As my daughter’s 2nd birthday approaches, I find myself reflecting on the circumstances of her birth. Actually, I find myself reflecting on birth in general…how my own experiences were wonderfully empowering, how emotional it was for me to attend the birth of my god-daughter & niece, and how varied the experiences of women are when it comes to labor & delivery. At 17, when I was preparing for the birth of my first child, I was blissfuly ignorant about how much can go wrong during a birth. I had access to a computer, but we were still in the dial-up age so I didn’t refer to the internet much when it came to birthing information. Thank God for that, because as I frequented the pregnancy blogs in my later pregnancies, I got a glimpse of how scary these sites can be. Pretty much every horrible birthing incident you could imagine is detailed in a play-by-play format until your (already crazy) pregnant dreams are swirling with images of tragedy. Luckily, I was also spared the horror stories of labor that women often get from friends, and the occasional stranger-in-the-grocery-store who has nothing better to do than to give a pregnant women one more reason to sleep restlessly. None of my friends had babies, so they had little to share in the birth story department. And the strangers in the grocery store were more apt to offer judgmental stares than recount their tale of a 96 hour labor that ended in a basketball-sized hernia and a broken limb (I’ll take a lingering glare over a “labor -gone-wild” story any day). I did, however, manage to get my hands on a couple of books that I found at a nearby library—my favorite being Natural Childbirth the Bradley Way which I re-visited as I prepared for the birth of children 2, 3, & 4.
Thankfully, a well-meaning nurse pointed me in the direction of a childbirth class designed specifically for teens, during one of my pre-natal visits. I immediately signed up. The first day we were greeted by the most crunchy- granola, flower-child of a birthing instructor that I had ever met. And believe me, having been raised by my hippie-at-heart mother, I had met the best of them. But she was earthy, and open, and all-around awesome. I remember her saying that the labor and delivery staff at the hospital in which she worked, were always amazed by the ability of teen mothers to handle the rigors and challenges of labor. “Young moms come to the birthing room without any qualms,” is what she said. “They will vocalize their needs and make noise like you’ve never heard, but in the end this often helps them to cope through labor. Its amazing what a women can do when she is not worried about what others think of her.”
In the end, the most important lessons I took away from that class was this: Birth is a natural process, but can easily be impaired by fear, doubt, and (unnecessary) medical interventions. A while back, a study was publicized that examined the way a women’s attitude towards birth affected her labor and delivery. It concluded that the more confident a women felt about her body’s ability to labor and deliver efficiently, the less likely she was to have complication during this process. This echoed what our childbirth instructor tried her best to impress upon us: that the mind/body connection is not to be downplayed. This is not to say that every time something goes amiss, it is because the mother was fearful. But I do believe our own internalized doubts about the birthing process have the potential to manifest into difficulties during labor. Our instructor also stressed that the body of the laboring woman is designed to labor efficiently when a woman is relaxed, well nourished, and supported. Of course, there are exceptions, and times when intervention is absolutely mandatory for the safety of mom and/or baby. But generally speaking, if our bodies were not capable of delivering babies without modern medical treatments and interventions, the human race would never have made it this far.
As I approached Birth Day, I was confident in my plan to labor as long as I could at home (so as to be in my own comfort zone), and to avoid as many interventions as I could once I got to the hospital. And on January 27, 1997, everything went according to plan. I relied heavily on visualization & focal points, affirmations & music, and a near trance-like state. It got me through. We left for the hospital only when I could not comfortably walk or talk anymore. When we arrived, I was already 7 centimeters dilated, and my son was born less than 2 hours later, without any medical interventions or medications. Recovery was fast and uneventful, and I was left with an awe for my body and its ability to bring life into this world in such a flawless manner.
My next two births were very similar, save for a few minor differences: During my firstborn’s birth, I had my mother & his father present. For the second two, I was adamant about being alone, with the exception of my (now) husband. By this time I had already realized that my coping mechanism for pain is to retreat into a deep meditative state, and every distraction was literally painful. Also, during my 3rd son’s birth, I was given the option to induce, for the sole reason that it was a Thursday and my obstetrician was on call that evening. He said, “We can induce today and you’ll deliver by the morning.” As tempting as that was (it was mid-September and the temperature that day was hovering around 95…NOT a good feeling for a pregnant women in her 9th month). I politely declined, for fear that the administration of Pitocin (the drug used to induce labor), would create a domino effect of other medical interventions I wished to avoid. The baby was born was born 5 days later, and, like his brothers before him, he arrived following a calm, quiet labor.
And so it was that I deemed myself a birthing queen—completely comfortable with the stages and progression of labor, and capable of dealing with anything that was thrown my way. I remained in this state of superiority throughout my 4th pregnancy…until little by little doubt began to chip away at my golden confidence. The superstitious part of me wondered whether or not my birthing luck had run out. I mean, following 3 textbook-perfect births, could I truly expect to pull off another uneventful delivery? Would this be the birth where everything goes wrong, and the baby’s health-or my own- would be in jepordy? I tried to shake these fears by preparing as much as possible- even attending yet another childbirth class, though by this point my husband & I were so familiar with the material we had to resist the urge to jump up and teach the class ourselves. Days before her birth, we decided we would give our daughter the middle name Ixchel, who is the Mayan goddess of birth, midwifery & medicine. My husband liked the way it sounded in contrast to her simple, classic first name. I liked the fact that it invoked the spirit of childbirth and safe delivery.
Birth Day #4: I had prepared diligently, and felt like I imagine Micheal Phelps did as he approached the Olympic pool back in 2008, when he walked away with a gizillion gold medals. Composed and confident, yet undeniably nervous of the rigorous path ahead. My wild card came when my water broke before any contractions had started. “Damn it,” I remember muttering, and it was not because I had JUST sat down to eat a delicious bowl of minestrone with fixings, and hadn’t even had the chance to take a bite. (Okay, actually that was big part of my disappointment, but hey, I was 9 months pregnant, its perfectly understandable). In the back of my mind, I knew that the instant my baby was without her protective amniotic sack, she would be deemed “in danger”, and I would be asked to come to the hospital. I reluctantly called my doctor, and sure enough, was told to go to labor & delivery ASAP. I shuffled around the house at a snail’s pace, knowing that the instant I arrived at the hospital, I was be prodded, evaluated for progress, and hooked to an IV. I had never labored like that before. When I finally turned myself in (okay, that’s a bit dramatic, but it seriously felt like a jail sentence to me), I was hooked to a contraction monitor and told I was not contracting regularly. My designated nurse came in and explained to me that, should I “fail to progress,” I would need to have a C-section. “How long do I have before that happens?’ I asked, suddenly very unsure of myself. “About 5 hours,” Nurse replied.
I was now officially on a timer, and my confidence was severely shaken. The countdown had begun. I tried to hold back my tears, mainly because I had an audience in my room this time, which included my sister, mother-in-law, and my fairy godmother (aka, my eldest son’s step-mommy). I felt that if I lost my composure, I’d lose complete control, so I took a deep breath and tried to recall what I knew about labors in which the amniotic sac broke prior to contractions beginning. To begin with, I refused the administration of pitocin, as I still had hope that my body would kick into gear without the help of the notoriously painful synthetic hormone helper. (Plus, I knew that Pitocin brings on longer, more forceful contractions, thereby increasing the risk of the c-section, and placenta abruption.) My doctor was not pleased with this, but I proceeded to labor unassisted anyway. My husband -to his credit- was also aware that piton can bring upon a domino of interventions, and therefore stood by my decision to refuse it, and whispered encouragement to counter my doubts). For the next few hours, I paced, sat, and shifted in a 5×5 foot radius, attached to a dripping IV, and under the close watch of the nurses who seemed perplexed at my refusal of the labor aiding drug. My only thought was to keep up the pace & intensity of contractions so that labor would progress, and surgery would not be needed. During this time, I realized how a women in labor- no matter how stubborn-is profoundly susceptible to criticism and suggestions by medical staff. When you are in pain, and worried for your baby’s safety, you may agree to just about anything if it means that relief- and a healthy baby will result. I am not saying that all advice from medical staff is misguided, or should not be taken seriously. Only that mothers and their partners should be aware of the procedures and routines that come with a hospital birth, and the risks that accompany them. In the end, labor progressed on its own, and my baby was delivered by….ME! The last half-hour progressed so rapidly that the nurse was out of the room, & the doctor no where near when my daughter made her appearance. I was the first one to hold her, and I will cherish that memory for my entire life.
The word obstetrics originates from the Latin word stare, which means “to stand by.” Modern obstetrics, however, has shifted from a natural process of “standing by” and allowing the woman’s body to respond naturally, into a practice that can be invasive and ripe with (sometimes) unnecessary interventions (i.e, my doctor’s offer to induce despite a medical reason to do so). Our cultural conditioning causes us to turn ourselves over to pregnancy experts, and it is easy to lose touch with ourselves as we become reliant on our team of experts who depend on tests and machines to tell them how to help. Medical interventions such as labor inductions for “convenience,” carry with them complications such as increased risk of prematurity, higher risk of birth defects such as cerebral palsy, C-section, and maternal death. As it stands today, the U.S. has some of the highest rates of pre-mature birth, C-sections, and maternal death in the world. For a nation that spends as much as we do on medical care, that is unacceptable.
I can’t pretend to have all the answers on how we can go about shifting the tide on this one. I only know that it will require embracing a model of maternity care that we have gradually shifted away from in the era of malpractice, pharmaceutical profits, and technological advances. A model that embraces the role of the doula and/or midwife, and has faith in a women’s intuition and her ability to birth with little intervention. In the end, it’s true, the most important outcome is a healthy, happy baby. But in those early days of postpartum adjustment, it sure is nice to reflect back on a peaceful birth as you’re cuddling that new little person in your life..