Tuesday, October 30, 2012

Time for Gratitude - Medical Technology

Ok, so in my work as a doula and as I work on my childbirth educator certification, I'm really all about natural, intervention-free, normal, physiological birth. Obviously (or, I hope it's obvious), as a doula, I'm not going to tell any of my clients what they should and should not do...that's not my job. I mean, if a mama wants an epidural and she knows that she wants one, I'm not going to tell her that she shouldn't have one for "this reason or another". But, I am going to make sure she understands what an epidural does and ensure that she's making an informed decision, and not just doing it because her friend said she'll love it.

I believe that women's bodies were designed by God to give birth.The majority of women can have a normal physiological birth without medical intervention.

And then there are those mamas who are exceptions to the rule and have a true medical reason that they need some intervention.

These mamas are the ones I'm going to talk about a little bit today.

I'm going to tell you a story about a mama who wanted a completely normal, natural, physiological birth. It was their first baby, and she and her husband prepared for it, they studied up on it, they took a natural birthing class, they talked to their doula often, they had a great midwife as their provider, and they were ready. As ready as any couple could be.

And then she was diagnosed with pre-eclampsia.

She did all the right things to minimize her risk...she upped her protein intake, she rested well, she ate healthy, did her best to keep her stress down, etc, etc.

Her blood pressure still spiked and she needed to be admitted for induction before she was ready. It was a difficult time, but once she came to terms with the fact that she was going to need to be induced, she was ready. She armed herself with as much information as possible, she relied on her midwife and doula for informative support, and her husband was right there by her side as they began the magnesium sulfate and induction.

She did a great job laboring through her contractions, and never once asked for any pain medication or epidural. As her labor progressed and things got more difficult, however, her cervix didn't dilate. She was having strong contractions, she was doing a great job of relaxing through them and working with her labor instead of against it. She had even more challenges because *she couldn't move* during labor. Everytime she moved - got up to go to the bathroom or anything - her blood pressure spiked. High. There were only three positions she could be in comfortably that they could also get the baby's heart rate (making sure baby is ok while on magnesium sulfate and pitocin is very important).

She was at the same dilation for eight hours. Since her contractions were so strong (pitocin contractions) and she wasn't able to move much, she wasn't able to try to get her baby in a different position, and frankly, she was getting tired! She had such a wonderful midwife...so many providers would have whisked her off to a cesarean since she would have been considered "failure to progress". She was blessed to have a provider that wasn't in a hurry.

After her eight hours of very little progress, no dilation, and utter exhaustion, her midwife suggested something that she rarely, if ever, does. She suggested that she try an epidural. Hopefully it would help her pelvis relax just enough that her baby could move in just the way she needed to and mama would begin dilating. Her midwife also very gently told her that if her baby didn't move and she begin to progress, she would likely need a cesarean. She was in no hurry, though, as long as baby was stable.

So, mama got the epidural (she was even quite relieved to get it at that point!), and got comfortable so she could get some rest...as did her husband and doula.

And to her and her husband's relief she began dilating - hooray! It only took her a few hours to finish dilating and for baby to move down enough to begin pushing. At this point she felt her contractions, knew exactly when to push, followed her body's cues, and vaginally birthed her beautiful baby.

This is an example of when medical intervention is truly indicated, and I'm SO grateful that we have things like pitocin, continuous fetal heart monitoring, epidurals, and cesareans! I am not grateful for the amount of unnecessary usage of these medical technologies....just that they exist so they can be used as needed for women like the one I told about here.


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