So you get pregnant, and, knock on wood, no serious health complications arise. Before long you have to begin to start digging into the wide variety of methods, workshops, procedures, and people you might use to make sure that baby gets out of you in one-squirmy, blood and mucous covered, wailing piece.
You read about homebirth, birthing centers, water births, silent births, hypno births, epidurals, ob-gyns, midwives, and doulas who are different than midwives though it isn't exactly clear how at first. And in addition to considering the where, how, and who there are also all the things you can do to get ready. I'm talking about birthing classes, childcare classes, visits with lactation consultants, putting the nursery together, putting a birthing plan together and contemplating the long, and often contradictory, lists of things you can and can't do or eat to ensure maximum health for you and your baby.
The other day at Intelligentsia Coffee I heard an old lady, daunted by the elaborate offerings and prices, scream "Just a coffee, please!" The barista nodded and then asked her for four bucks. She sighed.
Well, this about sums about how I feel about giving birth. "Just a birth, please!" I screamed, to my computer screen, about two months into pregnancy.
I don't think there is anything wrong with coffee brewed with a siphon, nor do I think there is anything wrong with sitting in a tub at home with a cadre of midwifes, doulas and loved ones leading you through breathing techniques while your patient and well-informed husband gently massages your sacrum and explains that your contractions are now a minute a part.
But I also don't think there is anything wrong with some good old hospital-bed with a splash of epidural coffee for me, or you, or any woman who doesn't want to devote themselves to directing and choreographing their labor on their own.
And so, when it comes to giving birth, I have decided on a Laissez-Fare model, one that involves taking the path of least resistance when it comes to delivery. I call this "lazy birthing," though the research which brought me to this Tao of George Costanza-like approach required a fair amount of effort. For me, this birth feels very — how do they call it? — "natural."
I felt guilty about this at first, thinking I was depriving myself and my baby of some special experience, or, worse, guaranteeing that we would have some terrible experience — either of which would affect us for years to come. But ultimately there is no perfect and safe choice anyway, so we all got to do what makes sense for our lives. And let me tell you, the "just coffee" birthing plan can make a whole lot of sense.
Doctors, and Science, Aren't Necessarily So Bad
Okay, the first tip is pretty simple. Find an ob-gyn and hospital you like. Never has bedside manner mattered so much until now. And not just on the big day. On every visit leading up to it you will want someone who you feel like gets you. For some reason ob-gyns have this terrible rap that they will rush you out of their office as fast as they can, ignore your phone calls, and then, when the big day comes, trick you into a c-section just so they can get home to catch the end the Real Housewives reunion. Their reputation is a stark contrast to that of doulas and midwives, who, as their reputation has it, will slow-brew you some safe-for-pregnancy herbal tea while discussing perineum massaging techniques every Tuesday at 4pm.
But ob-gyns aren't all bad. Mine is this pretty awesome mixture of warm and thorough while still being very easy-going and laid back. And the majority of my friends and relatives who went the ob-gyn route have had good, or good enough, experiences with their doctors. So, be a little picky at first, but once you find one like you can sit back and relax knowing that this person went to medical school and has like decades of experience delivering babies . . . all so you don't have to worry come labor day.
Now for science.
Yes, there are some risks associated with hospital births, and yes, hospitals, in order to provide care that is uniform and safe, might not always be able to provide exactly the right thing for you at exactly the right moment. Could they do better? Sure. Are there valid advantages to going the home birth/ midwife route? Totally. (Finding some unbiased research comparing the two is, unfortunately, pretty hard, but this comes close.) But if you are the kind of person who is willing to forego a more personal and controllable experience for the comfort of knowing that your baby will be taken care in the case of certain freak life or death circumstances, hospitals are still the way to go.
If you do decide to go to a non-hospital birthing center, you will have to devise an emergency plan to get to a hospital in case complications arise. For me this felt like one more very big thing to think about. And lazy moms don't want one more thing to think about.
Oh, and epidurals. The evidence that they do any harm is slight and often anecdotal. The evidence that labor hurts like hell is not. (From what I gather, the worst thing they are guilty of is slowing down labor. But in some certain circumstances, like when the baby is big, the slowing down effect can actually be good for you. Have you seen a 9 pound watermelon? Have you seen your vagina? Think about it.)
I have never, ever passed on anesthesia for any other painful procedure, so why would I start now? I mean, they shot my arm up with novacane to remove a teeny tiny mole. I'm talking pin-sized. I have read in some places that if you work really hard to prepare your body during pregnancy you don't need the epidural. But, sorry folks, I don't have an extra hour a day to do these exercises and practice breathing techniques. That time gets used up just by all the peeing and napping that I squeeze in while working full-time and occasionally seeing friends. But even if I did, I would still call foul. Sorry, but I just don't buy it. For most of us, all the prenatal yoga in the world will never, ever have anything on an enormous needle shot directly into our spinal cord.
DIY is not good for Personal, or Societal, Progress (You Don't Need a Birth Plan)
Sophisticated societies rely on the specialization of labor. I take this to mean that my doctor went to medical school and has spent years understanding the ins and outs of labor so I don't have to. Really, what business of it is mine to write an elaborate birthing plan and tell her how the whole thing should go? Who the heck am I? All the books, classes and iPad apps in the world, and I still can't catch up to her in expertise.
Sure, there are a few things I can think about before, like which drugs I would be willing to take and to what lengths I want to go to avoid a c-section. But do I really need to spend the next 9 months pouring over every possible complication and treatment and decide in advance what I would do should that happen? Nope. I would much prefer to hire an expert, a.k.a. a doctor, who will present me with the options and her professional opinion should the complications arise.
It's not that I am going into labor ignorant. I read the books, watched some videos, all that kind of stuff. I just feel need to come up with some official plan that I have my husband print five copies of and pass out to the nurses and my doctor when I give birth. Instead, I am going to trust them to do their thing.
This should leave you with a bit of time to think about all the things that do require intense consideration. Which leads me to my next point . . .
You have enough to worry about!
Okay, giving birth is hard. Sure. But you know what is harder, if only because it lasts way, way longer? Taking care of a baby. You know what is, for some of us at least, even harder than that? The famous/infamous/ impossible/ possible dream of a work-life balance.
(We all know that when we say "life" for women, everyone is really talking about taking care of kids. Charming, right? We are struggling to balance "work" at home and "work" at the office. But I digress.)
Instead of spending 10 months investing in learning about one day, you could use that time to figure out what exactly you are supposed to do with that lil' guy or gal once you get them home. I say read books, take classes and talk to your friends about childcare because that is the thing you will actually have to do on your own, as opposed to labor during which you got some serious support.
And man oh man is there a lot of think about. You've got breastfeeding and/or pumping and/or formula to consider, and who is going to do what when you bring the little one home. Oh, and then there is all the stuff! I had gone into the registry process with the intention of being all minimal, in the way I imagine Danish women who live on houseboats are. But after a weeks of going through registry checklists and reading product reviews online all I have to say is "bless you imaginary Danish houseboat residents." Because from what I can tell you need-need a whole lot of stuff. And then there is a whole category of crap that you might not need-need, but, if you can get it, will make your life much easier. Figuring out what you need-need, just kind of need, what is adorable but not necessary, takes a lot of work.
This is also a good time to think about money. If you are like most women in the United States your maternity leave is probably either tiny or non-existent. Can you afford to work after the baby is born? Can you afford not to work? How long can you take off? What kind of childcare is available to you? What kind of childcare can you afford? These are some big questions, and can be quite emotional for men and women who want to continue to develop their professional lives, to whatever degree, while also being present during the first year of their child's life.
(Full disclosure: I wrote men and women because I do believe they are questions that both partners should answer, but, frankly, these big questions are mostly for the women. Our husbands probably get no paternity leave, and they don't have to deal with the physical recovery from birth nor breastfeeding. So it is most often the woman who has to figure out some new schedule.)
And, as long as we are on the topic, pregnancy is also a good time to make a little extra money if you can, and also to pursue any career goals that will inevitably get derailed for at least sometime once the baby comes.
See? Even with the lazy birth, there is plenty to overwhelm you.
Lazy Might Actually Be Better for You
Okay, so in theory, I get the appeal of the hospital-free birth. Hospitals are for sick people. Doctors treat sick people. But pregnant women aren't sick people who need treatment! They are goddesses, who need hand-holding and soothing, encouraging voices as they breathe their way through labor. Why wouldn't I, come contraction time, want to take a slow stroll in some pastoral landscape instead of being confined to a hospital bed while a rotating cast of characters comes into the room to check on the progress of my one and only vagina?
But, the truth is, like with everything else in life, stress is not your friend when it comes to labor. And any big birth plan, one that you are soooo beholden too or one that involves a lot of coordination by you, is inevitably going to cause you stress. And the more elaborate it is, the more stressed you are likely to be. You can plan this whole big day, or you can just tell yourself you are going to a good local hospital and not think about too many of the details.
Studies have shown that anxious mothers take longer to labor — the adrenaline produced by nervous mothers slows things down. Now I know this might not work for everyone, but because I chose "lazy" and am willing to cede control to the professionals on labor day, I am actually less anxious than I would be if I was more involved in choreographing the day. Out of all the ways to manage birthing anxiety, letting go has to be one of the easiest, and possibly the most effective.
Of course part of my letting go is rooted in the fact that I will be asking for an epidural once the pain feels too much. (Which is probably, like, 100% likely to happen.) But a recent study shows that, following the birth, this might be the better choice for all of us. Apparently 80% of women who experience post-traumatic stress disorder after childbirth are ones who forego drugs. Also, according to the same study, having a midwife or doula around didn't lessen their chances of having PTSD. As I said before, the science on all this stuff can get sticky, and I am not here to say that one way is better for all women. Just that, going the "just coffee" might have some legitimate perks for you and/or your baby's health.
The Lazy Lady's Doula – Her mom!
Last but not least, I would like to give a shout-out to my "doula" of choice, my mom. My mom did not require me to spend time interviewing candidates, is free of cost, very, very!, consistent with her check-ins and has a real emotional investment in the birth going well. (Will insert a ptui, ptui, ptui, for her sake). But that isn't even the best part. What really got her the job is that fact that while she is really the only person in the world I have no business telling to go fuck herself when she tells me to push harder, she is also the only person in the world I can scream "go fuck yourself" without feeling too bad. For me this is way more appealing than a half-stranger encouraging me to stay strong. And it allows my husband to also be a bit lazy, because he won't have the pressure to coach me on his own.
Yes, she might not know the latest on water birthing or which direction I should rotate my hips on a birthing ball (promise, you can learn all this, quickly and for free, on the Internet) but she has the straight-up home court advantage of having pushed me through her vagina 32 years ago. I mean, really, how can you say "no" to a woman who went through the exact same thing to bring you into this world? Not to mention, the three other times she did it when delivering my brothers and sister.
And even if you do tell her to fuck herself a hundred times over, helping you through labor will still be one of the most special and fulfilling moments of her life. Why would you want to deny your mom that?