Homebirth tragedy

Janet Frazer of Joyous Birth is a staunch advocate of what is known as freebirth. I discovered homebirth, unassisted birth and free birth in my quest for natural birth methods and honestly, they made a lot of sense, provided the proper infrastructure was present.

A home birth is essentially a birth at home, attended by a midwife. An unassisted birth is a birth that is exactly that - unassisted. It may be at home, or in the hospital, but it basically trusts the mother to go with her instincts and give birth to her child in a manner that is most comfortable to her and her child. A freebirth is a birth that is unassisted and where the mother gives birth to her child alone. Needless to say, free birth, while a courageous move and trust in instincts is also quite risky.

Janet had an earlier child with an emergency C-section, and chose to free birth her child at home. After a week of labour her child was either stillborn, or died shortly after birth. That's tragic. My heart goes out to Janet. Various people variously have criticized her choice for a home birth or pointed out that infants die in the hospital too.

My take on this is different. What proponents of unassisted birth or freebirth say, makes sense, that there is a possibility to call for medical assistance if things go wrong. There is no guarantee of life and death in the hospital either. However, I find the concept of free birthing as a little extreme. I think of myself as extremely tuned in to my instincts, yet it is my instincts that want me to have another person capable of keeping an eye on the medical/emergency aspect of things while I give birth in peace.

If we are to talk about instincts, humans are social animals. It is in our nature to be interdependent. I don't see the big deal in going against our natures to refuse assistance in a time of vulnerability.

Sure, hospital births carry greater risks of infections, may expose the mother to less than comfortable medical interventions, may increase risk to the child through unnecessary medical interventions. Yet, these are things that can be worked around. They may be uncomfortable, sure, but how long does that discomfort last, and does avoiding a hospital or midwife guarantee absence of discomfort?

In my opinion, if Janet was in labour for a week, that in itself was an indicator that some attention may be needed. Not getting any medical attention throughout pregnancy and then in an abnormally long labour, is criminal negligence, particularly when her previous delivery was an emergency C-section. The child may not have lived in any case, but the point is that there were things that could have been done to prevent its death, which were refused through choice.

I see this kind of a perspective as slavery to medicine as well, just in the opposite direction. If proponents of free birth criticize hospitals for taking away choices, their method takes away other kind of choices, with a far greater price. It is a classic case of counter-dependency - I refuse to give you power, so I refuse to accept any good in you, that could help me. Sad!

On my part, I'd love to have an unassisted birth, but in the hospital. Now, I know that there will be some amount of interference, but like I said earlier, I can get through anything short term.

Also, I find the idea of the home being more comfortable for birthing absurd. Sure, some women may prefer the reassurance of familiar surroundings, and I may be a nomad with less of an attachment to places, but if my husband is with me for birth, I'm fine. In fact, I find a certain reassurance that if things go wrong, I'm not going to end up travelling.

Luckily, in India, we have maternity homes, which are only for delivering pregnant women, so there is less risk of the germs and all that the proponents of free birth speak about. The atmosphere is cozy, and I can focus on my child after delivery rather than clean up the birthing mess.

I see a pattern of independence in these choices, which I find disturbing, because I worry that it could be a case of cutting off your nose to spite your face. I think its okay to be knocked off your feet (or stay off them as a treat) rather than get back into action immediately. Its okay to need medical attention, or even have someone keep an eye on things though you are perfectly capable and confident of handling the delivery of your own child. If not a hospital, a midwife, is a lovely option, with the comfort of home, and the wisdom of a professional who knows when things are going out of the safe patterns and will raise an alarm. At the very least, someone else who knows enough of birth to take a call on when enough is enough and dial 911.

So, if you are considering birthing your child on your own, I suggest:

1. Read up on what to expect.
2. Go to checkups regularly and be familiar with any risks you may face.
3. Consider a midwife.
4. Have the flexibility to change your mind about medical interventions if needed, and be open to them as a possibility so that if you need them, you don't increase delays and risks avoiding them on principle.
5. Speak with your doctor about what you are planning, and ask for advice, and keep them on speed dial to consult with, it things seem off. They can't do medical interventions on phone, so there really is no harm in asking for advice if you are not sure.
6. Don't create an image out of your choice. I suspect that being an advicate of free birth could have been a factor in many choices Janet made and some alarms she may have ignored.

Good Luck!

Planning Labour and Delivery

I've been thinking of labour and delivery for many days. Not with any fear, just to plan what to expect and make my desires clear to the doctor and things like that. Then why do I say not with fear? Because every pregnancy site seems to talk about this with fear as the main theme. Strange. I thought these guys were trying to reassure people, but that's for another day.

My dilemma was different. I was reading about all these wonderful things to keep in mind - natural birth, freedom of movement, skin to skin contact immediately after birth, breastfeeding, and what not.

This morning, I woke up in a 'what will be will be' space.

Each "maternity home" I spoke with this about seems to have a similar take on things, which is described as "out-dated" on most sites - free to move till birth is imminent, and then on your back with your legs wide you go. They are happy not to feed your kid, but if your milk doesn't seem to be coming down, they 'recommend against' letting the baby go hungry, etc. That kind of stuff.

One thing I can do is educate myself online, make demands on the maternity homes, and overall become a problem patient that takes them out of their zone of practiced efficiency. It has the added bonus of driving me insane trying to figure out details of an experience I'm clueless about.

Without any of those fancy articles to tell me, I can straightaway predict some results from that:

• The staff is going to be distracted by my demands
• The staff is either going to resent being ordered around by an inexperienced patient with a 'know-it-all' complex, or they are going to wonder what their next step will be, all through.
• Its going to add stress to me, knowing that the staff don't have a routine in place for what I want.
• Its going to stress the husband, who's already a certified wimp about me being in pain and force him to keep in mind things and get into arguments in a time when I'd rather he focus on me and the kid and celebrate the moment.
• An unpracticed team is less efficient, and more importantly, I'm not a part of it, so suggestions taking them out of their comfort zone in a high stress time are not exactly going to be welcome - this is not the best 'care' plan for myself.

So now what? I've got this beautiful image of a perfect delivery, which seems to be a little skewed by reality. Even the doctor being pro-natural birth doesn't mean anything in an emergency.  What do I do?

Well..... I follow my rule for dealing with tough situations - I suck it in, and know that I can deal with ANYTHING short-term. Going to the absolute worst-case scenario, where I lie on my back and give birth to a kid I get to hold after being cleaned only. So what? It will hurt - d'uh like it won't in other positions? The kid will fare better - that's a joke, right? I mean its not like doing this one thing will guarantee an awesome life for the kid. Nor is it the only thing I can do to ensure that result.

What I think I need to do is take the stress out of the game for a less painful experience all around. I need to look at what makes me not fear labour.

Its simple. I know it will hurt. I know I want to go natural, so I'm probably going to feel every moment of it. On the other hand, I've have a 'track-history' of living through tough times all my life (haven't died yet). Also, look at the population of the world. Whatever agony there is, its obviously short term, or we wouldn't have people around. Short term I can do.

And then, there is always the option of screaming the place down until they do something for my pain :D

Helps to know I won't be helpless.

Helps to know I will have Raka with me and he is not going to love me any less no matter what choices I make.

Helps to know the doctor has a reputation for being pro-natural birth, and has been known to coach people through tough moments rather than reach for the needle.

So, I will move as I like till someone tells me to get my bottom on the table. So, I will, when the baby is born, if I have the energy left, ask to hold it before they do whatever they have to. I doubt if anyone is going to tell a mother that she can't hold her baby in that moment - this is better than planning a demand. If I don't have the energy, Raka will ask to hold her. If it doesn't happen, so be it.

Just last month, I'd been reading about preemies who weren't held by their parents for weeks after they were born, who are growing up healthy. No matter what, I'll sure hold mine before that much time passes. What's a couple of hours in the greater scheme of things?

The same goes for breastfeeding. Sure, I want to breastfeed my child. Sure I don't want it to get anything other than breast milk for 6 months. However, if my milk is slow in coming down (or whatever their measure of a hungry baby is), they are not going to give my little one anything poisonous with the awesome reputation they have. They do have a reputation for supporting breastfeeding too. The little one and I will suck it up, and work with it in another couple of days when we are home free.

Who knows how the shangrila from the articles translates into practical life? Since all of them seem to agree, it seems to be 'the correct' look at things. Yet, most articles also agree that a woman in her 29th week (or similar) starts thinking about breastfeeding, snoozer pillows and other pregnancy pillows are God's planned way for pregnant women to sleep, etc. This couldn't be farther than the truth - I've been thinking about breastfeeding ever since a friend brought up the subject in my first trimester, tried all kinds of pillows and what works for me is my husband (there's more psychology than ability to relieve discomfort in getting me to crash).  Obviously more a case of lack of originality than the ultimate voice of truth in these sites.

Sure, to some extent, we get suckered into the whole unconscious set up. For example, I AM writing this blog (like the pregnancy sites recommend - though they probably do it to get free content and traffic for their site), I am writing this post in my 30th week of pregnancy, I did speak of fear related to labour, even though I don't feel it.... somewhere, too much exposure to these unconscious patterns sucks us into the scene.

Anyway, this skepticism of mine extends to those perfect labours as well. The information is all good, but when there is a mismatch between imagination and reality, I'm not going to stress over how to make reality match imagination, but simply go with the flow, and ask for what I need where possible, and see where it takes me.