More Quick and Easy Births

I went looking for a news story today, about a local backseat birth, and I found several! I didn't find the one I was looking for, though.

Last week, I was teaching a HypnoBirthing class, and a dad is concerned about a backseat birth, so we've talked about it a little every week now for 5 weeks, trying to reassure him that if the baby is coming that fast and easy, it's not a problem. This is a common concern for parents, especially HypnoBirthing parents, because if birth is comfortable for mom, and they aren't sure they are in labor, they figure they might not leave in time to get where they are going. We address that concern in class, (even the moms who do have completely painless births still have sensation , just not pain) but truly, although I've got maybe a dozen stories total here on the blog and we hear about one of these on the news about once a month, if you think about how many babies are born, it just isn't something that happens all that often. I've been teaching childbirth classes since 1991, and none of my parents have ever birthed in the car (since I began teaching HypnBirthing though, most do arrive at the hospital at 7-9 cm because they don't think they are really in labor until they are quite far into it).

So they come in last week and tell me that their heater broke in their car, and they were in getting it fixed. One of the mechanics, I believe, sees my client is pregnant and tells her about his exciting weekend.

He had just bought a new car (and I got the impression that for the dad, this was a very important element in the story; that he had to have his car detailed because it was brand new) and his wife was scheduled for a cesarean on Monday for pre-eclampsia (and here is a fun fact, women who actually have pre-elampsia are very sick... getting the baby out quickly is the only way to keep the mother from having seizures and possibly dying. An emergency cesarean is imperative, not 'oh, go ahead and have your baby shower this weekend and we'll schedule surgery for first thing next week').

In any case, after the baby shower, the mom 'felt funny'. She didn't feel like she was in labor, just 'funny'. And since she'd been told she was sick (and may well have been getting sick) she thought it was a good idea to go to the hospital. But by the time they got to the car, she said something felt really odd, and asked her husband to take a peek. She was wearing his boxers, and when Dad looked, he was just in time to catch the baby; the head was already out. I don't know how big the baby was or anything, but mom and baby are going fine. In the retelling of the story, it did seem that dad thought catching his own baby was very cool. Maybe it made up for the wet back seat in his new car.

Now, you'd think this would be news, but there was nothing on it when I looked. Perhaps the family is just private that way. Which makes you wonder how many people this might happen to who just don't want the attention.

However, while I was looking it up, there were TWO OTHERS that happened in the last two weeks. One was in Ohio. A little peanut baby at 4 lb. 3 oz. One was in Michigan. This one just "sort of fell out" at 7 lb. 7 oz.

I also found another I didn't have in the first list. This one happened 2 years ago, and the archive just has the first two sentences, but that gives us the basics. There is a picture of the baby boy, but no weight. He looks to be about 6 lbs.

I actually hope more and more of these happen so people will realize that these quick, easy birth are the way we are designed to birth! However, I fear that if women aren't really thinking things through, their fear will still prevent them from thinking critically.

Years ago, there was some movie star talking about her near car-birth on The View. One of the women said something like, "we hear you have quite a scary story to tell about the birth of your baby". She said yes, then proceeded to tell them that she had surges (contractions) all day, but she didn't think she was in labor. It didn't hurt, so she just went about her daily business.

Eventually, she realized that the sensations were just a few minutes apart, so they headed to the hospital. On the expressway, she felt like the baby was going to fall out, so she got on her knees and told her husband to drive like a maniac. Within minutes of arriving at the hospital, the baby did indeed 'fall out'. I had one client who had a similar story from a previous birth.

In both cases, the doctor's advice was that next time, they should come in two weeks early and be induced to avoid such a scenario again. Fortunately, my client saw the illogic in this, but the movie star in The View thought that sounded like a great idea!

Her labor was so painless, she didn't know she was IN labor. Her baby almost FELL out. So instead of having a homebirth with a midwife next time to avoid a repeat, she thought it would be better to introduce a multitude of risks? Induction is so common these days many are under the impression that there is little or no risk to elective induction. That's simply not true.

First of all, planning to induce two weeks early, as determined by ultrasound, risks preventable prematurity. Ultrasound can be off by two weeks on either side of a 'due date' which itself is actually a 'due month'. "Due" is anytime between from 38 weeks to 42 weeks. 38 weeks is not 'early' and 'late' isn't until 42 weeks 1 day. Less than 5% of women actually give birth on their 'due date'.

After 28 weeks, an ultrasound can be off by as much as 3 weeks and is not supposed to be used for dating after that time. Yet I hear women all the time saying, "Well, my due date changed again." Your 'due date' doesn't change! I always ask them how many times their conception date has changed. You are the same amount pregnant regardless of what the machine says!

So, if someone is induced 2 weeks early based on an ultrasound date, they actually might be FIVE weeks early. Prematurity has considerable risks for the baby, and iatrogenic (doctor caused) prematurity due to increased inductions is a concern for the doctors who have to try to save these babies.

"Elective induction of labor, either for medical convenience or at the patient's request, and the practice of cesarean birth on demand have become increasingly common.10,11 The National Center for Health Statistics reports that 19.9% of all labors are induced; the rates have doubled since the last report in 1989.12 Although many inductions are for medical indications, it has been suggested that two thirds are performed for nonmedical indications.10,13 For example, the American College of Obstetricians and Gynecologists (ACOG) has classified psychosocial issues as an acceptable indication for induction.14 Further, after careful consideration, a woman's right to choose a cesarean delivery is also supported by ACOG.15

Although a scheduled birth may be convenient for the parents and the obstetrician, it is often painfully inconvenient for the infant who is not ready for prime time. Anyone who practiced in the '70s and '80s knows all too well that there is an increased risk of iatrogenic prematurity with elective deliveries, particularly those without lung maturity studies 16; the risk of RDS is also increased in infants delivered by cesarean especially in the absence of labor.16,17 One study reported that 18.2% of the cesarean births in their population were elective; 38% were performed at maternal request.18" (Buus-Frank, 2005. pp 233)

But that's just the beginning. IF the mother isn't actually anywhere near her 'due date', induction will fail. There is actually something called a "Bishop's Score" to determine how likely it is that induction will work. If the cervix is not in a forward position, is not soft, is not already effacing and dilating, and the baby is not low in the pelvis, induction will fail, leading to an unnecessary cesarean. Well, by that time it will be necessary because pitocin and/or cytotec will have likely led to a life or death emergency. So a better word might be an avoidable surgery. Then there is the maternal mortality (death) rate for 'elective cesarean' that is 3 times higher than for a natural vaginal birth. (Wagner, pp. 68)

Part of what causes such risk with pitocin is that it causes contractions that are longer, stronger and closer together, meaning they are very painful. Remember, we were talking here about babies who were born so fast and easy because their mothers were so comfortable they didn't realize they were in labor.

So now, instead of the logical option of staying home with the next baby and letting the baby fall with a midwife to watch over them, we are looking at what might happen if they choose to be induced two weeks early, which is the suggestion of the doctor.

Once pain is introduced with the pitocin, a mother is likely to beg for an epidural or other 'labor drug', which is really a misnomer, like Demerol which also creates risk.

Let me take a slight detour to explain the illogic of 'labor drugs'.

My best friend broke her tail bone while pregnant and "4 days overdue" (meaning she was NOT overdue) and asked for something for the pain. She was told they couldn't give her anything because anything strong enough to help her would be harmful for the baby. BUT if she let them induce her, she could have something for the pain. She asked why she couldn't have those same drugs now, for the pain she was already in. Because they are 'labor drugs' she was told. I love her response.

She said, "So, let me understand this. I'm in pain now, but the drugs are bad for the baby?"

"Yes." said the nurse.

"But you can induce me, create pain, and give me drugs?"


"And these are the same drugs I can't have for the pain I have now, because they are dangerous."


"So, in 30 minutes these drugs become less dangerous?"


"Then why can't I have them now?"

"You aren't in labor."

My friend was stunned, and the nurse never did comprehend what the problem was. My friend went home and used hypnosis for the pain. She had an hour and a half labor and birth a 10 lb. 4 oz. baby boy in a tub at home 4 days later (8 days past her 'due date').

I haven't even addressed the risk of the epidural this woman might also choose, and actually I'm not going to because I have to run. However, for anyone interested, Dr. Mehl-Madrona has research paper title Medical Risks of Epidural Anesthesia During Childbirth that you can access by clicking on the title.

I think the point has been made that inducing 2 weeks early to avoid the 'problem' of the next baby falling out too easily and quickly is the height of idiocy.

Buus-Frank, M., (2005). The great imposter [sic]. Advances in Neonatal Care: The Official Journal of the National Association of Neonatal Nurses. 5(5):233-236.

Wagner, M., (2006). Born in the USA: How a broken maternity system must be fixed to put women and children first. University of California Press. Berkeley.


The Mommy Blawger said...

I'm pretty sure that there are actual statistics that show that the back seat of a car is the safest place to have a baby, based on the neonatal mortality rate. For the reasons you pointed out; when the baby comes quickly, there are generally no problems. It's when they come too slow that we worry.

Wildner said...

If you run across those, please forward them to me. I sort of 'collect' stuff like that. :-)

Like you, wouldn't choose unassisted birth for myself, but I AM for a woman's right to choose whatever birth she wants. (BTW I went to your MamaBlawg site and it ROCKS!)The only stats I have on 'unattended' birth is the press release, that intentionally tried to come off as a study, that ACOG used to convince people that 100% institutionalized birth was safer than homebirth. (Health Department Data Shows Dangers of Home Births, ACOG News Release, 1978). I will admit though, that's all I have because I haven't gone looking recently for stats on unassisted birth.

However, that one counted as 'unattended', "spontaneous abortions after 20-28 weeks gestation (all still births) and accidental births in taxis, on the street, etc." (Stewart, pp. 222) and "...homicides by unwed mothers who did not want their babies and left them to die of exposure..." (ibid.) Nice bit of misrepresentation there, huh?

In any case, if you, or anyone in the UC movement has such stats, I'll be more than happy to put them up here on the blog.