It's the Birth!

It’s the BIRTH, Silly

©Diane Wiessinger, MS, IBCLC

with updates by Jeanne Wade, ICCE, CLE/C, ICD

How your BIRTH can effect BREASTFEEDING

Breastfeeding is complicated, painful and most mothers can’t do it. That’s what this culture (and formula companies) have taught us since the early part of the 20th century. But the more we learn, the more we realize human newborns are just like every other mammal newborn: they know what to do. The mother doesn’t have to do much or know much. Mothers don’t breastfeed; babies breastfeed. It’s that simple.

But breastfeeding is still complicated, and we’re finally realizing why. Most mothers in our culture haven’t given birth since the early part of the 20th century. And no mammal who has birth taken from her goes on to nurse easily, or even to mother easily. It’s not breastfeeding that’s the problem. It’s the birth!

When a woman (or any mammal for that matter) goes to a strange place and lies down and is anesthetized for a process designed for an alert, responsive, mobile woman in a familiar place, she increases the risk of a host of complications that make things more difficult for both her baby and herself. It’s called the “cascade of interventions” ~ where one intervention often leads to another.....and another.

Today’s women do hard physical labor at gyms, in their yards, perhaps on the job. Would numbing anesthesia help with that kind of labor? No; it would just keep them from doing the job as well ... or at all. Today’s women understand the notion of hard physical work just as well as their mothers and grandmothers did, and they’re fully equipped for the physical work of having a baby. What they fear, perhaps, is the loss of control that comes with doing an unfamiliar job. And so they offer up all control, becoming spectators at their own births.

But you can do this work! You were born to do it, you’re built to do it, all the sensations come from your own muscles, and if you’ve ever seen the face of a woman who did the birth herself, completely on her own terms, you can see that it’s one of the highest highs a woman can experience!

UNICEF and the World Health Organization, back in 1990, realized that breastfeeding was doing just fine where women birthed at home with a midwife; it was in hospitals where breastfeeding was in trouble. No surprise. Take birth away from women, and we take breastfeeding away from babies. Certainly, a mother can get breastfeeding back… but it can be harder and more painful and much longer than the labor she tried to avoid. Motherhood always involves labor, in one way or another. Take the easy route! Labor before your baby is born, not after.

Epidurals are good for hospital "management" and good for business. They keep women in bed, they keep them still, they keep them quiet, they put the hospital staff in total control, and they are profitable. “It’s time for your epidural now” can put an extra $2,500-$3,000 on your tab.

Giving birth isn’t wildly painful, and you get a break after every contraction, but it’s no walk in the park! Our bodies normally respond by producing endorphins that help block the pain. Being born is no walk in the park either. The endorphins circulating through the mother's bloodstream help block the baby’s pain as well. No labor pain = no endorphins, and the baby’s discomfort increases. No endorphins in our milk means he can’t find the same comfort there, either.

Oxytocin is another hormone that contracts the uterus - (to get the baby out). Epidural stops the mother’s natural production of oxytocin, or stops its normal rise during labor. This necessitates the use of the synthetic drug - pitocin that carries it's own risks for the baby. Normally, at the moment of birth, we produce a surge of oxytocin and may feel “the ecstasy of birth.” Oxytocin helps us fall instantly in love with our babies. Pitocin does not act in this way. Without the feeling of giving birth and without these normal "love" hormones, the experience can be quite flat, as if it happened to someone else - and sometimes, as if that baby isn’t really, truly ours. That’s why other mammal mothers tend to reject any baby born after a medicated birth in a strange place.

Giving birth on her back turns a woman into a patient when she deserves to feel – yes, during labor – like a queen. The baby’s pressure on large blood vessels affects blood pressure for both of them. Her pelvis can’t expand normally, so she’s more likely to feel pain during and afterwards. Her baby doesn’t descend and rotate properly, requiring tugging and turning that can leave the baby in pain as well. Birth works best when the mother keeps control of her body and the process.

BIRTH IS NOT AN ILLNESS

Having a long epidural can involve the liquid equivalent of at least 14 cans of soda or more. The excess fluid swells a woman’s face, fingers, ankles, breasts… and nipples, making early breastfeeding all the more difficult. And it can slow down her milk, resulting in jaundice and supplements for the baby, both of which increase the risk of early weaning. This excess fluid also alters a baby's (accurate) birth weight.

Don’t let them kid you; having an epidural is uncomfortable. It can hurt and ... it may not work. This is not simple Novocain; half your body goes numb.

Normally in labor, a woman adjusts her position automatically. She labors standing, squatting, on one hip, on her hands and knees, on a birth ball, in the shower or in a birth tub.

The position that feels the best works the best.

The woman who can’t feel takes pot luck… and takes the episiotomy and vacuum extraction that often goes along with it. (Did you ever wonder why a woman would need an episiotomy for a 5 pound baby? It’s not the baby, it’s not the woman, it’s the anti-gravity – on your back, knees up – position.

Another important thing most mothers are NOT told about epidural anesthesia is that a potent opioid called Fentanyl is added into the mix. This opioid does "get to the baby" and can cause drowsiness and a disinterest in rooting for and latching onto the breast in the early hours and days.

The point of all this is not to scare you. It’s to remind you that bringing a baby into the world and caring for it involves work, no matter how you look at it. You can labor during the birth, or you can labor afterwards. But no one who has enjoyed a good [normal] birth would trade it for a spectator sport.

Lactation consultants who are also doulas and/or teach birth relaxation techniques, find that their clients don’t generally overlap; informed mothers who kept control of their births find their babies can usually take care of the breastfeeding.

If you want a birth that will be a joy to remember all your life instead of something that you and your baby need to recover from… you have some work to do! Ask your childbirth instructor for some good books on birthing without medications and referrals to local birth Doulas. Doulas DO make a difference!

You’re going to surprise yourself!