News about elective C-sections

The controversial topic of elective C-sections just keeps making news. As many of you may have read, a new study has come out comparing planned primary C-sections to vaginal deliveries. The results were really not surprising or new: C-sections require a longer hospital stay and cost more than vaginal births. They also have a higher rate of complications, such as infections, that require rehospitalization within 30 days of delivery. From my experience, women who choose C-sections are usually aware of all that. What this study did not examine is the difference between planned C-sections and emergency C-sections, and almost every one of the women I interviewed who chose the surgical option did so because they believed they were at a higher risk of ending up with a C-section after a long labor, because of their age or other factors. It also did not examine the long-term effects of vaginal labor on pelvic floor health. The current research on that is still inconclusive, but it is another reason why some women chose to go under the knife.

This is clearly a topic that will be furiously debated as long as women have babies, but I thought the most interesting thing about the New York Times' coverage of it was this quote from Dr. Edmund Funai: "In a very general sense, Caesarean delivery tends to be modestly more safe for the baby, while more risky for the mother." Ironically, much of the mom-to-mom criticism I have heard about elective C-sections is that it is a selfish choice by women who don't want to be inconvenienced by painful labor. But according to Dr. Funai, women who choose it are putting their baby's health ahead of their own. Of course, this contradicts a previous study that showed that C-section babies have a slightly higher risk of neonatal mortality than babies born vaginally. It's all a lot to chew on, and yet another reason to do all the research and come to your own conclusion before you decide what is best for you and your baby. What do you think?

Misconceptions

So, last week I listed some things I was not so fond of in my hospital birth: cramped quarters, a few rude nurses, the complete impossibility of sleeping more than 15 minutes in a row. But I think it's only fair to clear up some misconceptions I have heard about hospital birth from women who chose to deliver at home or in a birth center.

"You are not allowed to move around to get comfortable": Not true. I was encouraged by everyone to walk around to get my labor moving. I could have squatted, rolled on a ball, whatever I wanted. And yes, once I chose to have the epidural, I was confined to bed, but since there was no more pain, I was happy to lie down and rest.

"You have to give birth lying on your back." I cannot vouch for every hospital, but at NYU, the beds miraculously transform to birthing chairs (Jeremy said it looked like I was sitting on a throne), and you give birth upright, with gravity doing its thing. But it it true that giving birth standing up or on all fours (positions that other women have found effective) were not options for me.

"You have to get shaved down there." Um, no. This was done in the past for "sanitary" reasons. I have not heard of any hospitals that do this anymore for a vaginal birth.

Bottom line is, if you are concerned about any of these things or have questions, talk to your doctor or midwife well before your due date. I have heard from many women who were able to negotiate the rules.

What I loved most about my hospital birth: the availability of the epidural, my sensitive and funny doctor, the spacious and comfortable labor room (as opposed to the tiny and uncomfortable maternity ward room).

Of course, every hospital and every labor is different, so I'd love to hear from other women about what they liked about their hospital birth—and what they would change the next time.

Some thoughts on home

I was recently talking to Andrea Christianson, one of the amazing midwives I interviewed for my book, and she asked me, "If you had another baby, would you consider a home birth?" And, you know, my answer really surprised me. I honestly said, "If I knew for sure my next birth would go as quickly as my last one, I would consider it."

Because I have to tell you, with Bellamy's birth, after seven or eight hours of hard contractions, I was ready for my epidural and thrilled with the relief it gave me. But when I had Molly, the labor went so quickly that by the time I got to the hospital and got the epidural, it was almost besides the point. The baby came out a few minutes later. And then I was stuck in the cramped maternity ward, being woken up every few minutes by announcements and various pokes and prods from nurses who wouldn't win any congeniality contests. I left as soon as the doctor let me—roughly 24 hours later. And frankly, the worst part of my labor was riding in the taxi from my home to the hospital, so if there had been a midwife and doula at home to help me get through the labor, the experience may very well have been a lot more pleasant. (I won't go into all the other powerful reasons women choose home birth here—you have to buy my book to get all those juicy details!)

Some key parts to this tale: I live a five-minute drive from a top-notch hospital (backup plans are essential for any out-of-hospital birth), and if I had not experienced two healthy, normal births already and spent the last couple of years talking to so many women who had great home births, I would still feel way more comfortable in a hospital.

So I do wish that more alternative birth stories were out there, and more women got to hear them—not necessarily so every mom-to-be would deliver that way herself (I am all about adamantly supporting each mother's right to give birth wherever she feels safest and most comfortable), but so they might consider it for at least a moment, and then understand why another mom would make such a supposedly "radical" choice.

Name this!

I've been thinking about baby names a lot recently. Not because I'm even halfway contemplating having another one of my own, thanks very much, but because in the space of just a few months, four babies will be born to three of my closest friends, and each of these unknowing little babes was given a very colorful in-utero nickname. The Fetus Formerly Known as Baby Eightball arrived first, and she was given the less quirky but much more beautiful name Samantha Rose. When my sister-in-law announced she was pregnant with twins last Thanksgiving, my two daughters quickly decided the babies would be named Elmo Boots and Snoopy Benjamin, and they have been referred to by those monikers ever since. We're all lobbying now to keep those names on the birth certificate, but I have a feeling they'll go a more traditional, less furry route. The fourth baby on the way is called Lefty, because her mom is convinced she's got a southpaw growing in there.

I wonder if any of these nicknames will stick around after the babies are born and become regular Joes, Janes or Isabelles. A former baby-sitter of mine told me about another child she watched, whose name was—I swear—Poopie. If it was just a nickname, the parents weren't telling, but I could only imagine the kind of diaper explosion in the maternity ward that would inspire that name. I guess Elmo Boots isn't so bad after all.