Thursday, January 27, 2011

Avoiding the PowerBirth


What it is.  Blogs about it. And why I'm thankful I didn't have one.

According to what I've read, a PowerBirth is the birthing technique that some midwives are using; at 5cm dilated those midwives will tell the mother to start pushing.  Just to give you an idea that's 5cm BEFORE hospitals or half way as early as hospitals.  But that's not necessarily the most dangerous part, the dangerous or invasive part are the vaginal examinations and cervical manual dilation.   

I was recently directed from another mother to read the posts:

My birth was a wonderful experience, and I know everyone says that.

It's the best day of your life, you have the  baby you've been waiting nine months for.  But my birth experience was a really great one.  I didn't have to get an I.V., I didn't have to sit in a bed while in pain, I didn't have to starve myself, I didn't have to have someone telling me to PUSH!, I didn't have any negative thoughts, except once, when I thought-oh, this is painful and I want it to stop!  and that's when I decided I should ask if it was okay to push, and my midwife let me decide and gave me permission to trust my body.  Our birth was at home, unassisted until about 3 hours after my water broke, when I told my husband to call the midwife.  She had checked me, vaginally, once before that phone call earlier that morning.  I started having contractions/surges on Thursday, she saw me at her office that night, and didn't check me.  Then, stopped by my house Friday morning and I asked her to check me and she did, I was 3cm.  Then, she left.  Husband and I stayed home in bed and I got up as much as I wanted and ate as much as I wanted and pooped and peed as much as I wanted.  When my midwife, Shell, showed up around 3pm on Friday she checked me and I was 6 cm.  I continued birthing as normal, but was glad to have a number to know how far along I as.  But that was it.  I got back up and tried hands and knees but EVERYtime I was in that position I thought I was going to throw up- so walking around was best for me, that and sitting on a toilet.  Once I realized I was pushing I asked if it was okay to push, she gave me the permission (I NEEDED) to trust my body and checked me once more to see where I was.  She noted that I was pushing the last bit of cervix out of the way, but she didn't tell me I should (or shouldn't), my body did that.  I am thankful that my midwife managed my birth as she did, I needed that help and guidance.  Thankfully, she never forced any style of birthing on me.  She never told me what to do, she allowed my body (and Sonja's) to make the choices in delivery.  Its too bad that the PowerBirth technique also uses laying on the back as a rule for delivery.  Many doctors and apparently these midwives are robbing women of the ability to move during birth.  

Movement during labour is so important.  A great book to read about movement and birthing positions is Active Birth.  Often when a women is in pain, that movement will allow for the changes necessary to relieve that pain.  In fact, even if a baby's heart rate is dropping movement can regulate it.  A knowledged midwife will be able to give the mother's body options (such as a different position) and allow the baby to continue with it's entry into the world.  Another issue with PowerBirth is the vaginal exams.  I had a friend who had a hospital birth, she told me about her birth and reiterated a few times that the most painful part of her birth was the vaginal exams.  I've had several friends share their birth stories with me and they ALWAYS sound more traumatic and more painful than mine.  Which absolutely breaks my heart.

Let me make this clear, I did not luck out with either my birth or my midwife.  We interviewed 2 midwifes, read several other midwives' websites and went to the OB/GYN before making our choice with the wonderful woman who assisted me during Sonja's birth.

My birth was not easy, even though I reflect on it like it was.  I told my husband after the birth, it was easier than I thought it was going to be.  But, Little Miss was turned posterior and that is one of the most challenging type births especially for  a first time mom.  My sister had a similar birth and ended up getting a cesarean section.  And after that experience she was scared to try VBAC, why go through all that labour pain only to end up with another C-Section?  It's too bad that she had to have major abdominal surgery to have her sons.  I know she thinks it was easier than a vaginal birth but I was walking around after my daughter's birth.  I was chatting, SITTING and walking around my house with family and friends over.  People make the choices they do regarding their births with the information they have.  I want EVERYONE reading this to have this information, to make an informed choice about their birth options.

I would advise EVERY pregnant woman to find out what a "normal" birth is like from their care provider.  step by step.  Listen to their cues.  

Do they prefer a certain technique/process/protocol?
      What if you do not fit in with that process or protocol?
           Are you happy with all of your optional outcomes? no matter how rare or unlikely they may be?

Do they usually have the mother birth in a certain position?
      (ask if you can birth squatting, hands and knees, ANYWAY you want, if they say, no.  That should be a red flag, find out why not, is it because they don't know how to catch in that position? or because you're too likely to tear? those are also signs to look out for!)

How many births has the dr or midwife attended?

How many vaginal checks do they normally perform?
       Get a number! remember I only had 3, and remember my friend said it was the MOST painful part of her hospital birth

What is the typical birth that requires intervention?

What is their c-section rate?
        Should not be more than 15%, another red flag is if they are known for their c-sections!

What conditions make you high risk and how are they handled?

How would they prevent those conditions before they make you high risk?

What are the normal guidelines for weight gain?

Do they deliver breech babies?
      I was dead set on NOT getting cut open and had read you CAN deliver a breech baby vaginally.  I made sure to find a care giver who agreed with me!

What do they try to turn a breech baby?

How long are they willing to wait for a baby in a bad position to change positions before labelling the pregnancy high risk?

What percentage of their clients tear?

How do they work to prevent tearing?

How long and when are they willing to let a client push, or do they base it solely on the baby's stress level?

Do they have a problem waiting for a while after the placenta is delivered to cut the cord or lotus birth?

What do they use to stop excessive bleeding after delivery?
       I used herbs.  Not Pitocin.  See if there are other options to chemicals such as going pee, breastfeeding or herbs.

Under what conditions would they artificially rupture the amniotic sac (break your water)?
       My friend had this done to her and hated the pain after.  My midwife promised she wouldn't do it, although I'm sure if truly medically necessary she would have explained why it was a good idea, but really, it opens the baby up to infection, so there is hardly ever a good reason, and to progress labor isn't one of them.

Have they had any bad outcomes for the baby or the mother? Please explain them.
      or what is the worst case they've had.  GET AN ANSWER, not rhetoric.

What percentage of mothers go without chemical pain relief?
      Make sure their percentage matches your goals!

Is video taping allowed?
      Some hospitals are banning this practice, many, including myself believe it has to do with legal actions if they do something wrong.  They don't want you to have the evidence.

Will my baby be with me at all times while I'm in the facility?
      This should be a yes, if you are a healthy person there is no reason your baby should have to be taken away, barring an emergency.  Find out what they believe is an "Emergency"- suctioning a crying, screaming, vigorous baby is not an emergency.

some questions taken from here. and here.

Happy Delivering and Avoiding the PowerBirth!

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