I recently re-read the post, “Silver Lining,” which I originally wrote when Peter was 9 months old. In that post, I discussed PPD and PTSD in parents of VLBW infants. I had learned that even at 2-3 years postpartum, mothers of VLBW infants show higher levels of PTSD symptoms than mothers of full-term infants. Now Peter is almost 2.5 years old, and I’m in a position to comment on that finding.
Honestly, as long as I keep busy, I’m fine. During the school semester, I don’t really have time to brood about my embryo-killing and fetus-evicting uterus. These are issues that I’ve already beat to death, and I know that I’ve done as much as possible to ensure that my next pregnancy will be better.
But right now I’m coming to the end of a long winter break, and I don’t feel particularly motivated to take care of the few things left on my to-do list, and I find my thoughts returning to those painful questions. Why did Baby A have to die? Why couldn’t Peter have been blessed with a living twin brother or sister? Why did Peter have to go through the pain and challenges of being born a trimester too soon? Why couldn’t I have experienced all the pain and discomfort of a healthy twin pregnancy? Why couldn’t I have had a happy birthing experience?
Is it masochistic to keep asking these questions? Is it an indication that I’m just a brooder by nature? Or is it a sign that I just like to draw attention to myself? Surely, the fact that I’m taking the time to write yet another blog post on the subject of my obstetric history is a sign that I’m just looking for sympathy. I know full well that many women can claim a more sordid obstetric history than my own.
Are these thoughts a sign that the old wounds still haven’t healed? Or are they a sign that they really never will fully heal? Perhaps these thoughts are just lingering symptoms of my PTSD. As indicated by the question marks, I’m not really sure. But I do know that I still have to get a couple things off my chest.
As I’ve said before, I did not spend much time thinking about childbirth before Peter arrived. I figured that I would start making a birth plan during my childbirth preparation classes. Therefore, it wasn’t until after Peter was already home from the NICU that I started reading and thinking about natural unmedicated childbirth. Part of what I read made me glad that I was able to birth Peter naturally even though it was the more dangerous method of delivery for a footling breech 27-week fetus. My uterus didn’t have to go through the trauma of major surgery, I was able to recover quickly, Peter was able to stay inside me as long as possible, and the vaginal birth may have even had a beneficial effect on his lungs, which were, after all, very good for a 27-week male.
I appreciate the fact that I did experience labor. Many mothers of preemies are robbed of the experience altogether. I feel better prepared for future deliveries because I know that the pain of an unmedicated labor is transient and though not enjoyable, certainly not completely unbearable. I don’t doubt that I could birth future children without the help of Pitocin or anesthesia or analgesia. I do worry a bit about having another precipitous labor, only faster than the one with Peter because I will have already given birth to one child and will hopefully be far enough along in pregnancy that I won’t be taking Procardia to dampen the contractions. Heck, there may even be a head pressing against my cervix to help it dilate! I’m not overly worried about delivering in my car, though. I don’t live far from UMass, so we should be able to head to the hospital at the first sign of labor and if need be, hang out in the lobby until things really get started.
Although I fully recognize the benefits of natural unmedicated childbirth, I can’t say for sure that I would decline an epidural or Pitocin if I had been experiencing hard back labor for 36 hours at term with little progression of cervical dilation. Admittedly, the main reason why I’m fascinated by natural unmedicated childbirth is because it was something I was forced into with Peter and something that I anticipate I may be forced into again. It’s common for women with extremely fast labors to not have the opportunity to get an epidural. Hats off to the women who conscientiously prepare for a natural unmedicated childbirth in order to have the best chance for a low- or no-intervention birthing experience. Hats off to the women who endure hours or days of painful labor with the conviction that unnecessary medical interventions should be avoided in order to minimize the risks to their own health and the health of their baby.
I came across the following post yesterday.
I choose natural birth because:
I LOVE the experience of ending this pregnancy with a warm, peaceful, mother/baby centered event.
At my birth no one is focused on a monitor to tell me how I am progressing. I can feel the contractions getting longer and intensifying and they just support me.
I draw strength from my DH as we do “the labor dance” I wrap my arms around his neck and sway or hang or grasp him tight and moan through the contraction. Then it’s over and we walk and talk and wait for the next one.
The gravity helps me dilate in a very short amount of time and then I’m entering transition and it’s time for the tub. No more talking, this is serious work and I rest between contractions and let the water (natures epidural) wash away the pain.
I know I’m fully dilated when I feel the baby head slip into my vagina and here comes the urge to push.
I resist the urge to push as long as possible and let my uterus do the pushing for me so I don’t get tired or tear, I give my perineum time to stretch. No one is shouting at me “PUSH” and counting to 10. They are just gentle voices telling me I am doing it perfectly while they listen to baby with a Doppler. No machines strapped to my body.
Finally I say enough and give one good push and he’s out! I wait for the MW to unwrap the cord from around his neck one more push and he is on my chest. He opens his eyes and the first thing in life he sees is his parents adoring faces.
He lets out a short cry and then watches us and listens to our voices with an alertness only a baby not exposed to narcotics can have. I nurse him and it helps my uterus contract and deliver an intact placenta (no shot of Pitocin needed) and the blood loss is minimal. Soon I’m up and in the shower and we are home 4 hours later. Birth can be a peaceful even romantic event that will leave you in awe of the process God created to bring life into the world. I wouldn’t have it any other way.
That is, of course, a beautiful description of natural unmedicated childbirth, but it throws a few unnecessary zingers at women who choose to or need to have their labor augmented with Pitocin, have analgesia or anesthesia, or have Pitocin to help manage postpartum hemorrhage. And while these types of stories are helpful for first-time moms who hear nothing but labor horror stories from their friends and family, they are not helpful for women who are inclined to believe that good planning can ensure that nothing will go wrong during their birthing experience. I believe that if you’re going to make a birth plan, you also need to think about what may happen if things don’t go as you hope. The statement, “I wouldn’t have it any other way,” implies that we can control the tone or ambiance of our birth experience. I really wish that my birthing experience had been a peaceful, romantic event that left my in awe of my clever reproductive organs, but that just wasn’t in the cards for me. Truth be told, very few birth stories I’ve heard or read lack one or two plot twists.
So I wrote an analogous description of my own natural unmedicated childbirth.
At my birth no one is focused on a monitor to tell me how I am progressing. I am in antepartum, cervix slightly dilated, hoping to be sent home for the remainder of my pregnancy. However, I feel the contractions getting longer and intensifying, and I eventually call for my nurse to come check on me again. With tears in my eyes, I hug my husband and tell him to call the nurse and ask her to hurry; I am in too much pain to call again myself.
I don’t realize that my cervix is dilating rapidly, but after my nurse arrives, I enter transition. Unfortunately, it is time to lie down again so that I can get checked. No more talking, this is serious work. A resident tries to find my cervix and tells the nurse quietly, “I feel nothing but membranes.”
I know I’m fully dilated, I give in to the urge to push, and the baby’s legs slip out my vagina with a huge gush of water.
I no longer have the urge to push now that my baby is in limbo with his lower half delivered and his head trapped in my womb. The medical professionals call code white (mother/baby emergency code) and wheel my bed to an operating room. No one is shouting at me “PUSH” and counting to 10; they’re shouting, “This is NOT the way it’s supposed to happen!” No machines are strapped to my body… it’s too late for that. We just need to get the baby out and resuscitated as soon as possible.
Finally, the NICU team is ready, and I’m told that it’s time to push. I give one good push and he’s out! And the placenta came right out with him! The OB doesn’t bother to give me pitocin because I’m not bleeding much. I start shivering uncontrollably because of the rapid hormonal changes. My son is limp and lifeless. First Apgar scores of 1… second Apgar score of 4. The NICU team does a good job, though, and after about 10 minutes, he’s starting to pink up. He opens one eye and the first thing in life he sees is his father’s terrified face as a respiratory therapist pumps oxygen into and out of his underdeveloped lungs.
It will be a few hours before I get to see my son, a few days before I’m allowed to hold him, about a week before I hear him cry, and about 6 weeks before I can put him to my breast. In the meantime, I religiously pump breastmilk 7-8 times a day.
73 days after his birth, I bring home a beautiful, healthy, 5 lb 6 oz baby. THAT was the happiest day of my life.
I guess I want the take-home message to be that natural unmedicated childbirth is not always beautiful. That doesn’t mean that it’s not a good goal for mothers to have as they prepare for childbirth, but if your primary reason for choosing a natural unmedicated childbirth is because you think it will be empowering, beautiful, or romantic, you may be sorely disappointed. Just as some women who imagine that labor will be relaxing and enjoyable as soon as they get an epidural may be disappointed. I don’t have any personal experience with epidurals or c-sections, but I can assure you that there was nothing empowering about my birthing experience. I have never felt so shocked and helpless in my life.
I do believe that childbirth can be and usually is a positive experience. It’s just naive to think that your birthing experience will necessarily be a warm, peaceful mother/baby-centered event. Everyone wants a warm, peaceful birthing experience, but not everyone gets one.
Luckily, if things don’t work during delivery, we still have the rest of our lives to make warm, peaceful mother/child-centered events. That’s when the real bonding happens.