Our final hypnobirthing class was this past Wednesday. I am so glad we took the class and would recommend it to any woman (and couple if your partner is going to be involved) expecting a baby.
The main "take-away" from the class, for me, was the release of all the fears I had associated with labor and delivery. I can honestly say that I'm not afraid to go into labor and I feel mentally prepared to handle whatever may happen. I have a belief that my body knows what it is doing and that birth is natural for a woman. I also am committed to having a medication-free labor, to the extent neither myself nor Lukas is in any danger. At the same time, I do not feel that the class has led me to hold unrealistic expectations or ingrained in me that I will somehow have "failed" if I decide to take pain medication during the labor. I now just feel educated and part of that education was understanding the whys of induction and the various types of intervention. When its time for Lukas' arrival, I am hopeful that we will be able to stick to my birth plan, but will remain flexible should the need for a different course arise.
I had my monthly (soon to be bi-monthly and then weekly) OB appointment this morning. And it was the first time I've seen my doctor since the hypnobirthing classes went in to full swing, so I had a lot of questions for her. Up until today, everything I have asked her or expressed a desire for has been well received by my doctor. And today was mostly the same, except for one major question.
We had already talked about how far past my due date she'd allow me to go. She's comfortable allowing me to wait 10-14 days (preferring only waiting 10). Check.
Her practice does not routinely perform episiotomys. Check, check. (It is shocking to me that some doctors just do them to speed up the process).
Today we talked about whether she waits until the umbilical cord stops pulsating before being cut. She said yes. Check.
Are the nurses at Northside supportive of an unmediated birth? (Our hypnobrithing instructor made it sound like most nurses don't know what to do with a woman wanting to have an unmedicated labor. I still don't fully understand this because I can't imagine its really that rare, but perhaps I am wrong). My doc said that the nurses at Northside will be very supportive of whatever labor path I choose. They just sometimes have a hard time sitting and watching a woman in pain since they are caregivers and feel the need to offer some relief. I can deal with this. We'll just make it clear that I do not want to be offered any pain relief medication. If I decide I need it, I can ask them.
Will the electronic fetal monitoring (EFM) be continuous or intermittent? As long as the baby looks good when we check in to the hospital, I'll only have to be hooked up to the EFM for about 15 minutes per hour. Otherwise I'm free to move around, walk, be in the tub, etc. Check.
Do you routinely give pitocin after the baby is born? Yes. WHAT?!?! This is where our uncomfortable conversation kicked in. I also flipped my lawyer switch without even realizing it. Our HB instructor had warned us about the routine use of pitocin after labor to help contract the uterus and reduce the risk of hemorrhage. She said that the birth companion really needs to watch for this because the nurses often just inject the pitocin into the mother's IV without even really telling you what they are giving you. And she made the argument that the pitocin at this point is not necessary. I wasn't even going to ask my doctor about this since I just assumed she wouldn't use it given the "unmedicated' route of labor/delivery that I was choosing. So when she answered in the exact opposite way I was anticipating, I really didn't know what to say. And she didn't really know how to answer. (I don't think too many patients, if any, had asked her this question before. I never would have known to had it not been for the HB class and our teacher cluing us in to this use.)
Pitocin is a synthetic form of oxytocin, which your body naturally produces to help stimulate the contraction of uterine muscle. So she kept saying that it won't interfere with breastfeeding (my concern is that this foreign medication will get to Lukas through my milk and if I have gone this far without drugs, what's the point now?) So then the scare tactics began. She emphasized that its a very diluted amount and its a precaution because women used to die (and still do die) from hemorrhage after child birth. And if I don't get the pitocin, I could hemorrhage and then they'd have to give me three major medications to stop the hemorrhage, so why not just take the precaution, which in her opinion is not detrimental to the baby. We went back and forth for a while because I was never really satisfied with her reasoning for giving it, other than that it's routine and everyone does it. (You can still hemorrhage even with the pitocin). I understand that hemorrhage is a concern and I, of course, do not want to put myself in unnecessary danger. But I just am not yet convinced that it's really necessary. So I have some research to do.
She did say she doesn't want me to feel forced to get a medication that I feel strongly about not getting. So she said she thinks she can get comfortable with me waiting as long as I agree to accept the three heavy duty drugs if it becomes necessary. She also said we could monitor the situation as my labor progresses and make a game-time decision. Women who birth bigger babies and go through a long labor are more likely to hemorrhage. So if Luke is average/small and comes quickly, then the risk of me hemorrhaging is reduced and she'd be more comfortable with my not getting the pitocin post-delivery. I'm sure she felt like she was on trial as I fired questions at her about why it is really needed. (This lawyer thing comes in handy every now and again!) In the end its really a risk analysis. What do I feel is more risky - taking the drug or the possibility of hemorrhage if I don't? So here's to hoping the trusty internet has some good information for me to make a decision.
Otherwise, we're seeing eye-to-eye on everything and she's really supportive of the hypnobirthing. I'll meet the other two doctors in her practice over the next few weeks (one of whom used to be my regular GYN, so I know I'm comfortable with her). It's nice to be in such a small practice where they all have the same views on childbirth. I am still having a hard time believing Luke will be here in a less than two months. And that I'll be someone's mom...
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