Sunday, November 23, 2008

Why you shouldn't "try" to have an unmedicated birth

You will hear many women say they are going to "try" to have an unmedicated birth. To me, "trying" connotes sheer effort and endurance. What I hear women say when they say "try" is that they are just going to see how long they can stand the pain. My dictionary defines "to try" as "to make an attempt or effort". What happens when you try something? Either you can succeed or fail.

There's a lot of derisive talk out there about birth plans and women who "plan" an unmedicated birth - or really plan anything about their birth at all. There is a lot of fingerwaving about how birth is unpredictable and you can't PLAN anything. After seeing a lot of births, I have to say I agree. My dictionary says to plan is to "decide on and arrange in advance" - you can't really do that with your birth. What happens when you plan something? Maybe your plans work out, and maybe they don't.

What I wish more women would say, and take ownership of, is that they are preparing for an unmedicated birth. My dictionary says " to prepare" is "to make ready or able to do or deal with something".This sounds just about right! Someone who is prepared does not fail or have plans not work out - they meet what comes with their goal in mind. They have made themselves ready to handle birth and any twists and turns they might meet on the way.

I encourage women to think of birth as a marathon - it is long, challenging, sometimes painful, sometimes exciting, and can be very rewarding. Many people regard having run a marathon as difficult, but very rewarding and a huge achievement. However, if you knew someone who told you that on Saturday they were going to "try" to run a marathon, you'd probably look at them a little askance. You'd start asking questions: "Have you practiced? Did you read up about marathoning and long-distance running? Do you know anything about the route?"

What would you think if they said, "I'm just going to start running and see how long I can stand it. There will be people along the way to tell me where to go." You might have some more questions for them. "Don't you think that at some point you're going to get exhausted and want to quit? If you haven't prepared, how will you have the resources to keep going? Wouldn't you like to know something about the course - where the steep hills are, where to save your energy, where to expect things will be tough?"

If this person then tried to run a marathon, and dropped out at mile 10, or had a miserable time, and then told their friends how horrible marathons were and how stupid someone would have to be to go through that awful experience just to prove they were "tough"...wouldn't you be skeptical about their opinion? And yet that's where we're at in a lot of ways. Many women see unmedicated birth as some kind of test that you pass via sheer endurance and "feminist masochism", as one doctor in "The Business of Being Born" puts it. There's often a vague, generalized perception that drug-free is "better", but without much clear understanding of the actual risks of drugs. If you "try" to have the unmedicated birth and "fail", then you have a lot invested in trying to convince people that this "test" is silly and has no bearing on your strength, motherhood, or womanhood (a position I agree with completely). I think many of the birth horror stories and dismissive "just take the epidural, honey, you're gonna need it" comments that pregnant women here come from that place.

On the other hand, if you approach natural birth with the mindset that this is a rare and challenging event that you would like to fully experience, with interventions available whose risks you'd prefer to avoid, you can prepare for it. You can take classes, read, and find good coaches and support systems. You can remain flexible and open to changes in the situation. Let's ditch this whole "trying" thing and switch to "preparing".

18 comments:

Abundant B'earth said...

and along those lines we also have this gem: "I'm going to try and breastfeed."
see how that plan is going at 6 weeks, 2 months, 6 months.

publichealthdoula said...

Yes! I used to hear that all the time when I talked to women prenatally. "Well, I'll try, but I don't know if it's going to work out." I always just tried to nicely say, "I'm sure it will work out - I believe almost every woman, with the help of a good lactation consultant, can have a great nursing relationship with her baby". So many people come at it already defeated!

Sarah said...

I love your "trying" to run a marathon analogy! So true, and it sounds just ridiculous in those terms, but for some reason, I hear it all the time regarding birth.

I'd like to give another side to the "trying" thing, though. When I was expecting my first baby, many friends and acquaintances were pregnant as well. Most of them wanted to go natural, and a few stated it as if it were a done deal. There was no way I was going to tell people, "I'm going to have an unmedicated birth," because I had no idea what birth really felt like and if I could actually do it. Those people I saw so emphatic about what they were going to do--almost all of them--then had to eat their words and I believe they were pretty embarrassed. I did prepare and take classes and read up and practice helpful labor techniques, but I believe I also used the term "try" when people would ask (I wouldn't volunteer it). (Just in case it matters, I did succeed in going unmedicated.)Anyway, I think your point is a good one; I just didn't think to use the term "preparing" instead (though I did use it in my birth plan :), and I didn't want to be the one that seasoned birthers snicker at and say, "I *told* you you couldn't do it!" Perhaps there are some women out there who use the term "try" the way I did: so as not to set themselves up for failure like saying "I'm *going* to do this" does.

I do agree with you, though. Such a better way to go about wording it. When I hear a woman say she's going to "try" for natural, I immediately put a vote in the "I'll be surprised if you do" category, and *I know* it can be done! How's that for cynical?

Really enjoy this blog so far. . . I'm here by way of my birthing instructor's blog. Saw your comment and was intrigued.

publichealthdoula said...

Sarah, I'm glad you enjoy it! I agree, the women who say they'll "try" to have an unmedicated birth or breastfeed I always feel doubtful about. That's a good point - when people say "try" they may just be shielding themselves from that "good luck, girlfriend" knowing look. But I think a lot of the people who say it really do mean it that way - "Well, we'll give it a shot. I'll just lie there and endure as much pain as I can" because I think that's the idea a lot of people have about unmedicated birth!

Sarah said...

Just now making my way back to this post. I believe you're right. The majority probably use the term "try" to mean that they'll tough out as much as they can. If only women knew it wasn't about being tough! I've known some very tough women who were not "able" to go unmedicated, (athletes, even!) but it was all about a lack of preparation. It should encourage women to know that even if you're a wimp (I am) you can still totally do natural childbirth. So much of it has to do with your mind.

Anonymous said...

I know this is an older post, but I just had to comment. I love this article - it's SO TRUE.
I've forwarded it to my doulas and I've bookmarked it for myself.

-Preparing for a natural childbirth in April, 2010.

:)

Rebecca said...

I'm so glad you found it useful! Best wishes for your birth and enjoy your preparation :-)

pixie_19 said...

I love your article but would like to add something that I encountered while planning for my un-medicated birth and breastfeeding.

People don't take you seriously. I was a Bradley baby (breech at that) and all my life I've known that I would do whatever I could to have an un-medicated birth (barring any emergencies). I went to the classes, read books, talked to my mom and cousin (who's two children were also Bradley), read whatever I could on-line, and spoke to my two friends (who also planned for Bradley births, one successful and one emergency c-section to save baby's life). I considered myself rather prepared and with my history of pain management (I suffer from severe migraines, nothing helps them) I knew that I could do it. However, most people to whom I spoke about an un-medicated birth laughed at me, in my face and said I could never do it, that I would change my mind, that I should just get the epi and stop being crazy. Even my Bradley friend said, well you can try but it might not happen.

I encountered the same problem when I mentioned I was planning on breastfeeding, and doing everything within my power to make breastfeeding my baby a success. The same Bradley friend, who breastfed her LO, said you're going to "try" to breastfeed. I didn't go into this feeling defeated, I went into this with the very same people who planned the same things I did, trying to defeat me. I know they were trying to say, "if it doesn't work out, don't be too hard on yourself" but that's not how their message comes across.

I did in fact have my Bradley birth, and the idea of asking for medication didn't even cross my mind...not once in my 32 hours of excruciatingly painful, back to back contractions with no respite did I even think of asking for an epi. I mustered my strength, of which I had very little left and soldiered on to give my baby what I thought was best for him. I succeeded because I am strong willed, I believe in myself and I know that if I believe in something enough I will find the strength to accomplish it.

I then had problems with breastfeeding. My baby couldn't latch and my supply was getting low because he wasn't eating enough. I went to an LC (and $300 later, and I'm not making any money), I have been working with a nipple shield to train my baby, and a pump to keep up my supply...so far he's improving but two weeks into his life we're still working on the problems. But I haven't given up, despite the pain and frustration.

Back to my point, I never said I was going to "try" or was "planning" an un-medicated birth or that I was going to "try" to breastfeed. I said I was going to have an un-medicated vaginal birth (barring any emergencies) and I was going to breastfeed. I told everyone I was going to do whatever it took to make it work. I never doubted myself, my strength, my will to accomplish what I felt was right for my child. But, I met with a lot of resistance even from people who had tried what I was planning, they tried to break me and luckily were unsuccessful.

I think this is why so many women say "try". There is so much opposition to nature, so many people trying to make you feel like you can't do something because they're too afraid. They take it out on you, and some women aren't strong enough to trust that they can do it, so they decide they'll try...because they don't have the support they need.

Regan Anne said...

I love your marathon analogy. It's so absolutely true. I think you have to either commit to an unmedicated birth or not. If you take the "try it and see" approach, the temptation to say "I've made it far enough" is too strong. Of course things might not work out for you, just like in a marathon-- sometimes you MUST have a c-section, just like sometimes you break your leg and can't run 10 more miles on it. But you have to make a deal with yourself ahead of time that you will continue as long as your body will let you, and you agree not to consider the alternatives mid-stream. It worked for me. While I was in labor I thought, "this is nuts! Why am I doing this?" but I had promised myself I wouldn't even think about pain meds. Once it was all over, I was able to look back on it as the amazing, life-altering experience I'd expected it to be.

Rebecca said...

@Pixie: Congratulations on your baby, and on your success in having the birth you prepared for! There is a lot of negativity, and I understand the hesitance to take a stand about preparing for an unmedicated birth (and potentially have people waiting for you to "fail" so they can be "right"). I wish those comments didn't happen!! Still, I do think it takes preparation - whether or not you want to talk about your plans/preparations with others.

Best of luck with breastfeeding! I hope you're getting the best support you can.

Sarah said...

Rebecca, I was just sent in the direction of a post on another site that was awesome. . . and familiar.

I'd like to let them know you are the author, and will try to do that, but thought you might also want to claim authorship of the piece that ends: "author unknown."

Here's the url: http://www.birthresourcenetwork.org/blog/94-why-you-shouldnt-try-to-have-an-unmedicated-birth

Expectantly Looking Forward said...

Great post!! Glad to see it is making the rounds on Facebook and Twitter. I will have to re-post on both as I picked it up from San Diego BirthNetwork.
Stacy Lowery Pagan
Expectantly Looking Forward

Rebecca said...

Sarah - thanks for the link! I'll let them know.

Chrissy said...

What an excellent analogy with the marathon. i really like that! I approached childbirth with exactly that 'well i'm just gonna dive in there and people will direct me when i need it' mentality, and i felt SO lost and out of control. I didn't know how to manage my pain, and i was so uncomfortable speaking up, when i had never met the hospital midwife, who then of course left me as things started to get really hard, because it was time for a shift change. THANK GOODNESS i had put my hand up to have a 'student midwife' follow through my pregnancy and she stayed with me through the entire birth, and tucked me in bed afterwards telling me i had done a great job, she was a godsend.
I am now PREPARING for the arrival of my second child, I'm terrified of going back to hospital and having shift changes so i don't know the people coming and going throughout, it seems so unnatural. But this time i will take responsibility, learn where the hills and steep sections of my marathon will be, and how to go about conquering them.

Rebecca said...

Chrissy, I'm glad you liked the analogy! It sounds like your student midwife functioned as a doula who provided continuity for you through all the shift changes...can you ask for another student midwife, or find a doula who can work with you this time around? Either way your preparation will surely help!

Annie said...

I also really liked your analogy of a marathon. With my first birth, I had to have an OB/GYN because there wasn't a midwife available for me, so I ended up in the hospital where you can easily request an epidural, instead of having a home birth like I wanted. After 6.5 hours of intense back labour, they gave me morphine "to ease the back pain", which did nothing and then I finally requested an epidural. I also had the notion that I would "try" and I wouldn't beat myself up if I couldn't do it. I also had my doctor, who flat out told me I wouldn't be able to handle it. My mom had given birth three times without any meds, but she had no idea how to coach someone, so when I asked for the drugs she just told them to give me drugs.
When I was pregnant the second time, I had a midwife and was able to have a homebirth. With homebirthing, there is no option for drugs so you have to really make up your mind going in. I was dead set against drugs and was able to give birth to my beautiful son, then my second daughter 21 months later, with no interventions, no drugs, no medical help of any kind! I definitely had people who said I was crazy and why would I do that when I could have an epidural. I simply tell them I'd had a birth with drugs and it was a harder recovery and I didn't need to put drugs into my brand new baby's little body.
I'm so happy I was able to give birth unmedicated and I wish everyone could have the same experience.

Lisa said...

Great post! I definitely prepared for my natural labor and delivery every bit as much as I prepared for the two marathons I finished when my baby was three weeks and seven weeks, respectively, in utero. The word choice is important, as it influences how the mother-to-be regards her responsibility and role in the birth, which in turn will influence those she speaks to about her experience.

Doula Brandi said...

Great post! Educate and Prepare! A great approach to birth and life in general!