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Becoming empowered to have natural childbirth the second time (even if the first time wasn't great)
by Cathey Thomas

Question: When I had my first baby, four years ago, I wasn't at all prepared for what I would experience. There were a lot of complications and interventions, and everything was just totally out-of-control, especially me! I've regretted the way things went ever since.

I'm expecting my second baby in December, and this time I'm determined that things will be different! I plan to have natural childbirth this time, and want to be really well prepared. My husband is very willing to help me, and we're both anxious to find out what we should be doing to get ready for this birth.

So, where do we start? Are classes really any help? And, if so, which ones are best? Or can I learn everything from books? Can you recommend any?

Answer: First, I want you to know that I think it's just great that you're going to have natural childbirth this time. You'll notice I didn't say that you want to "try" natural childbirth. That's a mistake a lot of people make, because it shows a lack of confidence and understanding that, with the right kind of preparation, support, and determination, barring any serious medical complications, the vast majority of women can give birth naturally if they really want to, and will cherish the experience. Unfortunately, most mothers don't get the right kind of preparation or support in the first place, and don't realize it, nor do they realize the difference it would have made.

Many couples take a series of "preparation for childbirth" classes, typically offered at or through a local hospital, and they logically assume that's enough to enable them to get through labor reasonably comfortably, thinking that they've been prepared for "natural childbirth". Then when they find labor too much to handle, and resort to epidurals and other medications, they naturally tend to draw certain conclusions about the experience, and unfortunately pass these conclusions on to other women.

The first conclusion they tend to make is that women who are able to get through childbirth unmedicated are either blessed with an unusually high pain threshold, or were just lucky enough to have a really "easy labor". They may further assume that no "normal" woman, experiencing a "normal" labor, could possibly bear it without turning to drugs and interventions. This is a huge fallacy, but an understandable assumption to make.

Secondly, a woman who "tried" natural childbirth, but was unable to manage it, may very likely suspect that her own labor was much "worse" than normal in the first place, otherwise she would have been able to tolerate it more easily.

Finally, there is the belief that classes don't make much difference, nor do birth books, based on the mistaken idea that nothing could possibly make any real difference to what a woman feels in labor. This is another big mistake, largely due to the sad fact that so many women simply take the wrong classes, assuming that they are all essentially alike. Make no mistake about it; they're not!

While preparation for childbirth classes can be a great resource, and I recommend them to everyone, you need to be aware that many are not aimed toward preparing you for NATURAL childbirth, even though the term "natural childbirth" may be mentioned prominently. So some will be more helpful to you than others. You might want to ask the potential instructor what percentage of the "graduates" of that program who give birth vaginally go on to have completely natural childbirth, and how many have epidurals, etc.

Frequently the classes offered at typical hospitals are logically focused on preparing the average mother-to-be for the average hospital delivery, and these days that is definitely NOT natural childbirth! About 80% of women in the United States today have epidural anesthesia during labor, and many classes only help you deal with early labor contractions, with the vague expectation that you'll probably "have to" have an epidural to help you deal with "hard labor". While breathing techniques are discussed for all of labor, it may be frequently mentioned that you may "have to" have an epidural. This attitude doesn't exactly fill you with confidence that you can get through the whole experience unmedicated, nor does it equip you to do so!

A good natural childbirth instructor really believes that the average woman can experience labor and delivery without any medication, as long as she has the right kind of preparation, support and attitude. And that belief can help to give you the confidence and information you need in order to succeed with natural childbirth. She will have a wealth of information to share about how to deal with the more intense aspects of labor, such as using strong counter-pressure on the lower back, or various different positions and other techniques to ease you though the harder parts of the experience. So definitely look for classes that focus on NATURAL childbirth, not just "preparation for childbirth" in general. Talk to OB nurses, or, better yet, to midwives.

Since your husband is going to be involved, you might want to look into classes in the "Bradley Method" of husband-coached childbirth. There are books on it, the original being "Husband-Coached Childbirth" by Robert A. Bradley, M.D., [new York, Harper and Row, 1965] and I urge you to read all about it first, since you have plenty of time. I'll post a link at the end.

There are other books about natural childbirth that will help you to understand the connection between fear, tension, and pain. The Lamaze Method is famous, and I can certainly attest to it's effectiveness, if taught by qualified instructors. Here's how to find a Lamaze class, if you're interested: call 1-800-368-4404.

There's a basic fact about contractions: if you're not deeply relaxed, they hurt a LOT more, and often take longer to get the job done. Natural childbirth usually involves using specific techniques to keep you stay relaxed and calm, thus minimizing pain. Generally this involves breathing and visualization techniques, and a great deal can be learned from books on the subject, following up later in pregnancy with the right classes.

If you have a home birth or birthing center delivery with midwives in attendance, they will be a tremendous source of support and resources. They will either provide preparation for childbirth classes themselves, or be able to refer you to the best classes available in your area, such as the Bradley Method, or Lamaze.

If you have a hospital delivery, there is a special helper called a "doula", whom you can hire to stay with you during labor, to support you, and do things and teach you things to help you to stay as relaxed and comfortable as possible. She does a lot of what a midwife does, but doesn't actually deliver the baby. She will work with you before the labor, going over the possible techniques and breathing methods that will help you have the least discomfort during labor. She'll also be able to recommend the best books and videos to help you prepare for the birth. And she'll be there throughout the labor and delivery itself, helping you and your husband to have the best experience possible. There's a link to the website for Doulas of North America, that will tell you all about these wonderful people, and can help you find one in your area. See the list at the end of this article.

There is also the option of "HypnoBirthingT", a relatively new way of bringing about a relatively painless birth through special hypnosis. I have no direct experience with this personally, but it looks very effective, judging by films, reports and news stories I've seen on the subject.

There are of course many books about pregnancy and childbirth that can provide a wealth of information and inspiration. Your local library will have some. I'd suggest reading all you possibly can, especially the ones focusing on natural childbirth or homebirth. Why homebirth books, if you're planning a hospital delivery? Because homebirths are natural, and reading about them can give you a great deal of useful information and confidence, which will help no matter where you deliver.

As a retired midwife, a generation older than today's mothers, I know a lot more about the "classics" than about more recent books. The challenge will be to find some of them, since I believe that they're almost all out-of-print! Libraries are the first and most logical starting point, of course. Used bookstores are a great place to find bargains on childbirth books, because women tend to get finished with them, after a certain point, and pass them on. If you request an out-of-print book, "Amazon.com" will do a search of all of their used bookstores, and will let you know whether they've found any particular book within about two to three weeks. Of course, recent books will be much easier to access at bookstores. Do a search online, or at your local library. Just make a point of informing yourself, by reading as much as you can. I'll provide a reading list and some links below.

And remember that women who are not as well prepared or as well supported during childbirth as they need to be, whether they realize this or not, may have horror stories to tell, which you must keep in context. There is no doubt that unprepared or under-prepared childbirth can be a real nightmare, (as you yourself found out with your daughter's delivery). And a few women who had to resort to various medications and interventions in their deliveries may not be at ALL supportive of your plans to have natural childbirth, but please don't let them discourage you. Keep reading, keep learning, and you'll be prepared for whatever happens. And I'm sure you'll be in a much better situation to deal with your upcoming birth. Good luck!

BOOKS

My list of "Golden Oldies"-note-since these books were written several decades ago, and may contain some out-of-date information. But they are just as valuable as ever in terms of preparing a woman for natural childbirth. After all, some things never change!

Childbirth without Fear by Dr. Grantly Dick-Read. [New York, Harper and Row 1959].

Thank you, Dr. Lamaze! by Marjorie Karmel [New York, Doubleday, 1965]

Commonsense Childbirth by Lester D. Hazell [New York, Putnam's. 1969 (New Revised Edition). New York, NY: Berkley Books, 1976.

And my favorites,

Birth Book by Raven Lang [Cupertino, Calif., Genesis Press], and

Spiritual Midwifery by Ina May Gaskin [The Farm Press]

And these miscellaneous books:

Immaculate Deception by Suzanne Arms [Boston, Houghton Mifflin]- about the cultural experience of childbirth

Birth Without Violence by Frederick Leboyer, M.D.-revolutionary book about the unnecessary and lasting trauma inflicted on the average newborn in a typical hospital delivery.

WEBSITES TO EXPLORE

The homepage for the Bradley Method of Natural Childbirth: www.bradleybirth.com

"Lamaze International" site: www.lamaze-childbirth.com

Lamaze class video, for women who can't attend classes in person. (Price: about $50.00): www.lamazevideo.com

More Lamaze videos: www.lamaze.com

"Birthing from Within": the extra-ordinary guide to childbirth preparation: www.birthpower.com

"Natural Beginnings"; a site about natural childbirth, with helpful links: www.naturalbeginnings.org/naturalchildbirth.htm

"CoMadres"-a site that is dedicated to "Enhancing the health of women and families through the art and science of midwifery" www.themidwife.org/comadres

Doulas can be found through these sites:

www.dona.com

www.icea.org/doulas.htm

The HypnoBirthingTInstitute can be accessed through this link: www.hypnobirthing.com

----
Cathey Thomas is a retired lay midwife and childbirth educator who has attended over 200 births, mostly at home, and all natural and unmedicated. She has also had extensive experience preparing couples for natural childbirth, and has been present at dozens of hospital deliveries, serving as a doula, and sometimes assisting with the delivery. She has also had many years of experience assisting mothers with breastfeeding and newborn care and teaching classes for expectant fathers and siblings. Cathey welcomes questions and comments. You can reach her by email at Cathey@texas.net

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