The business of birth

[Aphie]

Here in Australia we have national, free healthcare for the majority of necessary procedures - including birth. I'm under the public healthcare system so the costs of my birth are covered by the government. This will include any possible surgery or help for myself or my child (though everything's been "textbook" so far and *knock wood* will continue to be). It's not a perfect system by any stretch, but from what I've gathered about the US version of healthcare it's VERY good - and it's certainly less overstretched than the UK's NHS scheme.

Because of this, my options are limited by what the public healthcare system provides expectant mothers - I must give birth at an accredited birthing centre; in this case, the one inside the major hospital in this area, I can only choose options available within that centre (so no waterbirth for me, sadly - I may get a bath or a shower, but that's it) and whilst I have several options for my antenatal and post-natal care, I must choose from the options presented.
In my local birthing centre, no matter what, this means that provided my experience continues to be low-risk the majority, if not the complete amount, of my care is given by midwives. The state is very keen on both midwife care and breastfeeding, something that has confused many North American women I know into thinking we're a utopian paradise! ;)

The midwives at the hospital strongly encourage you to have a WRITTEN birth-plan from about 28 weeks onwards, that your midwife and support person(s) have copies of.
They gave me a little pamphlet detailing a range of things to consider for inclusion in said plan, and the idea is to make your birth as comfortable for you as possible, and for you to have thought about, researched and discussed with medical professionals your options in regards to medical procedures, pain relief, etc, prior to the actual day, when you're going to be a wee bit distracted!

So far I have a very short list for my birth plan. It reads:

I would like, if possible:
-To touch Splodge immediately after birth
-Breastfeeding immediately post-birth

DO NOT WANT
-Random people - other nurses, midwives, students, random family members, etc, wandering in and out.
-Any person laying hands on me in ANY way - especially between navel and knees, without telling me they're going to, what they're going to do, and why.
My body is not a damn piece of meat. And it's mine. I'd really rather not be having panic attacks or flashbacks through labour!

I'd really prefer not to, thankyou, but if you feel it becomes medically necessary and can explain it to me then I can be convinced:
-An episiotomy
Some sources say it's better to be cut than to tear, others say tearing's better. Again, I have a strong visceral reaction to my body being treated like a piece of meat and carved up - and, there's always the POSSIBILITY you will tear, but once you apply the knife that's it.
-An epidural
Lots of studies say the best birthing positions do NOT include that darling of films and television; flat on your back, feet in stirrups. If you can move around during the labour, not only does gravity ease the process some, but apparently you decrease stress for yourself and bub, and decrease recovery time as well. An epidural pretty much guarantees you're flat on your back, strapped to a bed.
-A c-section
Consider: you could take a week, maybe two or three before you can stand up and sit down with the ease of pre-birth. OR you could definitely take several weeks before you can sit unaided in bed, bend over the baby's crib, and potentially have a numb or painful spot on your lower stomach for anywhere from a couple of weeks to the rest of your life. Gosh, that was a tough choice */snark*


Um. That's about all I have so far. Lighting, food/drink, heat and cold packs, other forms of pain relief, music, all seems a bit negligible or negotiable.

My attitude to the birth generally is that I'd like as little medical intervention as possible, an attitude that seems to be encouraged by the midwives I've met, and which is backed up be a slew of studies indicating that medical interventions during birth can have a "cascade" effect, necessitating more and more medical procedures to ensure a safe delivery of the baby and a live mother at the end.
That said, I'm not silly enough to think I'm some sort of Amazon who'll have no trouble with massive cramping pains, or that Western medicine has not developed the way it has because it's completely contrary to what helps people live.

[Aphie]

Cheers Emily, I'll look into it!
I'm pretty sure someone told me that birthing balls are available in the local birthing unit, but I'll check with the midwife at my next appointment.

I have a history of abuse, so I hear you on the trust issues - unfortunately, I'm likely to have one of the midwives assigned to the birthing unit at my actual birth - none of whom I've met at this point, rather than my antenatal midwife. The only reason I should ever see an obstetrician though is if my condition or Splodge's becomes less than textbook (or perhaps if they do have to give me an epidural, when I'll also talk to the anaesthetist).
I think a lot is going to come down to myself and my partner really - we're planning to attend the classes the hospital runs, and they show you some films of births and talk you through the process of labour and some of the early baby stuff, so hopefully with that and our own research the midwife will just be there to doublecheck stuff.

[Emily HW]

Birthing Ball! See if your birthing center has one; they are a miracle sent from the higher power of your choice. That's the only way I was able to make it through; I had planned on grabbing my hospitals only tub room but someone else already had it. :: shakes fist ::

Your list seems great! I hope they follow it; we have a problem with that in the US. The worst part about my birthing experience was that my OB (I'm not allowed to have midwives on my insurance and we were both poor college students at the time) was on vacation. I cannot instantly trust someone, so I was happy that she and I had built up such a strong relationship... to only be replaced by a man who I had never met before and didn't understand what I was going through. This caused a lot of anxiety.