When the first hard contraction hit my wife Deirdre, buckling her at her middle and squeezing from her lungs a shocked cry, her first thought was, “I don’t know if I can do this without drugs.” Her second thought was, “I don’t know if I ever want to do this again. She did it—gave birth—without drugs, and she does want to do it again—without drugs.
Looking back on our decision to deliver naturally— letting nature take its course as much as possible, without intervention — I can recall only a vague certainty that it was the right way to go. The vagueness didn’t make my certainty any less certain — I had a strong gut feeling, a conviction — but I couldn’t give much of an accounting for it. My sister-in-law had delivered naturally and was a strong advocate. But I wasn’t exactly sure of her reasons.
Deirdre had a clearer idea. “It seemed right, first of all, that you don’t take drugs, so the baby doesn’t get the drugs. The baby is much smaller. And I had heard there were side effects — sometimes the baby has trouble nursing, sometimes the mothers have headaches.
“And I wanted to experience childbirth. I really did want to feel the baby being born, even if it hurt. I wanted it to be a good experience too. Also, I was afraid of drugs; some other women I knew had bad experiences. They were going to have children again, but they were afraid.”
“I felt like I had been hit by a Mack truck,” said a friend who had received pitocin, a drug that stimulates contractions. “It was the most horrible experience of my entire life.” Her second child was born at home, naturally, and Deirdre characterized it as a serene, relaxed, wonderful thing — “like night and day.” She knows other women who recalled positive experiences with drugs, but she still wanted to go natural.
Several months into Deirdre’s pregnancy, we started attending a Bradley Method birthing class, led by Nancy Flint. The method is named after Dr. Robert Bradley, author of the seminal work, Husband-Coached Childbirth, but it is not so much an esoteric method developed by a doctor as a policy of cooperating with nature.
Because such a policy often conflicts with the standard practice of most hospitals, Bradley people have something of a reputation as fanatics. Flint, on the other hand, is just the sort of person you would want to introduce it to someone. She is unthreatening, unmilitant. She has given birth both naturally and with drugs — concern for the baby’s health after a car accident led her to accept a pitocin-induced labor, but she declined painkillers. She has worked with an obstetrician and as a doula, or labor assistant.
Her North Park home, where she teaches her class, is cozy and bright, stenciled and knickknacked. Her features are soft and friendly; her manner, nice with a hint of businesslike efficiency. She is not above making a strong statement — “My very blunt view of women taking medication despite the fact that it can harm the baby is that it’s very selfish,” she says — but in general, she is looking to avoid a fight. This is not always easy; Bradley students are often thought of as people who are suspicious of doctors and who try to buck the system.
“In the last couple of years or so,” admits Flint, “I have started telling my students not to really advertise themselves as Bradley students; rather, as natural child-birth students. Something other than the Bradley name, just because of the negative connotations that go with it. When I was in labor and they knew I was a Bradley teacher, that’s what they put under ‘Problems with patient.’ That was my one problem. They sort of assume that the person is going to give them a hassle.”
Hassles do happen. Flint remembers a man who pushed a doctor away from his wife because he didn’t want her to stay in bed and be monitored. The man was restrained and removed from the room. “It’s only been one person in a hundred, but that’s the one person that doctor will remember forever, that this Bradley stuff is horrible.
“Trust is the big issue. They feel like they’re not being trusted if everything they do is questioned.” So, Flint counsels her students to try to establish trust within the context of the birth plan, the list of things the couple does and does not want during the birth. This is the plan we submitted to Kaiser, signed by ourselves and our certified nurse-midwife:
We, Deirdre and Matthew Lickona, would like to cooperate as much as possible with the professionals who will be aiding Deirdre during her labor and delivery. We would also like Deirdre to deliver as naturally as possible. To minimize tension between these two desires, and to indicate our wish to be both flexible and responsible in working with Kaiser Permanente, we have prepared this Birth Plan. We would like Deirdre to deliver under the following conditions:
Mobility — we would like Deirdre to be able to walk freely during labor. This includes use of the shower.
Minimal electronic fetal monitoring [EFM] — to enhance mobility, we would like to limit use of the EFM to no more than ten minutes per hour.
No routine IV — we would prefer that Deirdre not receive an IV and that she be allowed to eat and drink during labor instead.
No medication — we would prefer that medication not be offered except in an emergency.
No frequent exams — we would prefer that Deirdre not be examined unless necessary.
No episiotomy — we would prefer that Deirdre receive no episiotomy and that massage and/or warm compress be used instead. If it comes to a choice between cutting and tearing, we would prefer to let Deirdre tear.
Upright position — we would prefer that Deirdre not be flat on her back during delivery. Rather, we would like her to be sitting up.