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What's Better, Natural Or Medical Birth?

If you read one birth story before going into labor for the first time, read this one. It’s not about what’s going to happen to you. It’s not a cautionary tale. It’s not typical, perfect or inspirational. It’s a winding, messy narrative complete with splashing amniotic fluid, taco salad, nipple-sucking and an iPod.

But what I love about it most is that it shows the power of both “natural” birth and “medical” birth.

How perfect for our times?

I’m talking about “My 55-hour Labor” by writer/screenwriter Andrea Meyer. Meyer talks about her fantasy of a smoothly paced, three-act Hollywood birth, and then lays out her reality. The story goes from a cute Kate Hudson vehicle to something more akin to an Andy Warhol film: Long, boring, painful and in real time.

In the Hollywood movies, the water breaks, an arm shoots up; TAXI! And the next thing you know mom’s on a gurney being rushed down the hall, gripping loving husband’s hand. And you know what he’s saying: “BREATHE!”

But what happened to Meyer is a lot more typical. Her water broke, the labor had barely started and she was told to stay home. The contractions eventually kicked in big time, but labor was hard and slow going. She coped in a million ways by changing positions, showering, stimulating her nipples, walking, listening to music and getting very positive helpful reassurance from a doula. After 36 hours of doing everything under the sun, she had made it to 6 centimeters.

With her doctor, she decided to use pitocin– a drug that can induce or augment labor contractions– and an epidural to help with the pain. She had been hoping for a “natural” birth but at this point she’d done all she felt she could do and with her waters broken for 36 hours, there’s some concern about the risk of infection.

At first the medications helped her get to 8 centimeters but then, oddly, her cervix tightened back up to 6 centimeters. (This is unusual, but it can happen). More pitocin was administered and soon she gave birth. From soup-to-nuts it went 55 hours. Longer than your “average” first time labor, but not unheard of.

Meyer’s story is a perfect illustration of a scenario where all kinds of things helped: hard work, labor coping, water, movement, positioning, doula, doctor, drugs.  Everything on the menu was sampled. All the work she did before receiving medication was vital. And the medication at the end helped the labor, helped her and probably prevented a c-section.

As a childbirth educator, I spend a lot of time dealing with some version of the question “What’s better: Natural or Medical birth?”

But this question doesn’t make sense without looking at each situation.

Is an epidural going to slow down labor? It depends.

Is an epidural going in to increase the chance of a c-section? It depends.

Is pitocin going to help or make my labor more difficult and lead to more interventions? It depends.

In general, the longer you can wait before medical interventions are used, the fewer the risks to mother and baby. An early epidural (before 5 cm) does increase the chances for a c-section, but one given at the very tail end of a terribly hard, extremely long labor can actually prevent a c-section. Pitocin is overused  these days, but when the water has been broken for more than 24 hours, it can help move labor along and decrease the (most often small) chance of infection.

Meyer’s narrative is messier and more medically accurate than the Hollywood version of birth. But it’s different in another way, too: There are no good guys or bad guys. It’s not Evil Epidural and Dr. Pit Vs The Naturals. It’s just a big, long, painful, completely normal birth with a very happy ending.

photo: Jyn Meyer/flickr

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