Friday, April 03, 2009

The Politics of Childbirth

I've been through this once before.  The "this" I'm referring to is the politics and, essentially, the judgments of giving birth.  We had a wonderful doula before and want to use a doula again.  A good friend of mine has recently become a doula, but her mother has some serious health issues and I am either not selfish enough to demand that she give her full attention to me or too selfish that I want it.  Our doula for Conor's birth will be on vacation during the twins likely time to pop out, so she can't commit to fully being there, either.  

So we've been looking for a new doula.  I have to admit, right off the bat, that my tolerance for annoying things is very low right now.  I just can't be bothered with bullshit lately.  It makes me cuss (more than usual).  

So I've spoken with two doulas who are members of the Local Doula Network (LDN).  I'm not going to name names or name organizations, so the LDN is not a real group.  I also don't want to offend anyone in the area who absolutely loves their experiences with this group.  To be quite honest, if I was having a singleton, they would fit right in with my goals.  But I'm not having a singleton.  And some of the statements I've been hearing could be  interpretted as dogmatic.  I'm sure in a less pregnant state, that would not be the case, but I actually do not agree that the *only* way I can have a vaginal birth with twins is to have a home birth.  After 8 miscarriages, I am not giving birth to my twins at home.  I want a hospital birth.  Besides, 50% of twins are delivered vaginally in a hospital.    I can explain the difference between 50% and 100% if you need me to, but it will only make me much, much more annoyed.  

I assume that most professionals (OBs and doulas alike) are trying to do the best they can. I fully understand that professionals view their jobs through particular lenses, which may not be the same lens I view the world through.  But that alone does not make them evil incarnate.  And people who automatically assume that others are GOING TO DO BAD THINGS, because of their gender, ethnicity, country of origin, or PROFESSION, annoy me in the best of circumstances.  Now, it makes me likely to open up a can of twin pregnancy whoop ass on them. 

So I would argue that the premise that I can only have a vaginal delivery at home is false.  In addition, do you know how rare a twin pregnancy is?  1 in 87 births are twins.  Do you know the current probability of being an adult and being in prison in the US is?  1 in 33.  You're more likely to be in prison than to give birth to twins.  Even if you account for both a mom and dad (2/87), you're still more likely to be in prison than to be a parent giving birth to twins this year.  

So, let's go back to the home birth option.  A doula and/or a midwife would have to see well over 150 births to see 2 sets of twins being born. At 24 a year (two births a month), they would need over 6 years of experience to attend two twin births.  There is no way in bloody hell that I am going to be the first twin birth someone has every attended.  You are effing kidding me.  And for someone to push a home birth for  me feels to me like they are working off their own agenda (to see a home twin birth) than to help me have the birth I want to have.  

So what birth do I want to have?

1)  I want a vaginal birth.  Baby A is already head down and my primary OB has been trained in vaginal breeches.  So even if Baby B stays breech now or after Baby A pops out (the second twin will somtimtes turn after Baby A leaves), I believe I have a real option of having a vaginal delivery of my twins.  

2)  I want a vaginal birth because I want to be able to breastfeed as easily as possible.  Vaginal births help one's body know more quickly that it's time to make milk.  Even if I have to have a c-section for the second, my body will already know from the vaginal delivery to pump up the jam.  (or whatever)

3)  I'd rather have an unmedicated birth, but I'm willing to give on this.  If they did have to do a c-section for the second baby and I wasn't using an epidural, they'd have to put me completely out.  The delay in starting breastfeeding and bonding would bother me.  

4)  Instead, I want to labor as much as I can at home and perhaps I could even bypass the whole problem by popping the babies out before there was a chance for an epidural or a c-section.

Things I know that are going to be sucky for me giving birth at a hospital:  I'm going to have to deliver in the OR.  I hope I can labor in a regular room, because I would hate to spend 4-6 hours in a cold, sterile OR.  Bleah.  It is more likely they will push for a c-section early on.  However, with my doula and my primary OB, I believe I will get the support I need.

But still the main goal is a vaginal delivery of (at least) Baby A, no NICU time for either baby, and two healthy twins coming home with me 48 hours after delivery.  

All of those options seem reasonable.  And they seem reasonably likely in a hospital.  To say otherwise and imply that I am wrong and I don't know what I'm talking about is likely to let you hear a stream of words and phrases you didn't think pregnant woman could say outside of an unmedicated labor.  You don't want to go there.   

And, BTW, we do have a doula.  She is not going on vacation this year and she works as a childbirth educator at the hospital we are going to use.  She will help us find the right nurses to meet our goals and she thinks a vaginal delivery is quite possible.  So, phhht.  

Don't annoy me for stupid reasons.  It doesn't help anyone.  :-)


Kim said...

Go Anita! It sounds like your goals are so logical and non-risky! I HATE stories about child birth where the mother just HAS to have a home delivery or whatever - even when it isn't the safest option. As an adoptive parent, my 10 cents says, the birth and its story is important, but not the end all. A healthy baby is the most important - or, in your case - babies!

Piratewench said...

Good for you! In the long run you will be doing what is best for those babies and yourself, whatever it is!

I didn't have any options. Since I had Max via c-section, my OB was not willing to deliver these twins any other way. It was not so bad though, for one thing, being unable to breastfeed, I wouldn't have benefitted in the same way that you will from a natural delivery. The first c-section kept me in the hospital for 4 days and this last time around I was out of there in 2!!!!

Anyway, I sure hope you get your wish!!


Birth plan - birth plan - birth plan.
Glad to hear you have a doula.
You can birth vaginally with twins-- being a doula and a montirice myself I would say that 85% of all my twin mom's that I assisted had vaginal births.

Hang in there:)

OneTiredEma said...

From what I hear, you don't get moved to the OR until Things Are Imminent.

You are, as usual, being smart about things...

Veronica said...

One of the things that made me so confident and comfortable about my doula was that (even though I was having a singleton), the first time I met with her, she was on a high from her successful partnership with an OB on an unmedicated vaginal hospital birth of twins. She was all about the mother and enabling the birth that was safe for the baby/ies and both safe and empowering for the parents. I'm so glad you found someone like that.

Anonymous said...

Mom of 1 year old twins her born via c-section because A was breech - he turned from head down at 30 weeks and never flipped back! But even with the c-section start I've been able to breastfeed them all this time. Here's hoping you get the vaginal birth for both babies but if you don't, just wanted to send words of encouragement regarding the ability to still breastfeed.

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