Some of us are simply petrified of natural childbirth, and that’s nothing to be ashamed of! An epidural can be a great thing. (Yes, I had epidurals for both of my births.) However, know that if you go that route, you can’t do all the stuff you’re able to do in a natural birth – things like walking around, laboring in a birthing tub, being free from constant fetal monitoring and an IV, etc. I didn’t understand that completely until I was in labor and learned that all the medical things like the IV and the fetal monitor and lying on my back, were all non-negotiable due to the epidural. Somehow I thought I would be able to convince the hospital staff to let me skip the IV and the fetal monitor and that I would win because I usually get what I want. Yeah, right!
If you choose an epidural, here are my Top Five Tips:
1.Labor at home for as long as possible. Take a bath, rest, breathe, and go to the hospital when your contractions are coming regularly, about 3 minutes apart. 2.Have an advocate (partner, doula, mom) with you at all times, to help you discuss any suggested medications and/or interventions. 3.Ask for medication before you need it – it may take over an hour for the anesthesiologist to show up. (You can also request pain or anti-anxiety meds as soon as you’re admitted.) 4.Be nice to the nurses. You may be stuck with them until the shift change (7am and 7pm), and you want them on your side! 5.Try to time the epidural right. You don’t want it too early (it may wear off while you’re pushing), and you don’t want it too late (you may miss your opportunity). Discuss with your birthing team to determine the ideal timing for you.
Remember this is your body, your baby, and the choices are yours. Though you may not always get what you want, don’t be afraid to speak up!
Due to the astronomical cost increases of medical malpractice insurance, nearly all of the birthing centers in NYC have disappeared. With the exception of the birthing center at St. Luke’s Roosevelt Hospital, New Yorkers are primarily giving birth in hospitals, with shockingly high intervention rates (see intervention rates on The Birth Survey for more info). I had both of my kids at the late St. Vincent’s Hospital, and we all survived, but both experiences were frankly very medical. That said, I chose medical births because I was wanted epidurals, and that, I now know, restricts your options for how you labor (see next week for tips on birthing with an epidural). But if you’re planning a drug-free hospital birth, here are five basic human rights that should be observed. You may need to fight for your rights, but hey, you’re New Yorkers, so you should be thick-skinned!
1.You have the right to movearound freely when you labor. 2.You have the right to be detached from an electronic fetal monitor. 3.You have the right to eat and drink during labor. 4.You have the right to refuse an IV. 5.You have the right to accept or deny any medications/interventions.
Remember this is your body, your baby, and the choices are yours. So discuss everything with your birthing team in advance. Be sure you’re all aligned, and have an advocate (partner, doula and/or family member) help you stick up for your rights on D-Day.
If you’ve moved beyond pregnancy and childbirth books, you might begin to notice that there’s a HUGE theoretical divide amongst parenting experts about how you should care for your baby. On one (very popular) side, there are credentialed individuals who advocate for attachment parenting, based on Dr. Sears theory that we should sensitively respond to our babies cues, feed them on demand, and be physically attached to our babies at all times (including co-sleeping and baby-wearing). On the other side, we have Dr. Weissbluth and many other credentialed individuals who recommend exactly the opposite, based on theories that parents should take the lead, foster independence, sleep-train, and create feeding and sleeping routines our babies. Both sides of the theoretical argument suggest (roughly) that if we DON’T follow their advice, we will have needy, and/or emotionally insecure children. If you’re already getting heart palpitations, take a deep breath, because it gets worse. You will soon learn that EVERYONE has an opinion about how you should care for your baby, and most of it is conflicting. Seriously, in the hospital with our first baby, one nurse responded to our babies cries with, “No wonder she’s crying, it’s so cold in here!” and she swaddled her up. Moments later another nurse came in and scolded us for having the baby swaddled and said, “No wonder she’s crying, she must be so hot!” And that was just the beginning of the unsolicited advice onslaught. The one thing that the experts aren’t saying, is that thereis no single theory or book that has all the answers. There is no right and wrong way to care for your baby. So take that stack of newborn and parenting books, and read it all with a grain of salt. YOU are the only expert you need to care for your baby. And don’t worry – despite your deepest fears, you’ll be a great mom!
You’re expecting a baby, you’re reading a lot, and you’re getting confused about what to believe. Sound familiar? You’re not alone. If you Google “recommended pregnancy books 2010”, 47,600,000 links appear, including hundreds of top-selling books (yes, you read correctly, that’s 47 million, six hundred thousand links)! New moms, beware. There’s a lot of conflicting information out there, and you will need a strong filter to weed through the crap that doesn’t apply to you, and a tough skin to endure the things that may make you feel like a bad mom, even before you become one! The politics of sleep and baby-wearing are the biggest bones of contention in the reading stack. On one side of the fence, you have the Attachment Parenting theory (which advocates co-sleeping and baby-wearing); and on the other side, you have a variety of Get-Your-Baby-to-Sleep-Through-The-Night theories. Both contend that if you don’t follow these methods, you will have a difficult, needy baby, and potentially inflict some sort of psychological trauma. Here’s what I recommend: Don’t buy it. Read all the books if you must (regretfully, I did), but don’t buy into the orthodoxy in any of these theories, unless it really works for you to follow one method 100%. One of my favorite Buddhist quotes applies very well to new parenting, "Believe nothing, no matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and common sense." My advice is to read what appeals to you, but take it with a grain of salt, and integrate a few different theories into your new life as a parent, with a good dash of your own instincts. Because generally, nothing works 100% for everyone.
If you’re having a boy, will he be circumcised? Have you thought about it? The U.S is the only industrialized nation that routinely circumcises boys, the American Academy of Pediatrics stated in their 1999 policy update that there’s no medical necessity for it, Holland basically denounces male circumcision in their 2010 statement, yet American boys are still routinely being circumcised in hospitals. Why? Female circumcision is considered “barbaric” and commonly referred to as genital mutilation, so why are our boys still being cut? I understand religious reasons (I’m half Jewish, and a briss with a mohel is far more humane than hospital circumcisions), but many Americans don’t even question it. You need to tell the attending pediatrician in the hospital if you don’t want your son circumcised! When I was pregnant with my son, I deferred to my husband, who instinctively thought that our boy would feel strange if his penis were different than his dad’s, and that it would be a locker room issue. I asked him to do the research and be in charge of the decision, because ultimately, I don’t have a penis and don’t understand the pros and cons and politics of foreskin. Ultimately, we chose NOT to have our son circumcised because we couldn’t find any medical reasons for it, and well, most of our friends did the same, which took away the locker room argument! What are you going to do?
By this I mean do you want an epidural or not? It's an increasingly complex question. The majority of the pregnant women I meet today want to try for a natural delivery, with the option of an epidural standing by, just in case. But the question for women in NYC is a lot more complicated. The question is really: Do you want a hospital or a home birth? At opposite extremes and with limited middle-of-the-road options, most of us will lean very strongly in one direction or another.A home birth was out of the question for me, because it just sounded waaaayyyy too scary; so scary I wouldn't even read about it! But now, when I speak with midwives who deliver babies safely at home every day, and hear countless beautiful home birth stories from women who've successfully delivered healthy babies at home, it makes me wonder if perhaps I should have considered it? Certainly knowing what I do now, I would, but I would still be scared. If you're on the fence about a hospital or home birth, check out Ricki Lake's film, "The Business of Being Born" below. It will open your eyes to the possibilities that, like me, you may never have considered....
I recently spoke with a woman who was 31 weeks pregnant with her second baby. Although she had no complications with her first delivery and delivered a nearly 10 lb baby naturally, her ObGyn is concerned about another big baby and keeps mentioning that she should schedule an induction a week before her due date. This mom wants to deliver naturally and has no interest in an induction, but she's afraid to speak up to her ObGyn. She is nervous that her ObGyn will drop her as a patient, or that he will force her to be induced. Now, this may sound silly, but it's a very real fear and it's too common, especially in NYC. Why not state your birthing preferences? Why are we afraid of medical practitioners? Whether you want to deliver naturally, have a scheduled c-section or an epidural, it's your body, your baby, and your preferences should be honored, period. Things may not go as you planned in childbirth, but if you don't discuss your plan with your birthing team, you will never know if they're agreeable or not. If you're not comfortable enough to speak honestly with your practitioners, or if they are not willing to honor your birthing preferences, perhaps you should find a new practice.