The facts of life and hospital births
It's interesting how many people are wondering about the same stuff. This week's emails were all about sex, drugs and epidurals. OK, not exactly rock and roll but what can you do?
Let's talk about sex, baby. One reader complained of feeling "passive" about sex and wondered if she'd be "normal" again after delivery. I have the impression she's still in her first trimester. She's tired, queasy and probably just doesn't want to. Normal, normal, normal. I don't want to have sex when I'm feeling puny either. Just wait, honey, it gets better from here—for a while. A lot of women get a porn-star sex drive in the second trimester when the nausea's gone and they have a little more energy. Their boobs are bigger, their genitals have more blood flow to them and the sex is great. This is Dad's "favorite trimester." Mom's not so big that making love requires major maneuvers but she's nice and round everywhere. There's a good time to be had by most.
Not everywoman feels hot though—they just feel heavy. They don't want to have sex—not in any trimester. They feel like crap and aren't crazy about the weight gain. They feel weird about having sex with a baby on board (not to worry—babies don't have a clue) and some have medical concerns that make sex a bad idea. If there are placental complications, early dilation, preterm labor, or bleeding (among other problems), doctors advise "pelvic rest." That's medical speak for Don't Do It. No sex at all. Sorry but that's the facts.
As for "will she be normal after delivery?" Well, eventually. The first month or two after birth are all about pelvic rest and healing. Doctors advise waiting until after the 4-6 week post partum checkup when most of the bleeding is over and any vaginal tissue damage has fully healed. Then, of course, there's contraception to deal with. That rumor that you can't get pregnant when you're breastfeeding is a big fat lie. Uh-huh, can too.
Once you've got your birth control worked out and clearance from your doc, go ahead and give it a go. It might be great getting back into "your body." Use extra lubricant and tell Dad to be gentle. It's not unusual though that some women still don't want sex. They're tired, overweight, their breasts leak, there's spit-up in their hair and a baby hanging onto their body 24/7. This is just Mother Nature's way of ensuring they don't have two babies under one year old. Not to worry—it gets better. Eventually you'll be back at it but it will be different than your pre-kids sex life. You'll learn a few new tricks. Like, sex during nap-time, sex while the kids watch Mary Poppins and the ever popular quickie.
Now about those drugs: Sara is studying the Bradley Method of childbirth preparation and wants a "natural" delivery. By "natural" I assume she means unmedicated (no pain drugs or epidural). She's delivering at a hospital with a high epidural rate and is "scared to death" the medical staff will insist on unnecessary medical interventions that will foil her plans. Oh, Sara, honey, you poor thing. I hate that you're going into this "scared to death" of your medical staff. You haven't even met us yet and already we're the bad guys. Give us a chance. A lot of "Bradley" families come to labor and delivery on the defense. I feel bad for them because in addition to all the physical and emotional transitions that come with birth, they also feel like they have to fight for their rights. I'm not speaking for every labor nurse at every hospital but I have worked in three labor and delivery units and the idea that we're out to foil plans is false. We really are there to help you have the best, safest birth possible.
It's true, though that sometimes birth plans go awry. Just because you've got your plans doesn't mean your birth's going to play out the way you expected. The baby, your body and the labor process have their own game plans and regardless of whatever you've written down, their plans trump your plans.
Sara says her hospital has a 99% epidural rate. Wow! That's a lot. The national average is about 65%. You might want to double check with your delivery unit to find out if that 99% is accurate, Sara. That said, here's your best game plan for having that "natural" delivery. Use a midwife with a high success rate in achieving unmedicated deliveries. I know you're already studying Bradley but consider reading up on other methods too, like Hypnobirthing or Lamaze so you'll have a variety of techniques available. Stay out of the hospital until you're in active labor (4 centimeters dilation). Stay out of the bed until you just have to lie down. Ask for a labor nurse who has lots of experience with natural delivery. Make sure you have a very supportive partner/labor coach and a minimum number of visitors while laboring (you'll need peace, quiet and concentration). Then, be flexible. Allow the birthing process to unfold as it should. It might happen just like you planned. Lots of "Bradley families" have easy, lovely deliveries. Some don't.
Some women who planned an unmedicated delivery ask for pain management anyway—especially first timers. Labor is way more intense and may last a lot longer than anticipated. If you're having a hospital birth, pain medication and an epidural are easily available. When you've been laboring for hours, your breathing/relaxation techniques aren't cutting it and you know an epidural is yours for the asking—you just might ask. And we won't say no. Even if your birth plan says "Don't give me an epidural even if I beg for it." Forget about it. We're not going to treat you like a child and we're not going to play games. If you ask for one, you're likely to get one. Refusing our patients requests for pain management would be cruel.
There are certain situation where we'll recommend an epidural to help your labor along. For example, if you're "stuck" at 7 centimeters for hours, an epidural might help your pelvis relax and continue dilating. If you're freaking out, climbing out of your skin with pain, an epidural might allow you to regain your composure and be fully present at the birth of your child rather than out of your mind. Frequently, epidurals are tools that help labor along rather than the bad guys who wheel you to surgery.
Try to keep an open mind about your hospital birth. Your medical staff is really just there to help. None of us want you to have unnecessary medical interventions (really, just more work for us). The way litigation has taken hold of the birth industry, there's no doubt a lot of defensive medicine going on and some practitioners are more conservative than others. Pick a doc or midwife with a low c-section rate, get ready for anything and trust the process. You and your baby are traveling together to the same destination. The baby's the one holding the steering wheel though and your body's a car that's never made this trip. Your medical staff is there to give you direction. Hang on, it's going to be a heck of a ride. Maybe that's where the rock and roll comes in.
Got a question for Jeanne? E-mail it to firstname.lastname@example.org and it may be answered in a future blog post.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.