When to Push

Two weekends ago we attended our last pregnancy education class, Labour & Birth. Out of the 15 couples that attended, we came the furthest distance taking about 40 minutes of driving yet we were the 6th couple to arrive on time, the rest all came after the course scheduled start time. All those that were late only had 8-15 minute travel time and the very last couple to arrive lived ON the street where the class was being held and walked there. Keep in mind, the class is held in a building just across the street from the hospital that we all plan to deliver at. The only reason we arrived to the class on time too was the fact that Anthony dropped me off at the building entrance then went in search of parking, metered parking.

We both found the class informative and fortunately they didn't show vivid videos of actual deliveries. I was torn with the idea of seeing one but probably leaning more towards not wanting to. There was one awkward point in the class where the instructor was trying to show us that the squat position helps open the pelvic area by about a centimeter thereby helping with the delivery. So she makes all the mums-to-be stand up and place one hand on their front pelvic area and run their other hand down their backside downunder, hold it there, then squat. Apparently this was so we can "feel" the pelvic movement. I think everyone there, even the guys were mortified. Nothing like a bunch of pregnant women touching themselves, squatting, and in a room with other women and men watching. Although I was impressed that none of the women fell over from laughing so hard. I was just worried I might pee in my pants.

The class was fairly uneventful after that. Although it did leave me with three open issues or at least areas of uncertainty.

You might have seen me mention elsewhere that Australia is big on midwives for labour and delivery. We touched on this subject in class but only briefly since we were the only couple there that wasn't accustomed to that idea. Even at my doctor's office they keep a midwife on staff to field questions instead of them going to the OB. So in the labour ward at the hospital every patient is assigned a midwife and they're the ones that will field our questions, check our dilation, and in most cases, there to deliver the baby. Apparently the OB is really only called to presence if it's anything beyond a normal birth or if I have to get wheeled off to the "theater" (or as we call it, surgery).

Basically the midwife does it all for the labour and delivery unless it's something beyond a "normal" delivery in which case she acts as a liaison to everyone else, the OB, pediatrician, anesthesiologist, etc. To be honest, we're not too keen on that idea. I have every expectation that my doctor will be present at the time of the delivery so needless to say, we'll be having a discussion with her to find out what's the plan on when she'll show up.

Another concern popped up when we were going over the stages of the labour period in which the contractions start. The instructor pointed out that our generation love to show up to the hospital way too early. Which means, they are then sent home. So I can understand that to a point since the general first time pregnancies seem to take hours before it progresses to the point of pushing. What I have an issue with is the fact that we live 40 minutes away, on an easy drive (like around the time of 2 AM) but on a regular work day and especially if it's during rush hour, it may take us 1.5 hours to get to the hospital. So my fear is, being it's our first baby, and the unexpected is to be expected, when should we actually leave for the hospital and if we left too early would they seriously send us back home?? Because I tell you what, if that happens, they are going to have a psychotic pregnant women on their hands.

Add to that the fact that parking is insanely expensive at the hospital. Up to the first hour is $10.00, then $12.00, then $15.00, $18.00, $21.00, then $24.00 and if you are there for more than 6 hours it's $30.00. And I'm pretty certain the odds of me being in labour for more than 6 hours are pretty good. And no, we can't use street parking, those are all metered with 2-4 hr maximums usually at about $2.40/hr. The last thing I want is Anthony running out every 2-4 hours to move the car and feed the meter. I don't think the baby will be willing to wait if it happens to be right at the end of the time frame. And the meter readers here are VERY VERY on top of catching expired meters. The ticket/fine is around $70-$100 dollars and it's not a one time fine, they'll keep giving you another $70-$100 ticket each time they come around to check.

And last but no least, pain meds. One option that is extremely prevalent here is inhaling Nitrous Oxide during the first stage of labour before the pushing. On TV, you see labouring women squiggling in pain and sucking on the gas like they've been deprived of oxygen or something. Apparently you're suppose to take deep breathes but more often than not the women are taking it in with rapid gasps.

This is an example of the contraption.

It's suppose to only take away about 20%-30% of the pain. I'll probably give it a go and I'm sure Anthony will be taking a few tokes too! It's suppose to not affect the baby whatsoever and in rare cases it may make me nauseous but otherwise pretty harmless.

Now the discussion of epidurals is actually what had me a bit unsettled. As with any medication there will always be risks. The risk seems to be greater because of the point of insertion for epidurals. The instructor listed off about 10 different risk ratios like odds of permanent disability, odds of severe headache to where you can't sit up, odds of infection, etc. As the list builds, the more uncomfortable I get about having an epidural. However, having said that, I have a feeling at the moment of crisis when I'm bawling my eyes out and chanting "I can't do it, I can't do this," I'll be begging somebody to either put me out of my misery or give me an epidural. So I walk away hoping I can muster up the courage to not need it so I don't put myself or the baby at any risk whatsoever from it but realistically when all hell breaks loose I probably won't care for anything but relief.

We did learn a tid bit about the anesthesiologists that administer these epidurals though. At the private hospital we'll planning to deliver at, there are 4 anesthesiologists that administer the epidural. Apparently they all charge a different fee for doing so. Two charge normal costs that from what I understand is covered by the insurance plans. Another charges $400 on top and the fourth one charges $1000 more! Now when we heard that, Anthony and I had to pick up our jaws from off the floor. Doesn't that sound absurd? 4 doctors that perform the same procedure in the same hospital would charge such extremely different rates. And to top it off, you're stuck with whomever is there so it's not like you can ask for the "cheaper" doctor AND they don't even bother to tell you which doctor it is so you get to find out when the bill arrives. If we get that $1000 extra cost doctor, that epidural better be the best drug ever.

We survived our classes, or more accurately, Anthony survived the classes. Oh wait, did I mention, we signed Anthony up for "Father's Time" course that's just for Fathers-To-Be?? I don't get to go so it'll be interesting to hear how that goes. I'll try to get Anthony to blog about it but no guarantees, he may want to forget the experience as soon as it happens! I told him it'll probably require him to hold hands with other guys while in a circle, singing Kumbaya, and crying over the end of their freedom.

- julie