Being Born is a Complicated Process

Some things, I'm glad I find out. I never realized how much I DIDN'T know about B's birth and everything that went on. I was a very trusting new mother. They know what they're doing, right?

Well, turns out. . . a lot of it is a bunch of milarky.

Let's start at the beginning. First, when I went into the hospital with Isabelle I probably wasn't in true labor. It was probably just another long evening of "false labor" for me. Although I was contracting every 3-5 min from 2pm until the wee hours of the morning there at the hospital, they weren't that bad (or at least I would soon find out they really weren't that bad, in comparison). But my blood pressure was high and I'd only dilated 1 cm from 9pm-2am, so they gave me the option of starting pitocin or having my water broken. I heard horror stories about pitocin, so I elected to have my water broken - also known as ARM (artificial rupture of the membranes) or amniotomy.

It all sounds good and nice - simple poke here, a yank there, a goosh down below and before you know it, you have yourself a baby!! Unfortunately, when you have an amniotomy performed there are risks. First, there is a risk for infection. Because of this risk, after having ARM you are now on a time clock - most hospitals want your baby born 12-24 hours after having your water broken. Also, it takes away the fore waters that would normally equalize pressure on the cervix. This often causes the cervix to dilate unevenly. Women that are induced by any means (be it amniotomy, pitocin, cervidil) are also at an increased risk for cesarean. There is risk that the umbilical cord could prolapse, gushing out ahead of the baby and into the canal, so every time you have a contraction, their oxygen supply is cut off. Also, since the fluid is no longer there to protect the baby, the pressure from the contractions are directed directly on the baby (and it's umbilical cord), which can cause unneeded discomfort and stress on the baby's part. Also, breaking the water releases hormones that cause contractions to quicken and become more intense and painful, so most mothers (like me!) aren't able to cope with the sudden full-throttle agony making those pain meds harder and harder to turn down.

I always thought you HAD to have your water broken if it didn't break on it's own. Turns out - you don't! Although nearly 100% of laboring mothers in hospitals have their water broken, there is rarely a medical reason to do so. It is simply the hospital hoping it will quicken the process and get you out of their room sooner. In a normal labor, the water often doesn't break until well into the labor or during pushing. On rare cases, the baby is actually born with the amniotic sac still intact, known as "en caul", which is historically known to be a sign of good

luck in many cultures. So with baby Squirt, I hope to keep those juices intact as long as I can. (For detailed information, go here.)

So then, little baby is finally born! They pop out, the cord is clamped and cut, and they are handed over to you for a few short minutes so you can see your precious new bundle, then swept away to get tested. Sounds normal, right? Wrong again!

While many doctors are quick to snip, it is actually to the best interest of the baby to wait until the umbilical cord stops pulsating before clamping it off. By cutting too soon, research shows that it not only deprives the newborn of a significant amount of it's OWN blood (increasing their risk for anemia) - about 54-160ml - but it also decreases their iron levels. If a cord isn't cut until the pulsating stops, it will give the baby enough iron stores for at least 6 months - crucial for breastfed babies.

It's debatable whether breastfed babies should be supplemented with iron. B wasn't. Too little iron can cause neurological issues and developmental delays. Too much tends to cause slower growth and digestive problems. So why not avoid both problems and get the baby off to the right start from birth? (Literally!!)

Once the cord is cut, those first few moments out of the womb can be critical ones. The hospital staff is eager to run their tests, take their measurements, and get on with the rest of their day. But this could be the most important part of your new relationship with your little one! To begin with, it is best if the baby is simply dried off and put on the mother skin to skin. Babies should be given the opportunity to breastfeed as soon as they show interest. They are more likely to latch on and latch well without any help, especially if the mother was unmediated during labor and birth. Their blood sugar is also higher during skin to skin contact. Now is the time to look into your babies eyes, comfort him, and

begin the bonding process. And no hospital warmer will work better than your own body heat. Not to mention skin to skin contact helps regulate their body temperature and stabilize their heart and breathing rates. On a biological note, it allows the baby to be colonized by the same bacteria as the mother. This, in conjunction with breastfeeding, can help prevent allergic diseases. There is no reason why babies shouldn't be able to be with their mothers for the first hour immediately following their birth. Hospital routines can wait; this is more important.

While the baby is on your chest, there are some simples tests and procedures that the nurses can do with you right there. However, some tests I'll be opting out of this time around. For good reason (or at least so I think).

Routinely, newborns receive a Hepatitis B vaccine and a Vitamin K injection. Hepatitis B is a sexually transmitted virus. So if you know the basics of how you contract an STD, you will understand than unless I had Hepatitis B, there is no way for the baby to contract it. And I don't so. . . we're not getting it right now. (But still plan to vaccinate around 24 months, just in case).

Vitamin K is given to help with blood clotting. Although only about .25-1% of babies need it, it is still given routinely. But if you have a healthy, full term, normal birth weight baby born with minimal interventions -- and even more so if you won't be circumcising -- you probably won't need it. Why not give it anyways? Well, first is it's cruel, in my opinion, to inflict any unnecessary pain immediately following birth. The dose is also 20,000 times the needed dose. (WHAT?!). It contains preservative that can be toxic to their delicate immune system. And some studies have shown a link between vitamin K injections and childhood cancer (which can be disputed). Instead, oral vitamin K is safe and effective. While you can administer it directly to the newborn, nursing mothers can instead supplement themselves with vitamin K and pass it on to their babies through their milk. So lets see. . . shoot my baby with a likely unnecessary supplement or simply take a pill for a few months. . . I choose the later.

And you know all of those pictures of goopey-eyed newborn? That "goop" is an eye ointment call erthromycin. It is used to protect the babies eyes from infection - infection I always thought was just from my mommy yuckies down there. Well, it's actually to protect them from the bacteria that causes gonorrhea or chlamydia. So if you are 100% certain you don't have gonorrhea or chlamydia, there is no reason why your newborn needs these somewhat painful and irritating eye drops. I also read some infants are allergic to the drops, and I can't help but wonder if that's why B came home with puffy, swollen eyes. Our society insists on making everything so freekin' sterile. That baby just came out of my vagina, give me a break! By not having the eye drops in, my baby will be able to look up and gaze at his mother without a filmy haze.

With B, once she was swept away my doctor began working on getting my placenta out. I assumed that since I'd had an epidural that I wouldn't know when to push or how to do it, so she just took it out for me and I was instructed to lie back and relax. I thought this was normal. It's not (or at least not in the general sense).

Ideally, it is best to let the placenta separate from your uterine wall naturally. Normally, the placenta is delivered 10-20 minutes after the birth of the baby, sometimes as long as 30 minutes. If you wait too long you can risk hemorrhage (although removing it doesn't mean you won't hemorrhage), but if you pull it off manually it is painful, fragments may be left behind (causing more bleeding and anemia) and it can also lead to endometriosis.

So that's it; that's what I've learned about the birth process. Are you surprised?