Baby Wallaby just turned two.
Which means it’s probably time to get around to writing her birth story.
At this point, a lot of the details have faded away. And yet it’s incredibly long — how does that work? Anyway, if you have a vague interest in childbirth but not enough to read this book, the “too long, didn’t read” version is the last 2 or 3 paragraphs at the end…..
In my perfect world, I would have approached childbirth as naturally as possible. Unfortunately, this is not my perfect world. I am disabled by fibromyalgia, chronic fatigue, and an autonomic nervous system disorder called POTS. I also endured three months of premature labor and the bedrest that went with it, during which I watched my already limited physical fitness drain away day by day.
In other words, my pregnancy and birth experience were extremely medical. I saw a high-risk perinatologist for the last half of the pregnancy, spent a couple of nights in the hospital with the premature labor, took drugs, got shots, had weekly ultrasounds in the last few months. A couple of months before my due date, I visited the hospital for a series of lung and cardiovascular tests to be sure I even had the capacity for a vaginal birth. The whole thing was about as far from a midwife-assisted natural process as you can get.
Vaginal, or C-Section?
I am one of those patients who Googles the *^&#%)(& out of every medical question. (You know, the patients that doctors must hate.) Because POTS involves blood circulation, I worried how it would affect pregnancy and childbirth. So of course I looked it up. There were only a couple of relevant research articles on the Web: one that said “consider scheduling an early C-section” and another in which the patient had a vaginal birth but then got so uncomfortable she had to be put completely under. Not exactly encouraging on the vaginal birth front!
My sister-in-law is a urogynelogical surgeon who has worked as an OB. Her advice was to schedule the C-section. Not even necessarily for POTS reasons, but she spends all her time fixing the ways that vaginal births ruin ladybits, and as a surgeon she sees operations as no big deal. So there was that, too.
But my perinatologist was probably the one OB in the world who pushed heavily for a vaginal birth. (Hyperbole, obviously — any OBs out there, please don’t take offense. But you know there’s a reputation….) She had three children by Cesarian herself, and she didn’t want me to have to face the difficult recovery. She assured me that, contrary to the image of labor as a marathon, the body can expel a baby fairly easily if you let the baby move all the way down the birth canal on its own. She said parapalegics and women in comas can give birth vaginally, so there was no reason I shouldn’t be able to as well. They would give me lots of IV fluids (it’s important to keep up blood volume for POTS) and hook me up to an epidural before I exhausted myself weathering any pain. I was terrified of the process, but frankly I was equally terrified of the C-section (cutting you open while awake??!?), so decided to give it a try. Still, I couldn’t help but worry about the whole idea — either c-section or vaginal birth felt a bit “damned if you do, damned if you don’t” — and I watched the last weeks slip away with a feeling akin to dread.
My Water Breaks
One of the fun bits of pregnancy, at least for me, was bonding with other women about their own experiences with pregnancy, birth, and motherhood. Technically my mother’s pregnancy and childbirth were my own history too, but until I got pregnant I never felt much curiosity about the process. Once I was pregnant, I hung on every detail.
My mother was the only woman I talked to who vividly described the feeling of having her water break. She said she was lying on the couch and felt an odd little “pop” inside her. On the day of one of my weekly ultrasounds, Week 37 in the pregnancy, I was half asleep in the early morning and swore I felt a “pop” just like the one my mother had described. Curious, I got up and went to the bathroom. All was normal, so I went back to bed. But something still felt somehow … off. So I got up to visit the bathroom again.
And halfway there, the flood began. I trailed a stream of fluid down the hall to the bathroom, unleashed a gusher once there, and then continued to leak as I rushed to the bedroom for a new set of clothes and back to the bathroom for a menstrual pad. Then, in the next 10 minutes, I wet every pad in the house, a couple of towels, and another set of clothes.
I woke Mr T to tell him it was Time. He groggily asked whether we could sleep until our originally scheduled wake-up time. At which point I murdered him.
No, not really, but hard-to-wake-up husbands and wives in labor definitely don’t mix! Luckily, he had a little time to shake off the sleepys while I rushed around throwing some possessions into an overnight bag. (Thanks to my obsessive research tendencies, I already had a detailed packing list for the hospital. But I hadn’t expected labor so soon, and hadn’t gotten around to actually packing the bag.) I grabbed some towels to protect the car in case of more leaking, and we hit the highway.
My sister-in-law did her residency at a hospital in Baltimore, about a 45-minute drive from our home. When I switched to a perinatologist partway through my pregnancy, I started seeing a friend of hers at her old hospital. The drive was only slightly inconvenient for weekly checkups, but I really started questioning my choices when we made the trek during labor! Luckily the pain wasn’t too agonizing at that point — a 4 on the standard 10-point scale — but I definitely felt every bump in the road.
The hospital offered free valet parking to women in labor. So we pulled up right outside, threw the keys at the valet, and ran off. (Or, in my case, waddled off….) But the labor department was on the opposite side of a GIANT city hospital, and there were no wheelchairs to be found. So we walked … and walked … and walked. Carrying our overnight bags, no less. Labor was still bearable at that point, but it wasn’t necessarily my ideal time for a lengthy hike.
Turns out we arrived at the labor department in the midst of a traffic jam. They had me wait in the waiting room for an hour or so — labor still bearable, so I said “no biggie.” But by the time we got into a room and they got me into a gown and hooked up to an IV, I was starting to hurt and awfully glad to finally have a bed to lie in.
We Get Started
Our hospital was a teaching hospital, and two years later I’m pretty blurry on the details of when I dealt with labor nurses versus med students versus residents versus orderlies versus heaven-knows-who-else. But “whoever” was weirdly skeptical of my claim that my water broke. They kept saying that, IF it broke, blahblahblah would happen. IF. You think most women would know — maybe some women pee themselves and get confused? (Or maybe, as an “urban” hospital that treated the fictional drug community on “The Wire”, as well as their real-life counterparts, the docs don’t trust any of their patients as a general rule…?) But, aside from the fact that I didn’t suffer pregnancy incontinence, I’ve never peed that quantity in my life. I’d have to have a super-human bladder. So eventually they did a swab test that confirmed the external presence of amniotic fluid. Once your water breaks, you are on the clock to have the baby before the risk of infection grows too high. So the big event would take place that day, one way or the other.
The maternity ward traffic jam meant that the anesthesiologists took a few hours to arrive with the promised epidural. And holy cow, did labor start to hurt! Not to freak anyone out — remember, I suffer from a disease (fibromyalgia) whose very definition is that pain signals are amplified beyond the normal range. The pain was truly, mind-blowingly, all-consuming. I was expecting an epidural and didn’t bother learning any pain-management or relaxation techniques, so I was caught completely unprepared. Every time a contraction hit, I panicked and just started sobbing.
Luckily, that phase only lasted an hour or so before the anesthesiologists finally made their blessed appearance. And I do mean anesthesiologists, plural — an entourage of five or six people. They made Mr T leave the room, carefully worked me into an extremely convoluted hunchbacked position with head down over arms crossed on the bedside table, and got to business. The doc doing the actual poking was an orthopedist who was learning the epidural ropes (never quite understood the explanation on that one), but he was supervised by the ward’s big-shot, who remembered my sister-in-law fondly. (And by “remembered my sister-in-law fondly,” I mean spoke the entire time about how she was a respectable resident in the days where residents worked for a living and not one of the coddled modern-day namby-pambies with their wimpy 80-hour weeks.) The worst part of the experience was having to hold COMPLETELY STILL, even when hit by the agonizing contractions. Luckily, there was a very sweet male resident stationed by my head, who gently talked me through each contraction and helped me find the strength to weather it without moving.
A Short Wait
My “epidural” was technically a spinal block. Advantage: they take effect right away. First my lower body was there, and then it wasn’t. It was nice to have a bit of time to rest after the painful contractions. My mother and in-laws stopped in from their banishment in the waiting room. “Whoever” gave me pitocin at some point to speed along the process, but the spinal block kept me from feeling any of the heightened contractions.
And before I knew it, my doctor came in and said it was time to push. I didn’t feel ready. There was no “urge” to push. The doc explained what I should do, and I tried a really wimpy version. They had to tell me not to talk, to focus all my energies, and to really throw my whole being into the push. It got a bit better after that, but it still took me a while to get into the swing.
My big problem with a numbed birth wasn’t so much the health concerns of anesthetic drugs passing to the baby, it was the birth position. When you can use your legs, you can squat in a natural position that works with gravity, lie in a tub of water, or whatever works. With the epidural birth, you’re pinned on your back to the hospital bed, with (in my case) the labor nurse and a very nervous male medical student each holding a leg all the way back toward your shoulders. Besides the fact that I spent the whole time fighting the urge to make inappropriate jokes about how that position landed me in this bind in the first place, it’s totally unnatural and forces your body to work against gravity to push out the baby. I felt very deeply, on an evolutionary, intuitive level, that it was just wrong. But there really aren’t any other choices. They did let me shift my shoulders up and my pelvis down by at least a few inches.
Turns out there’s one other problem with a numbed birth — it’s not so numb! You can’t feel the contractions, but you can still feel a lot of the actual pain of childbirth. (Again, fibromyalgia = extreme pain. Please don’t take my experience to mean that you, or anyone else, will experience the same level of pain.) Don’t know whether the numbed nerves don’t fully reach that area, or whether they turn down the drugs when it’s time to push, but one way or another the actual birth was #(*$&#& painful. It was the main problem with early pushing for me — I didn’t WANT to push because pushing just made everything more painful. (The exact feeling? In the immortal words of Amy Poehler in Baby Mama, “It feels like I’m shitting a knife!”)
The doctor said they have to give you some feeling so you can feel where to focus your push. I thought that was a load of crap, so I kept yelling at her about the pain. At one point I had a small hemorrhage, and as the doctor tried to stem the flow of blood I just kept yelling “I FELT THAT!” after every gush. ‘Cause there’s a big difference between “knowing where to push” and feeling every little sensation down there, amiright or amiright?
The one thing that got me through it all was Mr T at my head (yes HEAD, no way was he getting a view of the proceedings) murmuring encouraging words throughout. I tuned out everything but his voice, which helped me find the focus to get through. At one point, I was starting to feel too tired to go on. They had me reach down to touch the baby’s head — and her wet, hairy little noggin was RIGHT THERE at the opening, but I just couldn’t seem to push her forward. It was the epitome of “so close and yet so far” — an inch or two that I just couldn’t seem to get beyond.
And then, finally, I discovered the urge to push. I let out a giant yell, gave a giant push, the doc wielded her episiotomy scalpel with a flourish, and there was our baby. I had been a little nervous about whether I would feel bonded to the baby from the start, but I did. Oh, how I did. It was truly love at first sight. She was a mess, Mr T cut the cord, they took baby away for cleaning and checking — those minutes are a blur. I also have no memory of delivering the placenta. None. I assume it happened around now, but I don’t have the slightest glimmer of a memory. And then they gave her back, and I barely noticed that fact that a group of people was standing in Ginatown, several of them with needles, poking and sewing — all I noticed was that little one in my arms.
The exact timing is blurry this late in the game. My water broke around 7 am, I hit the hospital around 9 am, and Wallaby was born around 5 pm. I think I pushed for 90 minutes or so.
And physical damage? Oh yes, there was damage. In addition to the episiotomy (2nd degree), there were tears in other areas. I didn’t even know there could be tears in other areas, but sadly yes. It’s interesting — going in, if I had only one thing I felt strongly about, it was avoiding episiotomy. And when it actually happened, I was so grateful! My skin was neither stretching nor tearing enough to let the baby through, and I was growing exhausted from the repeated efforts. One little cut, and suddenly she had the space to make it through. So lesson learned, no matter how strongly you might feel about something in your birth plan — until you are actually facing the real situation, you just never know. It pays to leave a little room for flexibility.
And If I Do it All Again?
My choices were a product of circumstance. But if I have another child, I will try a more natural birth. My doctors were both pleasant and professional, and I have no complaints. But I felt powerless and more “patient” than — I don’t know, choose your metaphor, “warrior woman?” Knowing I can handle the basic process, I would be bolder about trying something that left me more in control. Even with another medical birth, I would love the assistance of a midwife or doula who might know gentle ways to avoid physical damage.
Others who have given birth, what would YOU do differently next time around?
If you had an epidural, were you also surprised by what it didn’t cover?
Anyone else with damage you didn’t even know could happen??