Toward the end of the movie Dumb and Dumber, the character Harry has a stand-off with the bad guy in front of Lloyd and Mary (Swim…Swammy…Samsonite!), and he ends up being shot in the chest. A few minutes later when FBI agents enter, he comes back to life to reveal that he was wearing a bulletproof vest. Lloyd asks, “What if he shot you in the face?!” The FBI agent then replies, “That was a risk we were willing to take.”
I got The Thinking Woman’s Guide to a Better Birth for Christmas while I was pregnant, and it was most helpful in preparing me for a drug-free, mostly natural childbirth. As I have written in my birth story, I decided to have my water broken artificially when I was “stuck” at 9 centimeters dilated, so it wasn’t completely intervention-free. However, this book helped me make the decisions I did during my labor tremendously.
Most of the chapters of the book discuss interventions commonly used during labor, including C-sections, episiotomies, artificial rupture of the membranes (breaking the water), electronic fetal monitoring, IV’s, induction, elective repeat cesarean, and epidurals and other drugs. For each intervention, Goer gives an overview of the practice, a bulleted list of benefits and risks, and a summary of findings from medical literature. She also covers situations of slow labor and a breech baby as well as options regarding caregiver and birthplace in other chapters.
The most helpful part of each chapter for me was her list of pros and cons for each intervention. Though she favors a completely natural birth, I found these lists to be pretty objective. I appreciated that she could say that one intervention is preferred over another (e.g. having your membranes artificially ruptured early in labor is less risky than and preferable to being induced), instead of completely dismissing the use of interventions in every circumstance. In this way, she seems to understand that sometimes interventions can’t (or don’t want to) be avoided. The book serves its purpose well in educating women about the choices they will be faced with in labor so they can make the best decision for themselves and their babies. You will not get the information she provides from a hospital while you are in labor.
In the case of my own birth, the midwife and nurse were very good about following my birth plan. But when the doctor wanted to intervene, the midwife suggested that they break my water to avoid a C-section. Though Nathan never showed any signs of distress, I was on the hospital “you-must-dilate-one-centimeter-every-hour-or-we-will-cut-you-open” clock. In discussing this with the midwife, I was not told the risks of breaking my water. Only after they performed the amniotomy did they give any indication of what it entailed. They immediately hooked me up to continuous electronic fetal monitoring because baby may not respond well, they told me, to his “pool being drained.” Then they began taking my temperature frequently to make sure, they told me, that I wasn’t getting an infection, something that is much more likely after membranes have ruptured.
Both of those things could have surprised me. But because of what I learned in this book, I was prepared to make the decision I did with all the benefits and risks in view. I knew that because I was so far along in my labor that the chance of infection and fetal distress was greatly decreased than if the procedure had been done earlier, but I knew the risks were still there. I also knew that an amniotomy was greatly preferred to having a C-section, something that became a very real possibility for me because of hospital impatience with slow labor. And I knew that the hospital clock toward C-section would tick a little faster once my water was broken. But the C-section was already impending for me, so breaking my water would buy me some more time to try it naturally. I could say after the decision confidently, “That was a risk I was willing to take.”
And that’s why I think this book is helpful for any pregnant woman, whether she is natural-birth-minded or not. Women need to be informed about the choices they will face in labor and the possible resulting risks to themselves and their babies so they can determine if those are risks they are willing to take.
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