Sunday, December 4, 2011

Baby class 2: Childbirth Express

From the ages of about 10 to 28, childbirth was my greatest fear in life. Then that fear was temporarily replaced by the greater fear of not being able to get pregnant. Now, to bring things full circle, I rediscovered my intense fear of childbirth in October during our hospital tour. And I realized I needed to do something about it.

Basically, for some reason when I was a little kid I watched some Liftetime-esque movie about a woman hemorrhaging so badly during labor that she died. Even though dying during childbirth in modern America is a fairly irrational fear, it is a fear I possess nonetheless. While we were on our October hospital tour I was doing fine until about two-thirds of the way through the tour, when the mantra, "This is where I am going to die" started going through my head, I started seeing stars, the sides of my visual field started turning black, and I told Matt I was just going to sit down (in the middle of the hallway, right in front of the nursery, amidst a gaggle of pregnant women and their partners) for a few minutes. Right as I sat down a nurse approached me, told me I was gray and this wasn't OK, gave me orange juice and put me in a rolling chair.

At that moment, I felt pathetic, and I knew that I needed to do something.

So I asked my doctor for some suggestions for handling my fear of childbirth. She suggested I read What to Expect When You're Expecting. I think you know about my history with that book. Check and check (and check). I clearly needed better solutions.

So I asked my friend Laura, who's a midwife, to see if she had any books she'd recommend. She very generously let me borrow several of her books including...

Planning for Pregnancy, Birth and Beyond by the American College of Obstetricians and Gynecologists
...which gave me some slightly more medical insights into the birthing process than what I gained through reading and rereading What to Expect...

The Labor Progress Handbook by Penny Simkin and Ruth Ancheta
...which is intended more for doctors, nurses and midwives than regular old joes like me, but it did give me a few pointers about natural delivery (which I do not plan to have, but you never know!)...

and The Baby Catcher by Peggy Vincent

...which is the memoir of a nurse midwife and probably my favorite pregnancy-related book I've ever read. Even if you are not pregnant and never plan to be pregnant, I think this would be a fascinating read for a lot of people to offer insights into a profession you may not have thought about much before now. Almost every chapter tells the birth story of a different woman Vincent worked with throughout her career. While nearly everyone went the medication-free route under Vincent's care and took overall different approaches to labor than I envision myself taking, I really enjoyed getting different perspectives on the birthing process.

After all this reading, and after consulting with my girlfriends who've given birth within the last four years, I decided Matt and I could benefit from a childbirth class more thorough than the two-hour class offered through Kaiser Permanente. So I signed us up for the aptly named Childbirth Express class offered through INOVA health systems, since I'll be delivering Baby Awesomerod at an INOVA hospital. As my friend Jenny, who is a nurse, pointed out, there's an added benefit in taking a class with the nurses who work at the hospital where you'll be delivering. If only it were true that taking a class titled Childbirth Express could guarantee that you'll have an express delivery. If only.

Matt and I spent the better part of our Sunday attending this class for six hours, and we shelled out $150 for the privilege. In the end, though, I would say it was time and money well spent, not because the class blew my mind in any way (it did not) or taught me a lot I didn't already know from my reading and conversations with my doctor (ditto), but it did offer me some piece of mind. I feel like I am as close to conquering my fears now as I can be until the day itself arrives.

The most important take away for me from both reading The Baby Catcher and taking Childbirth Express would be this: I am going to *try* to manage my labor for as long as possible before getting an epidural. I fully, fully intend to get an epidural, but I see the benefits in laboring on my own for as long as I can handle it before I scream for the epidural. So, maybe that still means I'll just be two centimeters dilated when I request the epidural, but maybe I can make it to five centimeters (I won't press my luck for more than that, but again, who knows).

While trying to go a little longer without an epidural would be my main childbirth revelation of the last two months, Matt and I did take away some more specific, practical information from Childbirth Express regarding labor and delivery, specifically:

1) Pack two hospital bags -- one that you'll take to the labor and delivery room, and one that your partner can bring to the room you'll spend the rest of your time in after the baby's arrival. I am sure I'll post about this more at some point and share my hospital bag packing strategy, but the main idea here is that you don't need that much stuff with you during labor and delivery, and there are items you clearly will not need until the baby shows up, such as a going home outfit for you and for your little one.

2) Plan to head to the hospital when your contractions are 5 minutes apart, lasting 1 minute each, and they've been following that pattern for 1 hour. The iPhone app (did I tell you I got the iPhone 4S? Probably not. Well, I did.) that I downloaded yesterday, Contraction Master, also alerts you to go to the hospital when you reach this point. And I gladly forked over my $1.99 for the first app I've ever purchased (with a hilarious name to boot) so that an electronic gadget can tell me to go to the hospital.

3) If you're panting you can't push. I thought this was a useful tidbit for attempting to avoid delivering your baby on the side of the road. Although our instructor definitely emphasized appropriate breathing techniques to get you through labor or (more likely, as she pointed out) to get you to the point when you have an epidural, she mentioned that if you're stuck in traffic and worried you might not make it to the hospital in time, pant and do everything she told us not to do to help labor progress in order to keep that baby in until you make it to the hospital.

4) You should be able to feel your legs after the epidural has taken full effect. This is useful to know so I can advocate for myself (or, more likely, get Matt to advocate for me). I've had several friends mention that they couldn't feel their legs after epidural administration, so I was interested to hear the nurse's take on this.

5) Work with gravity. This is the one tidbit that, in and of itself, I knew already, but our nurse went over some specific examples that helped me make sense of all this. Specifically, in early labor, especially before heading to the hospital, walk around and keep your legs open. If you're experiencing back labor (which results from the baby's head descending in the wrong direction, something I did not know before) try leaning over a chair and perform a pelvic rock and/or apply an ice pack to your back. Probably the most fascinating gravity strategy she demonstrated was going into butterfly stretch position after receiving an epidural as a way to gently nudge the baby down. All this time I thought women with epidurals had to just lie in bed on their backs or on their sides, and realizing that the butterfly stretch could be achieved and be effective was eye-opening for me.

6) In case your water breaks while you're asleep, a plastic sheet, shower curtain liner or heavy, folded towel underneath your mattress pad might be a worthy investment to protect your mattress. I think I might just try the towel option, as this is not a major concern of mine (famous last words, right?).

Additionally, it was helpful for me to see some medical instruments in person, such as a catheter (yuck, gross, but probably necessary), an amnio hook for breaking the amniotic sack if necessary, and forceps, the dreaded instrument (that I can still thank for my wonky eye 30 years later).

It was also helpful to see a box full of all the items the INOVA hospitals provide its patients for personal care, with a reminder to stock up on free extras from the hospital before being discharged. (Disclaimer: it's about to get real, again, people.) 

Specifically, the hospital provides those maxi pads you've no doubt heard about that add a whole new meaning to the word maxi...seeing one in person was...eye opening? Something to look forward to. But there were several other postpartum supplies I'd read about but didn't know if I'd be receiving from the hospital including:
  • plastic-encased ice packs (the kind you twist to activate) and then put inside your giant adult diaper maxi pad
  • Tucks witch-hazel pads, which are not just for hemorrhoid relief but also for soothing stitches
  • a peri bottle for rinsing your lady parts after using the bathroom
  • Advil, because when you're no longer pregnant ibuprofen is safe again and (at least the INOVA staff believes) better at postpartum pain relief than Tylenol (acetaminophen)
  • stool softeners, not a maybe...a must!
  • and, most surprisingly, a sitz "bath tub," which is basically a glorified potty chair you position over the toilet to help with vaginal pain relief (I just went there)
And perhaps the biggest take-home message of all that I hope you, dear reader, will apply to your own life: go tell your mother how much you love her RIGHT NOW.

P.S. Two points I forgot to mention as funny sidenotes: 

1) Clearly this class came at the right time, not only as I hit 36 weeks pregnant, but also because two nights ago I woke up from a horrible nightmare where I gave birth to a 15-pound baby (by c-section, of course) and when I woke up from my general anesthesia and asked what happened, even my doctor said, "It was not pretty." 

2) Despite my organized, be-prepared-in-advance tendencies, I was tied with another woman as being the most pregnant woman in childbirth class. We are both due the first couple days of January, but everyone else is due in mid-to-late February.  So, it looks like a lot of people take a one-day childbirth class when they're between 28 and 30 weeks pregnant.

1 comment:

  1. Rather than ice packs to put in your undies, I recommend taking a maxi pad, running it under water and freezing it. That way you can wear it, it absorbs and also soothes you. The hospital used newborn diapers, tore a slit along the inside and then pored ice in and then put that in the hospital panties. These were AWESOME, but we never tried making them at home.