Same job, different uniform.

Wednesday, December 28, 2011

Transition: My path to natural labor

Two weeks ago today I gave birth to a darling baby girl. She arrived in three short and (two) agonizing hours of labor. Now I know I am capable of giving birth naturally when six months ago I knew almost nothing about natural childbirth.

Our firstborn came after 19 hours of difficult and frightening labor. I yielded to every intervention short of a c-section. The waterfall of intervention one of my friends calls it. The doctor started a Pitocin drip around 7 AM. After six or seven hours I took some narcotics that rather than giving me some rest made me loopy. (Half conscious and calling my husband a name is funny memory though.) Essentially stuck in bed and (on my back most of the time) as a result of fetal heart monitors the doctor requires with the administration of Pitocin, I couldn't work through the growing pain. An epidural that only half-worked was next and it was dimness and fear and even pain for the hours that followed. Insensible to the pressure of my contractions I had to ask when to push. In the end, with the help of an episiotomy and vacuum extractors, my son appeared.

It was days before I recovered from the shock. I've blogged a little about that here. It's still true that I'd do it again...and more...to bring him into the world. But I didn't want to do it that way ever again.

It turns out many women share my experience with that labor and delivery: tons of medical intervention, confusion, disappointment, disillusionment. Uninformed, untrained and unhelped by their providers. Consequently they determined not to let history repeat itself.

My first indication that something was simply wrong, that there must be real alternatives to my experience, was the total lack of information about the consequences of induction. How is it logical to lie on your back, hooked up to a machine, when you are going to try to manage intense pain that is naturally relieved through walking, bathing or other movement? I was on my way.

Through a little bit of reading and lots of conversations with women, I began to understand that birth is a natural process not a medical procedure. This seems like common sense as I write it, but it was novel to me: Women should have the opportunity to let their instincts and their body's natural process guide them. Pitocin and comfort measures can interfere with this process, sometimes on a huge scale. For the most part, babies should be born on their own schedule, not the doctor's (or yours!).

My mom was the first person I recollect inspiring me to a natural birth. And this year a number of strong-willed friends unconsciously inspired me with their stories. From delivering a ten-pound baby without the aid of an epidural to a home birth with a midwife that produced a little girl after 40 plus hours, every story nudged me toward a natural birth. One friend even said with her usual frankness, "It's not like you're not going to die!" when I suggested that I couldn't handle the pain.

And finally a friend working on her doula certification urged me to use a doula. (A doula is a trained labor coach who, statistically, helps reduce the number of medical interventions during labor.) She went the extra mile and hunted down the name of a woman working locally. Initially I scoffed at the idea of a stranger helping me through what is a very private process. After reflection I realized a labor coach wouldn't be any more of a stranger to me than a roomful of nurses and a doctor that I know, if at all, only on a professional basis! Someone found her for me, and she turned out to be a godsend. Sensible, calm and empathetic I knew she would be a good fit. My husband liked her too, which was important to me for obvious reasons.

And without those two I wouldn't have succeeded.

The pain was mind-bending. Active labor lasted only three hours, two of which included back labor (the baby was posterior). This meant I had little relief between contractions. Crouched on all-fours, I didn't think I could move, but with the help of a highly skilled and persuasive nurse, they talked me into getting into the warm, deep jacuzzi tub. It helped. Every attention was paid to me; concessions were made; suggestions offered. None of these worked their magic like the calm I think you can response to my "I can't do it!"

In the end I didn't feel like I achieved a natural birth so much as it was achieved on my behalf by my husband and my doula. They fought for my birth plan by gently resisting my attempts to cave. Stick to the plan. You can do it. You're progressing nicely. Right down to her blessedly cold hands, which I sometimes found myself unconsciously clinging to, my doula did exactly what she was trained to do: advocate for me against me.

And my husband is my hero.

With my son's eventual birth, it was shock and confusion. I couldn't get up. I couldn't hold him. I missed his first bath. I resented the pain I'd undergone. This time relief and elation were immediate. It was over and she was here. I had undreamt of energy. The baby was in my arms immediately. I held her for hours before we gave her a bath. Photos of us in the hospital show me in my own shirt and blessedly free from wires and tubes.

After just a day, the memory of the pain was already fading to black and white. We left the hospital the next day, relatively strong and rested. I remarked on this incredible difference to my doula and she said it's amazing how we can feel when we don't have a bunch of drugs in our system. Combine that with an incredible sense of awe and accomplishment and you begin to understand why some women value a natural birth so highly.

It's best not to lie about these things: Labor is painful and not sexy or beautiful in the conventional sense of the word. Next time around I'll probably long for the epidural again. I'll whine that I can't do it. (More children? Never! Natural childbirth? Crazy talk!) An epidural might ease the pain, which is not nothing, but it might also prolong labor and result in unwelcome medical interventions. These things can, as they did in my case, lead to regret.

Today I am still on a high from the outcome. It was unspeakably difficult and painful but the reward was instant and long-term joy. No regrets. No bad memories. No fear. My body did its job and now I know that it can.

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