Putting this up here for a couple of friends of mine who are pregnant for the first time.
10 Childbirth Myths
Tuesday, January 12, 2010 at 9:38am
Childbirth Myths via my doula friends
Myth: Episiotomy is better than tearing.
Actually, tears are usually less severe without episiotomy, and the procedure itself can cause further tearing. Episiotomy--the cutting of perineal tissues during delivery--is not something that most women give a second thought to, at least not until they've given birth for the first time. The perineum is the delicate area between the vagina and the anus. After an episiotomy, even sitting can be painful, and sex can be unbearable. Episiotomy is the most common surgical procedure performed in the US, and, according to Sheila Kitzinger, "It is the only surgery likely to be performed without her consent on the body of a healthy woman in Western society."1 During a typical hospital birth, it's the rare woman who is not cut either "above" (in a C-section) or "below" (an episiotomy). Currently, at least 80 percent of first-time mothers delivering vaginally in the US undergo this painful procedure.2 A research review by the World Health Organization, however, indicates that evidence only supports a 5 to 20 percent episiotomy rate.
Myth: Epidurals have no side effects.
The use of epidurals is so common today that many perinatal professionals are calling the 1990s the age of the epidural epidemic. Maternal Risks include : Hypotension (Drop in blood pressure), Urinary Retention and Postpartum Bladder Dysfunction, Uncontrollable Shivering, Itching of the face, neck and throat, Nausea and Vomiting, Postpartum Backache, Maternal Fever, Spinal Headache, Uneven, incomplete or nonexistent pain relief Feelings of Emotional detachment, Postpartum feelings of regret or loss of autonomy, Inability to move about freely on your own, Loss of perineal sensation and sexual function, Very Serious and rare risks include: Convulsions, Respiratory paralysis, Cardiac arrest, Allergic shock, Nerve injury, Epidural abscess, Maternal death. Labor Side Effects: Prolonged First Stage of Labor, Increase of malpresentation of baby's head, Increased need for Pitocin augmentation, Prolonged Second Stage of Labor, Decrease in the ability to push effectively, Increased likelihood of forceps or vacuum extraction delivery, Increased likelihood of needing an episiotomy, Increase in cesarean section. Baby Side Effects: Fetal distress; abnormal fetal heart rate, Drowsiness at birth; poor sucking reflex, Poor muscle strength and tone in the first hours.
Myth: Laying on your back is the best position for labor and birth.
The choice of labor and birth positions has a huge impact on a mother's comfort level during birth and how quickly and effectively her labour does or doesn't progress. The more options she has, the more prepared she is to handle her birthing experience. Effective positioning can speed labor and reduce discomfort by aligning the baby properly, by reducing area-specific pressure, and by reducing unnecessary muscular effort. The reasons for using these positions have nothing to do with comfort or effectiveness for labor. Rather, they are used solely because they are convenient for doctors. While they allow doctors easiest access, they are detrimental to birthing for many reasons. Foremost among these reasons is that the pelvic outlet is up to 30% smaller when a woman is in these positions. They also restrict a woman from freely moving and put greater pressure on the perineum, all of which can lead to other unnecessary interventions or complications like tearing, episiotomy, forceps delivery, or vacuum extraction. In addition, the risks to the baby increase as well. Poor birth positions can decrease fetal heart rate or cause other types of fetal distress, which may lead to continuous or internal fetal monitoring, increased risk of shoulder dystocia/problems with presentation, or a prolonged pushing phase.
Myth: Women become screaming lunatics yelling at everyone in the room.
Childbirth is not a psychosis where a woman suddenly takes on a new personality. Although in the earlier half of the 20th century women were given labor drugs that made them act very strange indeed, becoming crazy isn't a part of the natural childbirth process. What does happen is a woman uses all her energy to focus on the work she is doing and distraction makes this harder. Women in hard labor will use the least amount of energy to communicate—this may mean body language, grunts or one word commands. Some women use hypnobirthing techniques to stay calm and focused throughout the birthing process.
Myth: A hospital is the only place to give birth.
There are many places to give birth. Home, birth center and hospital. In hospitals OBs and midwives attend births. Midwives also attend births in birth centers and homebirths. Birth centers and homebirths are equally safe as hospital births with a trained qualified midwife. In the Netherlands still today 1/3rd of births take place at home. Interestingly enough the Netherlands has the BEST birth outcomes out of 32 industrialized nations.
Myth: Babies should be born on or before their due date.
Allowing labor to begin naturally is the best way to assure that the baby is ready to be born. Only 5% of babies are actually born on their due date. Due dates are estimates at best. The average first time mom gestates till 41wks and 2 days. It is perfectly normal and safe to allow a pregnancy to gestate till 42wks and even beyond.
Myth: Drugs are the only way to relieve pain.
There are many ways to relieve pain during labor. The easiest one is to remain upright and mobile throughout labor. Laying down increases the pain and makes it more difficult to cope with. The use of water many women find soothing, either in a bath or shower. Massage with essential oils and using other massage “devices”. Using a birth ball is a very helpful aide. Long slow deep breaths to ensure you are getting plenty of oxygen. Many women today fear labor. It is a simple fact. And yet another simple fact is that fear in labor (or anything) will increase your pain. This is called the fear/tension/pain cycle. All this states is that when you are fearful, you tense, when you tense you cause more pain.
Myth: You can not push until you are 10cm.
Doctors, nurses, midwives, doulas and childbirth educators all warn that a swollen cervix will impede labor and increase the chances of tearing the cervix, thus causing hemorrhage. Non-medicated woman will never push so hard against her undilated cervix that it tears, because it will hurt. Pain is a natural deterrent to pushing too hard. However, when done in the correct manner, pushing to help rotate a baby and dilate oneself will actually eliminate a great deal of pain and cut hours off one’s labor and birth. So if you feel the urge to push, listen to your body – it can’t be wrong.
Myth: Once your water breaks you should go to the hospital ASAP!
About 15-20% of labors begin with rupture of membranes followed by contractions. If your water breaks and its brown or green in color and has an odor, you should go to the hospital. Or if you develop a fever after your water has broken without any color or odor you should go to the hospital. However this is rare. Ideally you want to stay home until you are in active labor. This isn't usually a problem since 70% of women with PROM will give birth within 24 hours. In fact, 90% of the women with PROM will have given birth within 48 hours. Only 2-5% will not have given birth after 72 hours. The “24hr rule” is hospital policy, sometimes it is even a mere 12hrs. Their thought is that you will develop a bacterial infection. Bacteria can’t migrate up the vagina unless physically pushed up there, for example by cervical checks. Hospitals are ramped with bacteria; MRSA, Staph and other bacteria. So when you are in a hospital your chance for an infection is much greater, especially if they are doing cervical checks every hour. Once in the hospital after your waters are broken you should limit or refuse vaginal exams.
Myth: You should be induced if your baby is too big.
Unless you've been wearing a corset since puberty...this is not going to happen. Period. The vast majority of the time, these weight estimates are based off of ultrasound very late in pregnancy. After the 1st and second trimesters, ultrasounds are off by up to TWO FULL POUNDS, either way. When ultrasound predicts a big baby, women may be just as likely to have a cesarean when the ultrasound is wrong than when it is right. In yet another study, roughly half the women predicted to have babies with birth weights in the top ten percent had cesareans regardless of whether their babies actually weighed in this range. It is very rare to grow a baby your body can’t birth. 50% of first-time moms that are induced will end up with a c-section. Women have been birthing “big babies” for centuries, women's bodies have not regressed in our birthing abilities.
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