Last night, Dan and I attended a transfer class at the Kaiser Walnut Creek Medical Center. We’ve been going to Kaiser Richmond for our regular prenatal checkups throughout the pregnancy, but since the Richmond clinic does not have an actual labor & delivery department, we have to go to either the Oakland or Walnut Creek hospital when it comes time to deliver the baby. Although the Oakland hospital is closer to us, we chose to birth at Walnut Creek because of its successful midwifery program, private facilities, low C-section rates, and their reputation for being supportive of natural births — which is something that is important to us, as we mentioned previously. In order to birth at either hospital, you need to attend a transfer class at which you sit in on an orientation with information about the facilities and the staff, get any questions answered, fill out paperwork so that its in the hospital’s database for when you arrive, and get a tour of the hospital.
The drive to Walnut Creek is roughly half an hour away (40 – 45 minutes in traffic), and so it’s not really around the corner for us, but we were impressed with how clean and well-maintained the hospital was. When we arrived at the transfer class, there were about fifteen other couples there, with due dates ranging from late March to early June. I don’t think I’ve ever been around so many other pregnant women before, so it was kind of fun to see. (When we were initially wandering around trying to figure out where the class was being held, someone pointed us in the direction of a herd of big-bellied women and told us to “Follow the bellies.”)
At the introductory information session, one of the midwives talked to us about the labor and delivery department and the midwifery program at Kaiser Walnut Creek. The hospital has nineteen midwives, at least two of whom are always on duty, accompanied by several nurses that will monitor and care for you during triage, labor, delivery, and postpartum recovery. The midwives work and communicate closely with the doctors who are on duty, in case any of them need to be brought in for emergency operations such as vacuum or forceps extraction or a C-section in case a complication arises. One of the laboring rooms has a labor tub (although it is not used for birthing), and the midwives are very supportive of alternative pain relief measures (other than drugs and epidurals), intermittent fetal monitoring, and allowing you to move around and be in different positions during labor. Kaiser Walnut Creek boasts one of the lowest C-section rates in the state of California, at around 15% (compared to the national average of over 33%).
The midwife had the couples in the room each share their name, due date, and why they were interested in Kaiser Walnut Creek, and you could really see that several of the couples were there because of their desire to have natural/unmedicated births or VBACs, and because of the great midwifery program that Walnut Creek has. From what I gleaned at the orientation, the midwives at Walnut Creek act more like OB/GYNs in the sense that they handle multiple patients at once and check up on you intermittently (rather than being one-on-one with you the whole time) and run from room to room catching babies while the LDNs handle you during labor. Considering that Walnut Creek delivers 4,000 babies a year, and an average of ten babies a day, you can’t really expect to have a midwife be one-on-one with you during labor and that is something we’ll have to accept since we’ll be delivering at a hospital instead of a birthing center. Still, we’re grateful that we have such a progressive medical center nearby that will be supportive of our birth plan.
After the information session, there was an extensive Q&A during which the midwife was very helpful and thorough in answering the plethora of questions that everyone had for her. After turning in our paperwork, we went on a group tour of the hospital, where we got to see the laboring rooms, birthing rooms, and postpartum recovery rooms. We, along with a lot of the other couples, were surprised at how spacious and nice the birthing rooms were. They come furnished with (besides the birthing bed) chairs that fold out into beds for partners and TVs and didn’t really feel like the sterile, cold hospital rooms that we were imagining at all. It’s nice that mothers can be in rooms that are so cushy and private for the first hour or so that they’ll spend with their babies after delivery, before getting moved to the more cramped postpartum recovery rooms (which still didn’t seem so bad).
The security at the hospital is of course excellent, and the NICU (neonatal intensive care unit, for babies who are high-risk or suffer from complications) is one of the best in the Bay Area. Hopefully our baby will be born healthy and strong so she will never have to see the NICU, but it’s great that it’s there just in case!
Overall, we were very impressed with both the facilities and staff at Kaiser Walnut Creek, and the transfer class and hospital tour reaffirmed our decision that it is where we want to deliver our baby. Fortunately, I can continue my regular prenatal checkups at my home clinic in Richmond instead of going all the way to Walnut Creek, so I suppose the next time we’ll be at Walnut Creek will be when it comes time to deliver. We’re just counting down the days now — I’m nearly 35 weeks, with about 35 days to go, give or take a few!
We watched a documentary film the other night, and our minds were changed forever. The Business of Being Born had actually been recommended to me by multiple friends and acquaintances, so I was curious to see what all the fuss was about. Dan and I are so glad that we had the opportunity to watch this movie before we set foot in the hospital for labor and delivery in a few weeks. It was a true eye-opener and I feel strongly that every woman who is expecting, as well as every woman who plans on giving birth someday, should watch it.
Produced by Ricki Lake, the documentary explores the contemporary experience of childbirth in the United States and turns a critical eye to the American health care system which emphasizes drugs and costly interventions, often at the expense of the best possible outcome for mothers and their babies. The film has an obvious bias in that it documents several home birth experiences assisted by midwives and shows them in a much more positive light than hospital births in which mothers are riddled with drugs and various forms of intervention. It’s a very clearly anti-hospital perspective, but the documentary does put forth a strong argument with very solid facts and supporting evidence:
The U.S. stands alone in the developed world in its physician-driven birth system — midwives attend over 70% of the births in Europe and Japan, versus 8% in the U.S. While the U.S. spends twice as much money per birth as any other country, it has the second worst newborn death rate and one of the highest maternal mortality rates among developed nations.
The film points out that the medical industry has convinced the majority of American women that they “don’t know how to birth,” creating a culture of fear — hence why women these days are so afraid of birth and the pain associated with it that they will cling to anything that helps diminish that fear, including pain medication and all sorts of intervention. In the past few decades, there has been alarming increase in the number of women who have Caesarean sections, with the most recent statistic showing that C-sections make up a third of of all births in this country. While in some cases, C-sections are necessary due to any of a number of possible complications, the reality is that most of them are unnecessary and could have been prevented. OBs are basically surgeons, and since they are often more knowledgeable about surgery than natural birth, C-sections are an easy way for them to speed up the delivery process and get the mother and baby in and out of the hospital as fast as possible. Litigation concerns also drive doctors to perform C-sections as soon as the slightest complication surfaces. These days in the U.S., childbirth is treated as a medical emergency rather than a natural occurrence.
The above clip from the documentary in particular stuck in my mind: it shows how the use of one drug can lead to another, and yet another… creating an inevitable domino effect. Pitocin is very commonly used to increase the intensity and frequency of contractions. This also means increased pain for the laboring mother, which often leads to her getting an epidural anesthetic to help alleviate the pain. But the epidural often slows labor, leading to a perceived need for more pitocin; this cycle of pitocin and epidural (along with any of a number of other drugs) may well continue until the baby’s blood and oxygen flow is compromised, leading to an emergency C-section. The doctor is then credited with saving the mother and baby, when the domino effect of all these intervention drugs may have been what actually contributed to or caused the emergency.
Overall, I thought it was a very powerful documentary, and it was really well put together, interviewing several women and documenting a number of births. It also gives a brief background of the history of birth in America, and how the medical industry has changed the childbirth experience within the past century. You can see the full trailer below.
On a personal level, Dan and I were really forced to rethink our birth plan after watching this film. After reading all my pregnancy books and listening to the labor and delivery experience from other mothers, I had kind of accepted without question that I would get an epidural and whatever other pain relief medication when it came time to deliver my baby — it just seemed like it was what all women did. I never really thought about all of the adverse consequences that may come about from going along with all of those intervention measures that the hospital throws at you. Isn’t it funny that we as Americans spend so much time researching certain things, such as what latest camera to purchase, but don’t give nearly as much thought and consideration to how we give birth to our children?
For us, it was a real wakeup call and we have decided that we are going to try as much as possible to have a natural birth. But before I go further into the reasoning of why, I want to preface this by saying that I absolutely do not think that not having a natural birth makes a person any less of a woman or a mother than one who does. In the same vein, I know I need to be realistic and be aware that you can go into labor with your heart set on a natural birth, but end up needing medical intervention or even an emergency C-section if a truly severe complication arises. My mother went to Lamaze classes throughout her first pregnancy when I was in her belly, preparing to have a natural birth, but ended up with preeclampsia (high blood pressure during pregnancy) and had to schedule an emergency C-section before my due date even came around. Due to the nature of C-sections performed back then, VBACs (vaginal birth after C-section) were not an option for her and she had to have all three of her subsequent children by scheduled C-sections as well — and she is the best mother I could have ever wished for, and I admire and respect her.
But I can’t help but feel that there is something inherently wrong with the picture when I see expectant mothers talking about how they will absolutely be getting that epidural when it comes time for them to go to the hospital. How can you be so sure that it will be necessary when you aren’t even in labor yet? Are you just planning on getting it because the hospital advises that you should? I feel like when you go into labor requesting all these drugs and medical intervention at the outset, you’re already setting yourself up to fight an uphill battle in terms of having a regular vaginal birth. You’re not even supposed to get an epidural until you are at least 5cm dilated, but not all hospitals abide by this rule and I’ve heard stories of women who had the epidural administered prematurely and they ultimately ended up in the operation room for an emergency C-section. (According to a statistic I read, getting an epidural any time before you are 5cm dilated triples your odds of needing a C-section.) A lot of people forget that C-sections are major surgery, and while hospitals have a lot of experience with them (apparently moreso than with natural births these days), it still poses a danger to both mother and baby and should be avoided in favor of a regular vaginal birth, unless absolutely necessary. Having a C-section also interrupts the release of oxytocin, a hormone that is released in natural childbirth which helps trigger an immediate bond with your baby and also stimulates breastfeeding. As I mentioned above, my mother had a C-section for all four of her children, so in the back of my head, I’ve always been aware that it could be a possibility for when I have a baby — but I’d like to avoid it if at all possible.
Another point that the documentary only briefly mentioned — that Dan and I ended up discussing further in detail afterwards — is that the rise in the use of these intervention drugs coincides with the rise in cases of ADHD and autism in children in the past few decades. There’s no real evidence that shows a direct link between the two yet, so it could be purely coincidental and more due to the fact that more and more women are giving birth when they are older… but we were discussing how we honestly wouldn’t be surprised if in the future, they find that there’s a direct correlation between such disorders and medicated births.
I know that this is starting to sound very anti-medical establishment and I’m making hospitals look like the “bad guys” for pushing interventions on women, but this is not the case. I have a lot of respect for the doctors and nurses that work in the labor & delivery units in hospitals (I know a few myself), and I think it’s amazing how every day they assist in bringing new lives into the world. I’m grateful that we live in a time when we’re equipped with more knowledge and medical advancements than ever to safely deliver babies, and thank goodness for the doctors who know how to administer an intervention when there are emergency situations that necessitate one. While The Business of Being Born seems to push home births, I personally don’t think I could ever do a home birth — I’m too paranoid that something will go wrong, and a home birth is just in general a little too New Age for me. I will likely always rely on a hospital for labor and delivery (although I may consider a birthing center in the future), and it would be silly of me to bash them when I am going to be completely in their care.
I do think it’s important, however, to find a hospital that is respectful and supportive of your birthing plan. Thankfully, the hospital we plan to deliver at is Kaiser Walnut Creek, which has a very progressive midwifery program; Kaiser hospitals in the Bay Area are known in general to set the standard for other Kaiser branches around the country, so we are pretty confident that we are in good hands. The hospital will assign us a midwife when we arrive to deliver, and an OB will only be brought in if there’s a complication or we request it. Kaiser Walnut Creek has a low C-section rate, and are known to be pro-natural birth and I’ve heard that they let you labor and push at your own pace, without trying to rush you with drugs and intervention. It’s such a relief to know that they will respect our hopes to have as natural a birth as possible, so that we won’t have to expend our energy putting up a fight in the eleventh hour.
We were able to conceive this baby without intervention, and she has been growing healthy and strong the past eight months in the womb without intervention, so it only makes sense that the best way for her to come into this world would be without unnatural intervention. Again, I know that there are so many unpredictable and unknown factors that may come into play in the delivery of our child, and although I may dream of a natural birth, I’m not necessarily going to get what I want when the time comes. I know I need to prepare myself for such circumstances, and if it truly comes down to a life-threatening situation for the baby, I will of course gratefully accept medical intervention. But with nearly 33% of women delivering their babies by C-section today (compared to the less than 5% back in 1965), I can’t help but question how many of those were truly unavoidable and how much of the intervention that is pushed onto mothers is really necessary.  I know that labor and delivery will be the most difficult, painful, and challenging experience I’ve encountered yet, but I just want to make sure that we’ve done as much as possible to have our ducks in a row to make it as smooth, healthy, and safe a delivery for both myself and for our daughter.
We went to our first childbirth preparation class this week. It’s a four-class program that we have to go to every Thursday evening in the month of February, and this past Thursday was our first. Each class is two and a half hours long, for four weeks, for a total of ten hours! It seems like an awful lot of things to learn and it’s pretty tiring to have to go to a class right after we get off of work; but at the same time, we’re lucky that the class is offered during the evening, after work hours during a time when we can both make it.
This week, we learned about the basics — the early signs of labor to watch out for, and when to call labor and delivery and get yourself over to the hospital. We also practiced a lot of hands-on exercises — prenatal exercises and moves that are helpful to know to help relieve contractions. We of course learned some essential Lamaze breathing patterns and techniques, but the teacher also threw in a broad mix of exercises that incorporated yoga, some new age relaxing exercises, and even a little bit of hula and belly-dancing moves! Some of the more subtle movements from hula and belly-dancing actually are known to help center your baby and calm him/her with the rocking motion. Almost all of the exercises taught require partner involvement, and it was fun watching the husbands get really involved and participating. And during the informative sessions, they seemed to be asking more questions than the pregnant women themselves!
Next week, we’ve been asked to bring our favorite lotions, a pillow, and an exercise ball if possible. I’m curious about what we’re going to learn!
We’re grateful that Kaiser offers such an extensive childbirth preparation course to help us learn and prepare for labor and delivery. There’s only so much I can learn from reading a bunch of pregnancy books!
I’ve been taking on some prenatal yoga on my own as well, and since I’ve heard a lot of other moms point it out as the single most effective thing they did to prepare for labor and delivery (in terms of pain management) — I hope it will help me too, when the time comes. 🙂
In other news, Happy Lunar New Year! This year is the Year of the Rabbit. Dan and I were both born in the Year of the Dog, but since our daughter will be a Rabbit, I did some research on typical traits associated with The Rabbit and found this:
People born in the Year of the Rabbit are articulate, talented and ambitious. They are virtuous, reserved and have excellent taste. Rabbit people are admired, trusted and are often financially lucky. They are fond of gossip but are tactful and generally kind. Rabbit people seldom lose their temper.
They are clever at business and, being conscientious, never back out of a contract. They would make good gamblers for they have the uncanny gift of choosing the right thing. However, they seldom gamble, as they are conservative and wise.
The rabbit is believed to be one of the happiest signs, with people born in that year renowned for their kindness, reliability and loyalty, though with an air of mystery and propensity to cry.
Another article also cited the following characteristics:
The Rabbit is a symbol of sensitivity, compassion and creativity. Rabbit-born people thrive on business dealings… A person born this year will be born in the Year of the Metal Rabbit. Rabbit-born people are charismatic, thoughtful, calm, gentle, sympathetic, fashionable, persistent and extremely shrewd in business dealings.
For the most part, all admirable traits! 😀 The propensity of cry sounds like an attribute that comes from me… haha* Hope our baby girl is not too much of a crybaby like mommy! And since both Dan and I both work in creative fields, I do hope that our child will be a little artist, too — or at least be able to appreciate art.
As mentioned above, this year is not just any Year of the Rabbit, but the Year of the Metal Rabbit — also known as the Year of the Golden Rabbit — which is said to be a particularly auspicious year, and children born this year are supposed to enjoy much wealth and prosperity in their lives. My hope is that our daughter will enjoy a lifetime that is rich in not only financial wealth, but in family, friendships, love, achievement, wisdom, and in her compassion for others.
My mother was actually also born in the Year of the Rabbit (the same Year of the Metal Rabbit, actually!), and in Japanese culture, it is believed to be extremely lucky to have one of the signs repeat themselves within the direct family line — so perhaps our baby will bring good fortune to the entire family, too!