This post is about childbirth and scientific evidence about it. If you're uncomfortable with the topic, skip this post. For the rest of you, I've been obsessing about childbirth in the last couple of days. 
My only earlier experience turned out not quite like I imagined. 52 hours long counting from the time the water broke, about 40 hours of induced labor, including 9 h 42 m of "active labour", starting from the time I insisted that I really am giving birth and a physician finally gave in against her better judgement and moved me to the right room. No anesthesia because until the very end no one was around to offer it to me and afterwards it made no sense anymore and finally being so exhausted that after childbirth, I passed out for at least 24 hours, only waking for brief moments. The entire experience was rather traumatizing. I know I've said I want several children but after that experience, I didn't want to think about going through that again.
Maybe if it hadn't been like that, I'd already be a mother of two. Finally I just decided I have to stop postponing a second pregnancy. Now that I'm really growing a tummy and I've even felt the baby move (as early as 15 weeks) and all the routine pregnancy tests have been good, I can't avoid the thought that I will have to do that again. So I've been thinking, how can I do that better? The most important thing - being alone during childbirth sucks. I'm hiring my own midwife to attend the childbirth. This way they can't neglect me just because another person in labor can make more faces and look more desperate. I don't regret sending Erkki home so he can get some sleep because after birth I needed him to stay awake when I couldn't. But I do kinda regret not looking more desperate and pitiful just to get a decent amount of attention from the local hospital staff at Tartu University Hospital. They're still the best in the entire Estonia and they did most things right. I would even recommend it to other people. I simply wouldn't go there without my personal helper. I don't know how much it costs but it's probably worth it compared to the pricelessness of a psychological trauma.
Some basics about childbirth: giving birth on your back is the worst possible position. Getting the baby out in that position requires much effort and is described as more painful compared to alternatives. In a modern hospital I was encouraged to get out of bed
although that makes things more difficult for the midwife. Squatting during labor is the fastest method and opens up areas below by 10%, but can cause tears because it is so fast. It's also a very difficult position to stay in. Water helps childbirth but I chose against it because being in water restricts my movement and makes me feel clumsy. Besides, water gets cold after a while and I've heard it can get quite icky during an actual labor. Episiotomy, or deliberate cutting down below is pointless because doing the cut to avoid a natural tear is kind of counterproductive and the cut can tear up more as the baby comes. Women who have an episiotomy are more likely to end up with a very deep tear compared to women who don't have an episiotomy. One thing that most people don't know is that there isn't much natural lubrication going on during childbirth. Ain't that cruel?
Long ago people used oil to make things more slippery but now women are supposed to believe that the greasy substance called vernix on the baby's skin is enough. Babies who are carried to full term don't have much vernix left so that certainly isn't enough. Now there's a new product called Dianatal gel which is designed to be a birth lubricant. Quite ingenious in my opinion. It costs a ton of money, around $130, but if it might help, I'd try it. Some midwives say it helps, some say it doesn't make a difference, I say the product makes enough logical sense to pay the cost.Pushing during the second stage of labor is also under debate. It's criminally common for childbirth to be portrayed completely wrong in movies: woman lying on it's back, people yelling "PUSH, PUSH! Take a deep breath, then hold your breath and push!". Although I wasn't instructed to stay in bed, I was instructed to push as hard as I can. This is the wrong thing to do. In normal labor when woman is not even drugged on pain medication, there is a natural force insisting that the woman pushes. It's hard to hold back. But when pain gets very strong, that can mean that it's really time to hold back a little to let skin stretch. That's how I felt. I wanted to pause for some time. "Push through the pain!", they told me.
I was given the clear impression that the faster we get the baby out the better and that the second stage of labor is very dangerous for the baby. The longer it lasts the worse it is. Well, that's not quite true. I found very clear data that the second stage of labor can last for HOURS (up to 5 and more) without any adverse effect to the baby - no decrease in Apgar scores. There really is no hurry. Very long second stage labor can be evidence of other problems but as far as everything else is okay, there's no need to force a hurried pace in the first three hours of "the pushing phase". After three hours there's an increased risk of significant blood loss. I did it in an hour and I was hurried along the entire time as if the midwife had a bus to catch. I haven't found any reliable data about "pushing through the pain", I've only found stories from women who say that there's less tears when you don't do that. I got the impression that the baby's heart rate decreases during the pushing phase but now I read that it only decreases because women hold their breath to push harder. Do try to push your hardest without holding your breath - it can't be done. Ironically, women aren't even supposed to push their hardest. If a woman just relaxes and pushes very gradually, slow and steady, while exhaling during a contraction, the baby comes out nearly as fast, with better Apgar score and causing less tears. Funny they never mention the side effects while yelling to push harder.
And they certainly don't look sorry when they're stitching up tears they helped create.I've been thinking about pain medication and frankly, that's been my last concern. Maybe I have indeed forgotten the pain but this time I'm planning to avoid any pain medication. It's not about being a martyr and a hippie.
I just really don't like the side effects. Most pain medication have only limited usefulness for the mother and can make the baby dizzy and unable to start breathing on it's own. All pain medication wears off after a while so its not likely to stay drugged the entire time. Pain is strongest in the end when also pain medication is the most dangerous. Epidural is effective against the pain, but it has side effects that I am not willing to agree with. It can make the woman unable to move her legs or to support her body for better birthing positions as opposed to lying flat on her back. It also makes the woman unable to feel pain on the inside so tears are more common. Also, it can completely lose the sensation of needing to push. The large amount of women having an epidural is actually the reason why midwives give the instruction to push, no matter what the body wants. Basically, epidural loses the woman's control over her body. 
Water injection into the skin is still an option I'd consider because it's only side effect is short term discomfort but it can relax the body by relieving pain and thus help with childbirth.After all that I've read about childbirth in the last days I'm actually somewhat eager to test my theory that it doesn't have to be so bad. I can't control whether labor is induced or not and I haven't made plans about that but I will probably try Dianatal gel, a personal midwife and lack of strong pushing. Also still avoiding pain medication, forbiddings epiostomy and avoiding laying on my back.
So, the experiment plan is done but I still have to wait a whole 5 months until I can put it to test. PS! Just to spread bad publicity for a dumb technological failure that should have been fixed long ago: IE9 is no longer beta but I still can't publish posts in Blogger using an updated IE9 browser.
