Natural Childbirth

I have never run a marathon. Actually, I have never run much at all. I have done a few very slow jogging miles which would better be termed slogs considering the pace at which I was traveling.

If I were to run a marathon, though, I think I would at least purchase some running shoes. Perhaps I would also invest in some proper attire for the expected weather conditions. I would most likely read some about marathon running. Oh, and I might run a few miles first.

I say this because I am always surprised when patients come to the hospital in labor, planning on "natural childbirth", or planning on using no medication or anesthesia whatsoever, and yet have not prepared for this momentous event in any fashion.

I admitted one such couple this past week. The mother was in active labor, already 4 centimeters dilated when admitted, and was in obvious pain. Her husband's powerlessness to help her was as obvious as her pain. I asked if they had gone to childbirth classes.

"No, we didn't have the time," was the response.

I asked if they had read any on childbirth breathing techniques or ways to help deal with labor. Again, the answer was "No".

Choosing to face labor without medication or anesthesia, especially a first labor, without preparing in any way to deal with the pain of the contractions, would be like choosing to run a marathon without ever taking the first step of running beforehand.

If you are contemplating, or choosing to, approach your labor without medication or anesthesia, there are some ways to prepare yourself:

• Attend childbirth classes. Most hospitals and birthing centers offer childbirth classes for free or for a minimal fee. If you don't find one associated with the hospital of birthing center where you plan to deliver, attend one from another site in town. Even if all the information isn't as accurate, the basic information on childbirth, breathing techniques and relaxation will be helpful.

• If you have attended a childbirth series and felt the information did not help prepare you for your labor experience, search for independent childbirth instructors in your area. Often these might have the name "Lamaze" or "Bradley" in the title.

• Read all you can on natural childbirth techniques. The hallmark techniques of natural childbirth are breathing techniques, relaxation and partner participation -- often in the form of massage.

• Practice the techniques you learn daily. Labor is no time to be deciding which techniques work best, or which the mother prefers. Practice until you know them by heart. Practice until you feel very comfortable with them and feel very relaxed doing them. It will be more stressful with the pain of contractions.

• Discuss together what you perceive as your roles throughout childbirth. Be open and honest about what you would like and wouldn't like, what you would feel comfortable with and wouldn't feel comfortable with. Labor is not a time to be having a heart-to-heart discussion about what to do.

You may also want to prepare a bag of tools to help you along the way. Things that can often help during labor include:

• Music -- whatever makes you relax and feel good. The more soothing the music, usually the better.

• Scents -- in the form of scented lotions, sprays, candles (if allowed). Scents can add a peaceful feeling to the room and aid relaxation.

• Massage tools --tennis balls, lotions, any number of items available at your local massage or lotion shop, can help make massage easier to give and more enjoyable to receive.

• Temperature --ice packs and hot packs can be used in various places to help encourage relaxation and to reduce soreness in muscles.

• General comfort --simple things such as lip balm, a hairbrush and contact solution and container can be big tools in labor. Remember to toss in a pair of socks, pony-tail holders and any other thing you think might help to make the mother (and father, too) more comfortable along the way.

Natural childbirth can be a rewarding experience, but more so for the couple who has prepared in advance and is ready to face the experience. Don't be caught off guard, don't wait until the last minute to prepare. Have everything ready well before you think you will need it, and practice more than you think you should.

With proper preparation, you can increases the chances of having your labor experience be all you have dreamed it would be.

A Tribute to a Wonderful Obstetrican

We could always tell he coming down the hall as the whistling of some Jimmy Buffet tune would precede him by several seconds. Whistling was such a hallmark of his, and such a habit of mine, that often I would turn a corner and find the nurses had been expecting to see him instead of me.

He was of the "old school." He believed in assessing the patient with your hands, your eyes, your ears. . .not with machines. More than once he would ask a new nurse how strong the patient's contractions were and when she pointed to the fetal monitor, he would shake his head, take her hand and place in on the uterine fundus. "Here is how you tell how strong the contractions are!"

The machine he disliked the most was the computer. He felt it had no place in the labor room, in the operating room, well, let's face it, I don't think he thought it belonged in the hospital at all! While he eventually acquiesced to using them, he always maintained computers didn't make everything quicker and easier for everyone, some people just seemed to be faster with pen and paper. He was one of them.

His patients, without fail, loved him. He had a way of caring for them that like a kindly uncle or a substitute father. He cared about the patients and their families. He wanted to know who everyone was in the room.

That isn't to say he didn't "tell it like it was." He did. to everyone: patients, family members, nurses, administrators, anyone within earshot. You never knew what story, what description, what exclamation was going to come out of his mouth. But somehow you knew, even if he was passionately complaining about something, that the source of it underneath was a genuine caring.

I saw that caring time and time again, not just to patients, but to our nurses. He would put a fatherly hand on the shoulder of a nurse on orientation and ask her how she was doing, and it was obvious he was truly concerned. Nurses who might be out sick for a while would find him asking if they were "doing ok now?" when they returned. He cared for us when we were sick and he cared for us when we were sad, when others might have just walked on by.

He was the very best, the very best, at watching a questionable fetal heart rate tracing. He was never quick to jump in to operate. He would sit at the patient's beside (which was reassuring to both the patient and the nurse) and watch that heart rate. He would sit and watch and wait and watch and wait. He would explain to everyone in the room how the baby's heart rate resolve if we would give it some time. Never, never did I see him be wrong.

He was a unique physician, a unique man, and it will be so difficult to be at work and not hear that whistling down the halls. We will miss that heart of song and smile of joy. . .

Benjamin Robert Busbee, MD