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The Honolulu Advertiser
Posted on: Sunday, May 13, 2007

Special delivery

 •  HawaiiMoms.com
The Honolulu Advertiser Web site that aims to help busy moms connect with each other and get vital parenting information.
Video: Give birth without drugs with hypno birthing
 •  In Hawai'i everyone delivers their way

By Mary Kaye Ritz
Advertiser Staff Writer

Tanya Bettis, of ‘Äina Haina, chose HypnoBirthing to get through labor.

REBECCA BREYER | The Honolulu Advertiser

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3 HOT NEW CHILDBIRTH TRENDS THAT HAVEN’T YET REACHED HAWAI'I

Three of the newest trends in birthing that have yet to jump the Pacific but can be found on the Mainland:

  • Water births. While showers and baths are often used when a woman is in labor here — Castle Hospital has deep Jacuzzi tubs in its birthing suites, and other birthing suites have shower attachments — hospitals have few birthing tubs, which resemble vertical baths. Here, Queen's allows the use of the tub, but only if a doula or midwife sets it up. Some don't allow it at all, doulas here said, though midwives and doulas are using it for labor and delivery in home births.

  • "Social inductions," or a caesarean section done for convenience reasons. Obstetricians here tend to frown on it, maternity nurses say.

  • The "push present." Dad, grateful after watching Mom give birth, gives her a new bauble in thanks. (Some think the jewelry industry is behind this one.) Jokes Hawai'i's Jennifer Riddick, "It should be a karat per pound."

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    Barbieto demonstrates a squat birthing position on an adjustable birthing bed at Queen's.

    Photos by RICHARD AMBO | The Honolulu Advertiser

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    Katie Barbieto, a post-partum nurse manager, looks at a light that hides away in the ceiling when not in use in a birthing room at The Queen's Medical Center.

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    Jennifer Riddick, top, of Honolulu, demonstrates HypnoBirthing on Tanya Bettis, bottom, of 'Aina Haina, as their toddlers keep busy.

    REBECCA BREYER | The Honolulu Advertiser

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    Jennifer Riddick's husband, a Secret Service agent, calls her "crunchy." As in granola.

    So when she told him she wanted to give HypnoBirthing, the latest maternity trend to hit Hawai'i shores, a try, guess how well hubby took that?

    "He said it was the craziest idea he'd ever heard," said Riddick with a chortle. "He went on the Internet trying to find out if it was a scam, but he couldn't find anything."

    Like any selfrespecting cruncher, Riddick gave birth to Ian, now 1, naturally and without pain, she said, though when she first arrived at the hospital, she was further along than anyone thought: "The nurses were not convinced that I was in active labor because I looked too calm!"

    These days self-hypnosis, water births and use of doulas are helping many women ensure a natural childbirth like Riddick's. But other trends are emerging on the O'ahu maternity landscape as well, such as a bigger audience in the delivery room and a pendulum swing toward the use of epidurals.

    CHILDBIRTH AGAIN, NATURALLY

    Pregnant with her first child, Riddick wanted to go as natural as possible, but she also knew her husband would allow her to reach for an epidural at the first furrow of her brow.

    "Husbands say they don't want to have the woman they love the most in the world in pain," said Patti Edwards, a doula hired by Riddick. "If they don't have someone to reassure them it's natural, they want to have something to help her out."

    The use of midwives and doulas, or labor attendants, has increased with the push for natural childbirth. Edwards said she's seen an increase in demand for her services, though she keeps her calendar to just two pregnant women a month.

    "We don't have enough doulas on the Islands," Edwards said with a sigh.

    When Riddick was looking into hypnosis, there were no specialists on O'ahu. However, that's changed: Eric and Connie Richmond became the second and third HypnoBirthing practitioners here, along with a growing spate of Neighbor Island practitioners.

    Riddick is spreading the word, too: She's turned her friend, Tanya Bettis, on to the experience and to other labor aids, such as use of a birthing ball. (That's Tanya's bump gracing the cover of this section.)

    PAIN IS OUT

    Even with the push for natural childbirth, experts say they're seeing an increase these days in the use of epidurals.

    Katie Barbieto serves as the nurse manager of the postpartum nursery at The Queen's Medical Center. She also gives childbirth preparation classes, so she is in a good position to gauge the mood of each year's new moms pretty well.

    She teases classes of mothers-to-be about calling from the parking lot: "I'm here! I want my epidural ready!"

    The estimated use of pain medications such as epidurals at Queen's is now at about 90 percent of births, said Barbieto, who came from Castle Medical Center, where she helped design the birthing suites.

    Kapi'olani Medical Center for Women & Children reports about 80 percent of its births use pain medications such as epidurals. Kaiser's and Tripler's are both about 86 percent, spokespersons said.

    Why the tip of the scales?

    WHEN IT COMES TO NATURAL CHILDBIRTH ...

    "We're really moving backwards a little bit," said Bess Essman, a doula here.

    While the state health department does not keep statistics on the many of Hawai'i's 18,982 births used epidurals last year, and therefore can't track the rise or fall, doulas and maternity experts see trends, such as a return to epidural. Why might that be? They have their theories.

    "Some women do not want to experience any pain," said doula Edwards. "I think epidurals are helpful if you can't relax. Women these days are giving birth later in life, have successful jobs. They have control over everything in their lives and plan this wonderful birth. If all doesn't go as planned, they're scared."

    Not that she's anti-anesthesia: "Epidurals help," Edwards said.

    It could have something to do with the fact that epidurals have evolved.

    Dr. Lynnae Sauvage at Kapi'olani, a neonatalist, explained that today, anesthesia can be so localized that some women even walk around with epidurals, enhancing labor, and by extension, the birth experience. (It sure beats doing multiplication tables in your head, a distraction technique Sauvage herself used to get through labor for her oldest child's natural childbirth. She went with an epidural for the next one.)

    THE PRETTIEST PLACE

    Hospital maternity wards are continually becoming more pleasant, with suites where mothers can labor, deliver and recover in one room. Amid the hospital white, maternity wards and birthing floors are spotted with touches of home, such as pretty wallpaper borders.

    Queen's has large rooms with flower pots on either side of the bed; partners can stretch out on an upholstered chair and matching ottoman. In the postpartum rooms, dads or other partners have a pull-out chair/bed, too.

    Another hot birthing trend: celebration dinners. Kapi'olani, for example, serves chicken cordon bleu, rice pilaf and asparagus tips — for new moms and dads — on a nicely arranged table, no less, the night before Mom is discharged.

    Many moms say the hands-down best part of the hospital experience these days is beds with removable bottoms and a "squat bar" attachment. (If you've ever had back labor, that particular piece of equipment will seem like a godsend.)

    A FAMILY AFFAIR

    Taking advantage of those surroundings is a growing entourage, say maternity nurses.

    Some cultural reasons explain the increase in numbers of people attending births here. Certain Polynesian groups view major life events as a village affair.

    But even factoring out cultural issues, these days the audience seems to be on the rise.

    Sometimes, it's a young mother who doesn't have any issues about her body or wants to please all the extended family, maternity nurses said. Nurses are happy to step in and play the bad guy, they said, if a relative is interfering with the labor process and needs to be escorted out.

    Chris Turner, the clinical manager for the Kapi'olani Birth Center, once had a record 16 people in for a delivery.

    And that's not all.

    "I had to say no to two dogs," she said. "People really want it to be a family experience."