I never got to have an ideal birth or even a sort of ok birth, because for some reason my body doesn't make platelets, or nearly enough platelets, and doctors would really like for mothers to have enough of those before they give birth.
Despite this circus, I've managed to have five, no caesareans, (although the first one and many subsequent probably would have been, had they not been so fearful of major surgery because of my blood.) 2/5 births were entirely unmedicated. Doctors were very hesitant to do epidurals, too, again because of the blood issue. No midwives and few anesthesiologists will take me on as a patient, so it's always high-risk hospital/high-risk ward. Pretty stressful.
However: last year my sister was in labor with her third, after unplanned/emergency caesareans with her first two. She has normal bloodwork but long pushing phases. Anyway she asked me to hang out for while in early labor, and ended up asking me to stay for the whole thing! After hours of pushing, the midwife was ready to call it and head to the hospital but I managed to get my sister in the right position and that baby finally came.
So, my little sister was able to have her midwife/home birth ideal, and she and her husband both say their third might have been yet another caesarean had I not been there. I knew all the moves and all the birth poses and I had been through so many suboptimal labors myself that I knew she could do it if allowed to do it, and she did.
So I never had my ideal birth, but I helped her to have hers. It all works out.
Wow - what a beautiful example of unexpected grace and redemption of your suffering! It’s incredible how important the support of other women can be during labor. I love that you were able to provide that for your sister.
Beautiful, Serena! I'm so interested in this topic as well. I had my first two in the UK, where as you know, home birth is an offering through the NHS (A big YES to "My midwives were regularly reminded of what birth can and should look like when it is not disrupted unnecessarily"). And sure, the NHS has problems and scandals of its own, but I found working with the midwives to be so lovely, and really appreciated their gentle encouragement of my own desire for natural births (while also recommending that I not seek a home birth for my second, due to my own history of postpartum hemorrhage...that resulted in a parking lot birth on the way to a taxi but that's a story for another day! And I can thank the midwives once more for telling me not to feel bad about calling an ambulance if I was afraid I might not make it, saved from freebirthing by 60 seconds).
I'm actually quite nervous about what birth will look like in the US, especially now that I'm expecting my third. I'm already facing the impersonal system demanding blood tests for STDs every few weeks, which is something I neither want nor need—and in fact was only informed what they were testing for when the blood had already been drawn. We're changing insurance in July so hoping to transfer to more personalized care, but it's such a shame that it can be so difficult for women to find!
This is standard care for me in NC with hospital based midwifery clinic, too. I was offended by this at first, but decided it was ultimately very pro-baby. Some women may not be honest with their provider or themselves about their risk of possibly contracting something, not to mention that the father (or other partners in question) may not be honest. Quickly detecting and treating an STD (which starts with a quick blood draw, usually already happening for CBC, iron, thyroid, hormone levels, blood sugars, etc), protects the helpless baby, who deserves good care whether his parents are making the best choices or not. If those policies mean women like me with no risk of infection are screened anyway, but it helps some other woman and her child get the treatment they need, I’m totally fine with that.
I can really see both sides of this one! I don’t necessarily object to the tests being standard, for the reasons you cite, Abigail. But I do think that women should be able to opt out of them easily. Especially if you have older children at home, it can be a real burden to be forced to make extra trips to get blood draws for something that provides no benefit in your specific case.
It’s always such a tricky balance when designing and interacting with large systems or bureaucracies; the administrators rightly want to minimize harm and maximize benefit on the population level scale, but as an individual, it’s natural and just to also want to be able to make the choices that are actually best for your particular circumstance.
This might not be a perfect analogy, but I think about this with schooling, too, and the choice of whether to send your kids to public schools or opt out and do private or homeschool. I see the civic benefit of having engaged parents sending their kids to public schools and working to improve their quality. But as a parent, my primary obligation is to my own kids. I’m glad the public schools exist, but also glad we have other options. I feel similarly with a lot of standard medical policies and procedures.
I never had to make an extra trip for blood tests - it was always wrapped up with my regular trimester check-ins, when we were already drawing blood for other routine prenatal screenings. But yes, anything that alleviates the burden of childcare for literally any prenatal care is welcome, since even well-behaved children are not welcome in the office… I’m expecting my fourth and am intimately familiar with this struggle!
Wow! I live in NJ, not exactly a bastion of quality obstetric care, and I've never heard of this. Just how common are STDs in babies and what is the absolute risk of any kind of adverse outcome, I wonder.
I know HIV retroviral treatment can drastically reduce transmission to the baby and there can be some other pretty rotten permanent consequences from other common infections, including serious deformities and stillbirth, but I don’t know about overall risk numbers. The CDC recommends a few tests for all pregnant women at a few points while gestating and more when certain risk factors are present, but perhaps different states or provider groups handle the extras differently. I’m not saying the powers that be always make the right calls in standard obstetric care, but I’m personally not dying on the hills that exist, in theory at least, for helping babies who need it.
We should compare notes some time!! I feel like I have gotten less crunchy as I have gotten older, but have been intrigued by some of your mentions of nutritional approaches to health issues, etc. Would love to hear more about what has worked well for you!
I am here to corroborate your experience that YES, those hemorrhage “massages” are more painful than birth! I hemorrhaged after my son’s birth (completely unmedicated and I didn’t even get the IV in before things took off), and declared I was definitely getting an epidural in the future in case that happened again. It did, but much worse, and the epidural being in place likely saved me from needing general anesthesia during treatment so I was alert and snuggling/nursing my daughter much sooner than I would have been otherwise. I’m following the same plan for the next baby (due this summer), too.
They are seriously THE WORST. My care during my third birth was subpar in lots of ways, but one thing they did do well was managing the bleeding. I had a heplock in place and they started the Pitocin immediately after baby was born.
I’m so glad the epidural helped you be present and able to bond with your baby even in the midst of scary medical complications - and that you got through it safely!
I have been blessed to have three different home birth midwives who treated me with respect and dignity. My second birth actually took place during COVID lockdown and I have such joyful memories of that birth and postpartum, thanks in large part to the care I received. I have also dealt with excessive postpartum bleeding (though not to the extent that you experienced, Serena!) and likewise did not feel traumatized by it. My midwives handled any and all issues that came up without unnecessarily worrying me (or my husband). I have complete confidence that if I had needed to be transferred for any of my births, they would have continued to advocate for me in the hospital. I love homebirth, but what I most desire for all mothers is the experience of person-centered care that you describe, regardless of where or how they choose/have to give birth. I just wish that experiences like mine were more common in the hospital setting.
Beautiful. Enjoyed the panel so much!! The most intense part of the conference, I think -- which I think speaks to how much power birth holds for us as women.
"the ideal birth is one in which those who care for the mother truly encounter her and care for her in the fullness of who she is—as body-soul composite, an autonomous individual who nonetheless is deeply influenced and even defined by relationship."
I love this so much and how careful you are to honor the experiences of all women. And the analogy with the consecrated life/marriage question was a very helpful framing.
I had five c-sections and each of those five pregnancies was followed by a different OB practice. I never got a chance to know my doctors and in general found the experience of prenatal care miserable, ranging from bad to worse to even worse.
And the only one of my deliveries I was remotely happy about was my fourth. I went into labor naturally a couple days before my scheduled surgery and of course having had three previous c-sections I was not a candidate for vbac. So we went to the hospital and my son was born in the middle of the night with the on-call surgeon doing the surgery. She was probably the best OB I've ever had, the one I felt truly encountered and cared for me. I wish my experiences had been better. I wish that what you describe as the ideal birth was the universal experience of all women.
This is lovely, Serena, thank you.
I never got to have an ideal birth or even a sort of ok birth, because for some reason my body doesn't make platelets, or nearly enough platelets, and doctors would really like for mothers to have enough of those before they give birth.
Despite this circus, I've managed to have five, no caesareans, (although the first one and many subsequent probably would have been, had they not been so fearful of major surgery because of my blood.) 2/5 births were entirely unmedicated. Doctors were very hesitant to do epidurals, too, again because of the blood issue. No midwives and few anesthesiologists will take me on as a patient, so it's always high-risk hospital/high-risk ward. Pretty stressful.
However: last year my sister was in labor with her third, after unplanned/emergency caesareans with her first two. She has normal bloodwork but long pushing phases. Anyway she asked me to hang out for while in early labor, and ended up asking me to stay for the whole thing! After hours of pushing, the midwife was ready to call it and head to the hospital but I managed to get my sister in the right position and that baby finally came.
So, my little sister was able to have her midwife/home birth ideal, and she and her husband both say their third might have been yet another caesarean had I not been there. I knew all the moves and all the birth poses and I had been through so many suboptimal labors myself that I knew she could do it if allowed to do it, and she did.
So I never had my ideal birth, but I helped her to have hers. It all works out.
Wow - what a beautiful example of unexpected grace and redemption of your suffering! It’s incredible how important the support of other women can be during labor. I love that you were able to provide that for your sister.
Beautiful, Serena! I'm so interested in this topic as well. I had my first two in the UK, where as you know, home birth is an offering through the NHS (A big YES to "My midwives were regularly reminded of what birth can and should look like when it is not disrupted unnecessarily"). And sure, the NHS has problems and scandals of its own, but I found working with the midwives to be so lovely, and really appreciated their gentle encouragement of my own desire for natural births (while also recommending that I not seek a home birth for my second, due to my own history of postpartum hemorrhage...that resulted in a parking lot birth on the way to a taxi but that's a story for another day! And I can thank the midwives once more for telling me not to feel bad about calling an ambulance if I was afraid I might not make it, saved from freebirthing by 60 seconds).
I'm actually quite nervous about what birth will look like in the US, especially now that I'm expecting my third. I'm already facing the impersonal system demanding blood tests for STDs every few weeks, which is something I neither want nor need—and in fact was only informed what they were testing for when the blood had already been drawn. We're changing insurance in July so hoping to transfer to more personalized care, but it's such a shame that it can be so difficult for women to find!
regular blood tests for STDs??? oh my word.
This is standard care for me in NC with hospital based midwifery clinic, too. I was offended by this at first, but decided it was ultimately very pro-baby. Some women may not be honest with their provider or themselves about their risk of possibly contracting something, not to mention that the father (or other partners in question) may not be honest. Quickly detecting and treating an STD (which starts with a quick blood draw, usually already happening for CBC, iron, thyroid, hormone levels, blood sugars, etc), protects the helpless baby, who deserves good care whether his parents are making the best choices or not. If those policies mean women like me with no risk of infection are screened anyway, but it helps some other woman and her child get the treatment they need, I’m totally fine with that.
I can really see both sides of this one! I don’t necessarily object to the tests being standard, for the reasons you cite, Abigail. But I do think that women should be able to opt out of them easily. Especially if you have older children at home, it can be a real burden to be forced to make extra trips to get blood draws for something that provides no benefit in your specific case.
It’s always such a tricky balance when designing and interacting with large systems or bureaucracies; the administrators rightly want to minimize harm and maximize benefit on the population level scale, but as an individual, it’s natural and just to also want to be able to make the choices that are actually best for your particular circumstance.
This might not be a perfect analogy, but I think about this with schooling, too, and the choice of whether to send your kids to public schools or opt out and do private or homeschool. I see the civic benefit of having engaged parents sending their kids to public schools and working to improve their quality. But as a parent, my primary obligation is to my own kids. I’m glad the public schools exist, but also glad we have other options. I feel similarly with a lot of standard medical policies and procedures.
I never had to make an extra trip for blood tests - it was always wrapped up with my regular trimester check-ins, when we were already drawing blood for other routine prenatal screenings. But yes, anything that alleviates the burden of childcare for literally any prenatal care is welcome, since even well-behaved children are not welcome in the office… I’m expecting my fourth and am intimately familiar with this struggle!
Wow! I live in NJ, not exactly a bastion of quality obstetric care, and I've never heard of this. Just how common are STDs in babies and what is the absolute risk of any kind of adverse outcome, I wonder.
I know HIV retroviral treatment can drastically reduce transmission to the baby and there can be some other pretty rotten permanent consequences from other common infections, including serious deformities and stillbirth, but I don’t know about overall risk numbers. The CDC recommends a few tests for all pregnant women at a few points while gestating and more when certain risk factors are present, but perhaps different states or provider groups handle the extras differently. I’m not saying the powers that be always make the right calls in standard obstetric care, but I’m personally not dying on the hills that exist, in theory at least, for helping babies who need it.
Love this! Thank you
Beautiful, Serena!!
Beautiful piece! We have stunningly similar medical histories 😝 thank you for sharing
We should compare notes some time!! I feel like I have gotten less crunchy as I have gotten older, but have been intrigued by some of your mentions of nutritional approaches to health issues, etc. Would love to hear more about what has worked well for you!
I am here to corroborate your experience that YES, those hemorrhage “massages” are more painful than birth! I hemorrhaged after my son’s birth (completely unmedicated and I didn’t even get the IV in before things took off), and declared I was definitely getting an epidural in the future in case that happened again. It did, but much worse, and the epidural being in place likely saved me from needing general anesthesia during treatment so I was alert and snuggling/nursing my daughter much sooner than I would have been otherwise. I’m following the same plan for the next baby (due this summer), too.
They are seriously THE WORST. My care during my third birth was subpar in lots of ways, but one thing they did do well was managing the bleeding. I had a heplock in place and they started the Pitocin immediately after baby was born.
I’m so glad the epidural helped you be present and able to bond with your baby even in the midst of scary medical complications - and that you got through it safely!
I LOVED watching the recording of this panel several weeks back! (a couple weeks before giving birth haha) So so good.
I have been blessed to have three different home birth midwives who treated me with respect and dignity. My second birth actually took place during COVID lockdown and I have such joyful memories of that birth and postpartum, thanks in large part to the care I received. I have also dealt with excessive postpartum bleeding (though not to the extent that you experienced, Serena!) and likewise did not feel traumatized by it. My midwives handled any and all issues that came up without unnecessarily worrying me (or my husband). I have complete confidence that if I had needed to be transferred for any of my births, they would have continued to advocate for me in the hospital. I love homebirth, but what I most desire for all mothers is the experience of person-centered care that you describe, regardless of where or how they choose/have to give birth. I just wish that experiences like mine were more common in the hospital setting.
Beautiful. Enjoyed the panel so much!! The most intense part of the conference, I think -- which I think speaks to how much power birth holds for us as women.
"the ideal birth is one in which those who care for the mother truly encounter her and care for her in the fullness of who she is—as body-soul composite, an autonomous individual who nonetheless is deeply influenced and even defined by relationship."
I love this so much and how careful you are to honor the experiences of all women. And the analogy with the consecrated life/marriage question was a very helpful framing.
I had five c-sections and each of those five pregnancies was followed by a different OB practice. I never got a chance to know my doctors and in general found the experience of prenatal care miserable, ranging from bad to worse to even worse.
And the only one of my deliveries I was remotely happy about was my fourth. I went into labor naturally a couple days before my scheduled surgery and of course having had three previous c-sections I was not a candidate for vbac. So we went to the hospital and my son was born in the middle of the night with the on-call surgeon doing the surgery. She was probably the best OB I've ever had, the one I felt truly encountered and cared for me. I wish my experiences had been better. I wish that what you describe as the ideal birth was the universal experience of all women.