Tuesday, December 22, 2015

April's Birth Story (respectful natural hospital birth)

April's Adorable Baby
Because there are many egregious examples of bias in the maternity care of women of size, sometimes it can sound like no women of size receive respectful care during birth, but of course that's not true. There are some WONDERFUL care providers out there who really do give appropriate and respectful care to women of size during pregnancy and birth. Periodically it's important to share those stories too. That sounds like a wonderful and upbeat Christmas week post to me!

Here is the story of a "supersized" woman who gave birth recently in South Dakota. Many care providers would have predicted gloomy things based on her size (over 300 lbs.) and age (35). Yet she had a healthy pregnancy and baby, as well as an easy and completely natural birth in the hospital with a very caring OB and supportive nurses.

Remember, while there is a higher risk of some complications in "obese" women (especially as size increases), many high BMI women have completely normal and healthy pregnancies and births, especially when they take good care of themselves and are able to labor spontaneously with excellent support. 

The value of truly supportive care providers cannot be underestimated. So let me stop and speak to the care providers among my readers for a moment.
Providers, the most powerful intervention you can provide to women of size is to treat them with dignity and respect at all times. Some women of size have been so shamed and mistreated that they avoid care providers whenever possible. Regardless of what the scale says, all women deserve gentle and respectful care, but far too often they do not experience it. Respectful care can be a transformative experience for women of size who have had mostly negative contacts with health care before. Help heal that relationship; go out of your way to be as respectful and gentle as possible. 
Today, we women of size send a big shout-out to all the providers who DO provide respectful, excellent care to women of size. Thank you for all that you do.

We thank you for your gentle care and for your advocacy on our behalf. We know it's not always easy to do so in the weight-biased environment of many hospitals, but it is SO important that care like this be available to women of all sizes. Thank you for your efforts on our behalf.

And now as a holiday treat, here is April's birth story, an example of respectful care for a woman of size giving birth in the hospital.

I'm from South Dakota and I got my pregnancy care and gave birth at Sanford Hospital in Sioux Falls.  
On my first visit with my obstetrician, she did make a point of talking with us about the increased risks due to my weight (340-ish at the time) and my age (35). She said that I needed to be cautious about gaining too much weight and that I shouldn't be alarmed if I lost weight but also that I shouldn't TRY to lose weight. She also made a point of saying that even though the risks were increased, they were still quite low - especially since I am healthy with no major medical problems.  
I ended up losing about 20 pounds over the next couple of months and then my weight just stayed the same until my last month when I gained back about 5 pounds. Neither she nor any of the nurses that weighed me every visit ever commented on my weight except once when the nurse asked if I was deliberately trying not to gain weight. I told her now, that I ate when I was hungry and she was good with that, she didn't want me dieting.
I did have several ultrasounds over the course of the pregnancy but that was because she didn't like to sit still and the tech had trouble seeing the bits of her anatomy that they wanted to see. Everything went very well with the pregnancy. 
I went into active labor 2 days before my due date though I had been contracting for a couple days before that - just very far apart. I said I wanted a natural birth and they had a copy of a birth plan (checkboxes) that my obstetrician had given me months before. I also brought a simple birth plan I had typed up myself - one page with simple goals and requests. I also requested a nurse familiar with natural birth if possible.   
My nurse was wonderful. They assign each woman her own nurse so she was by my side the whole time. She was super supportive - kept saying how wonderful I was doing and helped keep my confidence up.  I didn't have an IV - they were okay with a heplock and only intermittent handheld monitoring so I had complete freedom of movement. Also, I had a jacuzzi and a shower.  
I labored from early morning until about 4pm I was 7cm dilated. Contractions came constantly after that and I got the urge to push. They checked me and I was 8cm so they said not to push. I couldn't really not push, though I tried and the midwife tried to help. 10 minutes of that and they checked me again and I was 9 1/2 and could push. FINALLY!  
I was half on my side hanging on to the bars on the side of the bed and the nurses (not the midwife) tried to get me to roll onto my back. I refused and said the doctor had said I could push in any position, even upside down (which she had said). So they let me be. 
The doc came in and it was my obstetrician since she just happened to be on call that day. She confirmed I didn't need to move and my daughter practically flew out she came so fast!  The doc almost didn't make it to the room in time - they were seeing hair! 
I believe because of this [being in a side position], the birth went very quickly and I didn't tear at all. All the nurses were very surprised and I feel that they will be more supportive of alternative positions in the future.The nurses were amazed that she came so easily and that I didn't tear even though it was pretty fast. My little girl was 7 lbs 6 oz and in perfect health. 
So, even though there was a lot of pain (though I don't really remember the worst of it now) I'm glad things went as they did and I hope you all can have as wonderful an experience as I did. 
Key thing is ask lots of questions to find out what your doc/nurse is okay with and don't be afraid to speak up for yourself, though keep it civil - if you are confrontational it will just hurt you in the end. You need to radiate calm, confidence, and that you are sure you know what you want. Also remember that we have the right to give birth in the position we choose. 
I found the book "Natural Hospital Birth" by Cynthia Gabriel very helpful also. I highly recommend anyone wanting natural birth in a hospital setting to read it - it is full of tips on how to stay in control even in the hospital. 
Also, I'd like to mention that I'm donating my extra milk to the Mother's Milk Bank of Iowa and I'd like to encourage anyone who has extra breast milk to donate to their local bank. It is so important for the little sick babies in the NICU to have breast milk.  


Anonymous said...

This is fantastic, congratulations April!

I'm in South Dakota too and the care from Avera was terrible. It's good to know that Sanford is better so I know who to recommend to my friends.

crystal_b said...

Wonderful :)

Anonymous said...

Congratulations on the arrival of your little girl and thank you for sharing your story.