfeeding did not "magically click" for me and my son at 2 weeks. He only got off the nipple shield at 10 days. It was more like 6-7 weeks for us, but we're still going strong at 14 months. A huge factor for us, though, was all the interventions during his birth and separation immediately after birth. Still, I think 6 weeks is a more reasonable minimum commitment than merely 2 weeks.

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  55. Here's info on the "LIA" mentioned by Ms. Michalek -- I think it's a walking epidural and does involve a catheter in the back, as LIA stands for "labor intrathecal analgesia".

    http://www.childbirth.org/articles/walkingepi.html

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  56. I know it's been ages since you've written this but I just have to comment because I unfortunately had the most unsupportive team on-call the night/morning I had my son! Since my water hadn't broke, I was honestly in denial that I was in LABOUR! Turns out I was NINE centimeters dilated when they finally got me to triage!! So they rushed me to a delivery room where they broke my water and asked me to start pushing. I tried... but my back was killing me!! So I told them, I couldn't push while I was laying on my back and the OB's response was a shocker!! She said, "if you're gonna push like this we'll be here all day!" But I really couldn't push. Everytime I tried, I'd feel like my back was being ripped apart!! Tears were rolling down my face and no one bothered to offer I change positions! I asked if I can lie on my side and I got no response. Then a nurse who was looking at my face rather than between my legs actually took the time to say, "do you want an epidural?!" I thought I was too far along and I honestly wanted to try doing this naturally, but heck I was in soooo much pain (back-wise) I was willing to take anything! I was worried something would happen to my son if I don't push him out fast enough. So I said okay.
    Obviously there was a shift change by the time I was ready to push again and the new OB was sooooo much nicer! I think if she was there the first time around, I would've been able to do it epidural free. Honestly, squatting bars would've been heaven sent at that point. Wish I'd known about them. But then again, I expected my water to break and for things to go like they did with my first birth. I feel like such a fool now!

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I more than welcome your comments! I love them and am always looking for advice, encouragement, and love to read about your personal experiences! Speak your mind! And feel free to leave a link to your blog so I can learn more about you! Remember, no comment is too long :)