So I scrapped the first draft of my birth story, but I guess I’ll tell you how I started out. I was going to tell you about the process of my labor — when contractions got intense, how far apart they were, and how I figured out how to cope with the pain. When I started writing it that way, it became pretty clinical and dry, which doesn’t accurately portray the experience that Eric or I had. I also had an eloquently written disclaimer about natural birth — how it is right for some people and might not be right for others. But that seems pretty distant from my emotional experience as well.
What I can tell you for real is that I am a whole new person. Birth is a bridge you cross, and the whole of it collapses behind you once you step foot on the other side. I know now that I will never be the young girl that I was at twenty-two, carrying on about frivolous things, and I won’t be just a wife to my husband anymore. Sam will always be in the mix. He peppers the thoughts of my future with birthday parties, long nights dealing with fevers and coughs, after-school activities, growing out of clothes and shoes too fast, getting dressed for prom, and graduation, prepping for college in the month of his birth, and finally, leaving us behind to become his own person. It molds my future with possibilities that are not my own, tears and laughter that belong to someone else, and hopes and dreams that I will do anything to defend.
But it’s the bridge that I’m talking about here, the one that led me to this place.
There’s nothing that you can do that will completely prepare you for labor. I tried my damnedest to learn every possible aspect of what would transpire within my body to deliver my little boy. I read for hours, took my twelve week class, had marathon conversations with my doula, and figured out the process that I thought we would follow. I made a birth mix on my iPod (didn’t use that at all), practiced my cat-cow stretches (unbearably painful during labor for me), and packed my bags weeks beforehand (the only useful items for labor were cold, cold water and chapstick). I am a planner — and I tried to plan everything. It doesn’t happen like that, but I’m truly glad I did all of the work and preparation, so that I could be as ready as possible.
I went into labor at 39 weeks and 2 days, on Sunday afternoon, September 12th. Contractions actually started the night before but didn’t get regular until about 3PM that day. First they felt like strong cramps, which didn’t really bother me. In fact, it made me feel that I could cope the whole way through.
We called our doula to come around 8PM that night, after I had started my labor song, which would continue for the next fourteen hours. A friend of mine (who delivered the week before) had suggested that I hum to match the pain, which is probably the best advice that I got or could give. I vocalized with big “Ohhh” sounds in time with each contraction. This is what got me through much of my labor. I also used my doula’s Tens Machine, which helped for a long while during early labor. The other gigantic help was that my doula came to labor with us at our house for three hours, and chatted with us and petted our dog while I paced and moaned. The feeling in me at that time was nervous and anticipatory, and the pain was low, strong, and pressing. I happily talked away during each pause between the pains, not yet withdrawing into what my doula terms “labor land.”
At 11PM, we decided to go to the hospital. By this time the contractions had become more intense, and I had three in the car. This had me clawing at the seat and arching my back in the air — all I wanted to do was walk off the pain. Be mobile, pace, moan.
Once we arrived at the hospital, I was placed in triage for two hours, viewed by residents and medical students, and strapped to the bed with monitors on my swollen belly, all trying to get a “good read” on Sam’s heart rate.
Want to torture a naturally laboring woman? Strap her to a bed and tell her to be still while a 24 year-old med student asks her if she has AIDS or Hepatitis B.
At the end of this marathon triage, I was told I was only dilated three centimeters, which meant I was still in latent labor, and not in active labor. Apparently you enter active labor at four centimeters, and all of the work before that is … what? Not active? At that point, I was pretty disheartened. With the pain the way it was, I knew I wouldn’t be able to sleep at all through the night, and it would likely be all of Monday and into early Tuesday morning before I would deliver Sam. Up until that point, I had been excited. Hearing that my labor might take another whole day took some of the wind out of my sails — especially since I was hearing this around midnight. They told me I had the option of going home and coming back, but that seemed like such a step backwards in time. I told the resident I’d rather not go home, since my parents were on their way, and everything was in order for me to be in the hospital.
After that, I walked. I walked through the hospital while my parents talked to my husband. I walked off the anxiety and tiredness while they readied my room. I walked through the labor and delivery room to which I was assigned, and I only barely tolerated the fetal monitors that strapped me to the bed, like clockwork, every forty minutes. I moaned and breathed deeply, sighed and paced. I rocked in the shower and swayed and sang out my labor song. Sometime around two or three in the morning, the room was darkened, I was in the hot hot shower for a brief respite between monitoring, and I began to dream as Sam moved lower in my body, and I opened more and more. Scattered images crossed through my mind, words and phrases came and went, nothing making sense, and I closed my eyes as I lay against the cool metal guard rail, the hot water running over the pulsing muscles in my back.
I wailed to be checked when my nurse came into the room around 4AM. I told Eric that I didn’t know if I could keep going if I hadn’t progressed — and I just knew that I had. The pain had seemed to intensify with each contraction, and I felt my body doing rapid, solid work.
When my nurse checked me, she smiled and said that all that walking had paid off. She told me I had dilated to six centimeters … I felt so proud of my body for accomplishing that much so quickly.
I said, “So it’s going to be today?”
She replied, “Yes. September 13th is going to be a cake and ice cream day in your home for many years to come.” Did I mention my nurse was amazing? She was the most positive and upbeat influence — and she was very relaxed when it came to how long I stayed on that awful monitor that tied me to a three foot area next to the bed.
After that, my sense of time began to blur. I remember the pain increasing, I remember seeking out the shower again, I remember vocalizing over and over.
It seemed that suddenly there were multiple people in the labor and delivery room — I’m not sure how much time had passed, but all of them insisted I stay hooked up to the monitor so that they could get a solid read on the baby’s heartbeat. They said it was too slow, but I could easily tell (even while in the depth of labor) that the monitor was reading my heartbeat and not Sam’s. When the monitor caught his heartbeat, it was strong and solid, so it baffled me as to why everyone was acting like something was wrong. When I saw my OB enter the room, I knew that something was happening.
My nurse was gone at this point, and a temporary nurse had replaced her. She told me that my doctor would have to break my water in order to insert an internal fetal monitor. I started to cry because I knew the contractions would hurt a lot more without my bag of waters as a cushion, and I knew that they would have to stick the monitor into my baby’s head. I had so not wanted any intervention, and it hurt me to know that I had to have it because the hospital equipment couldn’t see the strong heartbeat that was so clear to me. Eric and my doula assured me that it was best to listen to the staff — after all, now I would be able to walk around in my three foot space and not have to lie on the bed while being monitored. And I would avoid a c-section if they had a solid read on Sam’s heart rate.
“I can’t do this,” I said. I was in agony and knew I couldn’t take anymore.
“You can,” said the nurse whose name I don’t remember. “I did it twice, so you can do it.”
“You had two natural labors?” I asked her. “And you did it?”
“Yes, so you can do this.”
“I won’t want another baby,” I said. “I can’t do this again.”
“You will,” she said. “Don’t say that. You will.”
So I laid back and let my water be broken, felt it flow from me onto the plastic sheets on the bed, and watched as the strong heartbeat I knew was there register on the monitor as they attached the probe to Sam’s head. The nurse who had given me those words disappeared, and was replaced by a calm and gentle woman who would guide me through transition.
The rest of my labor, lasting about five hours, was the most intense experience of my life. After my water was broken, the contractions had very little pause between them — maybe thirty seconds to a minute of rest, followed by a lengthy contraction with a mighty peak of grinding downward pressure in my body. After a while, my moaning vocalizations became wails and loud, long screams — the only sounds on the otherwise silent labor ward. I would cry and tell the nurse over and over, “I can’t.” I told Eric, “I can’t.” But they kept telling me that I could, and that I was doing it. I told Eric I thought I would need an epidural if it continued like this, and he reminded me that it wasn’t what I wanted. My body was so tired that I went into my dreamlike state again, trying to lie down on the bed when contractions ebbed, and standing when the pain became so strong that I had to move my body and sway my hips.
The thoughts that circled through my head were the San Culpa affirmations that I had practiced in prenatal yoga during Savasana relaxation. I am powerful. I am connected to all the women who have come before me. I am a strong woman, and I can accomplish anything. Even as I screamed, “I can’t,” I tried to take in the “You can” from those around me, and I focused on the positive affirmations I had practiced over the past months.
When my nurse checked me again, I was dilated to 9 centimeters, with only a small bit remaining until I could push. I kept trying to convince her and my husband that I was ready to push. (Eric said this lasted for an hour or so before I actually started pushing, but it seemed like a short time in my mind.) My nurse told me I would know when I was ready, and she went calmly about setting up a delivery table and notifying my OB that I would soon be ready to have a baby.
As much as I wanted to push, I was terrified that it would hurt more than what I had already gone through. But yes, I knew. I could feel my whole body thrust down, the pressure overtaking me, and I screamed fiercely as the feeling swept through me.
“It’s time,” I said, and this time, the nurse believed me. “I’m ready to push.”
Let me pause to say that I thought this would be the scariest part — after all, a woman’s body opens completely to birth a child, and with that, the experts are fond of saying, comes pain. (If you haven’t read about the “ring of fire,” you will in your birth related studies.)
So I was scared. But here’s where the magic comes in — the pushing, the part that we as women are groomed to be terrified of, is exactly why I am so glad I didn’t have an epidural. I would have missed out on the most powerful experience of my life. I can’t imagine not feeling every push, not knowing when to reach down and touch my baby’s head, not FEELING him enter this world.
If you’ve done your research, you know that you have all sorts of chemicals in your body that do work for you. Well, adrenaline and endorphins are at work when you are pushing.
When Eric and the nurse helped me up onto the bed to start pushing after that last horrible contraction, these chemicals flooded my body. I felt an amazing rush of energy, and suddenly the pain vanished. As Eric and my calm, collected nurse held my legs, I finally bore down and felt my baby’s head travel lower and deeper through my body. The feeling was incredible — I was able to do work after ten hours of crushing contractions. Sam was moving lower — and I could feel him with every push. I watched Eric’s face between pushes. He was smiling and laughing as he saw our child’s head come into view. I could feel my the top of his head as he started to crown, and I reached down to touch him and his wispy hair. I was overcome with emotion … I was birthing my child.
The nurse told me to control my pushing so that I wouldn’t tear — and so that the doctor could arrive in time to deliver Sam! I tried to breathe through each rush of energy and slow down, but I couldn’t. He was coming fast, and my body was thrusting him quickly forward. I yelled that I had to keep pushing; the pressure was so great that I could not possibly stop. My doctor arrived about ten minutes before I gave birth — just in time to catch Sam. I gave my final pushes, guided by my doctor, and felt my baby’s head enter the world. In just one more push, his body followed. I heard a throaty, forceful cry — his first announcement of life. I watched as Eric cut his cord, and they put Sam onto my bare chest. My first thought was that he looked like my husband; my second was that I would have to try my hardest to be the best mother possible for the rest of my life.
My legs were shaking and I was shivering as I held him. The nurse covered us with warm blankets and brought me ice water. Sam was fussing and making noises, still covered in milky vernix and fluids. I was examining his fingers and toes as the doctor told me to push one last time to deliver my placenta. I barely felt it — I was still on the incredible high of delivering Sam.
Eric went to go get my parents to come meet him. I handed him over to my husband to be weighed and measured. I smiled and watched as my parents took pictures and bustled around the room. There was a whirlwind of energy and celebration that didn’t die down until Sam was safely asleep and I was delivered to my recovery room, legs still shaking.
I remember saying to Eric, as Sam nursed contentedly, “We did it. Look what we did.” And he replied, “No, you did this. It was all you.”
I can’t say that any birth experience is more empowering or life-changing than another. I only have mine to go by. I can say that I’m glad I made my plan, educated myself and got what I wanted for Sam’s birth. I know I am so lucky that the only intervention I had to have was the monitor — so many women plan to birth naturally and then need interventions that alter the experience they wanted. I know that I am blessed to have had a positive natural experience at a small hospital with amazing doctors and nurses. And I know that this experience was right for us — I feel so connected to Sam because we were partners in this experience. I talked to him in my labor dreams and told him that we could do this. And we did — the first experience we had together as mother and child.
What’s a birth plan?
A birth plan is what it sounds like — a plan for how your childbirth should go in the hospital. Mostly natural birthing mamas tend to write birth plans. Why’s that? Medicated birth is the norm in America, and so natural birth (while it is the most natural, physiological process a woman’s body is meant to go through) is something that requires a plan.
Why should I have a plan?
Well, why on earth would it require a plan? I mean, really? A woman is a customer at a hospital, and the hospital is providing a service. Why can’t they listen to the mother and her significant other in the moment? Well, because of the nature of the service that the hospital provides, doctors and nurses are generally given the ownership of all decisions and as such, frequently perform routine procedures without a mother’s knowledge — or even her consent (i.e. performing an episotomy or using forceps to deliver the baby). A woman can also be pressured to use pain medications such as an epidural or stadol, or to have a c-section even when labor is progressing at a normal (if slow) pace. Given these pressures of a “routine” hospital birth, it becomes essential for a woman who wants something outside of the norm to take control of her autonomy and make a detailed plan that outlines her wishes.
How do I craft a plan?
1. First, thou shalt do research.
I’ve just finished working on the second draft of my birth plan. I’m currently 33 weeks pregnant, and I’ve done a shitload of research, reading, thinking, asking questions, talking to experts, and listening to my birth instructor. I would contend that you shouldn’t go into a hospital wanting a natural birth without strong, self-propelled research and a strong outline of your wishes. I can’t even fathom setting foot into a hospital without knowing how labor progresses, what interventions are necessary and when, and what happens after delivery. I would strongly suggest a good birth class (we’ll discuss those on A Savvy Mom soon!) so that you can get a grip on these things, supplemented by reading at least one book on natural birth. (Your Best Birth would be my top recommendation for an easy, informative read — and it talks about birth plans at the end!)
2. Second, thou shalt look at sample birth plans.
When it comes to birth plans, plagiarize freely (something I get really pissed at my students for doing). But trust me, natural mamas everywhere post their plans online, and most of them are nice friendly ladies who want to share. I found a pretty awesome birth plan on Diaper Swappers (I’ve turned into a forum dork), and I also took bits from my doula’s birth instruction book. If you don’t look at any birth plans, you won’t know what to include!
3. Third, thou shalt keep it totally simple.
Nurses and docs don’t want to read a tome when they are trying to get you prepped for labor. It must be no more than one page typed! Use bullets, make sure it’s written as simply as possible, and don’t over-word or over-include! My doula suggests printing several copies on florescent paper so that the medical folks can easily find it in your chart.
For your perusing pleasure, here’s a solid draft of my birth plan, liberally plagiarized from multiple sources, and inspired by my birth instructor, doula, husband, self, books, other ladies … (Some of it might be Greek to the non-birthing ladies, but if it is, frickin’ do some research if you get knocked up and make sure you know what all of it means! The knowledgeable woman is the empowered one!)
We are so excited to have our child at Virginia Hospital Center. Our goal is to have a natural, intervention-free birth, and we respectfully submit the following requests as our preferred options for labor and delivery. We ask for your consideration of these requests as long as the health of both mother and baby permit. We trust that you will inform us in the event that any problems arise so that we may make a responsible decision together.
For labor and delivery, we request …
- Limited fetal monitoring after initial 20 minutes
- No IV (Heplock if necessary)
- Dimmed lights, as much privacy as possible, and a closed door
- Alternative methods of induction besides Pitocin
- Internal exams limited to one upon admission and one at transition
- Choice of positions for labor—shower, walking, squatting, etc.
- Ability to drink fluids and eat light foods during labor
- Gentle, guided pushing with warm compresses on the perineum
- Limited interventions (no episiotomy, vacuum or forceps unless necessary)
- Positive encouragement instead of pain medication
After delivery, we request that you …
- Place the baby on the mother’s chest immediately after birth
- Do APGAR tests there and place warming blanket over both of us if needed
- Delay cutting the umbilical cord until after it has stopped pulsing and turns white
- Delay routine procedures until two hours after birth to allow time for bonding
For baby care, we request that …
- The baby room in with the mother during her stay in the hospital
- The mother breastfeed immediately
- Our male child not be circumcised
- No Hepatitis B vaccine or eye medications be given
- The baby not be bathed until we request it
- The baby not be given any supplements, formula, pacifiers or glucose
Anyone reading the above could totally agree with me or think I’m totally crazy! That’s why it’s up to you to complete your own plan — be prepared, know what you want, and get it down on paper.
After six months on the waiting list, I finally got a call from the only freestanding birth center in Northern Virginia. (For those of you who aren’t yet birth geeks like I am, a freestanding birth center is a building not connected to a hospital, where you can give birth, attended by only nurse midwives. There are birth centers connected to hospitals as well … but anyway, this is not that.) They told me that I would soon move off the waiting list. The lady on the phone hesitated when I asked if I could come to the next orientation, acting as if I might not want to do that since I could remain on the waiting list. I said I’d come anyway, and so the husband and I went this past Tuesday evening.
It turns out I’m glad we did. Because it turns out it wasn’t all that we expected.
When you first walk into the freestanding birth center in Northern Virginia (I won’t name names, but it’s easy peasy to find on the online), you realize it’s like a lot of other businesses in the Old Town Alexandria area: it’s a converted older townhouse or office building that was probably first built sometime way back in the day. The air conditioning was not fully suitable for the hot, hot day, and my belly started to tighten in Braxton-Hicks contractions some time after we sat down. The furniture was older and dingy, and it didn’t quite seem clean in the downstairs area — not that it wasn’t, it’s just that older buildings give you that sense sometimes.
Everyone who came in was given a folder with brochures about the center, and a long list of medical reasons that can “risk you out” of giving birth at the center. First red flag. These factors include, but are not limited to: breech presentation, carrying multiples, anemia, previous stillbirth or missed miscarriage, previous c-section, being older than 40, post date pregnancy (after 42 weeks), decreased fetal movement, or “any other significant condition which exposes the client or the baby to increased risk,” which really, could be … anything. Most likely a prolonged labor. Risking out? What does that mean? That means at week 36 or whatever, or during your labor, they send you on to a major hospital down the street to be handled by a doctor you’ve never met. How often does this happen? 10% of the time during labor (!!!), and the midwife was majorly vague about telling us how often it happens BEFORE you go into labor. Probably a lot given the list of things that could risk you out, or automatically risk you out.
When the orientation started, there were 20-25 people, mostly well-dressed Nova couples, one hippie couple in homemade clothes, and a couple of single ladies. The range of pregnancy was from just found out, to totally about to bust (me). The midwife who led the orientation gave a brief overview of the center, conveniently skipping over review of the risking out business. But a lot of us had already noticed. The presenter went through a lot of the advantages of birthing at the center, heavily relying on all the things that are great about natural birth to carry her point. (It’s empowering, you can breastfeed immediately, you get an endorphin high, it’s awesome, la la la.) The actual advantages of giving birth at the center seemed to be that you get a midwife and a birth assistant rather than a doctor and nurse. And your appointments last 20-30 minutes instead of 5-10.
Cool enough. I like to chat about my pregnancy. But did it sell me? Not quite. What’s wrong with that equation? Well, you see one of each of six midwives when you go, and you give birth with whomever is on call when you get there. Doesn’t matter if you don’t like her, or she doesn’t remember your name, or you wanted someone else. Sounds an awful lot like my first doctor’s office, where you see one of six docs or a midwife, and you give birth with whomever is on call.
Then there were questions. And continued dissatisfaction. (Note: responses were edited in my own brain’s sarcastic tone of voice.)
- Are most women risked out because of prolonged labor? Yes.
- That’s one in ten women? Yes.
- What are the stats on women who get risked out before labor? I don’t really know. Next question.
- What are the statistics for maternal and infant mortality? About the same as the hospital, but not quite. I won’t really tell you.
- I see you only have two beds. What if three women show up at the same time? Well that doesn’t really happen that often.
- But what if it does? Well there’s a futon in the office. You can hang out on the futon. But it doesn’t happen very often.
- What if two women want to use the jacuzzi? One of them just has to wait. But it’s very rare that two women would be here at the same time. (My mathy husband figured out that the chances are 1 in 6 that two women would go into labor on the same day.)
- Why can’t you give birth in the tub? Is it illegal in Virginia? Um, I don’t think it’s illegal in Virginia. But it’s not safe since the baby could drown.
- It’s legal in Tennessee. Don’t they do it at the birth center in DC? Um, I don’t know. Next question.
- Are the birth assistants all doulas? No, but they have doula-like experience. (WTF does that mean?)
- MY question: So do I have to use one of your birth assistants? Or can I use my own doula? We’ve already paid her. I’m sorry, no, you have to use one of ours. The birth assistants here are trained to clean up. And your doula wouldn’t know how.
- MY follow up comment: But no one told me that when I first got on the waiting list. I paid my doula at 20 weeks. Sorry, no exceptions.
- MY follow up comment, as I walked out of the door: We’ll be going with Virginia Hospital Center. I have some feedback for you. In the future, please tell clients to come to orientation when they get on the waiting list, or tell them not to hire a doula before they come here. Hmm that’s interesting.
We did take a tour. And the jacuzzi is super nice. I mean, really primo. But the bedrooms look like “the motel of your dreams” (quote: Eric), and they don’t really look big enough for a laboring woman, midwife, birth assistant, and significant other. Not to mention parents or friends if you want them there.
Why is it like this?
Oh! I can answer. It’s because of this wonderful thing called malpractice insurance. The midwives have to pay it out of the wazoo to keep their birth center alive. So, new furniture and more beds take a backseat to packing in as many clients as they can manage (up from 20 to 30 women a month), and malpractice insurance stays a whole hell of a lot cheaper when you risk women out to the hospital for any variation of a normal pregnancy. I mean, you don’t get sued and lose your license for being too cautious (which is why c-sections run rampant in this country to begin with). If there’s any risk, you get sent to the big hospital. Sorry, see ya.
Why did I decide to peace out?
Well, besides the fact that our doula is selected and paid for (and we love her), I figure it’s just as, if not MORE likely, that I’ll have a natural birth at Virginia Hospital Center than at the birth center. Why? I’ve done a lot of research and picked out a doc who is friendly to natural childbirth. Besides that, he’s the head OB at that hospital, and works only with other docs whose kids he’s delivered, all of whom are friendly to natural childbirth. He strongly recommends a birth class, reviews your birth plan with you, and talks through your plans in the five minutes he spends with you. Besides that? I’ve been seeing him for most of my pregnancy. He knows my medical history. And? And? He delivers twins and breech births naturally. He once let a woman push for nine hours. He tolerates prolonged labor. And when she said she couldn’t do it anymore? She got an expert c-section, immediately. And? He’s been doing this for 35 years.
There might be disadvantages to going to a hospital. But I’ll have my doula. The one I chose. And I’ll have a doctor who knows his stuff and is a good guy. His office is filled with pictures of him holding babies. My favorite pic is of him holding triplets.
I’m sure I’d get excellent care with a midwife. But better? Debatable.
The jacuzzi can wait. I’ll hang out in the shower. I’ll tolerate the fetal monitoring. I’ll risk getting a nurse who is not natural-friendly. And next time, we’ll probably do it at home — forget the center.
I got a call yesterday telling me I’m off the waiting list, and the birth center would love to see me for my first appointment. Too bad. I like to do things on my own terms, and it seems like the hospital is a better choice for that right now.
For those of you who knew me before Eric and I started planning to get pregnant, you may have at least guessed that I wasn’t exactly a natural birth advocate. I thought the idea of a scheduled c-section sounded like a great idea, and the thought of breastfeeding totally creeped me out. I had a colleague who had had an all natural birth that lasted thirty-six hours, and that was enough to convince me that ALL THAT was something I did not want. After all, as Americans in the twenty-first century, we’ve been given the opportunity to do away with pain during labor. Why wouldn’t you want to do away with pain? Why wouldn’t you want to do away with the strangeness and ickiness of breastfeeding? Knock me out, and give me the drugs. That was quite and very much the way of my reasoning.
Fast forward to July 3, 2009. That’s right — almost exactly a year ago. Eric and I formally decided to go off of birth control that day. I only remember it because it was the one week in the summer that Eric was home from a business trip to San Diego (one that he thought I’d be able to go on, but that’s another story), and it was the night that we saw Away We Go, the day before the fourth of July. Yes, a baby. We decided we were going to have a baby in 2010. Exciting. As you might have guessed, I hadn’t given labor too much of a thought, except that I still thought it was a yucky, painful process. One that I clearly wanted to avoid.
And then I read this post on one of my favorite blogs. (And this one and this incredible, beautiful conclusion to follow up. If you read one of those posts, read the last one, please. Yes. So amazing.) And with those words, and her experience, I began to question what I once knew. When I went to stay with my husband his last week in San Diego, I told him that I thought I wanted a natural birth. Of course, he’s always been a big supporter of this, pretty much calling me crazy for wanting a c-section — I mean, that’s major surgery, and why would you want to schedule that when you don’t have to?
Fast forward again to January 2010. I find out I’m pregnant on the day that we go to visit Eric’s family. I read What to Expect When You’re Expecting that weekend, and it only makes me nervous. After that, I start to do my research in earnest. I read everything I can get my hands on about healthy pregnancy, natural birth, and labor: Ina May’s Guide to Childbirth by Ina May Gaskin, Birthing from Within by Pam England and Rob Horowitz, Your Best Birth by Ricki Lake and Abby Epstein, Pushed by Jennifer Block, Hypnobirthing by Marie Mongan, and The Birth Partner by Penny Simkin for my husband and coach. (And I just got The Birth Book by William Sears.)
I began to realize that I was seriously under-educated about pregnancy and childbirth. I began to realize that most of us — women and men — are seriously under-educated about childbirth. As Americans, we’ve also been seriously mis-educated, misled, and misguided about PAIN. We hear a lot of cliches about labor in particular, and we see them on our television and movie screens. We hear this: “You wouldn’t undergo a root canal without anesthesia, right?” or “It would be like trying to push a watermelon out of your nostril.” We hear about how painful it is, how it’s unlike any other pain you’ve experienced, how it’s pure insanity to go it without pain relief. We see women in terrible pain on A Baby Story, lying back as the doctors swoop in to save the day. We see Ellen Page in Juno and Katherine Heigl in Knocked Up begging for epidurals when they go into labor (and Amy Poehler in Baby Mama celebrating her choice to have one in a rather public way). Think about it: do you see any positive portrayals of natural birth in the media? Do you see any portrayals of women being empowered as they choose the way their child comes into the world?
Let me know if you think of some. I can’t.
In fact, I would posit that we’ve been taught to fear labor, fear the natural signals of our bodies, and fear the pain that is associated with those natural signals. We’ve put our trust instead in doctors, who are incidentally, mostly dudes. (Side note: there are lots of great doctors, and natural-friendly ones to boot. But there are plenty who keep on pushing the fear.) By putting trust in someone other than ourselves, and by passively absorbing the fearful images we see in the media, we give up a valuable part of our birth experiences. We get swept away in the wave of fearing pain, and we don’t give ourselves the opportunity to become educated, take control, and guide our birth experience as captain, rather than passenger.
When you fear something, it gets a lot worse, right? It hurts worse, it feels more painful, it is more intimidating, more frightening … so it is with labor. If you fear it, you will automatically tighten up, which works against the natural contractions your body is producing to guide your baby forward. When you work against your own body, and cannot relax, it can hurt a lot worse. Common sense, right? But still, over nine months (and indeed, the many years before we get pregnant), we are developing an image of an intensely painful experience that we cannot cope with, that will control us, that is compared to an illness in the medical world. How can one be expected to work against that fear when it comes to the day of labor?
Adrenaline plays a role here too. If you see a bunch of people you don’t know in your labor room, you get scared at the onset of a painful contraction, or your doctor gives you a rough exam while you are laboring, it can trigger an adrenaline rush. According to Birthing Naturally, “Adrenaline is the “fight or flight” hormone that humans produce to help ensure survival. Women who feel threatened during labor (for example by fear or severe pain) may produce high levels of adrenaline. Adrenaline can slow labor or stop it altogether.” And if your labor stops, you need the drugs, right? So say the doctors.
Well what’s wrong with the drugs? Pitocin and pain relief medications of all varieties help a tremendous amount of women through labor, but they can also mess with your body a bit in ways you might not expect. I’ll comment here about pitocin — it’s a synthetic version of the natural hormone that makes your uterus contract. But it doesn’t work in the same way that your natural hormone, oxytocin, does. It makes your whole uterus contract rapidly and all at once. You might guess that causes pain — not so great pain that might cause you to start seriously needing the pain meds. Pitocin also doesn’t trigger the natural pain relief mechanism your body has to offer — endorphins. So when you get the pitocin, you start needing the epidural, and the epidural, while innocuous to the body in many ways, can slow labor as much as 25%. And when labor slows? That’s right … “emergency c-section.” Sounds nuts right? It certainly happens.
Understandably, many remain frightened of the pain. But many remain unaware of the benefits of laboring sans drugs. You heal faster, you can walk around and try out different positions, you don’t have to have a catheter to pee, you can get in and out of the shower or tub, and you can sneak in a snack or a drink of water every once in a while. Too, you can listen to the signals of pain that your body gives you as positive markers of where you are in your labor. Finally, you are connected to the millions of women who have come before you — your ancestors — who labored naturally. But how do you cope with the pain in a society that tells you pain is unnecessary? Well, that’s the question. How can you?
In all the books I listed above, there are tons of relaxation techniques, exercises, and guided meditation that many women say can help. The Bradley Method encourages slow, abdominal breathing, while Hypnobirthing touts self-hypnosis. Birthing from Within tells about non-focused awareness. There are a lot of options out there. Hypnobirthing even claims that labor was never meant to be painful, and Mongan’s book all but promises a pain-free labor. (We’ll see about that … ha.) Whatever the technique is, the important thing to me is that I get to choose it. I manage the pain, and it doesn’t manage me.
I can’t tell you where I got so confident about this decision, but it happened early on in my pregnancy. I didn’t want this to be something that happened TO me, but rather a whole event that I guided in the best ways I knew how. I’ll state here that I’m not belittling anyone who chooses a different path — we’re all trying to be mothers in the ways that we think will benefit our children the most. I’m also not going to say that I won’t consider pain relief if I’ve been laboring for 36 hours. And I’ll certainly go with a c-section if my baby’s life is in danger. But the important thing to me is that I have chosen to become educated about my options, and not close my eyes in order to let someone else manage the process for me.
That’s all for now.
Welcome to the Savvy Mom Space
I’m a liberal feminist that believes that liberal, feminist ideals should gel with embracing your gender and motherhood (if that’s what you feel like doing). I support all kinds of moms and dads and parents. Oh and, although I totally love that natural vibe and not harming the environment, I supplement my organic milk and fresh fruits and veggies with the occasional Twix, the frequent Oreo, and the daily Coke Zero. I’m opinionated, not easily offended, and a loudmouth in person and on the internet. I am what I am. Welcome.