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Pre-natal Class Part 2 - Labour & Delivery

Posted Jun 14 2010 5:23pm
Friday was Part 2 of our prenatal classes which covered the all important Labour & Delivery!  Being the dork I am, I of course was looking forward to it.  Well, probably not looking forward to the actual class as I was looking forward to hearing the "what to dos" from the hospital where I am (lucky to be) giving birth.  I say "lucky to be" because our local Women's and Children's hospital is top notch, has an outstanding reputation whether it be for L&D or the medical care of the little ones and we are really lucky to have it here.  If I hadn't moved to Halifax, I wouldn't be as lucky to be giving birth at the IWK unless there was a high risk reason to do so.  I have only ever been told wonderful stories and experiences by people having had the occasion to go to that hospital.  The nurses and staff have always been given rave reviews.

The class started off having everyone introduce themselves and tell the class how you were feeling about "the big day" and when the big day was expected to be.  My response was "depends on the day!" which is totally how I'm feeling these days.  Some days it's nothing but excitement and pure joy about meeting our baby and what it's going to be like to hold him/her in my own arms for the first time.  Gah! I get teary just thinking about that part. Other days a little bit of anxiety and panic starts to hit home because well, the "big day(s)" is just that, right?

We referred to the resource book that was given out at the first class and the public health nurse started from the beginning addressing the signs and differences of the different stages of labour and how to determine whether it is in fact labour at all.  We went over the "possible" labour symptoms, early labour, active labour, transition and delivery.  She did a wonderful job going through all aspects of what to expect at each stage.  Because the average "first baby" labour tends to be in the area of 15-16 hours, she broke down that norm into how many hours to expect to be in each stage pointing out that the hardest part (transition and delivery) tend to also be the shortest! God bless her soul ;-) So I hope I can keep that in mind when my time comes!

Along with all of the things to expect at each stage, the next obvious topic was all of the different techniques you can use to cope with the pains of labour.  There are many.  Some of the options I can recall being mentioned were
  • Water (a big favourite - baths, showers etc. considered to be "nature's epidural")
  • Breathing (we practiced techniques too)
  • Lots of movement (keeps labour progressing along)
  • Distraction
  • Music
  • Meditation (hypnobirthing)
  • Massage & counter pressure
  • Changing positions
  • Birthing ball
  • TENS machines (which you have to rent on your own, but I happen to own one)
  • Nitrous Oxide gas
  • Drugs (epidural, narcotics)
There were some women in the class just waiting for the topic of epidurals to come up.  I was very interested in how this whole discussion was going to go down.  Some people make decisions beforehand that they know in advance that they are going to have one, others decide in advance that they are not going to have one and some make their decision at the time of labour.  One of the women sitting near me was the person who "finally" brought forward the drug option to our "buffet" of pain relief options and she commented quietly after, "Well we have to talk about it some time" almost like it was a tabou topic or something and seemed a bit concerned that it hadn't been brought up yet.

It was obvious to me before it was brought up that the nurse was painting a picture to the group that guess what? There are all kinds of other things you can do other than an epidural or in conjunction with, or in advance of having one and was encouraging consideration of all of the other options.  I was extremely happy that she was approaching it in this way because I'll be honest about how I feel here.  I have never been through labour and delivery before and while I am a bit, okay ALOT apprehensive about the pain associated with it, I haven't made up my mind for certain whether I will have one or not.  I just don't understand how people can just "decide" without truly looking at what the possible consequences are to making that choice.  I am just saying that I don't think it is a decision to be taken lightly or for granted.

I keep reminding myself that birth a normal part of life and I shouldn't be afraid of it so I'm trying not to be.  I am keeping an open mind because if there's any real consistent advice I've been getting from people who have been through it, is that anything can happen and holding a birth plan too strongly can sometimes lead to disappointment if it doesn't play out as you had imagined it would.  I personally believe that it's nearly impossible to script an experience that is first and foremost dictated my mother nature so I'm just going along for the ride and going to try to trust my instincts.

The nurse shared some rather surprising statistics with us about birthing at our hospital.  For starters, the epidural rate is 90%!!  9 out of every 10 women have epidurals giving birth at IWK.  This would explain why almost everyone I speak to tells me, "Oh just get the epidural and don't worry about it.  Why put yourself through the pain?  I had one and everything was fine."  An interesting comment she made was that because so many women were birthing with epidurals, it consequently has an affect on the labour assistance skills of the nurses as well.  If they aren't using those skills to assist labouring women, they can lose those skills eventually.  Interesting.

So far there is only one friend who I spoke to who gave birth there who "made it through" with no epidural although she said there was a time near the end where she had some nitrous oxide.  She herself, is a nurse and overall really pleased with her experience without an epidural.

The other statistic she shared with us is that the c-section rate is 35%!  That is pretty high when you think about it.  That's about 1 in every 3 women!  She had no explanation for the statistics being what they are as there really isn't anything in particular that can explain for certain, but our hospital is a teaching hospital and since it is the only women's and children's hospital in the Maritimes (I believe), many high risk pregnancies and births take place there, so it would most definitely contribute or explain part of it.

I will be honest and also say that if my baby's birth ends up leading to a c-section because of whatever circumstances, while I will understand that it's a necessary decision, I will still be disappointedThe reason is because I fear that I won't be able to hold my baby immediately after s/he is born.  That is really important to me.  It's all I think about when I envision the day our baby is born and it's all I've imagined from the beginning.  Even if with a c-section, it's within 30 minutes of birth, it will make my heart ache to have my baby handed to me all bundled up after the fact.  Sometimes those things are out of your control and are for the best, but even still, it makes my heart ache.

The nurse made a point that stuck with me and actually made things really clear as to why I am feeling reluctant to decide to get an epidural.  She said, "Once you get an epidural, you are essentially giving up control over your labour."  She said that the likelihood of further medical interventions does then increase for whatever reason, whether it be that your labour slows down (most likely because you can no longer move around as you could before), which can then lead to the doctors needing to administer Pitocin (a synthetic hormone of oxytocin that brings on labour) to keep it progressing or later requiring the use of forceps or a vacuum to assist or augment delivery, the statistics are that those kinds of interventions do go UP when an epidural is administered.  You may also need more guidance from them during the actual delivery, depending on what sensations you can feel or are unable to feel.  These have all become a "normal" part of childbirth nowadays.

I trust doctors and I trust science, but I also trust my instincts too.

We watched a few videos which included a natural childbirth, administration of an epidural and a c-section.  I fully admit that I was really ambivalent about watching the actual "birth" taking place on video, but it wasn't nearly as bad as I had thought it would be (or remembered from Grade 12 Biology class!) and very minimal on the "messy" stuff.  It's funny because I was really surprised at myself for shying away from actually wanting to watch it, but I just didn't really want to.  Probably because it's not really all that settling to watch even if it IS natural and normal and a miracle and all that. Knowing that's going to happen to ME is not all lollipops and gummy bears!  Regardless of if I watch it or not, it is an inevitable part of the amazing thing that is happening to me and our family and I still feel truly blessed to have the opportunity regardless of however many hours of unpleasant labour are involved.

Yes I know, cheesy, cheesy, but that's just how it is in the wonderful world of hormones :-)

Next up is hospital tour and pre-administration which is coming up in a few weeks.  Time is starting to narrow in on the main event here bloggies! Eeeeeek!

What was your experience with child birth? Loaded question I know! Did you have an epidural? Were you happy with your decision? Did you have a c-section? How was your post-pardom recovery?
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