Sunday, November 18, 2012

Crisis of Faith


Last year while processing the novel experience of pregnancy and contemplating how this ever-growing baby was going to escape from my body E and I agreed we would try to go the natural route. I am not really a hippie, though some people think I am crunchy and I certainly like to hug trees.

We attended weeks of Brio Birth classes and were surrounded by women whose commitment to an intervention-free experience exceeded mine. I did kegels, pelvic tilts, yoga and squatted whenever I thought about it. We did labor run-throughs practicing relaxation techniques.

I wholeheartedly believed that my body was designed to do this. That for eons, women have been giving birth unassisted by medical technology and given our healthy pregnancy I was a perfect candidate to just allow it happen – hands off. We even considered a homebirth, but decided to stick with our midwives who deliver at the hospital.

The literature I read ingrained the benefits of natural labor. That it may take many, many hours but it gives your baby time to prepare and allows your tissues to stretch. That the squeeze through the birth canal benefits the baby in ways we don’t yet understand. That there is no rush, so allow the placenta to expel on its own. I bought into all of it. The delayed cord clamping, the immediate skin-to-skin contact and suckling, the idea that I’d be less likely to tear if things progressed slowly and there was counter pressure.

I watched the documentaries and listened to the stories of groggy babies after epidurals. Of mothers who died because of complications from medical induction or a C-section. Of mothers who died because their doctor helped pull the placenta out unwittingly leaving a tiny scrap behind which developed into a fatal infection. That fear, coupled with the touted benefits of natural childbirth sealed the deal.

My mother delivered both of her babies without any drugs. E’s mother delivered two-thirds of her the same way – one was even a VBAC.

I trusted that my body and my baby knew how to do this. That they would indicate to me when the time had come. I scoffed at how science could dictate a standard gestation for all human babies; I was willing to go ‘overdue’ if that’s what my body and baby decided. But that’s not what happened. Before I was ever in labor, he died inside my womb and I chose a medical induction to deliver my already dead child. I felt betrayed. Betrayed by my body. Betrayed by my beliefs. Betrayed by the childbirth instructor, book authors and all those who preach the dogma.

Now I stand here in the third trimester making plans for Dragon’s delivery. Obviously the top priority is to get the kid here alive and safe regardless of the details of our birthplan. The midwife and the perinatalogist have recommended induction at 39-weeks if we do not go into labor before then. At this point I agree, but I am still hung up about the medical induction.

You see, the benefits of the natural process are deep rooted and much of me still believes those tenets. Plus, my grief-shaken self-esteem allows the horror stories of medical births gone wrong to grip even stronger. But I do not believe wholeheartedly in either ethos right now. So I am stuck standing in the middle desperate for some place to lay my faith down. I need conviction in one system or another so that I can unsaddle myself of this and all that’s connected to it including my confidence and my courage. 

17 comments:

  1. Oh goodness. You could very well be talking about how I felt at the end of my pregnancy with Alexander. I did not do the extensive research you did.., but I felt what you felt. Let me be. Let him be born. When ever. How ever. But it'll just be me and him...doing it together...until the end.

    And I could.not.believe he died after such a long, "healthy" pregnancy. And my preferences went out the window. I would have done ANYTHING to go back and do it any other way to get him here alive.

    My stance now is shot. Just broken. And I haven't landed on either side of the birth plan Fence yet. I don't know what's right for me. Of course, I want a live baby...but I'm terrified about the risks that come with pulling the trigger too soon.

    I'm happy to hear they will let you go to 39 week. I hope, I hope, I hope you go into labour before then.

    I wish I had words right now. Something to let you know there was a "right" way to approach any of this. But I don't. But I hope it unfolds with as much ease as possible.

    Sending love to you. May a happy, healthy delivery...with a beautiful living baby at the end be in your near future.

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    1. Yes Veronica, I too have wished a million times that I was the sort of woman who marches into her doctor's office on the due date and demands an induction the next day. Instead my provider was surprised we hadn't begun trying to get things moving on our own with teas or intercourse. I honestly believed my body and my baby would let me know when it was time. *sigh*

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  2. Here is my advice (which I know you didn't ask for) for what it's worth: try not to worry so much about it (haha! so much easier said than done, I know!). Let your body do whatever it can on its own and be open to what it needs help with. Tell your doctors and midwives what you are afraid of, what you want most, what a perfect scenario would look like, what an acceptable scenario would look like, what a terrible scenario would look like. And then let as much of it go as you can. Let them help you and trust them. I know it is hard - impossible? - but however natural childbirth is - and I wholeheartedly agree that it is - it is still largely outside our control. The only beef I have with natural childbirth promoters is the implication that our bodies and our babies' well-being are completely under our own control. They are not. And it is not fair that women feel like failures because they require some kind of medical intervention - sometimes we need help. Sometimes help saves babies. E was an emergency c-section. She is perfect. A perfect baby, a perfect girl. She was a bit 'mucousy' for her first night because she wasn't squeezed out, but that was not a big deal. We never had any troubles related to the c-section. My stomach hurt, but it was manageable. We were all ok. After the initial relief of realizing that my distressed baby was just fine, I did feel a lot of angst over my birth experience. I wished I could have done it the 'right' way. But, in the end, she is here and she is so much more than the experience of her birth.( Feel free to disregard all of this and send virtual dirty looks my way, if you like.) I hope Dragon comes before an induction, so that you can avoid that if you can, but I also hope you can let yourself "relax" (haha, I know) a bit in the meantime and know that you love that baby and your doctors care about your well-being and about your baby's and you are all going to do the best you can for him/her, whatever that turns out to be. Sending love.

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    1. "...she is so much more than the experience of her birth." That's it! I think that will be my mantra. Every time I start to overanalyze or worry about the labor and delivery I will repeat that. Thank you for the wise words, they are very encouraging.

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  3. I totally get this. My first pregnancy was similar. We did 3 months of Bradley method training. I did relaxation, squats, pelvic tilts etc. we watched videos and we were ready. It was hard...17 hours of labor, no drugs, or intervention. Kai was 8 pounds 12 ounces. Than I got pregnant with Camille. I didn't do any classes but assumed it would be the same... And then she died. Right at the fucking end and I wished I had been induced the day before. That I had a cesarean .... Anything but what happened. And so I was induced and I had an epidural and I gave birth to my beautiful dead daughter.
    And than I got pregnant with Harlow. I knew I would be induced. There was no way I was going past 38 weeks!!! And since I knew I was going to be induced I figured I would have an epidural. I was induced but didn't get an epidural in time so the birth was drug free and hurt like a bitch because induction is way different than the natural process.
    So I've done it 3 ways. Now. I really don't care about all the stuff I cared about before. I still believe in it but it all seems so tertiary to a living breathing baby. Good luck with the birth but mostly in managing your anxiety. All that other stuff, well who cares. But I know you know that. Sending giant hugs and a little bit of calm because you probably need both.

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    1. Thanks for sharing your experiences Renel. You're right, it doesn't matter how they get here as long as they are breathing, living babies. It's so easy to get caught up in the planning and anticipation.

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  4. Oh my dear. I felt betrayed. So betrayed when the twins were born so early and so sick because I'd tried so hard to do everything right, to keep them healthy. And I'd never done this research and I hadn't really thought about how they would be born. In the UK, they advise you to have twins in the hospital and to just go with what the doctors tell you so I'd never thought of all these aspects. I can't imagine how you must have felt, to have had all this knowledge and faith and then to lose your boy.

    Like you, I do not believe in either ethos now although my heart still pulls me towards a natural birth. But, having had two children who needed a lot of intervention, my brain loves and trusts medical technology and health professionals. And it's a very difficult call, when you have spent time here, in this place, and have read so many stories and details of everything that can go wrong. It's hard to lose sight of the fact that, in the majority of cases, nothing does, everything is fine. Just hard to trust that after you've lost a child.

    The twins were born naturally, very tiny, so physically it was fine. Their arrival also caused me to lose a lot of faith in my body's ability to do anything. My subsequent baby was born after a medical induction, I also didn't get an epidural. Not because I didn't want one but because once I was in labour, I physically couldn't get the request out until it was too late. And it did hurt, I'm curious about whether it would have hurt left had I let him come naturally but, given that he was 8lb 11oz, at 38 weeks, he may just have been too big and I'd had ended up with a different kind of birth. And that's the real crux of the issue. That we can decide what we want but whether that is what we end up with is another matter entirely. And all of us here know that, far, far more than most.

    But, I do have to say, that once he was in my arms I could not have cared less. He was alive, I was alive and that was just such a relief. I think Renel has described it perfectly, it all just seemed tertiary to my primary aim. Wishing you the very best for the arrival of your little Dragon and I hope that things start to happen before 39 weeks and everything goes as close to the way that you would choose as possible xo

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    1. Catherine - thank you for your insights. I worry about an induced labor being more painful and more intense. But sometimes I think I worry about these things because it is far easier to think about than to face the fact that I am in no more control than I was last time. That again, despite doing everything 'right' this baby too could die on my watch. So instead, I focus on the planning and on the paranoia.

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  5. I have not been down the subsequent pregnancy road, so I don't have any advice or perspective on that one. But in both of my pregnancies, I did a lot of research and fell far to the "natural way of doing things" camp. I might be a hippy. I'm definitely a tree hugger. My husband falls further in the home birth hippy camp, so we had planned on a home birth for Nathaniel. But home birth is a little outside of my comfort zone.

    My first son was born at the hospital. He was seven days late, and when they did an ultrasound, they saw that there was not enough fluid, so they encouraged induction. I had a two page birth plan, full of laboring in the tub, soft music, skin-on-skin contact after birth, etc. Well, we played the pitocin - labor until baby goes into distress game for 36 hours, and then I had an epidural. Then the labor picked up. We were really close to a c-section due to the fact that he kept going into distress every time I would have a contraction. It was scary, but he was born, he breathed right away, he latched on within the hour, and has been a very healthy human ever since.

    Nathaniel was also born at the hospital. He was 16 days overdue when I finally said enough. Induce. They did not give me any pitocin. The doctor put a piece of an ulcer pill up against my cervix. I was laboring regularly within the hour, and after about two hours he was born. It was an incredibly intense birthing experience. I labored until transition in the bathtub (at which time I was telling my husband and midwife that there is absolutely no virtue in natural childbirth, and no reason for a woman to endure such pain), demanded an epidural, walked down the hall to my room, and Nathaniel was born moments later. No epidural.

    That probably wasn't terribly helpful. But what I do know is this: all of the medical interventions that are basically demonized by the natural birth community were developed in direct reaction to the pain of loss. The pain of losing babies, the pain of losing mamas. It's not just, oh doctors want things to be easy for them. I think that they're trying to keep us, and our babies, away from the veil. Neither of my births were ideal, but I agree with Catherine: there is only so much control that we actually have. The rest is really out of our control.

    My advice echos Jen's: try to relax. Try to trust your doctors and your midwife. There are so many different ways birth can go, and most of the time, most of the time, most of the time, birth today ends with a healthy baby and a healthy mama. We're lucky that way. You probably have access to really great medical care wherever you are. You have a really good chance for a positive outcome. Unfortunately, we are all sitting on the shit side of statistics, and we know too well that things can go the other way. But I hope you can relax and trust that your doctors and midwives will guide both of you safely through Dragon's birth.

    Good luck with these terribly tough decisions. I am keeping you in my thoughts and prayers. <3

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    1. Thanks Suzanne. I can totally relate to your transition experience with Nathaniel. I clearly recall staring into E's eyes during transition last year and telling him that I was sorry but there was no way I could ever do this (deliver a baby) again, never ever. Of course it wasn't too long after A's birth that I made the decision to carry on with our plans to have more children...but in that moment I was convinced!

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  6. I was also believed (and still do to some extent) the idea that my body was made to do this and natural labor is the way to go. Even though as a NICU nurse, I believe in high tech medical interventions sometimes, I read Ina May and Penny Simkin and trusted my body. And then Bear died. I was induced but my body quickly took over the labor process. With Bode, I knew we would induce and I wanted another low intervention delivery, what I really wanted was to survive and have my baby be healthy. I was trying hard to trust my body, but of course that was (and is) very hard. I also tried hard to trust my care team.

    The best advice my midwife gave about pain meds was to make a decision out of power. She said that whatever decision I make during labor was the right one at the time and feel good about it. She in no way advocated for meds, but she wanted me to not see it as a weakness if I chose meds, but rather choosing what was best for me and my baby at the time was a powerful choice. After laboring most of the day and managing it okay, I was just SO stressed. The uncertainty of how long it would take, how bad the pain would get and whether Bode would be okay was just too much and I chose to get an epidural. I could still move a little, but did not feel any more pain. I was instantly able to relax, enjoy the moment and Bode was born 1.5 hours later. It was amazing!

    I am also not advocating for meds, but rather to make the decision that is best at the time and make it from a position of power. I felt more in control not having the epidural with Bear and then definitely made the right decision to get one with Bode. I get feeling so torn about it all. I'm thinking about you and your babies and wish you the peace to keep plugging along!

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    1. Thanks for sharing so honestly Julie; your unique perspective given Bear's death and also your career are very valuable. I agree, much of the decision making is going to have to be made during the process because nobody knows how it will shake out. We hired a doula with years of deliveries under her belt and experience with loss (both personally and couple's she's worked with). I think she will be a good advocate for striking the balance between doing what we need to do and trying to maintain as natural an experience as possible. Knowing she'll be there to assist and to run interference for us is already easing some of my anxiety.

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  7. I didn't want to but had to have a c section for my second, I was so worried about it but once Severus was in my arms happy and healthy none of it mattered.xoxo

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    1. Exactly right Michelle; it doesn't matter how they get here as long as they arrive safe and sound. I hope your belly is healing.

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  8. After Seamus died, I remember saying that I'd have gladly pushed him out of my nostril if it meant he lived...

    In my subsequent pregnancy, the weight of it was in the responsibility of making a decision that I may later run over and over in my head if something catastrophic happened again. I didn't want to be the one who had said - "yes induce", or "No let's wait one more day" and then for things to go really wrong. I wanted there to be no choice made by me... and actually that's exactly what happened. I had to be induced at exactly 37 weeks as he was an unstable lie, and was actually head down that morning. The doctors were unsure if he would move again, so they jumped on the chance and induced. As it happened, he became unstable again and I ended up with an emergency c-section. But he was alive! And I just didn't care.

    My thoughts have taken a turn again in recent weeks. I just had a meeting with my consultant who has said that she firmly believes I should never be allowed to go into labour again, and should have c-sections for any and all future pregnancies. (Just to be clear, I am NOT pregnant at the moment.)

    To my surprise, I've been a little sad about that... To be told it would be dangerous for me to go into labour. That I will only have planned c-sections from here on out. Plus I feel a bit disgruntled... because I suppose, I'll have a hand in any future baby's birth date... and it goes back to the start - I don't want that responsibility!

    I think, where you are is a very very difficult place. And perhaps, all you can do is try to make the decisions as they arise. Planning ahead is probably futile. And I think being open and a little flexible as opposed to rigidly adhering to one way or another is probably the best way to go about it. So, as uncomfortable as it is to lack the conviction you are keen to have right now, it may actually help. I don;t know... just my take on it.

    I hope that you spontaneously go into labour before the 39 week deadline!

    Sending so much love and luck your way xx

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    1. Yes Aoife! The responsibility is crippling! I am the one who is responsible for this child. I am the only one who can say whether today's activity level is 'normal' or not. I am the only one who decides which movements qualify during our kick counts. I am the only one who can say, something is wrong we need to go to the hospital. I don't want to shoulder all of this responsibility alone. Just like I am terrified of the responsibility of making the decision of induction and labor choices. The what ifs are too daunting.

      Does hearing that from the consultant add another layer of fear? Will you be afraid of your body going into labor in subsequent pregnancies? I guess it's hard to project. At 32-weeks the adjective for me right now is fearful so maybe that's why my mind immediately jumped to that conclusion.

      I found much comfort and validation in your words here. I will try to make decisions as they arise - though that's easier said than done.

      Thank you.

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    2. Yes - I will definitely be afraid of going into labour spontaneously. When I saw the panic on my midwife's face during Hugo's labour, I knew that things were serious. I remember being told to hang on, while a LOT of people filled the room and started plugging and plugging things, calling theatre to stop a surgery going in ahead of me, John being posted by the emergency button and me being instructed to get on all fours and push my ass in the air and my nose into the pillow. They were terrified of cord prolapse. Thankfully, they got him out alive and ok.

      So I suppose I'll just add 'labour' (you know, that inevitable ending to all pregnancies) to my very long list of things to worry about should I ever get pregnant again.

      Hope you are doing ok - I know these last few weeks are an excruciatingly slow crawl... thinking of you xx

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