How much control do you want during childbirth?

After recently reading a post about “who makes the decisions when you are in labor” my own labor and deliveries came to mind. Alongside were the memories of the numerous labor and deliveries that I attended as a nurse.

When I began my career, my first position was as an L & D nurse at a university teaching hospital in the Bronx. Starting out was frightening and never having had a child I had absolutely no experience of my own.

It was the early 70s and at this particular hospital, many of the patients did not want to be awake for the delivery of their baby.

Today, it is difficult to imagine such a time when moms did not want to control everything  about pregnancy and delivery even before they actually conceive.

The young mom of the 70’s would actually ask to be ” knocked out ” for her labor and delivery. Usually she would add “just like my mother was when she had me”. 

So back in the day, moms, who so wished, were given “twilight sleep” which was a mixture of several medications, one of which caused amnesia. So although a laboring woman could follow commands, move and talk, she had no recollection of what she was saying or doing or what was happening to her while in labor.

Husbands, significant others and family members were not allowed to be with a laboring woman who was medicated with this “cocktail”.

It was a privacy issue….since mom was unable to filter what she was saying. The medication was a type of truth serum of sorts. Sometimes during the stress of labor, a mom would call for someone other than her significant other which could indeed be problematic.

When it came time for delivery…mom would be taken to the delivery room. More often than not, general anesthesia was administered and a forcep delivery was done. Once the anesthesia was given the baby had to be delivered promptly which necessitated the use of forceps.

Natural childbirth, lamaze, and epidurals were the exception rather than the rule at this labor and delivery unit and in many units around the country. This was a standard of practice of the time.

After about a year at this particular hospital in the Bronx, I decided to move on to another university hospital in Manhattan.

It was a not only a change of hospital but I found myself in an entirely different world when it came to the practice of obstetrics.

Most women wanted to be awake for the birth of their baby, many had taken childbirth classes and epidurals were used frequently. There ware still forcep deliveries but there was no general anesthesia used for vaginal deliveries unless there was a complication.

In the 70s, doctors made most of the decisions and were not questioned too much, save for the few women who attended childbirth class with Elizabeth Bing, the founder of Lamaze here in the States.

Elizabeth Bing was adamant about teaching her mothers, who was the “boss” in labor and delivery.  She encouraged moms to advocate for the type of delivery that they wanted, she gave them the tools to help question their doctors regarding any decisions that were being made during labor. It was really the “birth plan” in its infancy. Elizabeth Bing was a physical therapist not a nurse and she was opinionated with very strong beliefs in “natural childbirth”. I had much respect for her and took her LaMaze teacher certificate course so I could understand and support my patients in their effort to have less intervention during their labor and delivery.

The role of the obstetrician is, in my opinion, a very important one especially if intervention is needed. I know the statistics in the United States are not overwhelmingly better than other countries but I also know what I have personally experienced in my own deliveries and while taking care of other laboring moms. These experiences definitely skew my view in this area.

My one child had only an initial Apgar of 1 for a faint heartbeat at birth due to complications of a C-section for a transverse lie (sideways position of the fetus). Upon my arrival in L & D, I was already 8 centimeters dilated, which meant, get the baby delivered before the water broke and the cord prolapsed causing severe lack of oxygen to the baby. It was a scary moment for me and my husband…both of us medical professionals. My doctor moved swiftly while I cried not wanting a C-section but knowing that I needed one. I felt confident in their haste and let them do their work…I was not awake…although every attempt was made to allow me to remain so. The discomfort was just too much…so asleep I went. I did not see my little girl for over 24 hours due to her own medical needs.

As for who should make the calls during childbirth…that is a very complex question with many variables. As best as I can figure, it takes a “Village” to raise a child but it also takes a “Village” sometimes to deliver a healthy baby to a healthy mom. I wish that all deliveries and pregnancies went smoothly and that all doctors could be “kind” at all times with great bedside manners. Unfortunately, we are all human and at a time of “flight or fight” you want someone who is able to “fight” for you and your baby based on good sound medical decisions which sometimes have to be made quickly without much hand holding.

Believe me when I say no one wants a less than perfect child and no one wants to lose a mother or a newborn.

So when you write your birth plan do it with your doctor or your midwife and be comfortable with them making some important decisions when and if it is necessary to do so.

Who Makes the Calls in Childbirth? You or the Doctor? | Being Pregnant.

Everything you need to know…”I don’t think so”!

Recently, there was a post on “Babble “that described a mom’s 8 Postpartum Symptoms that she did not know existed until they happened to her…

These days, it truly baffles me how there is any thing left to know about pregnancy, delivery and postpartum with all the resources at a mom-to-be’s fingertips.  “Everything you ever wanted to know”  is merely a click away.

But…my question remains, “HOW realistic is it,  to read something called “everything you ever wanted to know” about anything that you are going to experience?

Now, I am not suggesting to be unprepared for labor and delivery, nor am I saying not to have information to read when you are pregnant …but something with the title “everything” should give any of us pause for thought.

No mom-to-be or parents-to-be need to know anywhere near “everything”.

In my professional opinion…depending upon what you choose to read, you could be driving yourself right into your first legitimate “panic attack“. Then you will have to start reading about “panic disorders” as well.

A few years ago, I had the unpleasant experience of open heart surgery…oh sure, I read, and prepared. I learned about the robotics approach and how that would prevent the need for the open chest incision…which was certainly an appealing idea.

As a nurse, who had taken care of patients after open-heart surgery I new the smaller, less invasive approach was certainly a great option, but I also knew the ultimate choice was not going to be entirely mine to make. So, I put myself in the hands of The Bluhm Cardiovascular Institute at Northwestern Memorial Hospital here in Chicago and listened carefully to what the doctors had to tell me about the condition of my mitral valve. My surgeon told me robotics would not be the best approach. At that moment, I put my entire confidence and life in his skilled and capable hands.

No, he did describe all the details of what it would be like recovering from the scariest surgery of my life…but he was confident he could repair my valve without having to give me an artificial one…but that was not a guarantee until he was actually inside my chest looking at my heart.

I will not bore you with all I did not know about  post-operative open heart recovery…but I will tell you that I am glad there was no book with the title, “Everything you want to know when you are having open-heart and valve repair surgery”.

As it was, from my own nursing experience… I knew and had seen entirely too much…I was scared, but fortunately blessed with an inner calm and peace. I had a supportive family to welcome me back from the hands of my surgeon.

I am happy that I did not know all the gory details about recovery from cardiovascular surgery, just as I was glad that I did not know all that I would experience after delivering my first child, 30+ years before. I knew enough.  Professionals, friends and family helped me muddle through those six difficult post operative weeks after heart surgery just as they did as I muddled through those six blurry postpartum weeks as a young woman years ago.

A funny thing comes to mind about these so very different life experiences…I always tell my friends when they pack for a hospital stay to bring their own pillow…it will bring them much needed comfort.

As a new mom, when I left the hospital for the 2 hour trip home with my infant daughter I used my own pillow to sit on…after heart surgery, I was given a MENDED HEART pillow…on my way home, I used that pillow to hug .

For me…I guess all I really needed to know was have a pillow handy.

8 Postpartum Symptoms I Never Knew Existed | Babys First Year Blog.

Week in Review….Parenting in the Loop


Links of the Week:

Internet Safety:

via InternetSafety101.

The Internet has opened up an exciting new world filled with benefits for everyone. It has also opened the door to many potential dangers for children.


via Deep Fear of Childbirth Drives Some C-Sections | Healthland |

The mere idea of pushing a fully grown baby into the world the natural way can give even the bravest expectant mother pause. But a small number of women are so terrified of childbirth that it dramatically raises their odds of delivering by emergency or elective cesarean section, according to new research to be published in the international journal Acta Obstetricia et Gynecologica Scandinavica AOGS.


via Why Sleep Is the Ultimate Parental Bugaboo: Go the F— to Sleep Offers a Clue | Healthland |

For all the lead-up to having a baby, newborns don’t do much: eat, sleep, poop. Pooping happens without any parental intervention. Eating is a function of breast or bottle. But, ah, sweet slumber — that is the wild card.

It is a “snowy day” here in Chicago but the sun is trying to make an appearance.

Have wonderful weekend!

Oregon Plans Ban on C-Sections …

Banning early C-sections is a very interesting headline…I am not sure how hospitals in Oregon are going to actually enforce this hard line control on early, elective Cesarean sections.

Having a c-section for other than true medical necessity is never a good idea…the baby is still developing during the last weeks of pregnancy. Certainly it is not a great thing for a newborn to be shuttled off to the NICU for respiratory problems due to an early elective c-section…not to mention the added cost of the NICU care.

  • After delivery if a baby is in the NICU the bonding that is so important is difficult because mom is dealing with her own post-op pain and restrictions.
  • Breast feeding then becomes more difficult as well and cannot be established as early in the postpartum period as it generally is after a vaginal delivery.

It will be very interesting to watch how all this ‘plays out’ in Oregon and how it influences what is happening in other states as well.

Starting next week, many hospitals in Oregon will be taking a stand against early and elective Cesarean sections, reports. C-sections have become commonplace, and federal statistics now show that surgical deliveries account for more than 30 percent of all U.S. deliveries.

However, Oregon officials are now working toward the goal of giving “babies more time for important development and to reduce costly complications after birth,” MSNBC reports.

Seventeen Oregon hospitals (including all nine birthing hospitals in the Portland area) are implementing a “hard stop” on these elective procedures, says the March of Dimes’ Oregon chapter, as quoted in the MSNBC report. According to a 2009 study published in the New England Journal of Medicine, about 1 in 3 C-sections is performed before 39 weeks (37 to 41 weeks is considered full term).

via Oregon Plans Ban on C-Sections – Parenting on Shine.

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