My Birth Plan

Something I have been thinking about lately is my birth plan for Baby L come July. This isn't my first rodeo so I know what to expect in terms of how pregnancy goes and labor and all of that. But I really wanted to look further into all of my options and what I have plans to do.

This was the very first thing I thought about. Should I have a completely natural labor with no pain medication or should I have an epidural like I've had before. I have never experienced the joys (and pain) of having a completely natural labor and delivery experience. 

My experience with the epidural was this: amazing, lol. It completely took all the pain away that I was feeling except for the pressures associated with the baby descending into the pelvic area for birth. I was always afraid of needles -- and when I saw the needle used for the epidural it was no different. I was scared. It's a big needle to say the least and knowing it goes in between the vertebrae in my spine is kind of terrifying. I always have had luck with wonderful anesthesiologists, except once. I was 17 years old and delivering my first son (he lives with his father & for personal reasons I won't divulge that information) but I was 17 years old and a senior in high school. The doctors at Kennedy Hospital treated me like complete crap because of how young I was and the anesthesiologist didn't say much to me. Did what he had to do and left. And so I was numb but nobody told me about that glorious 15 minute drip option that comes along with the epidural. And if you don't know what I'm talking about, I'll tell you. The epidural comes with a button that you're allowed to press every 15 minutes to release more pain medication. Had I known this I may have had a bit of a better birthing experience. Anyway, my epidural with Caleb was exceptional. I went in had my water broken and all that stuff and then got the epidural. I felt those beginning contractions and I wanted to die -- it's painful, no doubt. I had a great experience with that & I pressed that button every 15 minutes on the dot to make sure I felt nothing. What I didn't like was having to wait to get moved to the recovery room because after the epidural you need to have feeling back in your legs and use the bathroom (because you have a catheter in the entire time). 

Here are 10 reasons why you shouldn't get a epidural: 

(1) Epidurals restrict movement.

Because epidurals require IV fluids, bladder catheter, and full time electronic fetal monitoring, mothers are unable to be in control of the natural progression of labor. Deena Blumenfeld, a Registered Prenatal Yoga Instructor and Lamaze Certified Childbirth Educator in Pittsburgh, explains, “The epidural restricts mom to bed, and it restricts her movement. When mom’s movement is restricted it can cause a number of complications, including: fetal distress, low fetal heart rate, and inability for baby to rotate to the anterior position (optimal and normal for birth).” Ultimately, she says that the “use of the epidural can be a direct cause of c-section.”

(2) Epidurals increase the risk of fever. 

It is not uncommon for epidurals to increase the mother’s body temperature. A recent study pinpointed that over 19% of women who received an epidural experienced a fever of 100.4 or higher. Fevers, in turn, can increase both the mother’s and baby’s heart rate. Since fetal heart rate can be a sign of distress, doctors often react with the suggestion of a C-section. Even if a C-section is not the outcome, the heightened heart rate often leads to further investigations of the baby after birth (which can include blood and spinal fluid samples). This can lead to days of separation, observation, and possibly antibiotics – which inhibits mother-baby bonding and the establishment of a strong breastfeeding relationship. Kelly Whitehead, author of High-Risk Pregnancy: Why Me?, had this very experience. After a spiking fever, she had to leave her baby behind at the hospital for a few days after her discharge as a preventative measure. She commented, “It was extremely hard emotionally to leave my daughter behind. Breastfeeding her kicked off with a rough start since I was separated from her moments after birth. Though the hospital lent me a pump, I found that difficult, especially being a first time mom.”

(3) Epidurals may cause the mother’s blood pressure to drop. 

A sudden drop in blood pressure is one of the most common side effects – which is why blood pressure is taken every 5 minutes when the epidural is initialized and every 30 minutes thereafter. A drop in the mother’s blood pressure affects how much of her blood is pumped to the placenta and can lead to less oxygen being available to the baby.

(4) Epidurals have been known to cause headaches.

Many women with epidurals report having persistent and/or chronic headaches post-delivery. Blumenfield says that this happens when the epidural needle is inserted too far, “...it can release spinal fluid up to the brain, causing a spinal headache. These are severe and often debilitating, lasting for hours or days.”

(5) Epidurals can slow labor. 

Epidurals often slow the second stage (or pushing stage) of labor by interfering with the natural hormone of labor (called oxytocin), as well as reducing moms’ ability to push effectively. Since the mother is numb, she is unable to get in the most helpful positions to help guide the baby’s descent.

(6) Epidurals increase a woman’s risk of having a delivery with the aid of instruments.

The gold standard of medical reviews, a Cochrane Review, came out with this research in 2011. Epidural babies were more likely to be delivered with the “help” of  forceps, a vacuum, or other tools that increase pain and discomfort for both mom and baby (Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD000331. DOI: 10.1002/14651858.CD000331.pub3). The use of instruments also increases the likelihood of a woman having a more serious tear and/or receiving an episiotomy.

(7) Epidurals increase the risk of Cesaearan Section.

Nick Angelis, a nurse anesthetist and the author of How to Succeed in Anesthesia School, states this matter-of-factly, “statistically, the chance of getting a c-section increases with each medical intervention [including epidural].” He also points out that mothers seeking a natural childbirth experience would be wise to avoid labor augmentation drugs such as Pitocin since it is known to make contractions less manageable for the new mother.

(8) Epidurals = a slower recovery.

Elizabeth Chabner Thompson, MD, is a New York mom of four. A graduate of John Hopkins Medical School, she initially did an OB/GYN internship, but ended up changing specialties to focus on oncology. Two of her babies were delivered with an epidural, two without. She far preferred her non-medicated births, “A woman delivering without anesthesia recovers much faster than with anesthesia. I tore much less — I could feel everything so I was able to pay attention to my pushing.” She even went on to say that she, “was up and running behind the stroller within a week after delivering without anesthesia…it was much easier to care for my other children.” Though perhaps not all new mothers will be jogging at one week postpartum, there is certainly something to be said for being able to get up and around quickly.

(9) Epidurals sometimes interfere with the early stages of breastfeeding.

Studies have shown a link between epidurals and breastfeeding rates among new mothers. Whitehead explains that this is “due to neurobehavioral effects in the baby in regards to initial rooting and suckling behaviors.” Note that epidurals also interfere with the natural production of oxytocin (as stated above)…the hormone which causes the let-down effect in breastfeeding and promotes healthy bonding between mamas and their babies.

(10) Epidurals may cause other unpleasant and dangerous effects for babies and mothers.

Women have reported nausea, itching, backache, and incontinence. Little is known how the epidural effects the baby, but we do know that the drug does enter the baby’s bloodstream. It seems contradictory that many women take great precautions to avoid deli meat, coffee, wine, and tylenol throughout their pregnancies…and then proceed to take in a heavy anesthetic agent right before meeting their babies for the first time.

Obviously epidurals aren't for everyone just like natural childbirth is completely out of the picture for others. It's all about your own personal choice and what you want personally for you and your baby.

This time around I want to go natural. Completely 100% natural. I also want to go into labor on my own (if possible). Any time I've delivered I have had to be induced, and it's really just my body & baby. I want to experience my water breaking and having that whole feeling of "we need to get to the hospital". Of course the beauty of induction is the fact that you KNOW when it is happening. It gives you more time to plan what else needs to be done in terms of babysitters, housework, things like that. It makes it kind of easier, but I would love to have the experience of going into labor naturally and on my own. Although I doubt that will happen. My mom went natural with all 5 of us. My 3 other sisters and my brother - 100% natural. She was so strong my mom. 

And I really feel like I'm going to have a more emotional and connected experience with my baby if I go naturally. If I have to get induced then so be it, but besides that I do want to go completely natural. No pain meds, nothing. 

Just balls to the wall (figuratively of course) full blown labor. With nothing to ease the pain.

Hundreds of years ago when there wasn't an epidural that's how women did it. Call me crazy but I just want to experience it. I think it would be incredible. 

Something else I've been looking into is a doula. 

What is a Doula? 

Doula is Greek for "woman who serves". It's been proven that these incredible women can actually make birth easier and better for mom, dad and baby :) & who doesn't want that? They meet you with before you have the baby, are with you during birth and also visit with you at home afterwards. It's truly an amazing thing and must be incredible for them to help someone else.

Another reason I want a doula is to help Ray... Why? because I am going naturally this time. And chances are he's going to hate seeing me in that type of pain, so I want to make sure that dad isn't left out of the equation as well. People seem to forget that dad's are in on birth too. They might not be physically doing it, but they are definitely there along for the ride.

I also really want this whole labor and delivery documented. I would love to have pictures of me in labor... pictures of Ray and I together... pictures of the baby being born (nothing to Alien vs. Predator) but I would love to have those for memories and all of that. and those first moments with the baby. I have found a few different doula's that I plan on meeting with to see if they are good fits for me. My good friend Amanda told me about them and she really had me wanting to learn more. 

Something else? Delayed cord cutting or DCC. 

What this means is you wait to cut the umbilical cord. It's proven to give more blood to the baby and the baby has a lower risk of anemia. 

It's something I'm passionate about and excited about experiencing. At my next appointment on Tuesday I am going to explain my wants and needs to my doctor. 

Have a great day! :) 

XOXO, Jenna