A mama with gestational diabetes posed this question to the mama community on a pregnancy website:
Q: Hey all, do any of you have any tips for how I can make my labor and delivery more natural? I have always wanted a water home birth, but with each of my pregnancies (this is my third) I developed gestational diabetes. My first two labors and deliveries were very cold and sterile and highly mechanical. My doctor has already told me that I have to deliver in the hospital, have internal fetal monitoring and if the baby gets too big, that I’ll have to be induced. I called several midwives around town, but because I am on insulin (my blood sugars would soar in the early morning so I take a shot at bedtime).
I really want to avoid as much intervention as possible. I have hired a doula. What else can I do to make my delivery more natural and comforting?
The mamas on this particular website came up with some awesome ideas and I am going to share them here.
You Call the Shots! I was really heartened to hear the mamas in this community encouraging and empowering this mama to stand her ground for as natural a birth as possible. Many suggested that she find a midwife, but when “mama” shared her complicated course and her need for insulin, the mamas agreed that she should deliver in the hospital. However, they gave her sage advice to be very clear on her desires for her birth and to make sure that everyone knows what she wants and is on board to provide that care. One must always remember that the health care staff works for YOU! And while in our current paradigm health care providers often act as if they know what is best for us, in the end, we have the final say as to what treatments we receive.
Make sure that you understand each and every medication, treatment and procedure that is proposed. If you have questions, make sure they are answered to your satisfaction BEFORE you sign any consent form. (Truly make informed consent!)
Have an advocate. This mama was on this, she had already hired a doula. Having someone who knows what you want and who can express your desires if/when you cannot express them yourself is critical. Also, having someone there who is “all for you” is a tremendous emotional boost. This person has to be strong, knowledgeable, able to speak up to hospital personnel and yet someone who will first and foremost have your best health interest in mind, someone who may be able to help translate difficult information so you can make informed health care decisions if necessary. A doula is an excellent option if you don’t have a family member or friend who can take this stand for you, or if you prefer someone without the emotional ties and has some training in this area.
You Can Refuse to be Induced. Now this is a bit sticky. In Gestational Diabetes, there is always the risk of having a larger baby. However, if neither you nor the baby is in distress, there are no complications and you are not post dates, there really is no medically necessary reason to induce. You have the right to a trial of labor. Discuss this you situation with your OB and get the exact, specific reason he/she wants to induce your labor. If you have questions, you have the right to consult with another OB for a second opinion. Just be sure that an induction is truly indicated as it carries with it increased discomfort, the increased likelihood of an epidural, the increased likelihood of you having a c-section and an increased risk of your baby needing intensive care in the neonatal ICU (NICU).
You don’t have to have an epidural. You don’t have to have an epidural. Again, if every thing is progressing without complications or distress, and you feel comfortable and competent to manage your pain, you are well within your right to refuse an epidural.
You don’t have to have an episiotomy. An episiotomy, a surgical cut in the perineum is not necessary. Many OB’s perform this to “prevent tearing”. However, there are methods of perineal massage that allow for natural stretching of the tissue in this area. Most Midwives know these techniques and most OB’s do not. Ask a midwife or doula if they can share methods of perineum softening/stretching to ease delivery.
Make Friends with the L & D staff. If you can, visit the Labor and Delivery floor at the hospital at which you intend to deliver. Chat with the staff. If you can, get a feel for how the nurses care for the patients. The more you know up front, in terms of how the floor is laid out, how the nurses work with the patients and the nurses themselves, the better will be your experience.
Bring things from home to make your surrounds more comfortable and “homey”. Most of the mamas advised that mama bring her own gowns, robes and slippers, candles, music, pillows-anything that she finds soothing and that will make her surroundings feel more like home and less like a hospital room.
In this podcast I have the pleasure of interviewing Darcel Harmon, owner, founder and blogger of The Mahogany Way Birth Cafe. Darcel is a mama passionate about all things birth! After a disappointing experience giving birth to her first child, Darcel made it a point to find alternatives for her subsequent pregnancies. Her research and her own experiences giving birth at home to her second and third children inspired Darcel to share her knowledge with other mamas, especially mamas of color, on The Mahogany Way Cafe.
Bedrest Coach Darline Turner-Lee reviews and comments on a recent press release issued by The Big Push for Midwives Campaign.
In the Press Release, the CDC notes an increase in home births in non-hispanic white women, yet decreasing or stagnat numbers amongst women of color. The press release also noted that
“The CDC report as well as other reports show that babies born to women cared for by Certified Professional Midwives (CPM’s) are far less likely to be preterm or born low birth weight, two of theprimary contributing factors not only to infant mortality, but to racial and ethnic disparities in birth outcomes.”
The Big Push for Midwives is hoping that this report from the CDC will spur action in legislation and amongst medical organizations to allow CPM’s to care for and be reimbursed for care given to women of color and low income women-women who might most benefit from CPM care.