What I Wish I had Known About Pregnancy

I think that one of these days, this will turn into a series of posts, but the best place to start is the beginning.

When I started this journey I didn't know what I didn't know. I have this annoying habit of questioning things, though. I'm sure it drives people crazy, but whatever.

When I first got pregnant, I chose my care provider based on distance from my house and distance from my husband's workplace. To be fair, I did look up some ratings, I think, but basically that was it. I didn't know what birth preferences were, so I didn't bother to choose a doctor based on my philosophies (I didn't have philosophies about birth yet!). I realized after I had The Baby Fish how lucky I was that I ended up with a doctor who cooperated with me. Most people who share my obnoxious/obstinate/nitpicky ideas about pregnancy and birth choose a midwife/birthing center/home birth. I lucked out, but it makes me a little anxious about next time (if there is a next time) because my current doctor is moving out of state.

So here's what I wish I had known. Let me preface this by saying, I'm not a doctor and I don't care how anyone else births their babies. My only caveat is that you should decide how you want to do things through your own research rather than just bobbing along and letting someone else determine what your experience will be. We are fortunate to live in a time where medical interventions are available and in some cases they are necessary. They just aren't necessary nearly as often as they occur. Do your research. Your body. Your baby. Your birth experience. You have to take responsibility for your care.

1. If you have any crunchy tendencies, read Ina May's Guide to Childbirth the minute the second line shows up on the pee stick.

2. Research your care provider's/hospital's Cesarean rate. I hate to tell you this, but there are some doctors that will try to convince you that you need a C-Section so that they can be home in time for dinner, or so you won't interrupt their day off. They won't tell you that's why you need one. They'll probably say something along the lines of "the baby is just too big" or "failure to progress" or "your bag of water has been ruptured for too long." Again, in some cases that's true. Not always, though.

This is a great article about the rise in the number of C-sections amongst low risk women. You might think, "Oh, but all of those surgeries were necessary to save lives." Not so much. The rate of "bad maternal/fetal outcomes" has not decreased with the increase of C-sections. Seriously. Do your research. The rate of poor maternal/fetal outcomes is super low in the US, but it is still higher than the rate in some undeveloped countries. Isn't that baffling?! Here's another great article.

3. Your doctor will probably mention an induction. You probably don't need one.

If you are low risk and haven't exceeded 42 weeks gestation and you don't want to be induced, do your research, figure out what you want to do, and fight for it. You cannot be forced to consent to any medical procedure. You have a choice. You may have to sign some sort of waiver, but find out what your options are. You are not "overdue" until you exceed 42 weeks. From 40-42 weeks, you are "postdate."

Ask what your Bishop Score is. If you are induced with a low Bishop's score, the probability that your induction will lead to a C-Section skyrockets.

The average gestation for a first time pregnancy is 41 weeks 1 day. My doctor would have happily induced me at 40 weeks. Not because of any complications or concern about the health of my baby or me. It's just kind of what they do. I declined a 40 week induction and the baby came out anyway! He didn't come out at 40 weeks, but he came out when he was ready. Crazy how our bodies and our babies know what to do! :)

4. Research Evidence Based Birth. If your doctor suggests an intervention that you don't want, ask questions about why it's necessary in your particular pregnancy. You are the consumer. You are paying for a service. Don't fail to ask questions because you don't want to "bother" your doctor. A good doctor won't mind answering your questions and putting your mind at ease.

5. Figure out what your birth preferences are well ahead of your due date so you can discuss them with your doctor and get his or her input. You don't want to find out that you're not on the same page in the delivery room. If your doctor isn't supportive of your wishes, find out why and decide if he or she is directing your care from the standpoint of standard protocol or if your particular medical needs are being taken into consideration.

I could go on and on, but the main point is this: Learn as much as you can about what kind of care you want and what kind of care your doctor is going to provide. Be informed. Know your options.

Resources for more info:

Amnesty International
Hypnobabies
The Business of Being Born
Ina May Gaskin
Evidence Based Birth Blog
International Cesarean Awareness Network

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