I’ve been thinking about getting pregnant.
Pregnant bellies have started looking really good to me and I’ve actually felt some jealousy when shopping for baby items and bumping into random bumps. I loved being pregnant and alhamdulilah I had a great birth experience. And of course it’s something that I’d like to experience again.
Naturally, there were definitely some things about my birth experience that I’d like done differently a second time around.
The hospital we chose was AMAZING. Apparently the labour help is top-notch, allowing labouring mothers to walk around and not to be tied down to an IV; no invasive baby monitoring; a low use of invasive delivery techniques such as forceps or episiotomies; and a dedicated nurse to coach you through labour (I wouldn’t really know first hand though, since we essentially walked in and delivered on the spot).
They don’t routinely suction newborns and will hold off administering any injections or clean-up if you request it. And the first place baby goes after being born is directly onto mama’s chest. There baby is left to calm down, breathe, and get some help latching on from lactation consultants if necessary. The aftercare is also brilliant — with daily group breastfeeding help sessions with one-on-one help available. I ended up using their breastfeeding clinic’s helpline almost weekly until Eryn was about 2 months old. They’ve also gone through extensive renovations and now have birthing units so that you deliver and recover in the same room. Each birthing unit is also equipped with a specially designed tub for water birth — which would be really neat in my mind.
Now, there were some things that I could have gone without. We were admitted at 7cm dilation. But within the time it took me to get changed and walk to the birthing unit (oh, about 10 minutes), I had hit the 10cm mark. When I walked into the delivery room I immediately said, “I have to push.” That’s when the nurse gave me a rigorous internal exam.
She swirled her hand around like she was washing rice and I quickly sat up and shouted, “woah! Not so fast!!” To this day I wonder if she was attempting to strip my membranes or trying to get my water to break. Once she determined I was 10cm, she lifted my legs, told me to grip behind my knees and push.
I was overwhelmed, confused and shocked. First I asked about the Hubby and if we should wait for him to come. He was SUPPOSED to be there. He was my voice and my support network. She said push. I then asked about my position — was it alright being flat on my back? In my head spun the unspoken options that we learned about in prenatal class: side lying, squatting, sitting. My crazy, hippy prenatal instructor was repeating over and over again, “avoid giving birth on your back.”
But instead the nurse said, push.
So I pushed. And a cheering purple push squad came into the room. After 10 minutes when her head crowned and the delivering OB came in he said, “stop pushing so hard. Ease into the push like you’re saying ‘house’. The slower the push, the less you’ll tear.” Great advice, but too late. Recovery had some interesting challenges outside of the broken blood vessels in my face.
So now that I’m wiser about how to deliver and I’ve been able to revisit my birth experience mentally and on film (God bless my techno-Hubby), I have a pretty good idea not only how I want to deliver, but how I’ll have the strength of mind to say, “I want to be side-lying or squatting. I’ll have none of the stirrups thank you very much.”
I also have been thinking about having a midwife instead of my OB. But I really have no idea about what the practical differences would be between a supportive OB (like mine was.. late, but better late than never), and a midwife. I could have my awesome OB throughout the pregnancy and end up with a dud on call for the actual delivery — which is what happened with Eryn. I had a dud throughout the pregnancy only to be delivered by Dr. Wonderful.
Delivering in a hospital setting is something I still would like to do, but to have more control over the actual delivery, which is what a midwife could potentially offer. There’s also the continuity of care provided by a midwife that the one 8-week OB appointment just can’t compare to. Instead of running to clinics, calling helplines, making specialist appointments during recovery, a midwife would coordinate all of that, or avoid the issues that would require extended aftercare. In fact, from what I understand, a midwife would also be able to mitigate purple push squad nurses and slow the delivery down to avoid a natural episiotomy (or as Dr. Wonderful told me to watch out for in future: prolapse 
)
What do you think? Anyone with practical experience willing to share?
We haven’t exactly started trying yet, or even really talked about it, but I’m starting to think the Hubby and I should start doing some research and have a couple of numbers on hand in case of a happy chance.
November 8, 2010 at 5:22 am
Have you thought about having a doula? My friend just became a doula here, and it’s something I definitely want, in part because there are VAST differences between the expectations and rights of the patient during pregancy between home and Korea, and partly because I feel like I need an impartial (calm) person who is both reminding me of what I’ve learned in birthing classes and helping me to make decisions in the middle of birthing.
By the way, my friend just had her 1st here, and the nurses were yelling ‘push HARD’ for an hour and a half…when another nurse ran in an said, ‘Oh! I just read that you don’t want an episiotomy…SLOW push!’ Well of course, by that point, it was too late. It’s those kinds of things that make me think that a doula is necessary, but I might just feel that way because midwives aren’t an option here.
November 8, 2010 at 2:38 pm
We looked into getting a doula with Eryn and interviewed 3 people. One just didn’t click and the other two ended up having too many clients to accommodate us. I guess they’re in high demand in this part of Ontario?
It’s not the labour per se that I’m worried about, since I was able to labour well and naturally on my own (I know all pregnancies/deliveries are different though). It’s having the physiological support during the pushing stage that I’m concerned with.
November 8, 2010 at 5:30 am
Salaam Sister, I agree with msleetobe, a doula is very effective in offering a more “down to earth” birthing environment, within a hospital setting – and will also provide to be a voice on behalf of you, helping you get the birth you want.
Have you also considered birthing at a birth centre? These are midwife run clinics, and are much more homlier than hospitals, but with all the modern facilities, and access to back up if need be.
My own birth wasn’t the best experience, but I’ve learnt a lot about what I would want next time around. I have just found out I am pregnant with number #2 and plan on having a doula, and laboring at home as long as possible.
I found your entry via HijabMan’s blog, and the books that he’s listed below your entry are quite good – I love Ina May Gaskin’s writings!!!
November 8, 2010 at 9:32 am
I would recommend thinking about what you want in a birth experience, and write down an exhaustive list of questions to ask your potential care provider. There are good midwives and then there are medical midwives, or ‘medwives’. They are like your purple pushing nurses, only with a midwife badge. Unfortunately, I think most hospital midwives are medwives, in that they are trained to follow protocol to a T. Maybe you can find one that has experience with homebirths but also has hospital privileges? My ideal midwife is one who can quickly recognize and deal with true emergencies, but is hands-off the rest of the time.
With my first one I had found a good group of midwives at a birth center. But because of the rules of the birth center, I was forced to transfer to a hospital because the pushing stage went over 2.5 hours. (It was my first and posterior, so of course it took a long time to push). I received 3 shots of local anesthetic, a vacuum extraction, and 3 episiotomies. They told me I had six contractions to get the baby out or they would cut me open. So I pushed at 200%, couldn’t feel the crowning at all, no one told me to stop pushing so hard, and ended up tearing into certain very painful but muscles and lost all ability to control bowel movements for the first two weeks. I would take the pain of crowning over that anyday! So this time I’m trying to think smarter, and planning a homebirth inshallah where there are much less rules and protocols.
November 8, 2010 at 2:47 pm
Thanks for sharing your experience. I also lost bowel function and was told it was “normal” at my 8 week post-partum check-up. No. It’s not normal. It happens during quick delivery or excessive pushing and can ABSOLUTELY be avoided. It’s embarrassing, painful, and very scary. I can’t believe they gave you a limit. I think it’s just more convenient to get women in and out as quickly as possible. Inshallah you’ll get the delivery you want next time around!
Writing down my needs/questions is a great idea — thanks!
November 8, 2010 at 11:41 am
Asalaamu Alaikum
I think some of the people answering your question are Americans so the situation there is not the same as here. We don’t have birth centres as you know and you can choose between home births and hospital births. The midwives can go to either place they are not stuck only in the hospital. I’ve had 10 kids. 4 with doctors in the hospital (that was before midwifery was legal in Ontario). 6 with midwives of which 3 were homebirths. I love midwifery and I love home births best. What I don’t like is that you can’t choose your midwife. Sometimes you don’t click and it makes things harder. What I love about midwifery is that they are always on call and make house calls and they take care of you and the baby for 6 weeks after the birth and the first couple of weeks they come to your house so you don’t have to drag yourself out of bed. I also like that the appts were for 45 minutes and never felt rushed. With a doctor I just felt like a number. They also help with breastfeeding which the doctor never did (that was before lactation consultants existed.) I encourage all muslims to have a midwife but they never listen except the young ones. The old immigrant ones think I’m crazy and only go to OB’s like they are the end all and be all and consider midwives to be backwards and uneducated even though that is not the case in Canada as they are university educated for 4 yrs. My daughter also went to a midwife and she loved it too. She had a hospital birth. What I also love about midwives is that they are all women (I’ve heard there is one male one though) and most of them have had their own kids so they get what you are going through unlike male doctors. Another thing is that there are a few muslim midwives now. I think two in the GTA and one or two in London.
Still not sure? Pray salatul istakharah. Allah knows what’s best.
November 10, 2010 at 9:05 pm
Wa ‘alaikum salaam Aishah — that’s great information. Again, I’m amazed that you’ve had 10 kids! masha’Allah
Busy lady!
And you’re spot on about istikharah — thanks for the reminder.
November 11, 2010 at 8:46 pm
I loved having a midwife for both my births. the before and after care was amazing, especially as a first time mom.
We had planned a home birth but when my water broke there was meconium so we went to the hospital. The hospital my midwife worked with let her do all the care and then they were there if they were needed.
November 13, 2010 at 2:15 am
I had a homebirth with a midwife last year (in the US). Personally I prefer to stay out of the hospital system for birth matters unless medical intervention is truly necessary. However, I’m aware that not everyone feels that way. To me, the biggest difference between midwives and OBs has to do with their basic philosophies toward birth. The midwifery model focuses on birth as a natural, normal process. The medical model views birth as potentially pathological. Of course, there are midwives who have a more medical view of birth and OBs who have a more midwifery-style viewpoint.
What I liked about having a midwife (vs an OB, which I did briefly see while pregnant) was that we shared the same philosophy about birth, we had longer appointments, there was more attention paid to things like nutrition, and there was less of a “do as I say” attitude and more of an honoring of my choices.
I’m not sure what the status of midwives is like where you live but in some areas it can be difficult for midwives to practice in hospital settings. Also, like a previous commenter mentioned, hospital-based midwives may be more inclined (or forced by hospital policy) to follow a medical model of birth.
It does sound like the hospital where you gave birth has some very birth-friendly policies so maybe you could find out which midwives have privileges there and perhaps interview them. There are books (and websites) with lists of questions that you could use.
Also, I second the suggestion of getting a doula, if possible, for a future hospital birth.
Ultimately it’s going to boil down to which provider you feel will support you in making empowered decisions during your birth.
January 30, 2011 at 4:38 pm
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