Cesarean Birth and Prevention

Blog post featured image: Photo by Jonathan Borba on Unsplash

Blog post featured image: Photo by Jonathan Borba on Unsplash

--- BEGIN TRANSCRIPT Instagram.com/homesweethomebirth ---

Hi. I wanted to come on and talk about cesarean and why I'm so passionate about preventing it. 

But what I want to mention first is that the rates in this country, in the United States, are going up and our outcomes are getting worse. Okay. The national average is 30%.

That's just unacceptable.

Some hospitals around where I live, the rate is 40 to 50%. Unbelievable. Why? There are so many reasons why, but I just want to share something with you.  

My rate is 5%. My rate of cesarean birth is 5%. I'm not bragging. This has nothing really to do with me. I, 

What's different. Why is that?

Why do you think the rates in my practice are 5%, and the rates in the national average of hospitals are 30% and climbing?

The families that come to my practice don't have different bodies. The people don't have different bodies. 

You know what's different. They're getting midwifery care.

They're getting midwifery care. They are low risk and healthy. And maybe someone even labeled them as high risk, but they're not really high risk. They're just healthy. They might have an issue or two, but you know what they're doing? They're taking responsibility. That's also what they're doing.

They're preparing as I recommend them to prepare, and they're taking responsibility for the birth, they're not just saying to me, do whatever, right. 

They are taking it upon themselves. 

Why do they need to prepare? I'll tell you why they need to prepare, because I know that women's bodies know exactly how to give birth. A healthy body knows how to give birth. Right? 

Why in the West do we need to prepare? Because we're in the West. We're in the Western culture.

I feel so strongly about this because I do hospital shifts. I do hospital shifts and I love to do hospitals shifts in hospitals that serve the immigrant populations.

I love that. And I can actually do prenatal care and help a mama in labor as much as possible with my heart and with my Spanish. Now I am not fluent, okay, but I love working with this community, the immigrant population that's coming up, because I'll tell you why. Not just, I love them, but the less Westernized they are, they don't need to take childbirth classes, they just come and birth just like that. 

And you know why? Because the newer they are to this country, the less westernized they are, they came from countries where they were surrounded by people having birth. And in a community. And the women in their community, the elders, the wiser ones would talk to them about it and they would see it. 

I mean, I just spoke with a grand-momma, an abuela, who had 11 babies in her casa - back in her country. 11 babies in her Casa. That's what everybody did.

She didn't need a childbirth course. She was surrounded by everybody doing that. So, she got that education, and she got that by osmosis, that “We know how to do this. This is what we know how to do". And you know what, it's hard, but we can do hard things. Like we don't need to numb ourselves from pain. They deal with pain. They just deal with it. The more westernized they are, the more we are in our brains, the more we are in fear. Not “we”. No, because I've healed myself, I've tried to de-Westernize myself when it comes to helping moms give birth.

And I feel strongly about this, because, we can't help the way of our culture. Okay. We get fear messages. Oh my gosh we get fear messages all over the media. You know, someone sees you're pregnant they're going to tell you a story. And we are addicted to Googling everything. We're just too much in our brains. It's just, it's just the way it is. We have to research this, we have to research that, and we have to numb. We're not comfortable with discomfort.

And that's why I love my yoga training. That taught me, that deep in yoga, to combine that with being a midwife is just an amazing combination. Yoga doesn't come from the West. It comes from the East. To be comfortable with uncomfortable. To be comfortable with discomfort. To be comfortable and relax into intensity. 

And I needed that to help me understand and how to help other people do that. But there are cultures around the world, here are countries around the world that never did any yoga. They just live in a community, and are surrounded by the elders and other women in the community. They just do it. You know, we do hard things. And we just give birth.

So, that’s why I think a huge part of the success of a lot in my practice, and a lot of my colleagues, is that we're really are, to the families that have a baby in the home, in our practice are Westernized. They might want to have a home birth, but it's their first time, they know nothing about birth. They haven't been around it. 

They tell me they don't know anybody that's had a home birth that I can connect them with. Well, I know tons of people that have had a home birth.

So, that's why I love connecting moms and their partners, so that they don't feel so isolated. But a lot of times the families that come to me, their parents gave birth in hospitals with all kinds of interventions and they just, they feel very isolated and unprepared. And, and just looking at videos and pictures, scrolling down, on Instagram is not the way to prepare. I'm sorry. It's not. And that's why I really think a lot of the success comes from myself and my colleagues really being insistent that the family who comes in to have a home birth is going to prepare like a boss, right? 

Get de-Westernized, get primal and get sensual, and learn how to relax into intensity and learn about birth because no one ever taught you. Right. And learn the techniques that you need to do to master your calm. And, and to just let your body do it. And, and I think that's a huge part of our success. 

I track my stats, and unfortunately the 7% of times that I have to go into the hospital, it's not because of an emergency. Emergencies are rare. We deal with them, or I can count them on my hand.

I'm the EMT. The midwife is the EMT at the birth. We prevent and we deal with any problems that come up. And if we need to go to the hospital, we need to go to the hospital.

But that's 7% of the time. That means 93% are having births at home.

But who is my 7% that needs to go to the hospital?
It tends to be, and I track my statistics. I've been tracking them for years. It's people with long, stuck labors, first time birthers, first time vaginal birthers, who did not prepare.

They just didn't want to take a course, they were preparing on Instagram or they, or they just weren't preparing at all before Instagram.

You can't prepare on Instagram. You have to take a class today. Yes. In the West. You have to take a class, unless your mom and your grandparents have given birth at home, and you're surrounded by, natural birth. Because natural birth in the West is very different. It's a very different experience if you've never done it before and you can't prepare on social media. Okay? 

Then, you have to think about who are you going to, who are you going to - let's say you want a natural birth. Well, if the hospital or the provider that you're going to is, let's say you're healthy and you want a natural birth, if the hospital and the provider that you're going to doesn't do natural birth. They're not into it. They weren't trained in it. They're into interventive birth, it's going to be very hard for you to have a natural birth, right? And one intervention leads to another intervention, leads to the other intervention, and unfortunately ends up in too much intervention and complications and cesarean births. 

I am so grateful for cesarean births for when it's necessary and that's why I post on it. And yes, we could have gentle cesareans for those mamas. Five percent - they're still human beings, and that's still a birth, and those mamas are rockstars because they need to have a compassionate, human, respectful family centered, gentle cesarean, and we can have as much as possible that home-sweet-home birth in the hospital or in the operating room, but we still have to prevent. 

So, you have to think about – even if you want a vaginal birth - let's say you want an epidural - if you want a vaginal birth, you have to know. Ask “What's the rate of cesareans in your hospital?”. Is it 30%? Is it 40%? Is it 50%? Then it's very unlikely - unless you prepare. Then have to prepare even more, right, to fight that system. Because, I don’t know, I talk about this all the time and I'm so passionate about it because I think that's how we make the change. 

How we be the change, how we make the change, is for you all to prepare yourselves and take back your birth and know what setting and what provider you're going to. 

And if you are blessed, if you're healthy, or you have a little issue or two, that doesn't risk you out of midwifery care. Find a midwife. 

That's the model of care in a lot of countries where the midwives who are trained. You know, I have seven years of training, it's not just a weekend course. I had to get my bachelor's, and I got my master's, and where I live, I need a master's degree. I have seven years of training and education, and it's specifically focused on supporting the low risk healthy.

Yes, we screen, we prevent, and we look. That's what prenatal care is all about, that relationship, and making sure that it is still safe and appropriate for that mama to have a home birth, or a birth with a midwife in the hospital. 

But midwifery, our specialty, is supporting normal. Keeping it normal. Lay low on intervention. No intervention. No interventions necessary when it's working well. 

What's an obstetrician? What's an OB/GYN. Do you know the difference? There’s a huge difference, and we need them, thank god, but an obstetrician and a gynecologist, OB/GYN, goes to medical school and does residency and extra training for high-risk pregnancies and surgery, to use very highly sophisticated technology to diagnose and treat high-risk situations, medically or surgically. But that kind of provider, I have doctors, I love the obstetricians that I work, but they always tell me they know nothing about natural birth. They're bored of it. They don't know what to do. They love the midwives. If someone's healthy, they say “you're going to get better care with a midwife”. 

So, it's very important for you to know the difference between a midwife and an obstetrician, their training and their background, because if you want a surgical birth, then no, you don't go to a midwife – go to a surgeon.

And that's what an obstetrician and gynecologist, OB/GYN is. And we need them. 

And that's why there are certain countries, that's why the United States ranks the lowest among all developed countries in the world, in terms of maternal and newborn outcomes. We're losing more babies and mamas, or having more serious complications with mamas and babies, than all the other developed countries in the world.

The countries that have the best outcomes are countries where, like Sweden, there's a lot of countries where everybody sees a midwife, if they're healthy. The doctor (obstetrician) is there for the high risk. High-risk and when surgery is needed. When medicine and surgery is needed. 

And that's how we serve the whole population of people having babies, and that's how we get excellent outcomes - live, happy, healthy mamas and babies. 

So last week I talked about a bleeding in pregnancy - this week I thought I'd talk about this.

If you found that helpful, comment, share. I'd love to hear what you have to say, but that's all for now. 

Have a wonderful weekend. Bye.

--- END TRANSCRIPT ---

 

Plan like a Boss! Create your ideal birth plan and take back your birth!

Feel empowered and prepared for your childbirth experience and all the possible interventions you need to make decisions about - whether you are planning to birth in the hospital, birthing center or home setting! :)

Creating your ideal birth plan with this FREE video and ebook guide will not only help you prepare in advance, it will:

  • help you speak up for what you want and what you do not want

  • provide the keys to prevent high rates of unnecessary, risky medical and surgical interventions and birth trauma, and

  • coach you about the hows and whys, and some great recommendations for helping you design the birth of your dreams!

This is the special guide that I give to each family in my practice, that has been refined and refined over the many years of practice, brought to life in an updatable, printable and shareable guide.


Then use these different but crucial resources to prepare like a boss! Prevent that first cesarean or plan your VBAC! It takes work and is worth every penny, but this is your and your baby’s health and life we are protecting.

Love Your Birth Course
Sale Price: $337.00 Original Price: $449.00
Get a comprehensive holistic reference guide to the journey of getting pregnant, being pregnant, birth, breastfeeding, postpartum and beyond. Check out the second edition of my international and national best selling book Natural Birth Secrets.

Get a comprehensive holistic reference guide to the journey of getting pregnant, being pregnant, birth, breastfeeding, postpartum and beyond. Check out the second edition of my international and national best selling book Natural Birth Secrets.

Getting Real With A Mama in My Practice Who Rocked Her VBAC

Part one and two of a an awesome video I was invited to do with Joni, a mama in my practice who had a homebirth birth after cesarean, that really brings together many things pregnancy, birth, and breathwork, holistic health and healing.

Learn how to rock your VBAC and have the birth of your dreams with these three different but crucial resources - so you can prepare like a boss!

Love Your Birth Course
Sale Price: $337.00 Original Price: $449.00
Get deep in this childbearing bible, a reference guide for the whole journey from planning a pregnancy, expecting, birth, postpartum and newborn care, with effective holistic modalities for common discomforts and issues along the way.

Get deep in this childbearing bible, a reference guide for the whole journey from planning a pregnancy, expecting, birth, postpartum and newborn care, with effective holistic modalities for common discomforts and issues along the way.

Beautiful Home Birth Story of Baby 5: Keys to Transforming Fear

 
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“The birth of Ezra was one of redemption and renewed faith in letting go and letting love be our covering. The whole pregnancy I had to ignore toxic fear, and just believe that he was going to be okay and we were going to be okay. With my four previous births, I delivered naturally, at home with a midwife and at a birth center in Norway where my husband is from. Each birth is story written in my mind, body and soul as a testament of faithfulness, strength and lessons discovered through seasons and growth ... separation and fulfillment. Somewhere in the practice of ignoring fear, I became ready for a birth that til this day, I'm at a loss for words on how to describe other than that I was so present that I could anticipate his decent, and catch him in a little less than two hours.                   

On December 3rd, the kids, my husband and I were doing what we had for weeks leading up to that day, preparing to meet the baby. For the kids, preparing was coloring pictures for the baby, talking about him and folding a handmade blanket over and over that my seven and six year old had made for him. For me it was cleaning, resting, eating a good meal and resting some more, going on walks, drinking herbal teas, watching the lunar phases and talking with my birth team. For my husband it was preparing the pool, helping with the kids and cleaning. On the morning of the third he picked up an early dinner for the two of us from our favorite Indian restaurant and when he came home, we sat down to eat. When I stood up, my water broke and we looked at each other with shock. It was 4:15 in the afternoon and this was it! 

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I texted and called the birth team, my family and our friend who was going to keep the younger kids. Gathering the kids, getting into more comfortable clothes and Gaute filling the pool up, I had quickly progressed to contractions that were 3-6 minutes apart… deep, piercing and I would soon have to stop and go into a separate room to cope quietly as the friend arrived to bring the kids to her house. Anelyn stayed with us and I just knew that the baby would be born within a couple of hours. The midwife, Bethany, my friend Amber who's a doula and photographer and a midwife's assistant arrived soon after I had texted. Shortly after they arrived and checked on the baby, I got into the pool to labor through the deeper contractions. So close. 


The sun was going down, the water was warm, as the contractions came, in my mind I whispered and thought comforting and peaceful thoughts… ‘This is good, it's okay, I'm okay, this is good, I love you, baby, you're doing it, I'm doing it, you will be here soon, breathe, he'll be here soon.’ I said that it would be, ‘Just a couple more contractions.’ Sure enough, two more contractions and he was presenting, I reached down and pushed 1,2,3 and he was in my arms. I just wept and wept... It was 6:04 pm and he was in my arms, so perfect and peaceful. I wept a tears of joy and pure shock that I was gifted such a beautiful and empowering birth, I looked at my husband and his face was glowing with tears, my daughter was leaning over to get a look at her new baby brother that she prayed for, a dear sweet baby to love. The birth team surrounded us with love, supporting, documenting, celebrating and serving so peacefully. This was the Birth of Ezra.

Thank you for your powerful and inspiring work and allowing moms share our stories.”

Rockstar Mama: Christan R @mommareveur 

Awesome Photographer: Amber Rhodes IG @amberdenaephotography and @amberhodes 

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There are so many wonderful ways to transform fear so common today, and have a beautiful empowering birth at home, in a birthing center or hospital. Excellent childbirth education and preparation in advance are crucial, and a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want. 

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of having a birth of your dreams is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

“Anne Margolis was my incredible midwife. She is practical, science-based, and vastly experienced, but most importantly, she’s an awakened woman here to light the path to your most joyful self. Anne is the incredible midwife who taught me, through t…

“Anne Margolis was my incredible midwife. She is practical, science-based, and vastly experienced, but most importantly, she’s an awakened woman here to light the path to your most joyful self. Anne is the incredible midwife who taught me, through this process, how to midwife my own patients’ rebirth experience.
Her own educational course is a deep but manageable dive into her accumulated wisdom, packaged for your journey. Forget your childbirth class, and take steps to your most empowering experience. If you are thinking about conception, pregnant, or love someone who is, take it from me that her wisdom is life-changing.Yours in the truth.”

— Dr. Kelly Brogan MD

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

 

Healing VBAC Birth Story

 
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“My first birth was a natural birth gone wild - my sons leg came out after 24 hours of natural labor - - so this VBAC was soooooo healing for me!!!!

I still cry thinking about both births!” Kimberly Spair of Reclaimers of Health

Here is a glimpse into my birth story, written by Birth Doula https://philadelphiabirthdoulas.com/ 

VBAC baby girl arrived on November 9 after 48 hours birthing!! (Vaginal birth after cesarean!) Past her October guess date it began November 7 at 8 pm and after exactly 48 hours of unmedicated birthing, Hypno-baby Braelyn Mae arrived our world at 7:55 pm naturally at 9 lb 4 oz. After over a day of consistent pressure waves (contractions) exhausted still at 4cm, mom released her emotions and fears about a repeat cesarean. Her first birth was scary and traumatic. She expressed her fears and replayed trauma of her first birth with us. We honored her, we reminded her that this is a new beautiful birth, and that she was doing it.

Birth was filled with beautiful intense emotions, physical challenges, consistent counter pressure, and mom continued to change positions, in and out of the birthing tub, using her natural instincts and accepted every suggestion to birth her baby. Mom pushed for 4-5 hours and then her moment was here… she reached down and their beautiful baby girl was in her arms.

“Fear is what got me through. I was MORE afraid of a c-section and more trauma. My birth was extremely hard-but not traumatic! I guess I can say “old fear” because I had very little fear of going naturally.” She shared and released her fears with us although what WE saw throughout her entire birth was fear that she overcame with COURAGE, STRENGTH, DETERMINATION, AND CONFIDENCE.

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It was an honor and joy to be part of this special family’s beautiful birthing. They mean so much to me. We were fortunate to have a calm, supportive environment and to work with an incredible midwife. All birth is beautiful, all birth is unique. Going on 6 years as a doula this birth experience was truly unique to any birth I’ve had the opportunity to support. I can’t possibly describe this 2-day birth in an announcement. One strong mama! Mama, You inspire me and I thank you for inviting me in to be a small part of your pregnancy and birthing journey. So proud of you. You did it! Thank you for sharing your birth as I know you inspire many other families. Congratulations to a very special family of four. #VBAC #Hypnobabies #unmedicatedbirth #VBACaccomplished #VBACthat #wowbirth #ilovewhatidoula

Was your birth upsetting or traumatic? Do you have more questions about processing your birth and need help healing? Arrange some time to chat with me. I’d love to answer your questions and help you heal and get yourself back - I have a program specifically for you, that can also include this revolutionary and profound natural healing modality called Clarity Breathwork.  Helping women heal from birth trauma is one of my passions and areas of expertise. 

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This is why excellent childbirth education is a must, why planning for your birth is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want. 

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of preventing birth trauma is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.

In looking for that supportive birthing space I talked about earlier, seek care providers and settings that have a low intervention rate (low rates of medical interventions like inductions and epidurals, low rates of cesareans, etc.)—their practices are more likely to be in line with your goals.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

 

Understanding Epidurals and the Benefits of a Natural Birth

 
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We’re discussing the pros and cons of epidurals! What is their place in the medical world and should they be as commonplace as they are?

Modern medicine today encourages epidurals like water. This doesn’t make epidurals inherently bad - they are simply being misused and overused. It is time we tell the truth about epidurals. Physician, neonatologist and researcher Dr. Michael Klein, points out in his three part Science and Sensibility blog analysis of the evidence

on epidurals, “Women need to be accurately and completely informed of their choices for pain relief in labour before they can provide their true consent. No matter how well intended, epidural analgesia increases the likelihood that women will have a variety of other interventions, especially if the epidural is given without specific medical indications….When used routinely as a first line agent, epidural analgesia can create problems that could have been avoided.”

Epidurals can be literally life-saving in a dire situation when a cesarean birth or medical induction of labor is needed, and there are times when they are indeed warranted, but there are serious concerns about their use in a childbirth process that is proceeding normally and healthily - when their risks outweigh their benefits.

I will hopefully give you an enlightening look at the different sides of epidurals, including the situations when they are very necessary. You making an informed decision for yourself, is what’s important here. But do your research.

Learn more about the intricate process of labor and delivery, as well as what your mind and body are doing during each stage, the purpose of its sensations and how to best cope with them. I go into this thoroughly in my online Love Your Birth course. The more you really understand what is going on, the less you will fear it, the more you will trust and lean into it. And know your strength and capabilities. You’d be surprised at what you’re able to withstand and overcome!

It is crucial to prepare for coping with natural labor, even if you think you will want or need an epidural, as you will still have to experience parts of labor, it is not always an option depending on your health history, the anesthesiologist does not often come right away, and the epidural does not always work adequately.

How do Epidurals Work?

An epidural is an injection of a large needle in the lower back that pierces the covering of the spinal cord. Medications are injected through a tiny catheter threaded through the needle, into space surrounding the spinal cord and then they infuse the nerves nearby. These medications consist of usually a regional anesthetic and an opiate.

The anesthetic drugs temporarily block the sensory nerves which usually create the numbing and this, in turn, inevitably blocks the motor nerves with some degree of paralysis. The opiates are included because they increase the effectiveness of the anesthetic, allow for less dose required, while working to decrease the blockage of motor nerves at the same time.

The Cons

The true downturns of using an epidural occur in a birth that is perfectly healthy and normal are many, according to the research. This will then lead to a cascade of other risky and dangerous interventions just by taking a drug in which there was no need in the first place. In fact, epidurals increase the risk of requiring a C-section, especially when given too early - but there are plenty of other reasons for this.

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According to Dr. Kelly Brogan’s research, there’s been a 60% rise of C-sections since 1996. A study has shown that a prolonged second stage of labor is the main reason for most C-sections. This prolongation can be directly linked to the use of epidurals, for many reasons, including a mom’s decreased ability to push effectively and her needing to be in supine positions that make birthing more difficult, as it goes against gravity and pelvic capacity is at its smaller dimensions.

Related: The Unnecesarean Birth Story - How It Might Have Been Prevented

What happens after this prolonged stage? A myriad of interventions to “help” induce the birth: “food and drink restriction, immobilization, IV fluids, bladder catheter, medications to augment labor, and continuous monitoring.” All of these will only encourage the need for even more intervention, like vacuums, forceps, episiotomy and increased probability of more severe perineal tearing into the anal sphincter and rectum, or major abdominal surgery. All medications, invasive interventions and operative deliveries risks birth trauma and injury to the baby as well as the mother.

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Epidurals prolong all stages of labor. They increase the incidence of fever for mom, which leads to IV antibiotics in case of infection that most likely is non-existent. Antibiotics disrupt the microbiome and lead to all the associated health risks of interfering with the healthy balance of bacteria within the body for both mom and baby. It can also lead to signs of fetal distress, which then lead to other interventions from needing oxygen to emergency surgical delivery.

This drug administration does upset the normal hormonal balance during labor. While the very nature of an epidural is to alleviate at least some of the pain and so easing a good chunk of stress, some stress during labor is actually quite good for both mother and baby.

Cortisol (the stress hormone), for example, lessens mom’s exhaustion; it gives the mother energy to push, and heightens her euphoria and sense of excitement—a big part of the natural birth experience which we’ll get into a bit later—and this euphoria actually increases bonding with the baby. For the baby, the healthy “stress” of being born turns many biological processes on during the whole birthing process, like the breathing instinct at birth, which eases transition to adjusting to life outside the womb. No surprise that babies may need more assistance to breathe.

There are so many effects that also take place in the aftermath of the birth since an epidural is a narcotic that’ll pass from mother’s circulation, through the placenta into the baby’s bloodstream.

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Evidence supports risks to the baby from epidurals, that include reduced muscle tone, poor feeding, jaundice, withdrawal, and sensorimotor impairment. Epidurals have been linked to failure to establish breastfeeding and this is not to be taken lightly, as breastfed babies have much healthier outcomes and less health risks than formula fed babies. Newborns also can get a fever and increased heart rate from the epidural, without having an infection, but separation from mom and extensive work-up in the neonatal intensive care unit ensues for evaluation, including blood tests, spinal tap, and precautionary IV antibiotics.  Renowned childbirth educator Penny Simkin highlights that “epidurals can result in short - term subtle neurobehavioral effects, such as irritability and inconsolability and decreased ability to track an object visually or to shut out noise, bright light. There are no data on potential long-term effects....Decreased infant responsiveness may lead to long-term consequences for the parent-infant relationship... (risking) labels of “difficult child” or “incompetent mother” (self imposed or by others).” 

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The mother can experience some annoying but distressing side effects - mostly from the medications entering her bloodstream and/or administration error, like itching, nausea, shivering, spinal headache, residual numbness, tingling and weakness, backache, as well as alarming side effects, like difficulty swallowing and breathing, rare permanent nerve damage, convulsions, respiratory paralysis, cardiac arrest, and even death. Evidence based care expert Henci Goer points out in her ongoing evaluation of risks and benefits of maternity care, that epidurals cause, “Somewhere between 1 in 1,400 and 1 in 4,400 women to experience a life-threatening complication.”

This is some very scary stuff! And yet, epidurals aren’t so much the problem as are our society’s tendencies to consider them such a benign and advised common practice for the majority of laboring women.

Epidurals necessitate hospital birth, and eliminate the home and birth center option, which are associated with better health outcomes physically and emotionally for mom and baby, when it comes to low risk healthy childbirth. Dr. Klein poignantly elaborates on the concerns that epidurals have medicalized birth so much so, that they increase the demand on the nurse to pay greater attention to the technology of all the resulting interventions, and consequently have less time, experience and skill to provide needed hands-on and emotional support for the laboring woman.

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Disruption of the normal hormones of labor with epidural use can cause the laboring mom to feel detached from her own childbirth process and to becomes more of an observer than a participant. Studies indicate that women who had an epidural may have had less pain, but were most dissatisfied with their experience even up to a year later. The provider and nurse can no longer assess labor progress by observing the mother and must rely on the monitor - which makes the experience more impersonal - and vaginal exams - which are invasive and increase risk of infection. Use of epidurals and the anesthesiologist alone raise the cost of care, and it increases exponentially with the cascade of hospital interventions that result.

So, when are epidurals medically appropriate? In an urgent or concerning health situation when there are serious complications, but not in a normal, healthy, natural birth. They can be also psychologically appropriate, in individual cases.

The Pros

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One of my founding philosophies in helping women to have a safe, healthy and transcending birth experience is that a birth (of any kind, in all settings!) isn’t a medical procedure—it’s a natural and miraculous process of life. It’s not in and of itself a dangerous crisis.

That being said, I’d like to affirm that an epidural has its place in childbirth.

When a labor isn’t proceeding normally, when there’s a prolonged or arrested labor or the mother is experiencing exhaustion, extreme pain and/or anxiety, the compassionate use of an epidural could be the answer, and can enable her to relax, rest and progress to vaginal delivery. There could be a real medical need for medications to help induce or augment labor, which make labor sensations much more painful.  As a last resort, an epidural can help relieve the pain and stress from an emergency situation.

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A woman suffering from preeclampsia, for example, who receives an epidural anesthetic, will likely not have a prolonged second stage of labor. Epidural tends to lower blood pressure, which is a benefit in cases of hypertension.

An epidural could also be an advantage during a major operation like a cesarean;  in most cases, it carries much less risk than general anesthesia and is a great alternative to being unconscious from the high doses of those medications.

Epidurals can provide relief or reduction of pain without impacting mother’s mental state. Since birth by C-section is still a birth, an epidural can help the mom stay fully alert and pain-free during this operation. She’ll be involved, fully capable of holding and bonding with her baby even after a C-section operation, as opposed to being put out from a general anesthetic.

Keep in mind that I’m speaking of C-sections that are necessary because of endangering complications and serious issues. This is not the same as C-sections that are caused by epidurals themselves like we spoke about before. Cesareans in and of themselves are supposed to be the last resort, and indicated for serious life threatening health problems —the fact that we have them more and more often in America and that they are treated as a normal procedure during a labor is a sore reflection of our society’s ideas of pregnancy and birth.

Related: How to Plan, Have, and Rock Your VBAC

How do You Prepare for an Epidural-Free Birth?

Photo by @senhoritasfotografia

Photo by @senhoritasfotografia

Not only is a natural birth the healthiest way to go but science is more and more discovering ancient truths about birth.

The women who come to me want to have their pregnancy and labor in their own way and they don’t want to numb themselves to the healthy and normal sensations of giving birth. It is, in fact, your own birthright as a woman to have this right of passage into motherhood. The women I work with want to feel that empowerment and the high of successfully bringing their child into the world on their own.

Understanding what your body is capable of can begin to give you the confidence you need to begin planning your natural birth. My Love Your Birth course can help you prepare for the entire process from beginning to end. You’ll equally learn how to cope with and handle labor pains...so much so that you can love your experience no matter how challenging. The right preparation really begins with a shift in mindset, not just about labor but in what your body is capable of doing.

“In labor, such high-levels [of beta-endorphins] are released and help the laboring woman to transcend pain, as she enters the altered state of consciousness that characterizes an undisturbed birth. In the hours after birth, elevated beta-endorphin levels reward and reinforce mother-baby interactions, including physical contact and breastfeeding as well as contributing to intensely pleasurable, even ecstatic, feelings for both.” -Sarah Buckley, MD.

Photo by @senhoritasfotografia

Photo by @senhoritasfotografia

My rate of successful women having natural births is 93%--the other 7% of cases had complications that required medical attention or surgical intervention. But, in over two decades practice as a homebirth midwife, I’ve never once had  transfer a mother to the hospital for an epidural or any other pain medication because she couldn’t cope with sensations of normal labor. Never once! It is not that women who come to me have different bodies. It has more to do with how well they prepare themselves in advance, their attitudes and mindset, and how they are cared for and supported during birth.

Women are able to do what comes naturally when they are prepared, supported and encouraged to follow their own desires for their birth. Women have been giving birth naturally around the world since the beginning of time. Today we interfere more with it, and sometimes we get in our own way. Have faith that your body and nature both have your back—they were designed to know what to do! We just need to step aside. That takes advance preparation in the modern world, as well as care providers and settings that will have the same philosophy and expertise.

The physicality that is required to give birth has been compared to the performance of an endurance athlete! There’s an inherent strength in every woman to go beyond what she knows herself to be capable of. And when she does that, she is darn proud of herself; she has discovered her strength and capacity she can draw on for the rest of her life.

Learn as much as you can about what that is, about yourself and your body. The pride and joy that a woman experiences after giving birth naturally is overwhelming. So many mommas are overcome with their own capability to bring their child into the world.

Don’t deprive yourself of the sensations and transcending experience. You are able and you are supported!

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I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby. For more info on the Bellefit girdle, check out my blog about it hereHave a Great Postpartum Recovery (with a little help from Bellefit)!

 
 
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