September 11, 2011

So, here she is. The ultrasound is, for now, the only real way she is making a visible appearance, since I look pretty normal and just continue to feel seasick. About 14 weeks now. The process of finding where and with whom to deliver is a tricky one in NYC. Maybe everywhere, but it seems even more challenging here in the big apple. My sister, Julie, is pretty brilliant (doing a double PhD in Anthropology and Communications at Indiana Univ. with 2 children under 3) and she has helped me to think through a lot of questions about birth. She had both of her girls at home.

We are looking at the Birthing Center at Roosevelt Hospital with a group of midwives there. I can't figure it out though. They are largely unreachable - they do not pick up the telephone (not ideal for a care provider). They do 20 births a month, so if your baby is born outside of its designated month, they won't take you...well, it is not like that exactly, but they have a strict range of dates and if your birth falls outside of those, even if still considered pretty safe, I guess it is the hospital for you. Care, as I imagined it, is hard to find.

There is a growing body of people in the US who are challenging the practice of birth and how it currently happens, often without any question from the women and men going through the experience. One book Julie recommended is "The Thinking Woman's Guide to a Better Birth," by Henci Goer. So far, crazy. You open the book and the author lays out some astounding facts about how birth gets done at the moment in the US. Things like:

- Cesarean section is the most common major surgery performed in this country...The consensus of medical literature is that half of these operations were not needed.
-Nearly half of women giving birth vaginally still have an episiotomy...Reserach proves that, with rare exceptions, this procedure does no good and often does harm.
- Virtually no pregnant women manage within the conventional medical system escape without having tests, drugs, procedures or restrictions that studies show offer little or no benefit when used indiscriminately but which introduce risks.

Alarming, because going into this experience, I don't trust the people in whose hands I may end up. The medical world often views birth as something from which to deliver a woman; the doctor must intervene. Yet, what I like about this other way of thinking about birth is that a woman's body is trusted, the woman is the actor - who delivers the baby - not the doctor, and birth is seen as a natural process. All of that makes sense to me. I remember watching "The Business of Being Born" and hearing that, physically, lying on her back is the worst position for a woman to labor and deliver a baby. Made me really doubt a medical establishment that insists on a position for its own convenience.

Anyway, so we are meeting with the midwives this week. I have a long list of questions. My nightmare is that I will end up on a hospital bed with an IV in my arm, epidural in my back, fetal heart rate monitor hooked up, my legs wide open - at the mercy of some doctor who could decide to intervene in any number of ways - all in a process I believe my body capable of handling without intervention at all. I'm not interested in a painless birth - in fact, I think that pain will be useful in understanding my role in how to best get a baby born - if I assume the role of primary actor. I'd like to work with someone who trusts my body as much as I do.


Jordan said...

My best friend is a doula and an aspiring midwife, and this is something we've talked a lot about! It really is unnerving how challenging it is for women to take control of their own birth experience in the US, even when you have very clear ideas of what you want. Not to mention women who don't have the information or resources to make any of their own decisions what-so-ever. I hope the meeting with the midwives goes well-- I'll be really interested to hear more about your experience figuring this all out!

Marnie said...

I've had 2 caesarians - 1 was an emergency and the other was scheduled after I failed to labour naturally with my second (after a 10 day overdue period).

At the time I had also read that c sections were happening in more than 50% of Australian births and I questioned the obstetrician I was seeing at the time. She pointed out that yes, the stats were way up, but the stats for birth-related infant mortality were way down. I think there is perhaps a relationship. Anyhow, natural is best, where possible. I was sad not to be able to see the process through the way I wanted to, but despite all that, I have beautiful, healthy daughters who came out with the most perfectly shaped heads. And at the end of the day, as long as your little one arrives safely and you've been well cared for, that's what is most important (in my mind, anyway. We're all different of course).

Good luck with your decisions. It's not easy. Midwives are usually a good way to go as women 'get' women. The doctors wafted in and out and the midwives always did most of the work. The operating theatre was the only place I was ever on my back. When in labour the first time I used beanbags where I lay on my side, knelt on all fours, whatever was comfortable and felt natural. The midwives were really encouraging of that. Feet in stirrups is a convenience for the doctor and nothing more.

Anyhow, I'm sure you'll figure it all out. Just do your research and go with your gut. Good luck : )

Ming said...

Best wishes to you as you seek to find the right birthing method that suits you.

I delivered three of my four children without any drugs, 'natural' as it can be in a hospital environment although I did have an IV in me each time.

I truly enjoyed the entire process. Fortunately, a year ago this Wednesday, I had the fortune to be with my daughter in the delivery room for the birth of my first grandchild.

The miricle of life is awesome.

Here's to less seasickness each day.

Anonymous said...

Emilie - i am a follower of your blog, but don't comment much. This topic is so near to my heart as a mother of two young sons and a woman who had an epidural with son #1 and went natural with #2. I wish you luck in your search for the right match of birth provider/birthing coach. It's so important to find that good fit so I applaud you for persevering, based on your expressed needs I think are asking good questions. While I live in Seattle where there is no shortage of pre-natal/delivery options to choose from, I definitely had to be my own advocate from beginning to end to ultimately choose a natural birth with #2. I definitely could have done so with #1 but kind of gave over my choosing power (so to speak) and it could have gone better. Anyway, I took control the second time around and it was an improved experience for my baby and me (with a tinge of regret for #1). I read the book your sister reccomended and it's a good one. The facts are daunting about US childbirth - so many c sections, a lot of "helper" drugs used, etc.
Big congratulations to you oon your pregnancy! best - amber

Emilie said...

thanks to all for your thoughtful responses. i really enjoy hearing other perspectives/experiences on this.

Brad said...

She is beautiful! I think she looks like X don't you? It's a girl!

I love that you are educating yourself and considering what is important to you and Xavier! I can't wait to hear all! Love you so!

Rosie said...

Oops! That was me Em. But I think Dad is really excited too! Blessings!

Ironically you were the only one of my babies that I had an epidural due to the insistence of my doctor. It didn't take effect until I was in the recovery room! I had a midwife with Andrew and it was the best birth!

Beks said...

love this em. i feel the same way with a bunch of this stuff! CANT WAIT! :)

Miss. M. said...

Over here in Holland, many women deliver at home without any drugs. Although there is some critism, it is still very popular. But we have more ceasarians as well.
I was lucky the first time to get my baby at home, but did get (minor) complications and had to go to the hospital. With my second girl I had to go to the hospital, just in case. But I went there with my own midwife, and the birth was really quick and good. Here we believe in: 'Power through pelvis', a woman is designed to give birth. Here we believe in diving in your contractions, a woman's body has an inner knowledge. Women are trained to follow the wisdom of their own body through yoga or some other sort of pregnancy course. So when the birth starts we always try the natural way. But, when there are complications, of course we (as Dutch women) take the step to the medical world. I wish you a very good pregnancy and then a very special delivery. And remember: you can plan a birth only to a certain extend. You never know how it will turn out.
With great interest I will keep on following your blog/life/pregnancy. Take Care.

Anonymous said...

First of all : Congratulations ! And I'm sure you'll make the right choice for the birth. You are the only one to know your body. The only important thing is to make sure that everything goes well (medically speaking). Et bravo encore une fois !
Second : I'm in LOVE with your photos - especially those of Baugé. Do you use all your photos for your blog only or are you planning to make a book for example ? I would be really interested in it :))
Yolaine - from Baugé

Xtreme English said...

Good luck! What I am concerned about is WHO IS GOING TO BE TAKING THE PICTURES OF THIS while you are otherwise occupied??!!

erin said...

i just had my third child in switzerland and while it was a c section for legitimate medical reasons, it was a world away from my previous two which i had in rome, where the approach is decidedly more 'american' or dr driven. i didn't even suspect that a c section could be so emotional and warm and not so clinical. the post care was AMAZING. their whole approach is very balanced and very mother/baby focused. it as a wonderful surprise and such a treat for both me and my new daughter. midwives played a huge role in every aspect and i credit the many gifted, educated and warm women i dealt with for helping create such a lovely experience. they were so pro natural whenever possible that after the surgery, while in serious pain one midwife came to me and said "please tell me if youre in pain and ill get you something to help" to which i quickly responded "yes please!" even in my blurry painful state i couldn't help but laugh when she came back with a dropper full of Rescue Remedy!!! and to think i was expecting something more along the lines of morphine! so if you don't find anyone you like in nyc i highly suggest Switzerland! ;-) congratulations

The Crebs Family said...

Hey Emilie! Congrats to your family on the beautiful baby.
I have been able to experience both ways of birthing. With Ava I was naive and just listened to my doctors and did things there way. I figured that they knew better than I did. I was wrong. There were many "interventions" that I was really uncomfortable with. I ended up not being able to really experience birth at all. I think when they numbed me, I didn't realize that it would drowned out the whole experience.
With Viviann I really took charge. I went to a midwife, I made a birthing plan, I made more of the decision. I contemplated a home birth as well, however, Riley wasn't comfortable with it. I think by us understanding that this was our birth process and not just whatever fit into the doctor's schedule, it made all the difference in the world. I loved everything about my "natural" birth. I loved the pain of it, and all the feelings that it evokes. I still had to fight the nurses at the hospital on a few things, (like not putting in an IV when it really wasn't necessary) but overall, it was a much more well rounded experience than my first. I hope to deliver all my children that way in the future.
Best of luck in finding someone that you work well with and that will help you get what you want out of this whole experience.
Lots of Love to you all!

Anonymous said...

It is a common misconception that birth is safer at the hospital, a misconception that hospitals profit from very much. Evidence based research and statistics and truth actually reveals that homebirth is, in fact, safer. Hospitals often have to "save" mother and baby from complications caused by interventions that the doctors and nurse midwives at the hospital actually inflicted themselves. My heart goes out to you as you and your partner navigate this beautiful life-changing process together, while folks throw heavy, opposing, confusing information and personal experience at you. Trust in your body. It is designed to birth the women's bodies have been doing since we've existed. Long before OBGYNs or hospitals or epidurals or c-sections. Also trust your baby - she is very very smart and she is a genius at getting born. She'll lead the way, and you will follow. Good luck!

Rebekah V. said...

Well, I think I missed the original announcement. so let me say first, CONGRATULATIoNS!!! I had one home birth and three at a freestanding birthcenter. I remember the almost religious search for the best situation for us to have the babies and all of the reading and realizing and learning that went into it. I think of myself as a birth minimalist. I just try to get as much extraneous stuff out of the way and let nature take its course. The trick is finding out what you think is extraneous. by my fourth I finally figured out that flexibility is really the key to a positive experience because every birth is different. For instance, in retrospect, after four natural births I am actually pretty sure that I would have benefited from an epidural with one of them because I ended up being deranged from sleep deprivation and had a horrible post partem experience because of it. I wish I could go back to my younger self and whisper "it is okay. you need to rest". That being said I am very committed to natural birth.

I have an autographed copy of "The thinking woman's guide..." and spent a lot of time at birthing conferences and reading to come to my final conclusion that the best birthing plan is that after all the big structural things are in place be as flexible as possible. My two cents.

I am thrilled you are having this experience!

PeregrineBlue said...

emilie: you'll do fine, i know it from your nature. the first thing is to find a gynecologist you feel really comfortable with. mine was a sweetheart from argentina. i gave birth to three children, all natural childbirths, no anesthesia at all (i agree with you on the pain) and did have an episiotomy with my second son because he was an eight pounder, nothing wrong with that. i then breast fed all three for 8 months which is when my milk ran out naturally. just tune into your body and what women like us have known for centuries. and please don't be scared or worry, it will be the most wonderful experience of your life.
now go play some classical music and put your tummy close to it...even that your child will enjoy.

gaminette said...



And I have no experience with pregnancy myself, but I do say bravo to you for exploring your options (and you DO have options). I've seen friends be practically bullied to tears at hospitals when they chose the "wrong" thing. Your body, your choice.

See you next week!

Kimberly said...

I am SO excited for you! After delivering 2 with an epidural and not really enjoying it both times, I did a TON more research for my third. I did it naturally, with no fetal heart-rate monitors, no IVs, or pills. And I LOVED it. It was definitely a WAY better labor, delivery, and recovery!

Power to you, and I hope hope hope that you can find someone that will allow you to deliver how YOU want to deliver!

P.S. I delivered all 3 of mine in a hospital but under the care of Midwives. It was the perfect compromise of "natural" and "in a safe setting" for Sean and I.

P.P.S. I hope the "seasickness" passes quickly! It's all so much more fun after that is gone!

D1Warbler said...

My take, after six births -- four of which were considered natural births -- is that natural -- including the pain -- is better. Niki was my easiest delivery and the most natural birth of all six.

I think midwives are a great choice; as I really do think that women understand the birth process best; but I would definitely opt for a midwife within a hospital setting as you never know what serious complication could happen.

One relative had the placenta detach during labor -- with no prior problem. The only thing that saved both her and her daughter was the fact that she was moments away from a C-Section and even then her daughter suffered some mild Cerebral Palsy. Had she even been across the street from a surgical center, the results could have been much more tragic.

As others have said, there are no guarantees for a perfect labor -- even when that has been your previous situation, so you choose the best options available to you.

Amy said...

Congratulations Emilie! Isn't it amazing and wonderful that there are so many options for pregnant women. I just wanted to throw my two cents in. None of my five deliveries ended up exactly as I had planned, and for awhile I felt some sadness about that. With time and maturity I've decided to focus on how grateful I am that my children are here and they are healthy. I hope everything goes as planned for you, but if it doesn't, focus on the positive and don't waste your energy on what might have been.

Jill said...

Without the doctors and the help of all those 'medical' things all three of my children most likely wouldn't have made it into the world safely and I probably wouldn't be around anymore. I say plan your ideal situation and hope for that best scenario, but be prepared for any possibility, because sometimes things don't go according to plan, and that's when you end up grateful for modern medicine and those doctors. I hope you have an easy one though. You're so healthy and fit, that will help so much. Love you. That baby is beautiful btw.

Chloe said...

This is an interesting post for me to read as a 4th year medical student just finished a rotation in obstetrics in the UK; I've always been very pro-natural/home birth in cases of low risk pregnancies where that was the woman's preference. In many ways what I've witnessed ha reconfirmed that - hospitals are inherently stressful environments, and particularly here in a socialised system where there is a certain stretching of obstetricians/anaesthetists/midwives it seemed to me that this isn't the place in which I'd like to bring a child into the world. Being in the UK though, at the very least there isn't the feeling that people might attempt to profit from additional proceedures or interventions.

That said, I also had some very interesting conversations with senior doctors here, all of whom expressed the opinion that whilst home births are great for 95% of women with low risk, for the remaining 5%, being 30 minutes or so from a hospital in the event of complications could be potentially disastrous, and it's a risk some people are too blasé about, perhaps being too quick to demonise hospitals. As one put it to me, although it's lovely to think of labour as a beautiful act of creation and bonding between a mother and child, it's an incredible amount of strain on two bodies that for many centuries killed many women who underwent it. It may have gone too far, but the medicalisation of birth did happen for a reason. Interestingly, both the female OB/GYNs I've met here chose to have elective C-sections.

The conclusion I've come away with is that personally, I would choose to find an OB who was respectful and considerate of my wishes, and have a very stringent birth plan and a well-informed birth partner in place to advocate for me in the event that I couldn't, but I would want to be in a medical environment. The additional concern of being away from help it if was needed would negate the relaxation of being in a home environment for me. But as with all medical things this is very much a "for me" issue, and I'll be interested to see your feelings and decisions as your pregnancy progresses.

Terri said...

Being an Emergency Room Nurse and also having worked in Newborn ICU and having had 7 children....I would really prefer to have my child in a hospital. My last child was an emergency C-section and neither he nor I would be alive right now, except that I lived 2 blocks from the hospital and thank goodness they had an operating room open at the time.
Some of my children came without drugs and IV's. (the reason they like to start IV's is because it is difficult to start IV's on people who are crashing with low blood pressure etc.) With one I had labor in the ER because we were really busy. I worked 8 hours and then ran to the delivery room and had her 10 minutes later. She was probably my easiest deliver!
All that said Emilie, I like the idea of having a midwife or a doctor and doing it naturally. I think you heal better and can get up and around much sooner.But, after what I have seen after 44 years of nursing. I would still deliver in a hospital and specify that you would like to try and do it naturally. But don't beat yourself up if it doesn't work out that way. Congratulations on the new little daughter to come.

Anonymous said...

My sister wanted to do it naturally and with a midwife for her first in a hospital. She and her son almost died ...had the doctor and hospital staff not been there to step in within seconds. Her son was not breathing and she was bleeding to death as the cord detached from the placenta. Why risk it..if she had been at home they would have died. Do it natural and with a midwife..but with a doctor attending. Sure it only happens 5% of the time but is it worth the risk? I lived all over 3rd world countries growing up and I saw and helped so many women that hoped and wished they were rich enough to deliver in a hospital. Why take that for granted we are so blessed.

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