A Birth, Revisited

I have three children. Three gorgeous, wild, red-headed boys (no, my husband does not have red hair, and yes, I know the low statistical probability of having three red heads when neither parent has red hair). But it was only after the second one that I got involved in birth work–because that was the experience that changed my understanding of how we DO birth, and why what we routinely do in birth is all wrong.

With my first son, my labor was induced with Pitocin. The contractions were long, with almost no breaks, and so intense that if I lay down my back arched up into the air without my volition. An epidural to relieve the grinding pain sped up my dilation but sent my baby into distress as the Pitocin levels were increased again and again. Through most of my labor, my husband and I were left alone, terrified and clueless about what to do. Several painful and frightening complications arose the few times Not-Red-Headed Husband had to use the bathroom, leaving no one to hold my hand or help me respond when my nurse rolled her eyes at my tears.

When it was finally time to push, we discovered that my son was in the occiput posterior position—head down, but facing my navel instead of my spine. Immobilized from the waist down, I had to push him out that way. His positioning broke my tailbone and led to an extensive episiotomy to prevent the broad bones of his forehead causing a tear to extend into my bladder. Those injuries took months to heal and stop hurting.

When they put my son in my arms, he was healthy and beautiful, but I didn’t feel what I’d expected to. In fact, I didn’t feel much of anything. I wanted so much to be a good mother to him, but before long my emotional emptiness made me start to think I was a bad one. Two years later, when I was diagnosed with severe, long-term post-partum depression, I finally verbalized to a friend that, as much as I loved and wanted my baby, the way my doctor and nurses managed my labor had made me feel like an object having things done to it instead of a human being on what should have been a joyful day.

When I got pregnant with my second baby, I wanted everything to be different. I switched to a doctor and a hospital with a reputation for supporting mothers, and through my prenatal yoga class, I found an experienced doula. She lent me books and articles that changed my entire way of thinking about birth. In this new approach, the pain of labor contractions was not a sign that something was wrong, but a sign that my body was strong and healthy and was doing the work necessary to bring my baby into the world; fear could slow or even stop labor, while relaxation, confidence, and a sense of safety could ease and speed it; and birth was something my body was designed to do safely, something that I could help to happen by letting go of my psychological need for control over the process. Those beliefs are very different than the ones instilled in us by popular culture, most pregnancy books, and even by our doctors. They are also crucial to having a positive experience with labor and birth.

This time, I went into labor naturally. Since I was already 4 cm dilated and 50% effaced, I went straight to the hospital. My doula kept me company, walking and talking with me throughout the delivery ward while Not-Red-Haired Husband (who’d just worked a 20-hour day) got four hours’ sleep. When my contractions got too strong for me to walk, I stayed in the delivery room, alternately hanging from NRHH or my doula and sitting on a birth ball with her massaging and encouraging me and him holding my hands and singing to me. I went to the bathroom on my own steam at about 7 cm (because I was not about to poop on the table!). After that, time and language lost their meaning for me; all I really recall is contractions so strong I couldn’t breathe through them, and flopping like a rag doll in between. I did ask for an epidural at one point, but by then I was already 8 cm dilated, and everyone knew it was too late.

I was not thrilled when I realized I’d have to push with no anesthesia. For several contractions, I resisted my doctor’s instructions, thinking, Surely somebody can make this stop.  Then I had what I call “my buy-in moment”: I realized that, short of being knocked out with general anesthesia or asking for a C-section with no medical indication, the only thing that would stop this was me pushing out the baby. I asked for a squat bar, and the doctor and nurses jumped to install it and help me get into the right position.

After two or three pushes, the intense pressure in my pelvis remained unrelieved and absolutely still, as if it wasn’t a living thing inside me but a stone.

“Something’s wrong,” I said. The room went silent as everyone looked at me. To this day I remember my doctor’s eyes, lake-blue and intent, as she listened to me tell her what I could feel: “He’s not moving down.”

The doctor squatted and checked out what was happening. She straightened back up.  “Okay,  he’s posterior, and he’s stuck. So after the next contraction, you’re going to get on your hands and knees to turn him around.”

Posterior.  The same position my older son had been in when my tailbone broke and I was cut from 1750 to 2006. Grasping for something to help me get motivated, I asked, “Hands and knees–is that the Gaskin maneuver?”  Ina May Gaskin was a touchstone for me; the decades of midwifery experience detailed in her books had helped me enter into this new way of thinking about labor and birth.

My doctor’s face broke into an enormous grin. “Are you ready?”

I was. With her coaching, the nurses, NRHH, and my doula helped me turn over, brace my weight on my forearms, and push my bottom up into the air. When the next contraction came, I focused all the force I could muster up into my raised bottom. A deep-throated growl came from someplace inside me, and I felt the tremendous pressure in my pelvis shift and release, and then a tight burning sensation between my legs. Gasps and cheers filled the room, my husband grabbed my arm, and my doula and the doctor shouted, “You did it! You turned him around!”  In fact, everyone there had watched the top of the baby’s head rotate 180 degrees and surge forward as he turned and crowned in one contraction—that’s how powerful it was to push from the right position.

Less than ten minutes later, I was holding my baby in my arms and the pain was gone. I looked into his face and—well, the only way I can put it is that I knew him. We had gone through this together, just as we had gone through the last nine (ten!) months together, and nothing would ever change that. I didn’t know it then, but the perspective I gained in his birth would help me stop blaming myself for my depression and start enjoying my older son as well.

That is what birth can be like. That is the kind of birth we can choose to have. Painful, yes; a strong labor contraction can force you down on your knees. But it can also change you, if you let it. It can give you perspective on the smallest things in life; it can empower you to trust your instincts; it can show you how strong you really are, and the astounding accomplishments of which you are capable. My natural hospital birth, unintended though it was, remains one of the best experiences of my life–right up there with our homebirth (blog post to come), and with seeing my oldest son’s eyes light up when I smile at him. This post is long; most will be about a quarter the length of this one. They’ll discuss what it’s like to be a doula, how we balance birth work with motherhood, and the crazy laughter (and crazy fights) we share with our partners along the way. I’ve been told I share this stuff very well. But I wrote this one early on because  the ways in which I birthed my children, and how that experience shaped me afterwards, is what gives me the fire to keep at this work–the work of writing, the work of doula-ing, the work of mothering.

Sharing our stories is important.

It is how we learn.

It is how we grow.

It is how we change the world.

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