Cesarean Birth: Choose Your Words Carefully
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Birth is the sudden opening of a window, through which you look out upon a stupendous prospect. For what has happened? A miracle. You have exchanged nothing for the possibility of everything.
~William MacNeile Dixon
I’ve had two cesarean sections. I’m part of the growing minority of women in the United States who had a surgical birth. At last count, the rate of c-sections to vaginal births was about 1 out of every three. In some states, like my own fair state of New Jersey, the c-section rate is just a hair shy of 40% (as of 2009; the last year for which I was able to find concrete records).
I also happen to be part of the other minority group – “crunchy parents”. It presents a conundrum for me. How do I advocate for natural things – like birth – when I’m the recipient of two cesarean sections, without devaluing my own births, nor alienating my cesarean-receiving sisters, nor eschewing my crunchy ideals? It’s a thin line to walk. And it isn’t always straight as there are so many variables when it comes to birth.
Here’s the truth. The increase in cesarean sections is alarming. Cesarean sections present dangers for mothers and babies that just aren’t there in natural births. Advocacy for natural birth needs to continue. Work needs to carry on to help women feel empowered in their decision-making surrounding their own births, to increase the number of doulas and midwives available to assist women in birth, and to make home-birthing a safe and legal option for women.
Within advocacy comes support; and the cause of my writing today. We need to be SUPPORTING women – not tearing them down. Too often, I fear that advocacy in natural birth trends towards guilt, shame, and anger. I’ve read things written about mothers who’ve given birth via cesarean section that make me cringe; that make me SO ANGRY. Women who have had c-sections shouldn’t feel the need to addendum their birth story with excuses, or explanations for their birth. Never should a woman be made to feel shamed, or at fault for how her birth culminated. A birth is a birth is a birth. At the end, every mother who has given birth has the shared experience of growing a birthing her baby. There’s shouldn’t be a dividing line, based on HOW you’ve given birth.
Natural birth is the most likely way to encourage a positive outcome for both mom and baby. There are ways to teach about natural birth and its benefits to both mother and baby, without alienating the very people natural birth will help. There are things you can do to educate and encourage and choices to be made which can increase likelihood of a natural birth outcome. But, it’s important to keep in mind, at it’s core, birth is unpredictable and specifically un-plan-able. The variables are myriad: The ways a woman reacts to pain, fear, anticipation; The support she has through pregnancy and in labor; Health conditions she may have – physical and mental and emotional; Past experiences she’s had – all play a role in how birth plays out.
It every case, birth is one of the most precious, amazing, challenging, awesome, and MEMORABLE times in a woman’s life. Natural birth advocacy should always be about helping and lifting up women, not humiliation. Empowering women, not disenfranchising. Above all, supporting women, no matter what choices are made, what direction birth takes, what the outcome is.
So to that end, here’s what I thought I’d do. I’ve prepared a list of things you SHOULDN’T say to (or about) a mother who’s given birth via cesarean section. These are things which I’ve either heard personally, anecdotally, or seen written. But because I don’t want to dwell on the negative, I’ve also compiled a list of things you SHOULD say to a c-section mom (or one who’s about have one).
Without further ado...
Things you SHOULDN’T say to a mother who’s given birth via cesarean section:
1) “Your C-section wasn’t technically a birth; it was a surgery.”
Yes, cesarean is a major surgery. But a cesarean section is ALSO a method of giving birth. By virtue of the definition of birth:
(From Merriam-Webster)
birth. noun.
1 a: the emergence of a new individual from the body of its parent (check!)
birth. verb.
1 a: to bring forth (check!)
2 b: to give birth to (check!)
birth. adjective.
1 a: biological (check!)
It ALSO is birth by virtue of the fact that mothers celebrate their children’s birth days, not their surgery days. A mother who has given birth via cesarean has as much right to birth as her vaginally-birthing sisters. Saying - or even suggesting - that a cesarean section isn't a birth not only makes you sound ridiculous, it's just plain hurtful, so please, PLEASE don’t do it.
2) “Your baby was ripped/torn/cut/pulled/forced out of you - before she was ready.”
We don’t always know what prompts labor, and we don’t always have control over the way our birth progresses. Sometimes, babies come before they are ready. Sometimes, signals point to babies needing help moving earthside. Sometimes, that help is a surgical birth. Regardless, no one needs to be reminded in such a callous way that they were sliced into, nor should any woman have to face the implication or suggestion that was in some way her fault. The vast majority of pregnant mothers do everything they can to ensure a safe birth for their baby. Their decisions are typically based on the knowledge they have at the time. There’s no room for inflammatory hyperbole.
As an aside, if a mother wants to talk to YOU about her feelings that her baby may have arrived before he was ready, or that her birth felt less than consensual or not as calm as she would have wished; please listen. Honor her feelings. There are unfortunately cases of women who aren’t treated well in birth and whose wishes aren’t respected. But even in those cases, exaggerating the negative isn’t helpful.
3) “Be happy; at least you have a healthy baby.”
I understand when this is said, it’s intended to be comforting. But really, saying this is a denial of feelings. No mother who is mourning the loss of her birth-as-she-planned-it wants to be brushed off. And every mother is grateful their child is healthy. Having a cesarean is typically NOT a planned event, and even when it is, it’s not what most women choose (in spite of what the media likes to portray – women as “insisting” on elective cesareans for “convenience” reasons). Disappointment or concerns over birth are valid! Listen, reassure, comfort; don't brush aside feelings.
4) “If you’d done (or didn’t do) x, y, or z, you could have birthed your baby vaginally.”
Look, unless you are the attending midwife or doctor, you JUST CAN’T KNOW whether X, Y, or Z would have resulted in a different outcome. Even if you WERE the attending midwife or doctor, you can’t change NOW what has already happened, so keep it to yourself.
In birth advocacy there is certainly a time and a place for analyzing your birth story, for thinking over what you wish had gone another way, what you’d like to try differently, what you want to do the next time, or even what you wished you’d tried. There needs to be time for grieving and for accepting and healing. But that’s for YOUR OWN birth. It’s not your right to analyze anyone else’s birth for them. Ever.
Things you SHOULD say to a mother who’s given birth via cesarean section:
1) “Good job, mama.”
Just that. No matter what transpired, no matter how the birth progressed, no matter how far "off birth plan" things went, a new baby was born to a pregnant mama, and that mama deserves a pat on the back. End of story. If that mama wants to talk about her birth, let her do so. Support her. Be there for her. Without judgment.
2) “How can I help you?”
Cesarean births present unique challenges to mothers and babies. It can be difficult to walk in the first few days post partum. Holding baby, changing your own position, breastfeeding, regular self-care, all can be more challenging after the stress of birth AND a major abdominal surgery. Many doctors advise weeks post-partum without resuming regular activities – like climbing stairs, lifting anything other than the baby, or driving.
Personally, even though I felt my recoveries were quick and relatively easy, there were certain physical challenges that were just a drag. I couldn’t do laundry, I couldn’t comfortably make it upstairs to my bedroom, I couldn’t move baby to where I wanted her to be when I wanted her to be there. Having someone there (husband, doula, friend) to pick up around the house, entertain siblings, cook meals, change diapers/clothes, can make all the difference in the world!
3) “If you need to talk, I’m here to listen.”
Every mother likes to talk about her birth story; it’s a defining moment in life. Some stories are joyful and easy, some are difficult, trying, tearful. Each emotion is real, valid, and needs to be addressed, in order to heal and move on. I’d say this is particularly true for a mother who planned her birth to be natural, who felt like she’d dotted all the i’s and crossed all the t’s, but whose birth didn’t turn out the way she’d hoped. When you’ve done “everything right” and things don’t go as planned, a shoulder to cry on, a non-judgmental ear to listen is so very important.
- - - - -
The truth is, current birth climate in the US is a challenge. Birth in the media is still most often depicted as scary, icky, and unnatural. Misinformation and assumptions about the benefits/dangers of natural and/or homebirth birth versus hospital and/or surgical birth are rampant, and the number of cesarean sections is still growing. Advocating for natural birth is necessary; I want my own children to be able to make empowering choices about the direction of their/partner’s future births (if they so choose); I want them to have even better experiences with birth than I did. But to get there, we need positive change. Commentary on what a mom did “wrong” in birth isn’t useful, it isn’t helpful, it isn’t advocacy. It’s hurtful, it’s shameful. The last thing we need in this world is more judgment. You want to see change in the birthing world? It doesn’t come from negativity folks; it doesn’t come from divisiveness. It comes from unity, from sharing our stories, understanding others’ points of view, using your experiences to educate, accepting differences of opinion and experience, listening, empathizing, and learning from one another. Every birthing mother has the right to feel good about her birth; it’s an amazing moment in time; whether it occurred in the birthing tub in your own home, or under the bright lights of the OR.
Words are powerful. Choose them carefully.
Breastfeeding is All About Support
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I was lucky enough to be able to breastfeed both of my children. I breastfed my daughter until she was four years old. When my son was born, we tandem nursed for a year and a half until my daughter weaned, then continued to nurse my son until he was three & a half years old. My years as a breastfeeding mother were some of my most precious and tender moments with each of my children.
Breastfeeding was empowering, comforting, and, in spite of occasional discomfort and challenges along the way, it was on the whole, a truly wonderful experience. I would love as many women as possible to be able to experience the wonder of nurturing their babies at their breasts, just as I did.
The reason I had such a wonderful experience with breastfeeding, was that I had wonderful support - from my husband, my lactation consultant, my family. I'm not sure I would have made it as far as I did without such support. For ANY woman considering breastfeeding her baby, proper support is KEY to her success:
REAL LIFE SUPPORT
Let your partner, your parents, your siblings, and your friends know you are planning on breastfeeding, and ask for their support in your intent. Don’t be afraid to tell them WHY you want to breastfeed! Specific knowledge about your intentions will help them help you if you encounter moments of wavering in your commitment. Having people to support you, to cheer you on, to remind you why you’re doing what your doing can make all the difference in the world to your success!
PROFESSIONAL SUPPORT
If you’re birthing in a hospital, call ahead to be certain they have a lactation consultant on staff, and find out how often she’s there. If she only works days or weekends, or, if you’re planning on birthing at home, make sure you are in contact with an International Board Certified Lactation Consultant who can be on call after the birth of your baby. Don’t forget to bring her phone number to the hospital with you! Here’s a listing of IBCLCs by state: http://www.lactivist.com/ibclc.html Another thing to consider is hiring a post-partum doula. Many doulas are breastfeeders themselves, and post-partum doulas are trained to help mothers establish breastfeeding, and help create the supportive environment they need to have a successful breastfeeding relationship. A doula is a wonderful person to have around - not only in labor, but afterwards!
WRITTEN SUPPORT
There are plenty of books and websites available with information about breastfeeding; but, unfortunately, not every one has accurate information. Here are a few good resources, I recommend:
Books:
The Breastfeeding Book by Martha Sears
The Ultimate Breastfeeding Book of Answers by Dr. Jack Newman
Breastfeeding Made Simple by Nancy Mohrbacher
The Womanly Art of Breastfeeding by Diane Wiessinger
Websites:
KellyMom.com - http://kellymom.com/
La Leche League - http://www.llli.org/
Mothering.com - http://mothering.com/breastfeeding
Breastfeeding.com - http://www.breastfeeding.com/
Best for Babies.org - http://www.bestforbabes.org/
Ask Dr. Sears - http://www.askdrsears.com/topics/breastfeeding
EXTENDED SUPPORT NETWORK
Aside from your lactation consultant, partner, and reading material, it’s a good idea to have an extended network of mothers who have “been there, done that”. Before your baby is born, find a nearby La Leche Leage group and attend a meeting! Having real-life mothers to talk to, cry with, and commiserate with, is vital to breastfeeding success. Knowing that “you’re not the only one” who feels a certain way, or who has experienced a certain issue helps you know everything is a-okay and on track. To find a LLLI meeting or leader near you, check here: http://www.llli.org/webindex.html Remember that LLL leaders are volunteers who love breastfeeding and natural parenting and want you to succeed! Don’t be afraid to give one a call, just to talk.
VIRTUAL SUPPORT
In the age of smart phones, online “been there, done that” breastfeeding support is close at hand. How I wish Twitter & Facebook was available to me when I first starting to breastfeed! Keep a list in Twitter of ladies who are lactation consultants, lactation counselors, la leche league leaders, or who have successfully breastfed, for instant on-the-spot help. To start, try following these folks:
Diana @DianaIBCLC | IBCLC: http://twitter.com/#!/DianaIBCLC
Liz @askthelc | RN, IBCLC: http://twitter.com/#!/askthelc
Lara @MamaPearDesigns | CLEC: http://twitter.com/#!/MamaPearDesigns
Shari @ShariCriso | Nurse-Midwife, IBCLC: http://twitter.com/#!/ShariCriso
Jessica @TheLeakyBoob: http://twitter.com/#!/TheLeakyBoob
Doudoubebe @mamabear_ca: http://twitter.com/#!/mamabear_ca
Infant Risk Center @infantrisk: http://twitter.com/#!/infantrisk
La Leche Leage Canada @LLLCanada: http://twitter.com/#!/LLLCanada
Message boards can also be a good resource for more in-depth discussion, though be cautious of any information you receive online; make sure you cross-check your info w/a book or in-person support! Mothering.com has an active board with a lot of caring, experienced mothers: http://mothering.com/breastfeeding
BREAST SUPPORT
Having properly fitting nursing bras, washable nursing pads (or disposable, if you don’t have someone who can do your laundry for you right away!), comfortable clothes (don’t need to be special nursing-specific clothes, just easy to access for nursing wherever – try to wear layered shirts with buttons down the front, or in cross-over chest style – nothing that is binding in the breast area or requires removing completely before you can start breastfeeding), and baby-safe nipple cream might seem like unnecessary items, but having them available before baby arrives, can really help with your post-partum, early breastfeeding comfort. And the more comfortable mama is, the easier and more smoothly breastfeeding will go! Make sure you have nutritious ready-made food frozen ahead of time, or have someone who will be helping you cook right after baby arrives, so healthy meals are easy and quick. Keep a travel thermos of water with you all the time (even in bed!) – nursing mothers need lots of water to stay healthy and hydrated. Continue to take your prenatal vitamins after baby is born – they are usually rich in iron and vitamin D, and will help your body continue to heal, while you nourish your new baby. And finally, get as much sleep as you can so your body has time to heal, and make milk! I’m sure you’ve heard it before, but as much as possible: Sleep When The Baby Sleeps! Learn how to nurse in the side-lying position, so that you can lie down with your baby and rest for naptime.
Above all, take it easy on yourself. Be forgiving of yourself, be patient with yourself & your baby (you are both learning a new skill!), and don’t be afraid to ask for help. You can DO it; your body was made to breastfeed your baby, and your baby was made to drink your breastmilk.
If you’re a breastfeeding mama, I’d love to hear YOUR stories of support! If you haven’t had your baby yet, but are planning on breastfeeding when she’s born, what are you doing to make sure you are supported in your breastfeeding goals?
Techniques for Turning a Breech Baby
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During pregnancy, babies spend their time in various positions. However, they “should” be heads-down (cephalic or vertex) – and most are (around 95%) – by the time they are ready to be born. However, some babies are persistently heads-up (breech), even until late in pregnancy. There are three types of breech – frank (where babies bottom is down & feet are up near their ears), complete (where baby’s knees are flexed & feet are by their bottom – like a crosslegged position), and footling/incomplete (one or both feet are down, lower than the bottom). The most common breech position is frank breech.
The determination that baby is heads-up typically isn’t welcome news because it often means, for many women (in this current climate of medicalized childbirth), that a vaginal birth is no longer easily available or an encouraged option for delivery, and a scheduled cesarean section is instead recommended for delivery.
There are studies which indicate that vaginal breech births are safer then breech cesarean deliveries – particularly for the mother. However, vaginal breech births can present risks for the baby – particularly when the baby is not in the frank breech position – such as cord prolapse, cord compression, and head entrapment. Consideration of these fetal risks, combined with the fact that as c-sections have been more and more routinely recommended for breech delivery – thus resulting in far fewer practitioners who are familiar with the procedure for safely delivering a breech baby vaginally – unfortunately has resulted in vaginal breech delivery being considered the more dangerous mode of breech delivery across the board and not recommended – particularly on an “untested” pelvis (first birth).
"Before a vaginal breech delivery is planned, women should be informed that the risk of peri-natal or neonatal mortality or short-term serious neonatal morbidity may be higher than if a cesarean delivery is planned, and the patient's informed con-sent should be documented."
See ACOG’s statement on term singleton breech delivery: http://www.ncbi.nlm.nih.gov/pubmed/16816088 At this time, in the United States, over 90% of breech births are delivered by cesarean section; an astounding number. Most women just are not given a choice of vaginal delivery any longer.
There is a recent documentary film called, A Breech In The System about giving women back the choice to birth their breech babies vaginally, instead of via cesarean section. You can view the trailer here: http://www.youtube.com/watch?v=vRjSmR9QmYg&sns=tw
The comparative risk of cesarean section versus vaginal breech delivery is a complex one, and many factors need to be considered, studied, and discussed with your care provider before making a decision. There are several places you can visit to learn about these risks & comparisons of modes of delivery:
http://emedicine.medscape.com/article/262159-overview
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)02840-3/fulltext?_eventId=login
http://www.ncbi.nlm.nih.gov/pubmed/3452635
http://jeremyscorner-grifter.blogspot.com/2009/03/breech-vaginal-birth-is-not-emergency.html
Regardless of what you decide once baby is about to be born; before baby is at term, there are many things you can do (and that I did as a pregnant mother carrying breech babies – twice) to help your baby to turn, and increase your chances for a safe vaginal delivery. I’ve included every idea that I tried through my two pregnancies, the theory behind the idea, the process & outcome, and my thoughts on each idea.
I recommend talking to your doula, midwife, doctor, or other care provider before trying any of these… just to be safe. :)
Ideas for Encouraging a Breech Baby to Turn
Idea:
Cold aversion – Take a bag of cold peas, and place on the top of your tummy, near where you believe baby’s head to be.
Theory:
Baby will move away from the unpleasant coldness, and towards the warmth of your lower abdomen.
Process & Outcome:
I tried this only with my first, and only once. Baby didn’t turn.
Thoughts:
I didn’t like this method – it felt intrusive and not entirely friendly to me. I “warned” her ahead of time & told her she might not like what was coming up. In all honesty, the coldness probably isn’t that shocking with all the “padding” between me & baby. But I have a thing about cold, and so I didn’t repeat the experiment.
*****
Idea:
Music/Sound – Play music or have a deep voice (preferably your partner so that baby will have a better chance at recognizing the voice) at your pelvis.
Theory:
Baby will turn to better hear the voice or music.
Process & Outcome:
My reading had suggested playing classical music, but instead I chose music with a heavier beat & deeper bass – to increase the chance baby would hear it. Adam also spent many nights talking to my lower abdomen. Baby didn’t turn.
Thoughts:
This idea was one of the easiest and least invasive. It felt very natural to me to talk to baby & play music as an enticement to move.
*****
Idea:
Light – Shine a flashlight at your lower abdomen.
Theory:
Baby will notice the light & try to move towards it.
Process & Outcome:
We tried this several times without luck.
Thoughts:
I had no problem with trying this one multiple times, but was dubious about the effectiveness due to how dulled the flashlight would actually be shone through so many layers of flesh, muscle, skin, blood, etc. I would recommend trying this when baby is awake – so drink a glass of OJ first!
*****
Idea:
Visualization – Picture baby moving downwards into your pelvis; settling into a comfortable heads-down position.
Theory:
Mind over matter.
Process & Outcome:
Upon learning of each of my babies’ breech positions, I immediately started thinking of them in a vertex position; birthing vaginally – particularly with my son, after having experienced a long, difficult labor with my first. I knew that positive thinking was so important. I knew my daughter would turn on her own, and she did. I also felt certain my son would turn as well, but due to circumstances beyond either of our controls, his in-utero environment was simply not conducive to turning.
It is difficult to know for certain if/how visualization helped with turning; but I would like to believe at the very least it improved my outlook.
Thoughts:
I believe this idea is one of the strongest and least invasive methods, particularly when used consistently and in conjunction with some of the physical suggestions. If nothing else, putting your mind in a positive place when it comes to birth, can only help outcome – even if the outcome is not that which you visualized, I believe knowing you’ve done all you could, will help with coming to terms with the birth you do end up having.
*****
Idea:
Inversion – putting yourself in various upside-down positions
Theory:
If baby’s tendency is to be heads-up, moving your own body in the opposite direction (i.e. your pelvis higher than your head) may encourage baby to turn.
Process & Outcome:
There are several ways to do inversions with the key point being raising your knees & hips 12 – 20” above your head & shoulders. I was able to achieve this in several ways:
- kneeling on the couch, and lowering my torso down onto my folded arms on the floor.
- “elephant walking” – i.e. a downward dog position, but with elbows on the ground, and “walk/crawl” around.
- doing a headstand against the wall (note: at the time, I had been actively doing yoga, and was in good physical shape, and familiar with this position – I would not recommend headstands if you’re not already familiar with and comfortable with doing them pre-pregnancy)
- lying inverted on an ironing board which was leaned up against the couch – I’d lean the closed board against the couch, straddle the board with feet on the couch for stability, then lay myself out, head-down. I watched a lot of TV upside down.
Whichever inversion you choose, hold the position for 5 – 10 minutes. Make sure that you are supported, comfortable, and won’t fall.
Several of these positions are documented in video/pictures at SpinningBabies.com (a wonderful site for optimal fetal positioning - well worth checking out!): http://spinningbabies.com/techniques/the-inversion
As for outcome, its hard to tell whether my inversions helped or not. I did them every day from about week 34 on with my daughter, and she did turn on her own, so I’d like to believe so.
Thoughts:
Another good idea, non-invasive, and overall will help stretch your ligaments, and has a good chance of encouraging baby to turn by using gravity. The only issue I had with these positions is that late in pregnancy, they can be uncomfortable to get into, remain in, and get out of, particularly when your center of gravity is off, as well as your sense of balance. I made sure that Adam was close at hand whenever I did any inversions.
*****
Idea:
Swimming
Theory:
Submerging yourself in water tends to push your fluids inward, perhaps giving baby a bit more room in which to turn. This theory works with the idea of inversions (above), with the benefit of buoyancy – inversions are much more easily done.
Process & Outcome:
Swim, flip, and do headstands; anything to help relieve the constant downward-pressure of gravity. Inversions are much simpler to accomplish in the water.
Note: if your bag of waters has ruptured, or you have a slow leak, please consult your care provider before swimming.
Thoughts:
I went swimming several times per week in late pregnancy – and it was the only time I felt really light, fluid, and graceful in my pregnancy. Whether or not swimming aided in my daughter’s position change, the benefits of swimming in pregnancy were well worth the effort. I highly recommend this method as it is non-bothersome to baby & mom… and just fun!
*****
Idea:
Moxibustion
Theory:
Burning herbs at the acupuncture point (BL67) on the little toe to encourage baby to turn.
Process & Outcome:
The suggested time is 10 minutes per side, twice a day. I purchased a moxa stick, and used an online guide to locate the correct point, and performed the moxibustion on myself. Here’s a video guide:
http://sarah-stewart.blogspot.com/2008/02/using-moxibustion-to-turn-breech-baby.html
I have also read that simply massaging this pressure point may help baby correct her position.
Even after repeated tries at moxibustion, baby did not turn.
Thoughts:
I was not able to find a practitioner with whom I was comfortable to do this procedure with my first pregnancy, so I attempted it myself. Performing moxibustion on myself was uncomfortable – it isn’t easy to get into the correct position when you have a huge belly – think about tying your shoes for 10 minutes at a time. I set up a block to hold the moxa stick, which did help, but I still found the heat and the smell rather non-relaxing and off-putting. Perhaps had I found an experienced practitioner, this method would have had a more positive experience. Overall though, it’s non-invasive to baby, so I’d recommend giving it a try; particularly with a willing partner.
*****
Idea:
Webster Technique (chiropractic)
Theory:
By loosening the ligaments holding baby though a chiropractic technique called the Webster Technique, the uterus will have more flexibility and openness, and baby will have more room to move.
Process & Outcome:
Prior to discovering my first baby was breech, I’d never been to a chiropractor. I found one certified in Webster Technique (which, I believe is SO important – I used a chiropractor not certified in the technique while pregnant with my son – though she was a prenatal & pediatric chiropractor – and her technique was completely different than the chiropractor who treated me with my daughter).
You can use this search took at the ICPA to find a Webster certified near you: http://icpa4kids.org/Find-a-Chiropractor/
The visit(s) will consist of back, leg, and lower abdomen/pelvic massage and pressure. The chiropractor will not (and should not) ever attempt to move or even touch baby – the technique is simply about loosening ligaments which may be holding the bottom of the uterus tightly.
More information on the Webster Technique:
YouTube Video: http://www.youtube.com/watch?v=Et7JuuMrr-Y
From International Chiropractic Pediatric Association: http://icpa4kids.com/about/webster_technique.htm
As far as outcome goes: I had ONE visit to the chiropractor while pregnant with my daughter – and she turned THAT NIGHT; I felt her move more in the car on the way home, and that evening than I had at any other time in my pregnancy. With my second pregnancy, I had repeated visits to the chiropractor, and my son never budged. Again though, he was in a previously sectioned uterus, and had very low fluid levels, and my chiropractor was not certified in Webster Technique.
Thoughts:
My visits to the chiropractor – both with my daughter & my son – were relaxing, rejuvenating, and I always left with a positive outlook. While I wouldn’t go so far as to say its completely non-invasive to mom, because there is a lot of manipulation, it is for the vast majority of the time relaxing non-painful manipulation, so as long as you can tolerate hands-on and lying on your stomach (the appropriate pregnancy pillows are provided), I have nothing but good things to say about the chiropractor. I highly recommend this method to all women – breech or not – to help optimally position baby.
*****
Idea:
External Cephalic Version (ECV)
Theory:
To physically turn the baby through external manipulation of mother’s abdomen.
Process & Outcome:
I was checked into the hospital, given a heplock, signed consent forms and warned about the inherent risks to doing an ECV. Once baby’s position had been confirmed again via ultrasound, I was given the option of having pain relief and/or a muscle relaxant, both of which I declined. I was wired with an external fetal heart monitor, and a nurse held a constant ultrasound, and my OB and midwife began the ECV process. I found the actual process to be very painful, stressful, and unpleasant. The manipulation was extremely forceful – though not blunt – just extreme pressure (my midwife and her OB backup were putting ALL of their muscle into attempting to turn my baby through my contracting uterus) on my sensitive pregnant belly. The first attempt my daughter made it about 3/4s of the way around but would just not move any further, and as soon as they released pressure, she moved herself right back up to breech. A second attempt was started soon after, which I requested to stop midway through because the pain was too much for me, and I was still not willing to consent to medication. Had I made a different choice in that matter, perhaps the outcome would have been different – that I cannot say for certain. The outcome was that my daughter did not turn from her breech position, my abdomen was bruised, and I left with a very negative feeling from my midwife (who felt the procedure failed due to my unwillingness to consent to muscle relaxant).
For information on the procedure:
http://www.aafp.org/afp/980901ap/coco.html
Thoughts:
I am torn about this very complex process. On one hand, having a baby optimally positioned for vaginal labor – heads down, anterior, is what you want. A baby in the “right” position is more likely to move more quickly “down & out”, labor is less trying, painful, and safer for mom. Less interventions are likely to be requested or necessary, and a baby in the optimal position is less likely to be cesarean sectioned. On the other hand, the ECV is a highly invasive procedure – and in some hospitals requires an IV, pain medication (even via epidural – which presents its own risks and increased chance of cesarean section), muscle relaxants, and continual fetal monitoring via ultrasound and heart monitor. You are essentially overriding baby’s preferred (for whatever reason) position by force. It runs counter to how I feel about pregnancy, childbirth, and child-rearing. And yet, if the procedure is successful, certainly it is less invasive than a cesarean section. I will say that had the ECV process been made available to me during my second pregnancy, I would have had to think long & hard before consenting to the procedure again. It was frightening for me, and concerned both Adam and I how it felt to our baby.
*****
I truly hope that by trying some or all of the techniques, are able to help your baby into a more optimal position for a safe, vaginal birth.
However, if your baby does not turn, and you & your care provider decide that a cesarean section is the best way to deliver your baby, I would encourage you to read about ways to make your cesarean delivery as comfortable, safe, and satisfying as possible for you, your baby, and your partner. It is my experience that even a c-section delivery can be a wonderful, and even empowering birth experience. Here are a few links to help you:
Plan a family centered cesarean:
http://www.ican-online.org/pregnancy/family-centered-cesarean
The Natural Caesarean: A woman-centered technique:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2613254/
Natural Birth Conundrum, or, Epidurals and Guilt
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As a natural birth advocate, I believe that birth is a natural process and that most women have the ability to birth their babies with little intervention if they are properly educated and supported through pregnancy, labor, and birth. Note I said most. I fully understand and acknowledge not ALL women can (I could not in either of my two tries) or choose to give birth with little intervention. But I do believe that the majority of women can. Yet due to the current climate of childbirth (very medically intervention-laden and guilt-heavy), many women believe they cannot (or should not) and so they do not.
If you ask my opinion of birth, I’ll share my belief in the importance of birth education, fetal positioning, birth support as best makes the mother feel safe (that may be partner, doula, midwife, doctor, home, birthing center, or hospital), and certainty in ones own natural ability to birth. Yet, from the perspective of my own birth experiences, I also realize that there are times which natural birth isn’t possible, nor perhaps in some circumstances, even preferable. And when those situations occur, there is good reason for birth interventions, safe access to hospitals for women who choose to or need to birth in a more medically-supported atmosphere, and guilt and anxiety-free support for the choices women make in those situations.
Such is the conundrum of my belief in natural birth, while being a recipient of two c-sections.
On one hand, I fully understand the benefits of natural birth. The sheer naturalness of it. The normalcy of it. The very real and true benefits to mother’s and baby’s health – mentally and physically. I appreciate the very real risks of birth interventions. It is from this understanding that I want to advocate for intervention-free births always, everywhere, for everyone. And yet – on the other hand – I realize that natural isn’t always the best in all cases for all women (though I may want it to be), because all of us women are different: our birth experiences, expectations, desires, wants, and abilities.
So where does that leave me, and perhaps many other women like me?
I came into my first birth experience believing that I would not get an epidural, under any circumstances. This belief kept me from fully researching epidurals before my birth. When I did finally consent to an epidural after many hours of very difficult (read: extremely painful) back labor, not much progress, and no sleep, it was done under what I can only describe as extreme duress. I do not recall being informed of the risks of the epidural in the hospital (I had previously declined the medical pain management class the hospital offered in pregnancy, thinking it wouldn’t apply to me), though I do recall signing something. I do recall wanting the pain to end, yet being terribly conflicted between my intense desire for a natural birth, and my need for decreased pain. Unfortunately, I believe it was my wanting for a “best case” natural birth that kept me from consenting to an epidural earlier in my labor and the anxiety from not knowing what I was getting into, and guilt at not being able to avoid getting into it that kept me from relaxing once I had consented. So, in spite of the epidural, I stayed awake, worried, and panicky about side effects (of which I wasn’t fully informed). I believe most of the potential benefits of an epidural were lost in my remorse at having to have one. Hours after consenting to my first intervention, my birth followed the “cascade of interventions” I’d been warned about, yet was unprepared to avoid, and culminated in a c-section. Now, I do believe my section was warranted. Yet, I also believe that had I been more open to and more aware of all of my options (without all the guilt) BEFORE I was in labor, that my birth MAY possibly have been different. There are far too many factors to know for certain. But how can I deny the possibility that had I not felt such a strong sense of failure from consenting to any kind of intervention, I may have been in a better place to accept an intervention at the right time that could have eased my labor along in just the right way? I can’t.
So, here on the fence I sit: between believing in the benefits of natural birth and conceding the need for interventions. Between my desire for women to choose to believe in their own bodies as well-built birthing machines and my acknowledgement that women need to be able to choose whatever they believe is best for them – which might include interventions, like epidurals.
Few things have the ability to raise hackles, and call out judgment faster than the epidural. Emotions run high on both sides of the epidural issue. Part of the issue is that there are far more than only two sides. There are women who didn’t want an epidural and didn’t get one. Women who didn’t want one, and did get one. Women who did want one, but didn’t get one. Women who did want one, and did get one. You can divide ranks even further: Women who didn’t want one, and did get one – and hated it. Women who didn’t want one, and did get one – and liked it. Women who didn’t want one, did get one – and won’t admit they liked it. Or, those who got one, and regardless of whether they wanted it or not, it didn’t work. And on & on, I’m sure I missed some. The point being, that we all birthing women come from all perspectives on the issue – which makes it such a complicated one on which to “take sides”; yet take sides women do, and the fallout from the mudslinging and judgment on each side can be devastating.
So I’m stepping off the fence a bit to say that I believe we need to stop taking sides over epidurals in birth.
Women need to have fully informed access to guilt-free epidurals in birth. This means information, without glossing over the risks, and without guilt over making the choice to have one (or not to). Informed access means all the information – fully disclosed – of all the very real risks associated with epidurals, well ahead of birth – provided freely by their health care provider, without any glossing over of said risks by said healthcare provider or well-meaning friends (e.g., “Oh you won’t even feel the needle and it will be so worth it” or “It doesn’t really matter if you can’t feel your legs – you won’t be able to feel the pain!”); along with full disclosure of the benefits, without the associated pressure or expectation by said healthcare provider or well-meaning friends (e.g., “Why would you even bother trying to go natural when you can go pain-free?” or “Don’t try to be a hero”), so that each woman can make a real informed choice about whether or not she wants an epidural; without pressure to feel a hero or a failure if one choice is made above the other.
But how can we get to that point when we are still taking sides? When health care providers are glossing over the negatives and natural birth activists are glossing over the positives of interventions like epidurals? Health care providers need to start trusting women enough to give them information and the ability to use that information in the way they choose – whether birthing naturally or not. And women need to start trusting themselves with the very real value of this information given. When you know ALL your options, and when you trust yourself as a birthing woman, you’ll be able to make the best decisions for yourself in birth, without guilt. Without guilt over our own choices, and with understanding of others choices is where we need to be on the very difficult yet amazing journey through birth and into motherhood.
Because all births are amazing. I repeat: All. Births. Are. Amazing. And every woman deserves to feel that amazement and a sense of accomplishment and grace in her birth, regardless of how the birth progresses or culminates.
Recommended reading...
Books:
Birthing From Within: And Extra-Ordinary Guide to Childbirth Preparation by Pam England
(I took a Birthing from Within course with my husband when pregnant with my second child. I highly recommend it!)
The Thinking Woman’s Guide to a Better Birth by Henci Goer
Ina May’s Guide to Childbirth by Ina May Gaskin
Websites:
Are We Using Our Brains When It Comes To Epidurals - PhDinParenting.com
Why I Won't Leave My Births Up to Chance - TheFeministBreeder.com
I Can't Believe I'm Talking About Epidurals - Strocel.com