Tuesday, February 15, 2011

Baby Talk- Arguments for Intervention

 First things first, I want to express how deeply my desire runs to have a healthy baby.  This is the number one priority for me.  I have had several family members and friends say things to me like, "Don't get too attached to your birth plan.  Things happen and you may end up with interventions."  I just want to express that of course we are aware that we may encounter complications.  Of course we are prepared for the potential interventions!  In the case of a true emergency where either the baby or I are at risk, John and I will be nothing but thrilled by the level of care offered to us by any of our local hospitals.  This isn't about 'following our birth plan'.  This is about giving us the best chance possible for a natural, normal birth.  Healthy mama, healthy baby- at any cost.  I just so believe that avoiding interventions as much as possible from the start gives you the best chance of both mama and baby being the healthiest they can be.

Ok, lets move on to when medical interventions are commonly offered and when they actually do become necessary.  

There are several reasons commonly used to introduce interventions in labor.  A few common ones for inducing labor are: baby is too big, low amniotic fluid levels, baby is past due, and the waters have broken but labor hasn't started.  

The way to determine weight of a baby is by measuring the length of the femur and comparing it to full term babies birth weights.  This measurement is frequently off by a pound or more.  An average woman's pelvis can birth a 13 pound baby.  This reason is bunk to me.  

Low amniotic fluids is a scary term to throw at a mom.  The way this is measured on ultrasound is by averaging several pockets of amniotic fluid around the baby.  This is clearly not an exact measurement.  A better gauge is monitoring the baby for a normal heart rate and activity.  

A baby being past due is probably the biggest reason people induce labor.  The due date is calculated at 40 weeks and generally first time moms deliver at 41.1 weeks.  As long as mom and baby are both healthy, there is no reason to induce just because you are nearing or past 42 weeks.  Of course, the placenta has an expiration date and can start to disintegrate around 42 weeks.  If this occurs, the baby's heart rate will drop and induction becomes necessary.  

The bag of waters breaking before labor begins is a huge no-no at the hospital.  There is an increased risk of infection and nearly all hospitals give you a 24 hour window to have the baby before they intervene.  What I have learned is that if your waters break and are clean and neutral smelling (no infections or meconium), the baby's head is engaged (cord can not wash under baby's head and cut off circulation), and the vagina remains a one way street (no infectious stuff being introduced) you are fine to birth on your own time frame.  The problem with hospital births is that they can't seem to keep their fingers and tools out of the vagina.  They want hourly exams to check progress, thus introducing an infection risk.  So, if your water breaks and the hospital staff give you an internal exam, you do indeed have a 24 hour window to have that baby before infection becomes a real concern.  

As far as an epidural goes, that is a personal decision for a woman.  I want to avoid an epidural if at all possible for reasons discussed before.  Avoiding induction is a key part of avoiding an epidural.  

I truly believe that the medical community has the best intentions in mind.  I don't think they are 'out to get' anyone.  However, when delivering in a hospital, the hospital follows protocol for everyone.  Everyone is treated in the same manner, no matter their risk level or individual situation.  John and I feel that hospitals treat births like a medical condition, an emergency waiting to happen.  Going against the grain is possible with a strong birth team and thorough birth plan.

Come back next week for "So, What DO we Want?


Funder said...

Being warned over and over that things might not go as planned has got to be so frustrating.

The needle-in-the-spine thing gives me the complete heebie jeebies.

Heather said...

I just don't get why people assume that we haven't educated ourselves to know that birth never goes exactly as planned. If we are preparing ourselves to the extent that we are, wouldn't it make sense that we are also preparing for the 'worst case scenario' as well?