KatiAnn Answers Questions

Q:How do you handle the pain if you are not in a hospital?

A:First it is important to understand that pain is actually an ally to health and well-being. If a child is born without the ability to sense pain this is a serious health condition. We need the signals of pain to tell us when our health is in jeapordy. Having said that, it is also a normal reaction, when feeling pain, to want to fix it so two things are accomplished - 1)the health issue corrected and 2)the pain soothed. Midwives have a variety of supports that do just that. The most potent aide is the relationship with their client. Because they spend much more time with a woman at her prenatal visits (and are actually present for most of the labor as well as the birth) mom has much greater confidence and relaxation for the process.

Another HUGE support is the midwifery prenatal focus on NUTRITION! This is almost absent in the medical model of maternity care. By encouraging and educating and monitoring optimum nutritional guidance in pregnancy a mother reaches term in much better health. This means less pain and better labors.

Also - unlike medical care - it is rare for the midwife a woman sees during her pregnancy to not be present for her birthing. Most women undergoing medical care have a different doctor actually present for the birth than the one who they saw during pregnancy. The emotional connection and confidence that a woman has for her care provider is a huge asset to pain reduction.

There are also specific measures that markedly reduce sensitivity to labor pain:

  • Movement - unlike the majority of hospital labors which involve women primarily staying in bed - midwives encourage you to remain physically active during labor. Since you are not hooked to a monitor or IV pole you enjoy the freedom of full activity. This provides a well documented effect of reducing the intensity of labor pain and shortening the overall duration of labor.
  • Nutrition - again, this is not the focus of hospital labor where most often you are only allowed ice chips from the time you are admitted until delivery. In a midwife supported birth you are encouraged to drink a wide variety of fluids and to eat lightly through as much of your labor as you wish. The result is that your energy level is better supported as your body is provided the nutrients and hydration it requires to do this work. This also means less added discomfort from poor hydration or semi-starvation. Anything that reduces discomfort will also reduce your sensitivity to pain.

    Also poor hydration results in inefficient uterine contractions. Recent - 2001 - medical studies show women NEED almost twice the IV volumes commonly given. Poor hydration results in longer labors which is directly associated with increased C-sections, forceps, medication, vacuum extractions etc.

  • Water - both the shower and the tub are invaluable assets in providing pain relief. This is so well proven that even hospitals are starting to use tubs in designing birthing suites and increasingly use showering during labor.
  • Environment - when a woman is in her own home or other non-hospital setting she is much more in control of what is happening to her. The subtle effect of this is to decrease some stress - always a benefit in supporting labor. In your own environment the intensity of the impending birth is tempered by surroundings that are familiar, comfortable, and NON-AUTHORITARIAN. If stress is reduced than so are levels of hormones that interfere with oxytocin production. Again - this means a shorter more efficient labor

    Some other tools include:

  • Accupressure
  • TENS units - electically interferes with pain signals
  • Herbs/Homeopathics - various forms for relaxation, diminishing pain, sleep promotion etc.

    Q: Don't most women have to have an epidural to stand the pain?

    A: It is a sad commentary that today so many women fear birth that they feel deeply this is the only way to "tolerate" labor. Women are held hostage by the medical community with the illusion of "pain free" childbirth. This attitude keeps women shackeled to a mode of care which undermines confidence that their bodies work. It also keeps women enmeshed with a form of care that has been documented over and over again as "interfering" with the process of MOST births. Yes, labor hurts! But you don't usually need morphine to deal with a sprained ankle. Yet it is often implied when speaking with a medical professional that the "epidural" is the BEST solution to labor pain.

    The truth is that 90% of women birthing these days (including about 70% birthing in industialized countries) do so without epidurals. Yet they do not view the process as one of unendurable agony. This is a great tool for some particular circumstances - but very real risks are commonly glossed over when information is given about the "benefits" of this technology. The attitude is invariably "if this little thing happens - and it is sooo rare - we can take care of it" (no big deal).

    BUT, MEDELING WITH THE NORMAL PROGRESS OF LABOR AND BIRTH ALMOST ALWAYS CAUSES A PROBLEM OF SOME KIND FOR THE MAJORITY OF WOMEN! MANY ARE A BIG DEAL!

    Epidurals have side effects that do cause problems for many moms and babys. These tend to be downplayed as of little consequence when a doctor or nurse is explaining the epidural to a woman in labor. But the problems caused are significant. They interfere with the progress of labor to such a degree that a woman has a greater risk of having to have a c-section or forceps or vacuum assisted delivery. All of these have added risk for injury to baby or mom. Epidurals can be misplaced - you can get a spinal headache (and they are horrible - worse than labor). Studies have now shown babies can have feeding difficulties for up to a week after birth. This can cause serious problems for breastfeeding in particular.

    Epidural use is a great tool when necessary - but in todays medical care system it is used so often it is abusing the birthing process not aiding it for a huge number of women.

    Q: Isn't it dangerous to not have your baby in a hospital - don't you have to have a doctor there?

    A:WELL - I do have a bias that the opposite is better. Hospitals, doctors and medical care are very important when there are problems. BUT... Most babies that have been born on this earth have been greeted by Non-physician hands. Most births are problem free if you have confidence in the process instead of FEARING THE RARE OCCURANCE and that your patient might sue you. It is well documented that there are no differences in statistics for deaths of mom or baby in midwifery or physician care. It is also well documented that actually hospital statistics are far higher for forcep delivery, infection, c-section, drug complications etc. In other words there are more problems and injuries for a healthy woman and her baby if they are receiving medical care than if they use a midwife.

    We have become so dependant on the idea that the doctor can fix it all and knows it all that most women in this country will doubt what they often sense is a better choice. After all "HE/SHE is a Doctor. In England, France, Holland and many other counties that have better birth statistic than ours, midwives provide most of the care and 50 % or more of the births occur at home or out-of-hospital clinics. In this country it is economically beneficial for physicians and hospitals to keep women convinced that the only safe place is "THE HOSPITAL".

    Send KatiAnn an email message to answer any questions.
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