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Humans have been birthing each other for quite some time. But what that looks like has changed. A lot.
Catch me up.
For centuries, birth was really dangerous, and it still sometimes can be. But in the last 100 years or so, maternal mortality rates dropped significantly. In the US, the main location to give birth moved from the home to the hospital. People turned more to doctors than midwives for help. And modern medicine played a bigger factor at the time of delivery: with increased use of things like C-sections, epidurals, and IVs.
So where are we now?
Giving birth in 2018 comes with much fewer risk factors than it did before. But unlike other developed countries, the mortality rate during birth in the US is on the rise. And it’s higher than any other major developed country. It’s also disproportionately high for black women, who may suffer from a combination of low-quality birthing environments, higher risk factors, and unconscious bias.
Give it to me straight. How should I birth my human?
However you damn well please. Some people say natural birth (aka minimal medical interventions) is the way to go. Others say ‘drugs, please.’ The safest method for you will likely depend on your risk factor. Meaning: what's the likelihood you'll need medical intervention during the process. If you’re low-risk, you’ve got more options. People often come up with a birth plan and consider things like…
The Who: As in who do you want to help make sure everything goes okay? People often choose between a midwife and a doctor. Certified midwives are trained health professionals who can often do pretty much everything a doctor can during natural childbirth, except certain medical interventions (like epidurals and C-sections). In the US, most people opt for OBGYNs – the docs. In Europe, midwives are often the norm.
The Who Else: Aka do you want family or friends around? Your doc may be juggling multiple patients. So there are often times when the mother doesn’t have a health professional on hand. There’s evidence to suggest that a plus one can lead to safer birth outcomes. Some people opt for a doula – someone trained to give you physical and emotional support (read: massage, treat you nice, have your back). You could hire one if you’re fancy, or ask a friend to be there for you. Some hospitals have volunteer doulas. Look into it if you’re curious. Your doc or midwife could help hook you up.
The Where: You could give birth at home, at a hospital, or a birth center – an alternative to the hospital setting staffed by midwives or OBGYNs. You could do it at home with aroma therapy or narrowly avoid giving birth in the car, like you see in the movies. If you’re pairing up with a doctor, you’re probably giving birth in a hospital. If you want to give birth at a birth center or at home, you’re probably turning to a midwife. Think on it.
The When: You don’t get to choose when the baby says 'heyyyy I'm ready to come out now.' Unless, that is, you schedule a C-section. Aka caesarean section. These are very common in the US: one in three births happen this way. But heads up: they can be dangerous. And only in some cases is it considered medically necessary. Like if the mother or baby goes into distress, or the position of a baby means that vaginal delivery could be really dangerous. So planning one in advance is a personal choice. And like most things with childbirth...a touchy subject.
The Other Things to Consider: Not everyone has the luxury to choose how they give birth. Often, your plans go right out the window when push comes to push. What your health insurance plan will – or will not – cover can be a game-changer.Check to see what works by you.
I'm birthing a human right now. What's happening.
First of all, are you? Not to be a bummer but many people have Braxton Hicks contractions – false alarms when your body preps for labor. And your uterus muscles make all sorts of moves. Problem is, these contractions can feel intense. And you don’t know it’s not turning into actual labor until after they stop. Cue many calls to your doc or midwife.
No, really. It's labor.
Got it. If it’s early on in labor, you may be told to eat and rest up. You’ll need the energy. After that, people are going to start saying lots of things. Here’s your cheat sheet:
Water breaking: Code word for your amniotic sac popping like it’s hot. That’s the water-balloon-like thing that protects your baby from infections. People’s water breaks at different times. And it's no reason to push the panic button. It just means it's time to check in with your doc or midwife.
Pitocin: If you plan on giving birth in a hospital, you may hear this. It’s a man-made version of a hormone that can help speed up labor. Some (like the WHO) think healthcare providers are too quick to reach for this. And that you can take your sweet time if you want.
Epidural: We see your labor pains and we raise you the epidural. It’s an injection that delivers anesthetics into your spine so you don’t have to feel the feels. Some women swear by it, others swear against it.
Placenta: The organ attached to your uterus that nourishes the baby and so much more. After you push out a person, surprise: you’re not done. Still gotta deliver the placenta.
Pooping: This might happen. It's actually pretty common while giving birth. That’s because you’re doing a LOT of pushing. Sh*t happens.
Tearing: Sometimes when you push, you can tear open the space between your vagina and your butt. Yep, we're going there. It's called a perineal tear and it’s surprisingly common. Depending on how big the tear is you might need stitches. And it’ll take time to heal.
Skin-to-skin: Right after you give birth, you may want time to bond with your baby. Like skin-to-skin contact. In hospitals, it’s common after birth to quickly take the baby away to run tests. But there’s evidence that skin-to-skin can help with things like breastfeeding. The World Health Organization is all for it. If it’s something you want, check to make sure you tell your OBGYN or midwife.
There’s more than one way to birth a person. And a lot of wild stuff happens to your body while you’re doing it. Good luck.
PS: There are a number of ways to electively have a child. You could adopt, have a surrogate, foster, etc. Do you.