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November 2011 - First Time At a Birth

 

Last night Orit (my 19 year old daughter) came to a hospital birth with me. The mom was having her second baby; the first birth (3 years ago) had been smooth and fast (I was their doula then as well), and the mom was perfectly fine with Orit coming along. A strong, healthy, happy couple, great attitudes and preparedness.

 

We arrived at the hospital at about midnight. The couple was already there, having wanted to avoid going through transition in the car like the first time.  Everyone (even me) had predicted that this birth would be even faster; she had already been almost 5 centimeters that morning with contractions she wasn’t even feeling. The doctor stripped her membranes, she started cramping, then labor kicked in around 9:30 pm. She was 7-8 cm. when Orit and I arrived, and doing very well. Instead of the amazing rapid progress commonly seen with 2nd babies at this point, she started to have some back pain, and did stay at 7-8 cm. for a few more hours. After just a little bit of squatting, the baby seemed to rotate, as her back pain went away, but there was still some kind of plateau, and no pushing urges, just continued strong contractions. 

 

Orit sat quietly on the couch, in the low lit room, and watched us. The dad and I both helped her through the contractions, usually he was holding her in various positions and I was pressing or rubbing her back. 

 

The couple had been checked in by the Charge Nurse, who was extremely relaxed and competent. They were then assigned a different nurse, who seemed to find potential dangers in everything, causing her to delay removing the monitor, confine the mom to bed, and give her periodic oxygen, while cooing “good job.” She seemed to have a very limited approach. (There were literally one or 2 variable decells. The rest of the baby’s pattern looked fine. To me, this mother looked - and felt - like she needed to be up and moving around). The experienced laboring mom was cooperative, albeit slightly irritated. Meanwhile the Charge Nurse came back in with a totally opposite attitude and interpretation - everything looks great, baby is fine, does mom want a birth ball, antibiotics are done, let’s unhook her). The combination of these two leads me to summarize the birth room atmosphere as relatively supportive. (ie. I’ve seen much worse!)

 

The baby was low, the mom got to 9 cm, the bag was bulging, so we all agreed to let the doctor rupture it. The plan worked, with the next contraction she had to push. She wanted to be on all fours, a very specific bodily instinct for her at that moment. While she did this, the nurse was setting up the stirrups. The doctor felt this was a big baby and seemed to anticipate a shoulder dystocia; she had called in 6 more nurses in addition to the assisting nurse. All seemed very unfamiliar with a mom pushing or at least delivering in that position. They had her turn over (on her back), but after a while she strongly requested turning around again. The doctor said go ahead, telling her she wasn’t pushing well anyway. She pushed for awhile on hands and knees, while the doctor seemed pouting and critical, yet offering no suggestions as to make things better.  Finally she was asked to turn around again for the birth, which she did.  Doctor’s mood improved, and she (doctor) was very positive from then on. Baby girl was born at 3:33 a.m., not big, no shoulder dystocia, simply a little pissed off about the whole process!

 

Orit got up and came closer to watch the birth. Mom and dad were joyful and taking things in stride as only 2nd time parents can do.

 

After 17 years of seeing films and listening in on birth classes, my daughter is considerably acclimated to birth. Now here comes the interesting part.

 

Birthing mom asked Orit if she was “traumatized” and Orit said no. As we rode home later though, Orit told me that what traumatized her was the HOSPITAL. The continual interruptions (“that annoying nurse kept coming in for no reason, pretending to do stuff”), the wires for IV fluids & antibiotics (“scared the crap out of me”), the monitoring (“that machine was beeping so loud”), the strangers (“I would never want to give birth if i knew I would have to be in a hospital, in that small room, with all those people I don’t know” “that bed looked so uncomfortable”), the crowd (“at the end there were like 10 people in the room!”), the stirrups, the forced position, and the bright lights (for the delivery). 

 

My daughter is not a childbirth professional, with any ideology or agenda. Yes, she’s been raised with hundreds of birth films, but I would still consider her relatively objective. 

 

The things that disturbed her are the things that we doulas, or at least I as a doula, suppress all the time, as we attend hospital births and help women have the birth of their choice, based on the knowledge that they have. It is frustrating, annoying and difficult to watch women get so INTERRUPTED, disturbed, disrupted, and distracted in labor. (This is not a criticism of fetal monitoring nor of requesting assistance for anticipated shoulder dystocia.) We see labor being hindered by poking and prodding and questions and procedures and attitudes.  What fascinates me is that it was not the intensity or pain that most struck my daughter in her first viewing of a birth (although she definitely did NOT want to see any stitching or baby heel prick). It was the sense of the woman as a hospital “patient,” confined to a bed or room, and defined by external protocols and attendants. Orit: “I would never want to give birth if I knew i would have to have all those people watching me.”



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