The Business of Being Born Message Board

Q: Hello.  I am due on March 3rd with my first child and am 24 years old.  I am currently active duty army and will be delivering in a military hospital. While they appear to be very supportive of one’s birth choices I am concerned about being able communicate to them my wishes because  they are so used to the “traditional” delivery laying back with those feet  pulled up and most women at this hospital opt for epidurals also.  For some time I thought hey birth is natural, I’ll prepare as things get closer and try to listen to my body.  Now that things are getting closer I realize maybe I should have been thinking about the kind of birth I wanted to have sooner.  I don’t feel the need no be superwoman but I’ve realized I just don’t like the idea of pumping myself and my baby full of medication so I’ve opted for a natural birth.  I managed to find a weekend lamaze class to help but I want to give birth in some type of upright position like squatting — using gravity and opening my pelvic outlet just makes sense. 

But here is my question finally– how do I best explain how to do that to whoever will be delivering my child (probably will be some resident– won’t know until the day I deliver).  I mean the mechanics and positioning of the health care provider and any other special needs and considerations?  I’ve worked on this floor as a nursing student (early in my pregnancy or else I would have taken the opportunity to get more out of the experience) and everything is usually prepped for the “traditional position.”  I mentioned it at a doctors appointment and that doctor said she would be open to the idea but a lot depends on the comfort level of the provider–she doesn’t think anyone at that
hospital has experience in delivering in a  squatting position.  (Frankly I think it should be more about my comfort level not theirs– I’m the one in labor :-) but we need to work together.) Are there better pictures out there?  What is the best thing for my husband to do during the delivery to support me (physically and emotionally)? I just want the provider to be confident in the situation so I want to give them as much information so I don’t run into any problems.  If the provider really seems to be reluctant I think I just might bring in “The Business of  Being Born” and show them the clip of the woman
giving birth standing up  :-)     

Thank you. Sorry so long.   

From Melinda

Dear Melinda,
 
A:  First of all congratulations on the birth of your baby and on your work in 
preparing for the birth.
 
There is a wonderful program called Operation Special Delivery, (http://www.operationspecialdelivery.com), that provides free doula services for army wives. A doula will definitely  assist you and your husband in communicating with staff in the hospital.
 
Perhaps in your Lamaze class there are some hand outs in positions that you can bring with you, if not, you may be able to buy some on the web.
 
Most care providers in any hospital setting, not just military, that are okay with the squat position for pushing, still require the mother to lay down as the head emerges.  It is a personal and comfort lever for either you and the doctor.  Their reasoning, is that they can control the perineum and therefore avoid tears.
 
Another very helpful tool would be to write a small birth plan and highlight the part of positions for birth, that way you can handle that to the staff that will be with you during the labor.  Dr. Marsden Wagner who is also in the film wrote a very good book about 
birth plans and you can read more at www.marsdenwagner.com
(http://www.marsdenwagner.com) 
 
I wish you all the best,
 
 
Ana  Paula Markel ICCE, CD(DONA)
Certified Doula, Certified Childbirth  Educator
DASC Director of Public Relations
www.apmarkel.com
(818) 822-9568