Monday, August 6, 2012

Childbirth Myths and Legends

I am amazed by the reports my clients come to me with concerning childbirth. Our introduction is often prefaced with "I am scared to death", "My friends tell me... " My mother said", and so on and so on. It seems that not only the internet but also well-meaning (?) acquaintances and strangers in the check-out aisle at the local Kroger have stories galore about emergency C-sections and fourth degree lacerations.

It disappoints me that in the area of labor and delivery, we don't seem to have a very supportive sisterhood in this culture. Rather than reassure or even just share the facts, it seems that women must out-do each other with the doom and angst of their childbirth. It becomes almost a competition for who had the worst time . And it is a real credit to share the pain with as many pregnant women as possible.

So just to set the record straight there are a few myths that I feel I must comment on.. Please feel free to email me your personal favorite. And I will always have time to comment on the latest nightmare. Top on my list of woes is , " I just don't have a clue about what is going to happen to me". Our bodies are quite able to handle childbirth in fact you can trust your body to know what to do, even if you don't. It's in our DNA. It's the only reason we were born, you know, to reproduce ourselves. Women have been doing it forever!

A true emergency C-section is not the same thing as an unscheduled C-section. An unscheduled C-section is what your friends have had when their labor is dysfunctional, the cervix doesn't dilate in an expected fashion,  the baby doesn't descend, there is a distinct disproportion between the size of the baby's head and the mom's pelvis, the baby is in distress as evidenced by an abnormal heartbeat. The scar that your friends show off is the result of a low, transverse incision. A true emergency C-section leaves a scar from the pubis to the sternum. Usually general anesthesia is used, not an epidural,

Meconium is a warning sign. It doesn't mean that your baby is going to be retarded or die. You don't have to call 911; you have to go to the hospital. They know how to assess and handle meconium. It doesn't even mean that you're next in line for an emergency C-section.

Fourth degree lacerations are tears that result from a perineum that isn't elastic enough to allow the baby's head through. If it looks like you are going to tear more than a stitch or two, your doctor will perform an episiotomy.  Episiotomies aren't done routinely anymore, but perineal massage is done by nurses and midwives and doctors too. You may do perineal massages for yourself the last weeks of pregnancy to get that tissue into stretchy shape. No one is interested in you ripping from stem to stern. And that elastic perineum does return to its previous state, so you will not be incontinent forever after.

No one wants to defecate when they are pushing out a baby. If you are worried about that one, give yourself an enema when you know that you are in labor. And you will know when you are in labor. You will watch that pattern of contractions take shape and if your contractions stop, you will empty your bladder and wait for the contractions to return with some regularity. If they don't, you aren't in labor. First labors are generally hours and hours in duration. You will have time to shave your legs and wash your hair and vacuum the floors.  Babies generally aren't born in cars or on the side of the road or in the toilet, because you don't know that you are in labor.

And the myths go on. Please be supportive of pregnant women and reassure them that they will live through their labor and delivery. If you are pregnant, disregard all the melodrama and discuss your concerns with your providers. There is nothing that we haven't heard and everything that we can share to calm your nerves and ease your worries. Let's work on a sisterhood that informs with fact instead of fiction. Isn't it remarkable that with all the horrible things that can and do happen in labor, most of us go back for more?