Hospital birth

Mama Leigh’s Birth Story

“For those and for so many acts both evident and subtle which have fueled the illusion of
separateness: we forgive ourselves and each other; we begin again in love.”
(R. Eller-Isaacs)

Prenatal period
The question that has come up over and over for me, as I think about birth in general and
my own daughter’s birth, is if maternity care providers really have mothers’ and babies’
best interests at heart, why aren’t they following evidence-based practices? I had read about
the Farm and the amazing outcomes there – better than hospital outcomes – which made
me think that out-of-hospital birth could be safer than hospital birth for low-risk women. Of
course, there was still a remote chance of a medical emergency, so I thought I could kind of
game the system and give myself the best odds of having a safe birth: to have a “home birth”
in the hospital – no interventions as long as everything was going well, but at least be close
to the OR in the rare chance of needing it. Now I am starting to realize that going up against
the system is like David and Goliath, and here is why.

At the beginning of my pregnancy, I didn’t have any strong feelings about birth, other
than wanting to have the safest one possible. But learning more about possible scenarios,
hospital routines, and interventions, I quickly realized that I wanted a natural, unmedicated
birth as possible. We signed up for the Bradley method class and I read a lot about different
options. At a prenatal visit around 6 months, I brought my birth wishes document to my OB,
and she told me that I had to have an IV for the epidural (me: “I don’t want an epidural”),
if I had a slow labor I “wouldn’t be able to handle the pain” (what she probably meant was
that with a slow labor they would probably have blasted me with so much pitocin I wouldn’t
have been able to breathe), even though she had had 3 unmedicated births, but “only
because they were fast labors. You know, the doctors and nurses are there to help you, and
these drugs are extremely safe.” As a graduate student in Neuroscience I knew that it is
scientifically impossible to prove that something is “safe” – at best you can show that there
are no known adverse effects, or that one procedure is safer than another. I could see that
she was lying to me about the risks and benefits of drugs during childbirth. I was shocked
and felt belittled, and I never went back to Dr. Misogynist.

I transferred my care to a nurse-midwife with a very gentle manner who attends hospital
births, who believed in normal birth, and who stated didn’t have any problem with the
requests in my birth plan. She also took the time to listen to me and give me advice
during the prenatal visits. I was very happy to have switched. Then I hired a doula whom
I trusted deeply, and ordered a birthing pool to take with me to the hospital (to labor in).
Finally, having taken these steps, the anxiety dreams about being forced into unnecessary
interventions started to subside.

But as I reached 40, and then 41 weeks, my midwife began to pressure me a little bit to be
induced. This was extremely stressful for me as I knew that induction necessitated IVs (I
HATE needles), continuous monitoring, painful contractions, and a higher risk of C-section.
To top it off, my husband was commuting back and forth weekly between our home and
his new job 800 miles away. He had flown in on my due date, and had only one more week
before he had to go back to work.

We tried every possible natural way of starting labor, but nothing worked. Yet, I was
determined to remain positive no matter what! At my 41-week appointment (a Tuesday),
my midwife swept my membranes (I was 1cm dilated and 80% effaced) to get things going

(I wouldn’t have agreed to getting my water broken, but I figured the sweep was better than
pitocin) and sent me for an ultrasound and some more monitoring. Everything checked
out fine – baby was doing great, so they sent me home but “made” me book an induction
appointment for Thursday afternoon.

EARLY LABOR

We went out for a nice dinner and I started to have mild contractions 10-15 minutes apart.
I was very excited! I bought some castor oil, too as a last resort should Thursday come
with no progress. But my doula and my midwife warned me that they had seen unpleasant
effects of castor oil and not to take it – though I couldn’t imagine that those effects would be
worse than a pitocin induction. My husband was really freaked out about it, too, so I didn’t
take it. We walked around town after dinner and then when I got home, I got in the shower
and asked my husband to time the contractions (which were getting stronger), but he was
really tired and also feeling quite anxious. I went to bed.

I woke up at 5am Wednesday, feeling I was definitely in labor now. I started to bake
cookies, my labor project, which was great at keeping me distracted for a little while. Then
I went back to sleep, and got up at 9am. I took a dose of my oral antibiotics (because I
was GBS+). After having contractions 3-5 minutes apart for 1 hour, I called my doula and
said I might need her soon. She arrived mid-morning and we had a lovely time hanging
out – she diffused the tension, and the three of us had a really nice time walking around
the neighborhood and eating lunch together. During that time the contractions varied,
sometimes were 7-10 minutes apart, sometimes 5-6 minutes. The pain was completely
bearable. I rested again for an hour or so, then contractions were 2 minutes apart and
getting stronger, so we got ready for the hospital. The nurse checked me and told me that
I was only 2cm dilated, 80% effaced and -2 station. I was upset, but my doula had lots of
encouraging words. We went home to rest more. Thank goodness for that, as the next day
was going to be a very long one. I managed to sleep a few hours and then the contractions
were pretty strong again for an hour or two early that morning.

At the HOSPITAL
At 6:30am Thursday we went back to the hospital. I had already been in labor for a day and
half, but could have coped fine for awhile more at home – there were just three issues. A), I
was on the schedule to be induced that afternoon anyway, and I knew they couldn’t induce
me if I was already there in natural labor. B), my back hurt and I wanted to get into the
birthing pool, which I couldn’t set up at home because I needed it at the hospital for when
things got really intense, so that I could avoid using narcotic pain relief. There were a lot of
inductions on the schedule and I was afraid that I wouldn’t get one of the rooms that would
be big enough to put my pool in. C), My husband had to fly back to his job in 5 short days
and I was really eager to get this baby out and enjoy her first. I thought I could will her out…

I remember the twenty nursing students in the lobby as I entered the maternity ward
entrance to the hospital, asking if I was okay every time I had a contraction (had they
never seen anyone labor before?). One great thing about that hospital is that you don’t go
through triage when you arrive in labor – you just stop by the nursing station, give your
name, and they send you to your LD room. I had a very big room with plenty of room for
the pool. Enter nurse M., who seemed pretty laid back. I consented to be checked – only 2+
cm. I couldn’t believe it – a whole night of labor at home and I had barely progressed. But
the Bradley training helped so much with this – I was determined to be patient! And Nurse

M. had some great words of encouragement: “the goal is not 10! The goal is 4. The first 4
centimeters are the hardest, then things will go on their own.”

To my surprise, nurse M. also responded very positively when she saw my birth plan, and
was happy that I brought extra copies of it, which she distributed to other staff members.
We went through each item together, and she showed respect for my requests. I was
thrilled. She told me that her sister had had an unassisted home birth in Canada, so she
had an appreciation for the whole range of birth choices. She said no problem that I wanted
to eat and drink during labor, but I had to agree that it would automatically disqualify me
from having an epidural. No problem, I really didn’t want one anyway! Now I knew that she
wouldn’t pressure me to take the drugs. I felt relieved by this, too.

As requested in my birth plan, after the initial blood draw, they left a hep-lock and not an
IV. The nurse got me set up to receive the IV antibiotics at the same time as the “required”
15 minutes of fetal monitoring per hour – I sat on the birth ball during this time, so at least I
wasn’t flat on my back in the bed. The first dose was not too bad and the contractions were
not coming as strong as before. My midwife came in to check me around 9am and told me
that my friend A. from my childbirth class – who had switched to my midwife just a week
prior- was down the hall giving birth! I was excited for her and surprised, and envious, too
– she was 2 weeks before her due date and I was 10 days after mine! Why was this labor
soooo slow? The nurse told me to use nipple stimulation (also stipulated in my birth plan)
so I wouldn’t “have” to have pitocin, as my midwife wanted to speed things up already. I
was dead-set against the pitocin, as the nurse and I both knew I didn’t want to be constantly
hooked up to all those monitors.

We called my doula and she arrived about 11am. I don’t remember, but I must have allowed
another exam and I was about 3-4cm. The nipple stimulation had worked, without me
having to be in on the monitors as I would have had with pit! Things were starting to get
intense – I was so glad my doula and husband were getting the pool set up. I got into the
pool shortly around noon and was soooo happy and relaxed – my back pain was relieved
and I could barely feel the contractions. The water was a bit hot, though, and I felt bad but
I had to ask my birth team several times to add colder water. After about a half-hour it was
time to go back on the monitor. To avoid making me get back out of the pool, my nurse and
the (male!) nursing student who was helping her went searching around for a way to use
the Doppler under water, or check heart tones with a stethoscope. They were so genuine in
this – I really appreciated the gesture. Finally I did have to get out of the pool, as we were
not able to find a waterproof solution.

It had been 4 hours since my first dose of antibiotics so they started them again while
doing the monitoring. Baby’s heart tones looked great, but the monitor was uncomfortable.
This is where I really started get stressed out. The antibiotics really burned me at the IV
entrance site. I have very sensitive skin on my arms – it is even hard for me to find shirts
with seams that don’t irritate me. I burst into tears and cried to my nurse and my midwife
that the IV was hurting me more than the contractions. They said that shouldn’t be the case,
but couldn’t find anything “wrong” with the IV site. I started to feel this internal conflict
about being there at the hospital. Well, this is what I had chosen and now I had to suffer the
consequences. The nurse told me if I really didn’t want the heplock, she could take it out
after the antibiotics, but that if there were a real emergency she reserved the right to re-
start an IV very quickly and not necessarily nicely. She was clearly not threatening me– I felt
like she was just being honest. Later I realized that if there were that kind of emergency, lots

of things would be getting stuck in me not nicely and that would be a moot point about the
IV. I just didn’t know what to do. I mumbled something about keeping the heplock “just in
case for the baby”.

We decided to go for a walk down the hall and see our friends with their brand-new baby,
the ones from our childbirth class. I remember rushing out the door of my hospital room
so that my midwife wouldn’t come back and try to convince me to do another vaginal
exam yet. I knew that I hadn’t progressed in the past hour – I could feel it, and my midwife
was beginning to annoy me. I didn’t feel like she was being very supportive – if I could be
patient all this time, why couldn’t she? I could see that she was annoyed with me, too, which
made me feel even worse. I was also aware of the scientific data showing that stress can
slow down labor, so the whole situation was really bugging me.

The walk to the other wing of the ward did a world of good, and it was thrilling to see my
friend A. holding an actual baby! So there is actually something that comes out at the end.
Plus, she had an unmedicated birth, which she had hoped for. I knew I could do it, too! I was
re-energized!! The walking also helped, although I thought it was funny that hospital staff
kept stopping and asking me if was okay. I was just having contractions, duh. Anyway, every
mom in labor should get to visit her friends down the hall and see their newborn. It really
got things going for me.

At 1:40pm I was back in my room, and tried to decline an exam, but my midwife insisted.
I was 4+, 100% effaced, and zero station. I already knew I hadn’t progressed much since
two hours ago! Why couldn’t she just trust me that I knew how to listen to my body? I got
back in the pool to try to relax. That helped so much. After about 15 min I started to throw
up into those little bins. I was so worried that my husband would get sick – I knew he was
queasy about vomit in general, but he held up just fine. My doula convinced everyone to
leave us alone for another 40 minutes and I got back into the pool at 2:20 and was able to
relax again. I started using visualization techniques, from Birthing from Within and some
others I devised on my own. I was trying to imagine the contractions increasing in intensity
on an imaginary dial, while imagining that my PERCEPTION of the pain on the other hand
was decreasing on a second dial. It seemed to be working!

At 3pm my midwife came back again and I consented to another exam: 5-6cm and
very stretchy. I was feeling a little more encouraged now, and the pain was still totally
manageable. I opted to stay out of the pool as I felt that my blood pressure had dipped (I
didn’t need to be monitored to feel that) because the water was still too hot.

Here’s where my memory of exact sequence of events starts to be hazy, and the memory
of the emotions is very strong. I started to throw up a LOT. I actually didn’t mind – I could
feel that it was just my body pushing the baby down. Also I had been sneaking a lot of food
out of fear that I would later be deprived of food and drink. At my prenatal visit where we
discussed the birth plan, we had a deal about no IV solutions (except the antibiotic), unless
I was “throwing up all over the place”. Just my luck. I felt beholden to that deal now and my
midwife insisted on the continuous IV. It was such a hassle dragging that thing around and
my arm still hurt. I went to the bathroom a lot as that seemed to help me labor, but I hated
feeling chained up. Well, I felt like I had to play by their stupid rules now. I couldn’t go back
in the pool either, and my back hurt.

At 3:30 I got onto the bed on all fours. My doula wrote: “She likes double hip squeeze. I can

feel baby moving a lot from the back of pelvis. I think baby is posterior, trying to keep her
on knees with hips up and rocking and swiveling hips. Dad could feel the baby moving too,
through the back.”

At 5:09pm I got checked again – still 5-6cm and zero station. I knew from the Bradley class
that I could have just plateaued for a little while to give my body a rest, but I was feeling a
lot of pressure from the staff to progress faster. Then I started to feel very weird, almost
light-headed. I couldn’t think straight and I was angry about that – I hadn’t had any drugs,
what was going on? My doula reassured me that I was just tired from 2 days of labor. I
broke down and cried that I wasn’t ready to be a mother yet. I wouldn’t know how to take
care of a baby. She reminded me that I had been incredibly patient so far and therefore
would be a great mother. I felt a little better. I asked the nurse if the antibiotics in my IV
could be making me feel so loopy, but she said that wasn’t possible. I was still mad and
confused. I asked my doula if I was in transition, and she was like, yes, of course! So that’s
probably why I felt like I was going crazy. Knowing that also helped. (A year or two later
when I got the itemized bill for the hospital, I saw a charge for metaclopromide, which is
sometimes used to control vomiting during labor, and can make you feel loopy!! Yet there
was no order or record of this medication being administered to me during labor, so it
remains a mystery.)

By 6:30 I was at 8cm! Things had gotten so intense in the last hour. Secretly I was hoping
that they would just knock me out, put me under GA and pull out the baby. But I knew that
was too risky to ask for. I kept thinking about all the risks of all those drugs. Nope, not
worth the benefits. I wasn’t going to subject my body or my baby to that. I thought about
friends who had natural births and had no regrets. I knew I could do it if they had done it!
At the same time, I could finally understand now why some mothers would want pain relief!
Yet at that point I didn’t want any more needles. If an anesthesiologist had come in offering
an epidural, I was sure I would have run away screaming. I wanted to be left in peace a
little, but clearly that wasn’t going to happen. We continued nipple stimulation, which had
really been working well so far. My whole body was really tired and I couldn’t go back in the
pool with the IV etc. Every muscle in my back and legs was just exhausted. I read through
the letter we had written to the baby a few weeks before. I told our doula the name we had
chosen, and started to feel a bit better.

At 7:40pm, I allowed for the umpteenth exam- just anterior lip now! I wasn’t feeling any
urges to push, but my midwife said I had to because baby’s heart had started to beat so
fast – 180’s -190s during contractions. However, between contractions it went down to
160s and was just fine. The pushing was horrible, especially with my midwife’s fingers
on my cervix trying to push away the lip. I had read that pushing would feel so great in
natural birth, so I was disappointed. I was really straining, pushing so hard. I tried to use
the squatting bar on the bed, but after about an hour I just couldn’t hold up my own body
anymore. Too tired.

At 9pm my midwife called her backup OB because the baby didn’t appear to be descending
and heart rate was too high. I was petrified. No pain I had gone through in the last few hours
could equal the fear – of surgery and of something going wrong – that I felt when she left
the room several times to talk to the OB on the phone. He arrived at 9:30pm – I refocused
and devoted all my brain power to pushing. With every push I visualized the baby coming
out. I asked to push on all 4’s again or squatting, as I loved squatting so much during late
pregnancy and I knew it could help a lot. She said no because she “wouldn’t have enough

control then”, so I stayed in an semi-upright modified lithotomy position on the bed, with
my legs held back. My doula and husband held my legs and gave me ice chips. I asked for
a honey straw, but my midwife said no “just in case” I had to have anesthesia thereafter.
Everyone in the room was cheering me on. I didn’t know what the risks or benefits of using
oxygen were, but I felt I could barely breathe so I was self-administering oxygen at that
point. I felt pretty frustrated and couldn’t understand why this was happening – I hadn’t
had that infamous cascade of interventions, but still things were not going well. The baby
warmer beeped every couple of minutes, and I had a prime view of the clock from the bed.
Not helping!

The OB sat in the corner, and to my relief, said nothing and did nothing. I found out later
that he had the vacuum extractor ready. He didn’t need it though – at 10:01pm I pushed
out Baby C., kind of on my own, with my midwife pulling pretty hard on her shoulders. I
was so excited that she actually came out! Unfortunately my midwife felt she had to cut
an episiotomy, which then tore even more – came close to a 4th degree laceration. In my
prenatal visits she had told me that she rarely ever does them, so I felt confident that given
the present circumstances, it was truly necessary. I also found out later that when the OB
was called, the nurse had also brought in the C-section preparation bag. Thank goodness it
didn’t get used. I still cannot believe how close I came to having a C-section though…

POSTPARTUM
All day I had been on a slippery slope of losing control of what was happening to my body,
and this peaked right after the birth. I had written in my birth plan: “I plan on breastfeeding
immediately after baby is born. I would like to hold my baby and have assessments done while
my baby is in my arms if possible.~ Please delay weighing, footprints, & eye ointment until we
have had an hour to bond. ~ Please bathe baby in my room.~ Dad will stay with baby at all
times.” This was not WHO-designated Baby-Friendly Hospital though, and the staff didn’t
change their routine just based on my initial request.

There had been a shift change, and my wonderful nurse M. had gone home by now and
my midwife’s demeanor had totally changed from nice and supportive at prenatal visits
to all-business and also still annoyed with me. I never consented to the pitocin they used
to deliver the placenta, and I complained as she pushed hard on my abdomen to deliver
it faster. I was supposed to be holding my baby now and breastfeeding! What was going
on? No one was listening to me. I started babbling on about how this was like my Master’s
degree year… 9 months of hard work and really hard at the end… The “baby nurse” (with
whom I hadn’t talked at all, and who obviously never saw – or didn’t care about – my birth
plan) was over on the far side of the room doing the assessments and the bath. “Big hands
and big feet!” she called. I still had not really seen my baby. My husband was nearby, and
got to hold our baby and cut the cord after they collected the cord blood, which we were
banking. He was thrilled to hold the baby. My doula was busy putting the pool away. No one
was advocating for me. I had wanted to breastfeed right away and do skin-to-skin. I was so
tired of fighting for myself, I just resigned to the fact that there I was, we were both healthy,
and I hadn’t had a C-section. It took a long time to sew me up – apparently I had lost a lot of
blood, and I needed a lot of stitches to repair the laceration. I was so glad I had not asked for
an epidural – there is no way I could have pushed so effectively if I’d had one.

Baby C. was 8lbs 2oz, 21.5 inches long, with Apgars of 8/9. Apparently they had been quite
concerned about her because her heart rate had been so high, and they “had” to examine
her quickly after the birth. She was totally fine at 5 minutes after the birth. Then they just

took at advantage of the situation and didn’t return to her to me until 11:03pm, bathed and
dressed and swaddled like a sausage. I tried to feed her but I was suddenly exhausted and
I have flat nipples so it was hard to keep her latched on. She must have gotten at least a
little milk, as I had so much colostrum during labor. My doula tried to help me a bit with the
latch, but the hospital staff was not around now to help (where were they when I actually
needed them?!). I couldn’t get up from the bed as I had local anesthestic from the repair and
was really sore. I felt helpless. The surge of endogenous adrenaline from the natural birth
had started to wear off, and I went from ecstatic to deliriously tired. I said goodnight to my
doula – she had had a long day and it was her birthday, too! Then I was transferred to a
recovery room in the Pediatrics wing, as they had run of room in Maternity. My husband fell
asleep on the empty bed beside me.

What followed in the next 36-hours was a total fiasco as I struggled to establish
breastfeeding. I felt detached from my baby – here was this little alien wiggling around
like crazy and crying and she was not getting latched on. Some of the nurses who were
lactaction counselors helped me with some of the feedings, but I couldn’t get her latched
on without their help. We tried skin-to-skin and that helped a bit, but the latch was still not
good and my nipples started to bleed a lot. Here I was feeling like a total fool. I had done all
the “right” things (natural birth, rooming in, no pacifiers or bottles or glucose water, etc)
and nothing was working. Why had I thought I would be able to breastfeed just because it
was important to me? Yet the difficult birth gave me confidence. I had this deep feeling of
yes, this baby will be exclusively breastfed come hell or high water, I WILL stay positive
and I WILL get this right. The next day a nurse brought me a breastpump to help “pull my
nipples” out- whilst using it for a few minutes before each feeding, I pumped over 3oz of
colostrum. Liquid gold, right? Well, 8 hours later it ended up in the trash because no one
was around to show me how or where to store the milk and clean the pump parts. The
second night (24 hours) after the birth was the worst – I kept trying to call my nurse, and no
one came for, hours. Finally a “tech” person came and told me my nurse was busy catching
other babies. I needed help getting my daughter latched on – she had gone from a little bit
lethargic (from the very long birth no doubt) to over-hungry and fussy. We did manage a
few short feeds in that time.

Finally at midnight our nurse came and then called our pediatrician to inform him that the
baby hadn’t had any wet or dirty diapers since the birth, and that we would have to have
her kidneys checked with ultrasound if she didn’t have a wet diaper soon. He prescribed
formula supplementation for our baby over the phone (sight unseen!), which the nurse
said we could administer with a syringe and tube rather than a bottle. I was crushed. My
husband begged me to “listen to the doctor”, and I was just so confused and deliriously
tired. I gave in – he gave her the formula, and she promptly pooped. We were told to
supplement after each feeding for the next 12 hours, and no one suggested that I give her
the copious breastmilk I had been pumping out and didn’t know where to put. By the time I
had my wits about me again and got home (about 36 hours after the birth), I was pumping
a lot of milk and knew how to store it, which we gave in a bottle after each feeding for the
next few days. It took a few more weeks to get the latch right and a whole 7 weeks for one
of my cracked nipples to heal, but I never again supplemented with formula, and I kept
breastfeeding my daughter until she was 15 months old and we both ready to move on. The
thing that enrages me to this day is that the staff and our pediatrician were not following
the science-based protocols for supplementation, and certainly the hospital procedures
were setting me up to fail at breastfeeding. Persisting at breastfeeding turned out to be the
best decision I ever made, and was still totally worth all the initial struggle.

My midwife’s backup OB stopped by the next day to “check” on me. He barely touched my
abdomen and didn’t even look at my stitches, then asked if I needed stronger pain meds
than just plain ibuprofen. I hesitated and said, “Well, I read about a breastfed baby that died
because he hypermetabolized the codeine ……”, but Dr. Big Oaf waved his hand in the air
(like “that’s nonsense”) and then walked out of the room. Great bedside manner. An hour
later my midwife came back – her nice, gentle personality was back (um, where had it been
during the birth?), and she spent about an hour with me talking to me about postpartum
care and recovery and actually looked at my stitches. I felt human again.

REFLECTIONS

When I think back now I still have really mixed feelings about the birth (4 years later!).
There were some bright spots, of course – that great nurse, as well as my husband and
doula who both did so much to help me (massage, acupressure points, and lots of verbal
encouragement). We were all “fine” without any apparent medical trauma. And I had a
natural birth in a hospital setting, which is what I was aiming for– it seemed to be the
best decision given the information and choices I had at the time. The recovery was not
so bad at all, except the perineal soreness from the episiotomy and some muscle aches
from the pushing, and I was so appreciative to not be in mind-fog from narcotics during
labor or postpartum. But I was also very disappointed in my midwife, who seemed to have
temporarily pulled a bait-and-switch and was not very accommodating during the birth
and did not do anything to facilitate that crucial initial skin-to-skin contact between my
baby and me. I had trusted her and she betrayed me!! At a postpartum visit, she said to
me, “You know, I don’t really believe in home birth, but you would be a great candidate for
home birth. You really didn’t want to be messed with.” Part of me felt validated hearing this
candid opinion, and part of me was mad. I had specifically told her at a prenatal visit that
I did want a home birth-like experience and was planning on a gentle hospital birth with
interventions only in the case of a real emergency. Why didn’t she believe me the first time?

Intuitively, I had always known that I wasn’t going to want to be “messed with”, which
is why we did Bradley method and why I wrote my birth plan and switched away from
horrible Dr. Misogynist (thank goodness also for that – I can’t imagine how awful the
birth would have been with her). I thought I would have true informed consent for any
procedures, especially during recovery. I thought my midwife would help me have a gentle
birth, but I misread her and didn’t realize that she was a midwife who really likes epidurals
and pitocin, as she told me later. I guess I was wrong about a lot of things. Writing this now,
having just heard of Whitney Houston’s death, I am reminded of one of her songs that was
a childhood favorite of mine… “No matter what they take from me, they can’t take away
my dignity…because the greatest love of all is happening to me…” Well, actually, they did
take away my dignity and furthermore jeopardized my breastfeeding relationship with my
daughter, with whom I didn’t really bond very well during the first couple of weeks. I know
that the care I received was not abominable and that it was better than the care that many
women get in the U.S. and other countries, but here is the truth: it was not the care I wanted
or deserved.

Having now read a lot of research on evidenced-based care that came out recently, and
then reading the excellent exposé “Born in the USA: how a broken maternity system needs
to put mothers and babies first” by Marsden Wagner, I finally started to better understand
what real choices are out there and how far the system is from aligning with actual human

physiology. Now that I have my PhD in Neuroscience I can really see a lot of the flaws in
the current interpretation of the standard of care. I realize that most of the trouble started
with this obsessive expectation of my midwife’s that I had to give birth by 41 weeks. With
the benefit of hindsight, having my membranes swept was probably a mistake – the 52-
hour-sluggish labor was probably a result of this “natural” (but not really) induction. My
daughter was probably not well-positioned to come out yet, and by forcing things along and
ending up at the brink of a C-section, we (my birth team and I) put both of us in the very
potential danger that I was trying so hard to avoid. Time and again I was asked by these
health care providers to ignore my maternal instinct and intuition. Futhermore, before
reading Dr Marsden’s book, I did not have a clear sense of my rights as a patient. On the one
hand, I felt that I had entered into some sort of contract with the hospital and my midwife
– by choosing to give birth there, with her as my birth attendant, I had to go along with the
hospital “policies” and follow her orders. On the other hand, I sorely underestimated the
tension and stress that would be created by asking to deviate from their protocols even a
little, especially in terms of frequent vaginal exams and the IVs. Did stress slow down my
labor? Very probably. And if I had actually stayed at home, set up the birth pool and labored
in it until I was around 8cm, would that have changed the outcome? Would my baby have
been better positioned? If I had insisted on pushing in a squatting position at the end, would
that have made a big difference? It is just impossible to know.

Expectant mothers should not have to make this difficult choice, this way, this Catch-
22. I (somewhat knowingly?) traded in dignity and respect, evidenced-based practices,
the possibility of a gentle birth, in order to be in close physical proximity to an operating
room in the very unlikely case that a true (non-iatrogenic!) urgent emergency occurred.
The consequence of that choice is that I was subject to non-evidenced-based procedures
that could have sacrificed mine and my baby’s health and well-being. Since then I have
read hundreds of birth stories and also a lot of scientific literature with a lot of statistics,
and here is the conclusion that I have come to: while it is technically possible to have
an unmedicated birth in a hospital, it is unlikely, as the so-called “standard of care” (if X
happens, do Y intervention, etc.) sets most mothers up to “fail” at this. It is not necessarily
enough to take a natural childbirth class, read a lot of books, have a doula present, practice
pain-coping techniques and meditation, plan on “staying at home for as long as possible”
and have birth plan, because all of this will go out the window if the hospital is not following
evidenced-based recommendations for induction and C-section and other procedures (i.e.
the research shows very low rates of induction and C-section and epidurals – and better
outcomes – when evidence-based care is used). Furthermore, it seems to be extremely rare
to have a gentle home-birth like experience in most hospitals, even among those cases of
unmedicated birth.

So maybe I can stop beating myself up now that I have realized that I was shooting for
something virtually unattainable, at least at that institution with that midwife. And for
the next child, if we have one… obviously, I will seriously consider out-of-hospital birth,
and most importantly: I owe it to myself and to my family to find a care provider whose
philosophy aligns well with evidence-based, women-centered practices: a midwife and birth
setting that I can trust to give me the safest and most humane birth possible. With a serious
dose of dignity.

“For those and for so many acts both evident and subtle which have fueled the illusion of separateness: we forgive
ourselves and each other; we begin again in love.”-R. Eller-Isaacs. (Thanks to my friend Elona Dellabough-Gormley
for sharing this very appropriate quote recently. I babysat for Elona when she was a small child many years ago,
and she is now grown into a delightful young woman, who happens to be a doula and midwife-in-training.)