A Recent Conversation with My Midwife
Midwife: So, before we finish the appointment, do you have any questions for me? She's always very willing to spend time answering my questions, which I love.
Me: Actually, I was wondering if Kaiser has a list of doulas that it recommends?
Midwife (looking startled): Uh, no. Kaiser doesn't do that.
Me (confused): Kaiser doesn't do doulas?
Midwife: Well, we don't refer patients to them. We can't. It's against our policy.
Me: Oh, okay. (WTF?)
Well, no problem. I can just look online I guess.
Midwife (almost apologetically): But I think it's great that you want to get a doula. What made you decide to look into getting one?
Me (opting for the short answer): Well, I am anticipating a natural childbirth and I feel I will need the extra support.
Midwife (skeptically): You want a natural
Me: Uh, yeah. Well, I mean, I think I may end up with one regardless because my epi didn't work during my first birth. I can't assume it will work this time.
Midwife: Well, it's just that most women don't go natural here. Didn't they try upping the medication when the epidural stopped working?
Me: They said it wasn't possible.
Midwife: Did they try re-inserting the epi?
Me (getting frustrated): No, they never tried that.
Midwife: Oh, that's so strange. Usually, they'll try that...
Me: Well, anyway, I just don't want to bother with trying an epidural again. I have no idea if it's going to work so I can't depend on it.
Midwife (leaning closer as if to whisper): OK, well, if you're really intent on trying for a natural childbirth, then I have something for you. I have it locked away in my office. I'll be right back.
Two minutes pass and she returns.
Midwife (handing me a small one-sided flyer): here is the name of a doula that I have heard is good. She also does a class on natural birthing - the Bradley Method. You can contact her. But please don't mention to anyone that I gave this to you. It's like contraband around here.I took the scrap of paper, feeling like I was doing a deal with the mafia.
Me: Great. Thanks.
Midwife: Oh, and if you plan to go natural, you have to understand something. When you get to the hospital, you are going to be pressured by the nurses to take medications. You have to be ready for that because when you are feeling labor pain, it will be really hard to say "no" when meds are offered.
And it's REALLY important that you pay to take a childbirth preparation class outside of Kaiser. Kaiser's class won't cut it if you want to avoid meds.
OK, so I left this appointment feeling really pissed. Not so much pissed at the midwife, but pissed at Kasier. Pissed at a hospital system that won't allow its midwifes to even hand out a list of friggin local doulas to its patients. At the very least, they could have a one-pager with the name of the certifying organization for doulas so that patients can search on their own.
When I was pregnant with my first son, I didn't even know what a doula was. That certainly wasn't part of the Kaiser childbirth preparation class. They were too busy passing around forceps and a vaccuum so we could see how our kids would probably be extracted from our bodies.
In any case, our conversation brought to light a larger question for me -
Do hospitals get in the way by complicating labor? Does the medical system (for all its good intentions) inadvertently hinder birthing mothers by intervening when it's really medically unneccesary? And at what cost?
**And here I think it's important to note that I think that hospital staff are wonderful, dedicated people who save lives. In an emergency, they would be the ones to provide the needed interventions to save my life and my baby's life. I recognize that and am very thankful for it.
But. I'm guessing that the majority of birthing women are not high-risk, nor do they ever become high risk during the course of their labor. And yet, we are treated as "patients", strapped down to our beds with IVs, offered medications at every turn. And maybe we WANT to take medications and that is our choice (hell, I was shouting for the epidural at the first opportunity!). But on the other hand, are we conditioned to think that we NEED these interventions? And, again, at what cost?
In recent months, I have read that epidurals are associated with stalled labor, increased risk of needing Pitocin, and c-sections for failure to progress. I haven't read all the research on this, but in my personal experience, I saw it (almost) happen to me. Though I didn't end up with a c-section, I was very close to it. And I know that the c-section rate in this country is astronomical. Why?
And I'm also wondering: given the potential risks and disadvantages of epidurals
, why don't hospitals more routinely offer pain-relief altneratives and natural coping mechanisms? Like, how about a shower in every room? Or, better yet, a soaking tub for a water birth? How about doulas provided for free, paid by your insurance? How about midwives on staff who can actually BE midwifes and help women prepare for a natural birth? How about a labor room that is bigger than my cubicle? How about birthing balls lent out to all women at their first prenatal visit? I know there are some hospitals that offer some of these, but guess how much of this Kaiser offers? Zero, zilch, nada.
That said, I don't think there's anything inherently wrong with seeking pain relief in labor. At all! I WISH we could have pain-free labors, and heck, I may even ask for the epidural again, but I hope I won't have to. Having experienced Pitocin without an epidural, I'm actually more afraid of getting an epidural now (and having it fail) than I am of trying to do it naturally.
But I'm curious: what are your thoughts on this topic? Do you think that hospitals get in the way of the natural birthing process? And if so, do you think the birthing mother pays a price? Or am I just smoking crack?
Labels: natural chilbirth