Myths About Labor
In honor of Labor Day, I want to talk about labor and delivery. Last year, I wrote about using music during labor, but this year I’d like to dispel some common myths about labor and delivery. It really is none of my concern how other women choose to give birth, whether they opt for a cesarean, induction, an epidural, a natural birth, or whatever, but what really bugs me is the lack of information women are given about these kinds of things. With such a large push for evidence-based medical treatment, it’s actually kind of ridiculous how many doctors aren’t up-to-date on this kind of information. So here are a few “myths” that really grate on my nerves.
1. “Your baby is too big to deliver vaginally” or “Your baby is too big at 37/38/39 weeks so we will need to induce.” Actually, the ACOG has concluded that a “big baby” is not a valid reason for induction, and most of the time a woman’s body will not produce a baby she cannot birth. I know people who have delivered “big” babies at (gasp!) 41 weeks and beyond and they didn’t have to do it by c section.
2. “You need an epidural.” Epidurals definitely do the job if you have difficulty dealing with the pain. I know this because I had an epidural with my first child. There is absolutely nothing wrong with having an epidural if you want one and sometimes it can help a woman relax more so that the cervix will dilate, but did your doctor also let you know that it can sometimes have the opposite effect? Sometimes epidurals can stall your labor, increasing your chances of a cesaerean, especially if your doctor is impatient and tired of waiting for your body to do things on its own. Also, if your baby would happen to get stuck on its way out, it is much more difficult to use different positioning techniques to help the baby to move to a more optimal position if you aren’t able to move your legs. Many women get epidurals and it’s not a big deal to them and things turn out fine, but it still bothers me that doctors don’t share the side effects of epidurals with their patients. Like I said, I had one birth with an epidural and one without, so the decision is totally up to the mother, but it is only fair that she receive all the information about it.
3. “You won’t be able to handle natural labor so you might as well just get the epidural.” Lots of women have their babies naturally and without drugs. In fact, that’s what everyone did before epidurals.
4. “Vbacs are not safe and scheduling a repeat caesarean is the way to go.” Yes, there is a small risk of rupture with a Vbac, but there are also numerous risks involved in cesarean, though it seems that most doctors don’t take the time to discuss them with their patients. If a woman chooses to have another cesarean, that is certainly her right, but it is a decision that shouldn’t be made without being given all the facts on both sides of the story.
5. “We need to schedule an induction by 40 weeks because the baby should be born by then.” Actually, the normal time frame for human gestation is 37 to 42 weeks and a baby is not technically “late” or post term until after 42 weeks. Though 40 weeks is simply the average length of time, it is by no means a “due date” or “expiration date.” It might be understandable if fluids and the baby’s well-being needs to be checked at this point, but most of the risk of post term babies doesn’t come into effect until after 42 weeks, so there is really no reason to induce at 40 weeks or before just based on numbers.
6. “An induction will be so easy. You just show up and we give you something to ripen the cervix overnight and start you on Pitocin in the morning.” As you have probably gathered, induction is not on my list of favorite things, but there are lots of reasons why. One is that the use of all these drugs to induce a labor that is obviously not ready to happen yet can cause problems. One of the cervix-ripening drugs (Cytotec) is not even approved by the FDA but is still used, so you should definitely find out everything that is going to be given to you if you do choose an induction. Also, I recently saw some information about the risks of Pitocin. Apparently, they know how that drug affects mothers but they don’t know how it affects the babies. What?! They are giving a drug to a pregnant mother to induce what is, many times, an unnecessary labor without knowing how it will affect the baby? Crazy. And regardless, a labor induced by Pitocin is said to be much harder and more intense than natural labor, so I wouldn’t say there is anything “easy” about it. Obviously, if there is a real medical risk, then agreeing to induce with Pitocin would be worth doing, but to me, the risk of Pitocin for no reason isn’t a good idea.
7. “Let me just break your water and things will go faster.” That might work for some women, but not all, especially if the mother is being induced and her body isn’t ready. If that’s the case, all breaking her water will do is put her on the time clock, and when she is still in labor 24 hours later, some doctors will insist on a cesarean because it has been 24 hours since the bag has been ruptured. Both times, things moved rather quickly after my water broke (and it broke on its own both times), so I feel like it would probably work for me a third time, but personally, I would never allow my water to be broken until I was much further into labor and knew that my odds of delivering vaginally were high. Many times, women get lucky and it does move things along and they do deliver vaginally, but lots of times, this doesn’t happen, and it can almost guarantee a cesarean, sadly enough.
8. “Cesareans are so easy.” Maybe they are easy in the sense that you can schedule them and you know exactly the date and (almost) the time your baby will be born, but I don’t see anything else easy about major surgery. The recovery is much more difficult and longer than recovery from a vaginal birth. Also, this often means that you will have to put up a pretty big fight to ever have a vaginal birth.
9. “Your baby is breech, so let’s schedule a cesarean.” There are lots of options to turn a breech baby, including chiropractic care, positioning, and external versions. Sometimes the baby doesn’t turn, but there are other things to try before just resigning yourself to a cesarean and your OB should be offering some of these options.
10. “Your pelvis is too small.” I have heard this so many times. This may be the case for a very small group of women, but a woman’s body is made to stretch during childbirth and the baby’s head is made to mold itself to fit through. Also, certain positions can help the body to stretch even more, and the baby’s positioning can help, too. I should point out that both of these things can be helped by changing positioning during labor, but this is difficult after being given an epidural, which is something to consider.
So you might be wondering what you should do about all this information? If you don’t care about how you have a baby, that is completely fine, and you can completely disregard everything you have just read. But if you do care how things turn out and you want to be in control of the decisions made about your pregnancy and birth, you should strongly consider:
1. Talking with your OB about his/her thoughts about these points to see what his/her professional opinion is, and if he/she still tries to sell you something that you know or suspect isn’t true, get a different one. Seriously. I did, and it was the best decision I could have made.
2. Hiring a doula. You won’t be sorry.
3. Doing your own research. There are so many possibilities in the medical world that your doctor cannot possibly know everything. What I usually do is look up some things on my own and then ask my doctor about it. A good doctor will be looking to learn new information and will be happy to keep up with new research and evidence-based treatment.
Birth is not a problem. It is a major life event and something that you should have some say in, if you choose to. You have way more options when it comes to your birth than you think you do. I firmly believe that most doctors do have their patients’ best interests in mind, but many of them are operating under old information and/or fear. There is lots of exciting research out there that is changing the face of labor and delivery and it might be up to you to find out about it. Obviously, there are medical issues that sometimes arise, and in those cases, you do what you have to in order to have the best outcome, but it’s also important to know the difference between a true medical issue or emergency and just a doctor’s preference. I am also in no way suggesting that everyone have a completely natural birth, but you have a right to know about the side effects of every decision so that you can make an educated one.