Let’s Make Mother Friendly Childbirths available for Mamas on Bedrest

March 4th, 2010

The Coalition for Improving Maternity Services (CIMS) is dedicated to improving the care provided to women and their families during the child birth process. They advocate a midwife model of care which accentuates freedom of movement while in labor, the ability to eat and drink freely while in labor, the freedom to choose where to deliver a baby (at home, in a birthing center or at a hospital) and who to have present at the birth (the partner as well as a doula or female labor support partner). While I am totally in favor of all that CIMS is doing, I am dismayed that little is being done to extend this same type of  care to “mamas on bed rest” or high risk pregnant women.

I attended the Coalition for Improving Maternity Services (CIMS) annual forum for the first time this past weekend.  I learned a lot about new research in pregnancy, labor and delivery and delivery of care for pregnant women and their families. But the one thing that kept nagging at me throughout the conference was that many of the findings and initiatives, including the Mother Friendly Childbirth Initiative (MFCI), are not available to “mamas on bed rest” or high risk pregnant women. While I wholeheartedly agree with the initiative, I kept wondering to myself, “What about mamas on bed rest?”

In my opinion, high risk pregnant women need mother friendly childbirths more than women having uncomplicated childbirths. When that red “High Risk” is stamped on a woman’s chart, she automatically loses the bulk of her power to choose the course of her pregnancy. She is told if she has to go on bed rest-there isn’t choice not to. She is told when she will deliver and where (often in a hospital operating room with a cesarean section). She will have medications and interventions-often without being told or asked if she wants to have them and all the while she will be told that if she wants to have a baby to bring home at all, this is how it has to be. Mother Friendly? Not in the least.

I don’t dispute that when a woman is having a high risk pregnancy that more medical intervention may be needed to sustain the pregnancy or to deliver the baby. What I am railing against is the powerlessness that high risk pregnant women have to succumb to in order to have a child. While many of us may already be humbled by infertility and conception difficulties, and threatened miscarriages and preterm labor, doesn’t it stand to reason that we need the support and comforting atmosphere of a mother  friendly environment even more so? Can’t we apply even a few of the MFCI points to high risk pregnancy right now?

I know well how using even just a few of the MFCI points can make a huge difference. When I had my daughter, I went into preterm labor and all hell broke lose! I was admitted emergently by one of my OB’s partners because she was off. Since I was scheduled for a cesarean section I was admitted and prepped in a surgical anteroom. My husband was present at times, but for the epidural and other procedures, he was asked to leave and I was all alone to endure the clang of instruments being opened and laid out, bright lights directed at the OR table and draped and masked “blue people” I didn’t recognize telling me everything would be okay. It was unnerving to have my belly bared to a room full of strangers; some to care for me and some to “take” care of my baby .

Once the epidural was administered, I began vomiting profusely and little was done to stop it except adding things to the IV bag. When my husband came into the delivery room there was so much commotion he was completely overwhelmed. When my daughter was born I asked him what she looked like and he was completely undone by the “crater” they had created in me to get her out. My daughter was quickly whisked out for more “intensive” care due to breathing difficulties and was only paused briefly by my face. My husband went with the baby and once again I was on my own. I was alone in the recovery room, vomiting and in pain for 2 hours before being transferred to the post partum floor.  A neonatologist briefly stopped by to tell me that my daughter was okay, they were checking her out and that I would see her shortly. She did not arrive while I was in recovery. We did roll by the nursery on my way to the floor. I still hadn’t held my baby and by now 4 hours had passed since her birth. On the floor I continued to vomit until 2 am when the anesthesiologist finally graced us with her presence and gave me something in the IV bag to stop the vomiting and put me to sleep. It was the next morning, 12 hours later, when I held my daughter for the first time before she was transferred to the neonatal intensive care unit.

The picture was completely different when I had my son 3 1/2 years later. First and foremost, he was nearly term, born at 39 weeks. I actually had him at a different hospital because I wanted to have my tubes tied and the first catholic hospital did not allow the procedure. The second hospital tried to make the surgical suites more friendly. It may seem strange, but a nice color and curtains at the windows does a lot to warm up a place. Every room was tastefully decorated with a place for a partner to sleep and a place for the baby’s bassinet. My OB delivered my son and I felt so much more comfortable with her attending the birth. My husband was so shell shocked from my daughter’s birth that we agreed he wouldn’t be present at my son’s birth. We flew my older sister in to be with me instead. She was by my side at all times and we were laughing so hard at one point, my OB had to ask us to stop giggling so she could stitch me up!

When my son was born, my doctor held him up so that I could see him. She did suction him (a midwife care no no)  and then she laid him on my chest. He nursed with a vigor I didn’t know a newborn could muster! The nurses wiped him off and wrapped him up to go see my husband. That was the only time he was away from me. He and my sister rode with me to the recovery room where my husband, my parents, my sister and baby were all present. My son nursed at will and also rode with me to my room and stayed with me in my room until I was discharged.

One could argue that my second delivery was so much better because my son was a healthy term baby and my daughter was preterm and had breathing complications. I did not have lots of choices regarding my care or treatment for either birth. But even within those parameters, I believe that the “warmer” , friendlier environment, having my OB who tended me throughout my pregnancy deliver my child and having a friend/family advocate always at my side keeping my spirits high and making sure I had what I needed went a long way to making my second delivery much calmer, more memorable (in a positive way) and more “Mother Friendly” than the first. Small changes such as these and a few others would go a long way towards making “mother friendly” births for mamas on bed rest.

One response to “Let’s Make Mother Friendly Childbirths available for Mamas on Bedrest”

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