In 2015 I had the pleasure of teaching thirty-nine families. My stats are based off the thirty-five families who attended reunions and returned their birth summaries to me.
The average maternal age was 31 years old, and percentage of families expecting their first baby was 94%. Parents with a variety of pregnancy variations such as gestational diabetes, planning vaginal breech birth, twins, advanced maternal age, and vaginal birth after cesarean, were all included.
The percentage of families who started with OB care was 74%, during my class 46% of families switched to midwifery care, and 23% switched to home birth. Midwife led care has shown to improve outcomes for women and is an under utilized option in our country, so encouraging midwifery care for low risk parents should be apart of any evidence based curriculum.
Labor began spontaneously for 88% of the families, and the average length of labor was 15 hours (excluding inductions). The average of when babies were born was at 39 weeks and 2 days.
Out of the families planning a natural birth, which was everyone this year, 80% birthed without needing pain relief from an epidural, narcotics, or nitrous oxide. Of the 11% who received an epidural, half had been induced with pitocin, and the other half had labored more than 40 hours and used the epidural for sleep.
Vaginal births made up 91% of all the births. Of the 9% of births via cesarean, none were planned and all parents labored naturally before needing an emergency cesarean. Reasons for cesareans included no fetal heartbeat, maternal request after a long labor, and footling breech. When possible (ie, not under general anesthesia) family centered cesarean practices were implemented.
Sixty-six percent of families hired a birth doula, and 87% of hospital birthing families hired a doula. No families that completed the class and hired a birth doula used medications for pain relief.
There were 0 failed births. Birth is not a pass fail event. My ultimate hope for every family is that they have a satisfying experience, free of trauma or disrespect, even when unexpected circumstances arise.
So there you go! I was going to wait until I had taught 100 parents (I'm to 72), but I was curious. Here are some of my thoughts... possible rambling...
Of course, we cannot compare these numbers to the general population, (up to 95% epidural rate, 40% induction rate, 33% cesarean rate) because we don't know what percentage of the general population wanted a natural birth, then did not have one... unless someone does... then, gimme. I do know I meet many parents who share that they wanted a natural birth, but ended up not having the birth they wanted. More parents who want a natural birth should be able to have one in the US. The decision to birth naturally is not frivolous, but often times is based on a desire to minimize risk to the birthing person and baby. So far my experience has been that the barriers to a natural birth are less often the birthing person's body, but the maternity care system and how birth is managed by care providers, so we spend a lot of time addressing those barriers and parents are encouraged to make decisions that will reflect their desired outcome. Some parents will need medical interventions in labor, but that should be from medical need or maternal choice, not because of a lack of alternative options/support. I encourage families to get support not only through my class, but many other practitioners in the community. Gather the village.
In addition to thorough education (my class is 25 hours), I believe in professional, but candid support. In the era of bait-and-switch maternity care, just asking a provider how they practice is not always enough. I understand many educators also work alongside care providers as doulas, and doulas may feel restricted in what they will share, but I'm not a doula. If my student asks me in private what past students have experienced with a care provider, I will share (while respecting past students' privacy).
Parents who ask want to know, and need that information to make an informed decision for themselves.
If you want pain medications in labor, to induce labor, or a cesarean birth, this post (and my class) is not about telling people what they should do, or that natural birth is superior. I've had both natural and medicated births that were my choice and that made me feel like a capable, confident parent. Your choices are personal and unique to you. No matter what your hopes are for your birth, I believe there are benefits to taking a fully comprehensive birth class.
I'm excited about 2016. Please check out my class schedule if you are birthing in Monterey or Santa Cruz counties.