When I think of childbirth, I think of hospitals and epidurals and doctors and beds and IVs. Hospital births are the most popular option in the United States, according to What to Expect, and they are recommended for high-risk pregnancies. My pregnancy will be high-risk for complications and c-section, so I likely will have to give birth in a hospital. Other options would be home births and birthing centers. Still, no matter where the birth takes place, there are more options than ever for how to give birth and who is part of the experience.
What to Expect reports that most birthing center and home birth deliveries are attended by midwives, but hospital births can be attended by a midwife or a doctor. C told me that one of the biggest factors in reducing tearing during childbirth is having a midwife. Doctors aren’t actually in the room for the whole process! A certified nurse-midwife and doula can be in the hospital room for the entire labor and delivery to support the person giving birth, while doctors and operating rooms are nearby if needed.
One thing I was particularly interested in is hydrotherapy or water birth. This practice involves laboring in a bathtub or other pool of warm water. Proponents claim it can help with pain, length of labor and risk of tearing. Sounds like it’s worth a try to me. More hospitals are starting to have the resources to allow hydrotherapy, although they don’t allow actual births in water under guidance from the American College of Obstetricians and Gynecologists.
Hydrotherapy is common in birth centers and home births. I’ve obviously heard of home births before (it’s a pretty simple concept), but I learned about birthing centers from my research. What to Expect describes birthing centers as midwife-run, less-medicalized, comfortable places for natural births. Most birthing centers don’t give epidurals and don’t have routine IVs or fetus monitoring. Those in labor can wear their own clothes, walk around and eat throughout their labor. The spaces are usually large, private and home-like. Some birthing centers have options for alternative pain relief such as hydrotherapy and hypnotherapy. Additionally, babies are not separated from parents after birth, and stays are typically shorter than at a hospital. Sounds amazing! Unfortunately, I personally probably need a hospital, but I will definitely be keeping in mind the resources and approaches of birthing centers to incorporate as much as possible into my birthing experience.
Many birthing centers also offer classes, doula recommendations and other support before, during and after childbirth. Birthing centers are harder to find than hospitals (duh) and are usually not covered by insurance. I found some places near me that aren’t actual places for giving birth but offer a lot of the same education, resources and referrals of the birthing centers described by What to Expect.
Besides the high risk of a C-section leading me to need a hospital birth, I also do not want a natural birth. Nothing about pushing a 10-pounder out of my tiny pelvis seems natural to me. Despite my inclination, all birth is natural. The term “natural birth” insinuates that unnatural birth is possible. But just like a woman with a pizza oven once said, “every pizza is a good pizza unless you drop it on the floor,” and I think that’s true for birth, too, in its own special way.
Kudos to those who can do it without meds, but I’m going to have to pass. Luckily, in researching options for pain relief, I learned there are so many more ways to feel better than just a giant needle in the back!
General anesthesia: you CAN be knocked out for childbirth! Amazing! It’s safe but extreme, so this is rarely used except for in emergency situations.
Epidural: two-thirds of hospital birthers use this method of pain relief. It’s a catheter straight into the spine that numbs the lower body. Some people say it is hard to push with an epidural.
Pudenal and Spinal blocks: later-stage pain relief in the vaginal and spinal areas, respectively. Both use the big needle. Pudenal block is most often used in vaginal delivery and spinal block is most often used for c-sections.
Analgesics: narcotic drugs that provide general pain relief through changing the brain’s perception of pain without disrupting feeling or movement. These can be felt by the baby with limited short-term side effects.
Nitrous oxide: laughing gas from the dentist but during childbirth! This reduces anxiety and increases feelings of well-being to diminish pain. The person in labor can choose when to inhale the gas.
Tranquilizers: mostly used only for cases of severe anxiety and/or to increase effectiveness of analgesics. They can make a person quite drowsy but have minimal risk to babies.
You can probably see what I’m most excited about. I’ll take the narcotics, please! But seriously. I hate the idea of being numb all over the lower half of my body. I hate the idea of being limited in movement by a catheter. I hate giant needles in general. I absolutely cannot understand why epidurals are the most popular pain relief option for medicine-assisted birth. Nitrous oxide also sounds pretty good to me. I don’t have to make any decisions for a long time, but I’m really quite relieved to know there are so many options to choose from.
There are even more options in the un-medicated realm, too. Un-medicated doesn’t have to mean painful. Hydrotherapy, acupuncture, massage, electric nerve stimulation, reflexology and even hypnosis are all becoming more widely practiced in the United States. Many of these practices come from indigenous healing practices and women-supported birth, approaches to childbirth before it became medicalized. We are coming full-circle baby!
No matter what kind of childbirth a person chooses for themself, providing more options to all people gives them more agency, voice and comfort in this life-changing event. Childbirth is safer, more comfortable and healthier when we incorporate different types of knowledge, histories and resources for the benefit of those giving birth. I have a lot of time to decide what’s best for me, and obviously one million things can happen between now and the birthday to change my options and wants, but I feel so much better knowing I can have support and resources to ask for what I need. All people should have the same access to all services they may want, unlimited by ability to pay or location or cultural norms. Hopefully by sharing more knowledge about what is possible, more people can advocate for themselves to get the care they deserve.
Sources: https://www.whattoexpect.com/pregnancy/labor-and-delivery/labor-pain/complementary-and-alternative-medicine-techniques.aspx and https://www.acog.org/womens-health/faqs/medications-for-pain-relief-during-labor-and-delivery
