Missoula Notebook

Natural Childbirth—In a Hospital?

By Sutton Stokes, 9-28-09

	Mother and baby relax in one of Community's comfortable private rooms.

Last December, when I started looking into rumors that the Missoula Birth Center was about to close, I had a personal interest in the story.

My wife and I had just started trying to get pregnant, and Amy was already a patient at the Birth Center. She loved the atmosphere and the staff, and—when we thought ahead to where she would give birth—we always pictured it happening at the Birth Center.

I wasn’t opposed to a hospital delivery, but Amy wanted to deliver in the Birth Center. Since she would be the one doing the work, that was mostly good enough for me. But really, I hadn’t given the matter much thought.

As I backgrounded myself on the subject of birth centers in preparation for writing my first story, however, I became aware of substantive criticisms of hospital deliveries. Many of these criticisms arise from the tendency of obstetricians—like any other medical specialist, or, indeed any human—to find reasons to use the gadgets and tools they have. Give birth in a hospital, statistics show, and you are at increased risk of receiving labor-speeding or painkilling medications and undergoing forceps, vacuum, or c-section deliveries.

Not everyone wants to avoid medications during labor and delivery, of course, but some people feel that these drugs can interfere with the mother’s ability to push safely and can disrupt the natural hormonal release that would otherwise occur during post-birth bonding and nursing. And despite the increasing popularity of c-sections, this is major surgery and far from risk-free, not to mention the fact that many doctors recommend against vaginal deliveries after a c-section, due to the increased risk of injury.

Other problems with hospital deliveries, I learned, include the possibility of staff shift changes mid-labor, policies against fathers spending the night with mom and baby, and the separation of newborns from their mothers for examination and cleaning in the nursery. There are even findings that women who give birth in hospitals are at risk of post-traumatic stress disorder.

I was converted. Clearly, birth centers were the only sensible place for women with low-risk pregnancies to labor and deliver naturally, and—just as clearly—hospital obstetrics departments were dangerous hellholes.

So imagine our disappointment when, a week after Amy showed me those two pink lines, we learned that the Birth Center would close.

We investigated the possibility of a home birth but gave up on the idea when we learned that our insurance not only wouldn’t cover it but might not even cover hospital care if any emergencies arose during one, because—bizarrely—our insurance company classifies home birth as an “experimental medical procedure.”

We would deliver at Community Medical Center, we decided. It wasn’t our first choice; we felt forced into it; we hoped it wouldn’t go too badly.

Then it didn’t go badly at all. In fact, our experience at Community was absolutely wonderful. Looking back on it now, I have difficulty imagining how this birth could have gone better, other than if we’d woken up one morning to find that Coen had quietly slipped out of the womb on his own and was in the kitchen frying us up some eggs and bacon.

After a sleepless night (for Amy; she was good enough not to wake me), we arrived at Community at about seven a.m. Amy started pushing about three hours later, and Coen was born a little after noon. Other than for intermittent monitoring of the baby’s heart rate, Amy was free to move around, leave her bed, assume whatever position felt comfortable, and even labor for a while in a tub. As we’d requested, no one ever offered pain medications.

After the delivery, we moved to a private room where there was a fold-out cot for me to sleep on. In addition to a dedicated lactation nurse, who made several visits to our room, all of the nurses who attended Amy and Coen were supportive of breast feeding and offered useful tips on this and a range of other subjects. Coen did make a few trips to the nursery, but these were optional and I was able to accompany him every time; he never left my sight, and we were always quickly back at mom’s side.

I should point out that at least some of the wonderfulness of this experience resulted from our own actions. Months before Amy’s due date, we toured the obstetrics wing and asked lots of questions. We also researched and wrote a respectful birth plan, went over it ahead of time with our doctor, and not only entered it into Amy’s chart but brought along copies to hand to the nurses. And we took Bradley Method classes, so we had some idea of what to expect during labor and how to get through it without resorting to drugs.

Finally, Amy had a relatively easy labor—words no man should feel comfortable typing, but true nonetheless. If her labor had dragged on, or if there had been problems along the way, our experience, and the actions of hospital staff, might have been very different.

And I should point out that, after the birth, we were very glad to be in a medical environment: Amy’s uterus took its sweet time contracting, which meant she just kept on bleeding and bleeding. If I’d seen that much blood after a home birth, we definitely would have been headed to the hospital anyway, and I suspect that an admission under those circumstances would have been a lot more stressful than Amy’s just being able to lie back with Coen on her chest while a medical team made sure that all of that bleeding didn’t turn into a real emergency.

Obviously, a hospital birth is not for everyone, but I think it’s important for Missoula to know that Community Medical Center has clearly been influenced over the years by the increasingly widespread interest in natural births—probably even more so than a big-city hospital on one of the coasts. Missoula’s just that kind of town.

Community is still a hospital, of course, and different staff members might have different philosophies and bedside manners than the ones we worked with.

Nonetheless, we succeeded in our goal of having a completely natural childbirth, even though we were in a hospital.

It can be done.

Want more Notebook? Read the rest here. I’m also on Twitter and Facebook, and I write a blog.

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