The Doula Advantage & Lying-In

The Doula Advantage by Rachel Gurevich (2003) — I liked it. It builds a strong case for why a woman should want to hire a doula to support her in labor and delivery, and also talks about postnatal doulas and antenatal doulas. Generally does a good job of citing scientific studies to support its points. The writing isn’t always strong, and the book gets rather repetitive, but overall, it’s a solid book in favor of doulas. I like how it does not portray doulas as a mere fixture of the NCB/homebirth movement, but makes it clear that they can be useful even when one is having an epidural or other interventions. 4/5 stars.

Lying-In: A History of Childbirth in America by Richard W. Wertz and Dorothy C. Wertz (1989) — This is a scholarly text originally published in the 70s, updated and re-published by Yale Press in 1989. I loved it. It’s a general survey of American attitudes towards and practices involving pregnancy and childbirth. It traces the shift from community-supported, midwife-attended, mother-centered childbirth in the colonial era to the current world of physician-attended, medicalized childbirth that emphasizes the safety of the baby and the creation of perfect children even at the expense of the mother. It covers major developments in obstetrics (anesthesia, forceps, c-sections) and medical misfires (puerperal fever epidemic, Twilight Sleep). The Wertzes’ sources are not always terribly thorough, but overall it’s a strong text that really gave me a good perspective on where childbirth has been and how we arrived at where we are. 5/5 stars.

Books to come

I finished Hypnobirthing by Marie F. Mongan (2005) today. I’ll review it later.

Next I think I’m going to change pace a little bit and read Mother Goose, Mother Jones, Mommie Dearest: Biblical Mothers and Their Children by Cheryl Kirk-Duggan and Tina Pippin, editors (2009). It isn’t a pregnancy or childbirth book proper, but it offers intellectual food for thought on what the Bible says about mothers and motherhood, and I’ve often struggled to embrace and feel comfortable with my identity as a mother. The book does have an excellent essay on the history of anesthesia in childbirth and the 19th century debate on Gen. 3:16a, which I have already read.

Homebirth in the Hospital & Natural Hospital Birth

Homebirth in the Hospital by Stacey Marie Kerr (2009) — Dr. Kerr seems like a really sweet woman. I really, really wanted to like her book, which is a collection of personal essays by her patients concerning their hospital births. However, there was just too much “hospital” and not enough “homebirth,” IMO. What I mean is, too many of the stories involved entirely elective or unnecessary interventions. Several of them involved women who never would have been good candidates for homebirth to begin with. As I said above, I’m not an NCB/homebirth advocate, but this book did not leave me particularly reassured on the prospects of having a natural childbirth in the hospital. 2/5 stars.

Natural Hospital Birth by Cynthia Gabriel (2011) — I loved this book. It was so sensible and down-to-earth and gave very clear guidelines on how to turn down unnecessary interventions and have a natural childbirth in the hospital. I wish it had been around when I gave birth the first time; I think it would have kept me from panicking when I went into labor. And I seriously wish I could go out to lunch with Cynthia Gabriel. She seems like the kind of woman I could really be friends with. Also, props to her for thoroughly documenting her claims. 5/5 stars.

In one week, I am having my Mirena removed, although we won’t begin TTC until January 2013. I am a little anxious about taking it out. Fearful of the “Mirena Crash.”

The Business of Being Born & Your Best Birth

Some brief reviews of books I have read and/or movies I have seen:

The Business of Being Born (2008) directed by Abby Epstein — I thought it was propagandistic in places, but most documentaries are. It was generally well-edited and well-argued with interesting interviews. I watched a few of the made-for-television sequels and they were far less organized and interesting. I gave the full-length documentary 4/5 stars.

Your Best Birth by Ricki Lake and Abby Epstein (2010) — It’s pretty much the movie in book form. It’s well written and easy to read, and it does help you to re-think your options and reconsider medicalized hospital birth. Not that it condemns hospital birth, but it does encourage homebirth and natural birth. However, what really, really bothers me about the book is that Lake and Epstein do not document their many claims. It strikes me as a bit hypocritical to harp on the need for obstetricians to practice “informed consent,” and then not provide much-needed information to their own readers to back up their claims. You can’t tell me that Lake isn’t wealthy enough to have hired a research assistant who could handle this for her. The only excuse is laziness. 3.5/5 stars (and that rating might drop if I discover that their claims are false/exaggerated/made-up)

A Formative Better Birth Plan

These are the things I am working towards changing:

• I am going to hire a doula. I am sure about this. If my current doctor tries to tell me I can’t have one, then he won’t be my prenatal care doctor.
• There’s only so much I can do to increase DH’s willingness and ability to play a strong supporting role in my birth. I’ll probably ask him to attend a childbirth education class with me and read a book, maybe The Birth Partner (2007) by Penny Simkin (provided I read it first and like it). I don’t plan to push him too much though. He tends to get squeamish about blood and I’ll consider it a victory if he stays in the delivery room for the entire birth.
• I still lack family in the area, but I will probably lean more heavily on the support of the women at my church. My pastor happens to be a woman. I may ask her to visit me and give me a blessing when I go into labor. I will probably invite my mother-in-law and stepmother to come out and help with the baby if they have any desire to do that, as well as my sister.
• I don’t live in Utah anymore and I’m not immersed in a culture that tries to limit women’s roles and pin it on their ability to give birth, so this shouldn’t be a factor. I feel free to reclaim the birthing experience and make it a positive one.
• My doctor is a family practitioner and a resident, so he’s close to my age. I like him a lot and I think we have a good relationship. He’s willing to take my questions and concerns more seriously than my last doctor did, so I am hopeful that he will be supportive of my labor and delivery plan.
• I intend to aim for a natural childbirth experience in the hospital. One of the things that I didn’t like about my last delivery was the sensation of being removed from my own birthing experience. I had magnesium for high blood pressure, Pitocin to induce labor, my water broken to induce labor, an epidural to manage the pain brought on by the Pitocin (though I was pretty certain I wanted one in advance), and an episiotomy + forceps delivery because my daughter’s heartrate was nose-diving with every push and the doctor wanted to get her out ASAP. This means I had all kinds of wires, tubes, and monitors attached to me (IV, fetal heart monitor, catheter, epidural, etc.) and couldn’t leave my bed. This time I’d like to try and stay off the interventions cascade altogether and manage my pain on my own—not because I think NCB is better or safer, but because I would personally like to play an active role in my next child’s birth.

That is where I am. As I said above, I am scheduled to have my Mirena removed later this month, and we will probably begin TTC in January 2013.

My Last Birth

So, what was terrible about my pregnancy the last time around?

• I didn’t have good support. DH was kind of deer-in-the-headlights about the whole thing. My family did not live in the area and my OB* didn’t allow doulas (see the next bullet point).
• Though I didn’t know it at the time, in retrospect, I wasn’t crazy about my OB. She was polite and professional, but there was never any kind of personal touch to her care. I saw her more than any doctor I had ever seen in my life, yet I couldn’t tell you a single personal thing about her other than that I knew she’d had kids of her own. On top of that, her practice was rather paternalistic and controlling. I was serviced by that clinic with the infamous anti-doula sign in the waiting room. I feel like my OB did not take my questions or concerns seriously. Also, her office staff was rude and they had sloppy accounting practices.
• The predominant conservative religious culture tended to worship motherhood and restrict women’s roles to the tune of “but pregnancy and childbirth are so awesome! Men need to be priests so that they can have something awesome, too!” This made me feel almost obligated to have a bad experience so that I could say, “Giving birth is not awesome. Your argument is invalid.”
• The books I had read and the movies I had seen pretty much conditioned me to expect pregnancy and childbirth to be terrible.
• I wound up with interventions that I did not want. The episiotomy was the worst, and my care providers did not tell me that an episiotomy could cause dyspareunia through psychological triggers even if it heals properly. I struggled with dyspareunia for three years after the birth.

I think that a lot of these factors can either be changed, or I can change my attitude about them. That is what I am working towards in planning pregnancy #2.

——–

* She was actually a family practitioner, but she practiced out of a clinic with two OB-GYNs and delivered babies exclusively. So I guess she was an OB-wannabe?

The Journey Begins

I gave birth to my first daughter in 2006, at the age of 24. DH and I have decided that it’s getting close to time to try for #2. I am currently finishing my master’s degree, so I kind of want to get to the point where I know my thesis will be done soon, get pregnant, and reward myself with a baby. Things are far from perfect for us right now, but I realize that if I keep on waiting for perfection, we may never have another baby again.

I have an appointment later this month to have my Mirena removed. (I for me at least.) I figure that we will begin trying to conceive (TTC) in January of 2013.

I have been reading pregnancy and childbirth books for the past few months. So far I have read:

• Lying-In: A History of Childbirth in America by Richard W. Wertz and Dorothy C. Wertz (1989) [review]
• Homebirth in the Hospital by Stacey Marie Kerr (2009) [review]
• Natural Hospital Birth by Cynthia Gabriel (2011) [review]
• Your Best Birth by Ricki Lake and Abby Epstein (2010) [review]
• The Doula Advantage by Rachel Gurevich (2003) [review
• Hypnobirthing by Marie F. Mongan (2005) added 11/19/2012 [review]
• How to Choose the Sex of Your Baby by Landrum B. Shettles and David M. Rorvik (2006) added 12/30/2012 [review]

You may look at that list and think I’m a homebirth/NCB advocate, but I’m not. I simply started with their corner of the book market and am working my way around. I’m currently reading Hypnobirthing by Marie F. Mongan (2005), and I think it’s full of crap.

Reading and visualizing my (hopefully) upcoming pregnancy is having a positive effect on me, and I think it may even be readying my body for conception. The entire time that I’ve had the Mirena, my periods have been 1.5-3 months apart, never less than 1.5 months. However, my last two periods have been 29-30 days apart. I began to really think and read up on going through pregnancy again in September.

So, I am looking ahead, and I am hopeful. I had a really terrible experience with pregnancy and childbirth last time, and I’m hoping to change that this time around. I’ll be using this space to talk about what went wrong last time and what I hope to change this time.