Friday, January 11, 2008

new documentary

Watch the trailer! I am so interested in watching this new documentary about childbirth in America. Fortunately, it's being released on DVD February 12, and I already have it on my Netflix queue. Anyone who has had or will have children will find this very interesting. As I am preparing to have my first, I have started thinking about how I want my birth to go. Obviously, I still have a lot of time, but it doesn't hurt to start thinking about these things now. My doctor is going to play a large part in that, and I want to make sure we are on the same page from the start.

Did you know that the US has the second highest infant mortality rate among developed nations? #1 is Latvia. Crazy! If you want to know more check out this CNN article. And for a review of the film check out this article from the New York Times.

I'm sure I'll have a lot more to say about this after watching the film and of course after I experience childbirth for myself, but I'd love to know what you all out there think. How do you feel about natural childbirth, hospitals, epidurals, midwives, c-sections, etc? If you've given birth, are you happy with your birth experience(s)? What surprised you most? The question posed on the film's website is this: "Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?" I really am interested in what you think, so please comment!


  1. Congrats congrats congrats! Yay. Okay so! I believe that birth should be viewed as a natural life process (because it is) but sometimes, hospitals get too worried about all the things that can go's a long discussion and you girls need to come visit soon!

  2. Oh I have a lot to say about this!! But I don't have time right I will be back later. Very interesting stuff. Also...SO SORRY you are feeling sicker. And it doesn't matter if other people have it worse that still sucks---you totally have the right to complain. Ok back later.

  3. Wow, that trailer kind of freaked me out a little bit (the whole "what a hospital isn't telling you" vibe). As I am neither prego nor have any children, I really don't have tons of opinions on what I liked and didn't like... but I do know that I fully plan to get an epidural when that day comes!

  4. It is so fun to be expecting, isn't it? So much to think about. That movie looks so interesting, I'd really like to see it. I think its sad that natural childbirth is so rare...and yet I had an epidural.

    It is shocking and scary to know the statistic about infant mortality rate in America!

    I will say that I was admitted to the hospital while being dilated to a 6. I had no idea I was that far along. I expected the pain to feel as if I was close to dying. I think I have a higher pain tolerance, which helps, but it wasn't that bad. So, getting an epidural while going that far on my own, I feel like I could do it 100% natural on my own. (Of course I could, women for centuries have...I guess I just mean that I will consider it even more.)

    Our Dr friend recommended that you're ever NOT going to get an epidural, don't let it be your first. I hate to write it, but uh, your anatomy just does better the 2nd time around because its "used to it" a little more.

    I'm sure you know Afton went with no epidural with her second and loved it, but was glad it was her second, not first.

    I feel very granola saying this-part of me really wanted to have a midwife, just to feel all womanly. And then the fear of complications set it. What IF something bad happened, and all I had was a midwife, someone who wouldn't be able to do what hospitals can? That really scares me and I'd feel totally irresponsible.

    On one hand it seems silly to experience pain if you don't have to. And yet I want to feel "all woman" sometime and do it as so many gazillion women have done it through time.

    C-sections-I have a friend who would like more but can't because she's had all c-sections. I've never heard of that, but??? I know it takes lots of recovery time.

    In case I haven't written enough, I'll also answer your question. For SURe, birth should be viewed as a natural life process. I suppose it is also a potential catastrophic medical emergency. But c'mon. I think that's like asking if marriage should be viewed as the ultimate relationship requested of God, or a potential union that could cause the most distress in life? Both "potential" scenarios are real possiblities, but pessimistic.

    I'll be interested to know what how you decide to go with your labor.

  5. hmm. well, here's my 2 cents. for my first baby, I wanted to go natural, and I liked the idea of having a midwife, but seeing as how my mom almost died with her first (me) I thought that might not be the best idea, which is good, because it turns out I inherited the specific problem my mom had, which resulted in a horrific 24-hour labor and lots of problems afterwards. I really liked the idea of having a midwife who was willing to spend a little more time and care with me (and who was a woman herself), because to some extent I felt like a piece on the assembly line at the doctor (especially in Provo).

    bottom line is: i think childbirth is natural, period. if that baby is born, that's natural childbirth. perhaps it's medicated or unmedicated, but either way, it's natural. with that said, i would personally like to have no anesthetic at some point, but then I think back to how I was screaming and sobbing the last time i had a baby and I had my hands over my mouth so nobody would hear me crying, and i think, you weenie! just give in and get the drugs already. so maybe not. but i am also very grateful for medical advances and the fact that we HAVE hospitals, and that there's someone who can clean up after you have the baby and you don't have to have the baby at home, and that we know about things like peurperal fever.

    with that said, i don't think we need to treat all births as catastrophic, especially with subsequent children. i think the most important thing is to be informed about what's going on so that you (or the sane person with you who is NOT in labor) can make appropriate decisions. but I think we also need to realize that childbirth can be fatal for either the mother or the child, and not take unneccessary risks in when, how, or where the baby is born, or what types of treatment we will and won't accept.

    and I think it is important to realize that while this is something totally unique to you, it's the medical staff's job, and they may not keep your preferences or total well-being always in mind, at least in favor of what's convenient for them. i had one baby induced for my doctor's convenience and one for mine, and i had great nurses for one baby and nurses who completely ignored me and refused to enter the room to check on me until i just started screaming "GET A NURSE IN HERE!" as loud as I could and then they realized that the baby was actually being born then (but I think this may be an issue unique to our hospital here, because two of my friends who had a baby within about a month of me had the same problem, i.e. the nurse assigned to each of us ended up in an emergency C-section and all the other nurses refused to come check us. One of my friends actually gave birth while she was yelling for a nurse to come, and the nurse came in and said she needed to calm down, walked out the door, and the baby was born right then). anyway. and i also had a friend who was in labor for 3 days (who was a nurse herself) before anyone noticed the baby was breech and gave her a C-section, and another friend who was in labor at the hospital for 42 hours before they did a C-section and when they did the C-section they noticed her epidural had fallen out.

    i don't mean to scare you with lengthy horror stories--just be aware that you will probably have to be your own advocate. and pick a good doctor or midwife who you TOTALLY trust!

  6. I tried leaving a comment earlier, but it wouldn't let me.

    In my own experience, you can be really excited about going natural, and then you're actually there, in pain, and you KNOW that there's an epidural right there--ready for the taking, all you have to do is ask for it. And in the pain of the moment, it's fairly impossible to resist.

    I have had one kid with no anything--no epidural, no IV, no monitors, because we got there a little late. So if you really want to go natural, getting there with only 20 minutes to spare is a good option. ;)

    Ethne was my breeziest birth ever, cause when I got to the hospital, I was at an 8 which hurt a lot, but they put the epidural in right away, I relaxed and waited for an hour, and then got to really 'be there' for when she came out--it was the first time I watched in the mirror, and that was cool. Also, it was kindof awesome to feel myself give two pushes, she came right down and out--it was sooo easy! And in that instance, I was glad to have chosen an epidural because I had something where the umbulical cord was attached to the uterine wall instead of the placenta, so they just detached, without the placenta coming out too, so the doctor had to grab the placenta and pull it out, which I've heard can be *horrificly* painful --and I didn't feel a thing. But you can't see ahead for those types of things, can ya?

    It's funny because I have a sister who's a nurse who always mocked women who came in and were only like a 1 or so, and then she ended up doing that, AND she always planned on an epidural-no question, but didn't end up getting one because of how the situation went.

    In brief, giving birth hurts like the dickens. And the question of whether it's worth going natural to experience it changes when you're just thinking about it vs. when you're in the actual pain. That's what I've found anyway.

  7. i agree with kayli--i planned to go natural right up until the 13th hour of ripping contractions and i found out i was only at a 4. then i thanked my lucky stars that there were such things as epidurals.

  8. Hi, random lurker here! Well, not super random since I'm friends with Emily Anne and Danielle...but I thought that since I've had 3 kiddos in the last 3 1/2 years, I might offer up a slice of my thoughts!

    Each birth experience has been totally different, and all have been positive because of the doctor I chose. I really think you have to be so willing to find the right doctor by asking lots and lots of questions. If it's not right, find a new doctor. With my last I went to a woman's clinic, with all women doctors and I loved them! Awesome, awesome doctors! I think this movie coming out kind of focuses too much on the negatives. There are still amazing doctors out there who love what they do and want to help their patients to the best of their ability!

    To make a long story short, I wanted to go without medication with my first baby. After a horribly long 12 hours I got to transition in labor, but my body was only dilated to a 7. The baby was coming and I was not prepared. I got an epidural in an attempt to calm my convulsively shaking body, and try to dialate enough to get the baby out. It worked, she was here 1/2 hour later! I got the epidural with my other two as soon as I progressed to a 6 with the other two births, and they were both such positive experiences. I wonder sometimes if I'm a sissy and should just suck up the pain, but then I wonder if my first birth would have ended up in an emergency cesarean with the baby coming down the birth canal, but nowhere to fit through! I might try it natural again someday...

    One thing I will say is that I find the idea of induction and scheduled cesareans totally absurd! I hope no one is offended, I tell my sister in law's this all the time because they always schedule their labors like a dentist appt. or something. I think it's natural to let the baby get here in its own good time, unless there is some danger involved and the doctor has to intervene. Well, that's my piece. I hope everything goes well for you in your pregnancy and labor. Labor is an amazing thing, and it is so true what they is all worth it!

  9. And oh my goodness, I did not leave that comment at 3:20 AM! It's more like 11:00 PM...I have kids for pete's sake!

  10. Hey Katrina! I visit your blog occasionally by way of Tracy's and I couldn't keep myself from commenting on this one. That documentary looks really interesting - I definitely want to see it! Thanks for the heads up.

    I've had one baby, and from the start I wanted to have her naturally. Because of a situation, I had to be induced 2 weeks early, so I was on pitocin. The contractions were really strong and consuming and at one point I almost asked for an epidural, but I ended up going natural the whole way.

    One of the things that helped me was laboring in the water at the hospital. It helped me dilate from a 4 to an 8 in about 30 minutes. When it was time to push, there were about 8 hospital workers (nurses, interns, etc . . .) who asked if they could come in and watch because they had never seen a natural childbirth. I said, "of course" (privacy was not an issue to me by that point in my labor)!

    I had a midwife who worked at a doctor's clinic. If there were any major complications, the doctor could be called in, but she knew her stuff and I felt very confident in her care.

    I think birth is beautiful and natural, and no matter how you choose to go about it, it always helps to be informed and prepared. Good luck!

  11. I've had three non-elective c-sections. I didn't have a choice about it, but I knew it was going to happen ahead of time. It never bothered me at all not to go through the labor process, but I'm sad that the c-sections were necessary. We'd like one more, but three different OBGYNs have told me that having another would be too risky - my uterus was shot from having three c-sections, and one more might cause my uterus to rupture. I was so surprised, because I've known other women who've had more c-sections than I have, but apparently, every uterus is different. DANG it.

    I really want to see this movie...

  12. I have lots of thoughts and random comments about this topic.
    1) Am I the only pregnant woman (have you noticed that the word "lady" is almost always inserted after the word "pregnant"? I hate it.) to cry when reading about a birth, hearing one, or watching one? Whether I'm at the gym, a bookstore, whatever. It just hits me.
    2) That documentary, while obviously slanted away from the medicalization of birth, I think provides a perspective that is often lost in the United States today. My husband served his mission in the Netherlands, where, like the doc suggested, nearly everyone has home births attended by midwives and they're fine for the most part. So that does make me wonder about the necessity of the hospital, fetal monitoring, etc. Also, I've read that C-section rates tend to go up on holidays and weekends (so I believe what they were saying about C-sections being convenient for doctors). Furthermore, I've read that even the presence of fetal monitoring devices can result in C-sections that were unnecessary. And many hospitals, including UVRMC in Provo, have almost 100% episiotomy rate, even though it's been shown countless times that they often aren't necessary and often heal more slowly than a tear would (as painful as that sounds). To mirror an earlier commenter's thoughts--and, like her, I don't mean to offend--but I am also kind of appalled at planned inductions based on convenience. The midwives I'm seeing have a lower than 10% C-section rate (as opposed to 30% nationally, I think) and they attribute that rate mainly to a lack of inductions. Obviously, there are medical reasons for inducing, but in my mind at least they should be limited otherwise. I could also write an entire post on breastfeeding and its relationship to the culture surrounding childbirth in the U.S., but I'll spare you :)
    3) Having said all of that, I can see the other side too. I do want to mention as well that comparing international infant mortality rates can be misleading because the United States has a rather unique way of computing them. I can't remember all of the details, but basically, one reason the U.S. has higher rates is because we count more babies as ever having been alive than other countries do. But beyond that, I do think there is a place for medical technology in the birthing room, and I'm having my first baby in a hospital, albeit with midwives. I feel like I'm getting the best of both worlds because there will be a midwife there attending me throughout the entire labor (as opposed to just the delivery), but if I were to need an emergency C-section (I didn't mean to imply in my earlier statements that these didn't exist), I'm there at the hospital and a doctor who could perform such surgery is in the wings.
    4) As for my choice to go medicated or unmedicated, I really feel so torn! Philosophically, I'd like to go the latter, but emotionally, the former sometimes seems like the only possibility. That having been said, I liked an earlier comment talking about how you'll never really know until you're in the moment. I've had cramps that were bad enough that I would have gladly accepted an epidural, so I'm nearly sure that I'll end up having one when I'm actually in labor. But this whole topic brings up another issue for me, on both sides. On the one hand, why am I "more woman" if I choose to experience more pain? It seems as if our culture places an undue amount of value on women who are "tough enough" to go it natural. But on the other, why do some people act like not going the medicated route is just sheer stupidity when doing so can increase the number of medical interventions in your birth and prolong recovery (to say nothing of numbing you to the actual experience of birthing)? It just seems like such a loaded and public question when it should be so private--but I guess that a lot of things surrounding birth are like that. So, what will I do ultimately? I'm guessing I'll have an epidural on this first one and try to go natural on at least one subsequent one, but we'll see...

  13. OK, I wasn't going to comment at first, but now I think that I will.
    I wanted a completely natural childbirth - no drugs. I looked for classes, nothing. Community resources - nothing. Support from my doctor - none. Not only was she not supportive, but after 10 hours of labor, she and the anesthesiologist pushed me into having an epidural, which is what I was trying to avoid. But I'm not saying that it was a bad thing, because like I said, I had had no classes or anything in going natural (not for lack of trying), so I really didn't know what I was doing. Plus, I was put on Pitocin, without even ever being asked whether I wanted to. And that drug is known to increase the severity of the contractions, so it probably was better that, in then end, I had an epidural. But I didn't know what Pit was until later and was just given it as standard procedure. In the end, it all worked out and I had a happy, healthy baby. But I really felt like I didn't have any options. I haven't decided yet what I'm going to do the next time, but I know that it is going to be different. (I gave birth in Idaho Falls, ID three years ago)

  14. Ok well I had a lot to say, but it looks like most of it has already been said. Let me just add that I do think that yes, the birth process is over-medicalized in the US, BUT, I think we also have higher expectations about things going perfectly in births and expect that if anything goes wrong during birth, that we should be able to sue someone for malpractice. There are reasons that doctors do things that sometimes end up being unnecessary, in an effort to prevent a potentially bad outcome. Hindsight is 20/20. When you see devastating things happen in birth as some practitioners do, I think they tend to be a little more cautious. Also, they have a ton of pressure to justify when and why they make decisions, and huge consequences riding on those decisions.

    I think all in all there are absolutely improvements that could be made in health care... period. Obviously nurses and doctors are human and things don't always work out ideally. But I also think I am super grateful to live in a place where we use the technology and resources we have to save babies who would have otherwise not lived. I see them every single day.

    I also agree with what Rachael said about it being a private family decision and that women shouldn't feel "less than" for not enduring as much pain etc, or they have to defend choosing a natural route. Bottom line, we are lucky to have so many choices when it comes to birth. I don't think that every birth should be treated as a "potentially catastrophic medical crisis", but if it turns out to be one, I am sure as heck glad to have people around who know what they are doing.

    I think the best thing that any family can do to have a positive birth experience is to be as educated about it as you can. That way, when things don't go exactly how you planned, you will be able to keep making good decisions that you are OK with. I also think that as women (and men) become more educated about the birth process and become more active participants we force the issue of having more options in birth and not getting stuck with what is more convenient for doctors and nurses etc. PS. C-sections unfortunately totally happen sometimes because it is more convenient for the doctor...a sad truth, but probably not the rule.

    So that's my 2 cents

  15. Oh I also wanted to say that having a certified nurse midwife deliver you in a hospital is kind of the best of both world's right now.

  16. Careful about that US being #1 in mortality rate. I saw someone else point it out already, but the biggest reason the US #1 is because more babies are born BREATHING in the US than in other nations....these babies end up dying 1,2,3...10 days later in NICU. I'd rather take my chances and try and save my baby than have a stillborn...both would be heart wrenching, though.

  17. That looks really interesting. I'm really going to have to rent that one!

    I hate birth being so medical but then I am scared that something will go wrong and I want the medical stuff there to back me up. I've been going back and forth with whether or not to use a birthing center.

    Luckily I have an awesome OB who is all about giving you choices, so for this pregnancy and labor I'll use a hospital.

    But I do dislike how medical they (nurses) make it :(