We are the type of people who are reassured, not petrified, by knowledge and birth was no exception. In D’s birth I’d estimate that we used only about 5% of what we learned, but I absolutely don’t regret the time we spent learning it. Plus you never know which 5% it might come in handy.
Midwives and Natural Birth
Based on some of my earlier reading we switched to a midwifery group, rather than an OB group, in the fall. I expected to get some criticism or strange looks from people, but we didn’t encounter that at all. For us, planning to deliver with a midwife in a hospital was a perfect middle way in the spectrum of possibilities. We wanted a provider who would be more involved, more supportive of natural birth and less likely to encourage interventions that might not be necessary. The fact that midwives are all (?) women was an added bonus.
The primary reason we hoped for a natural birth is the “cascade of interventions” we read about which can be initiated by using pain medication. For example, when you’re hooked up to tubes and wires you’re less able and likely to move around, which can make it more likely for the baby to be malpositioned. When you can’t feel the urge to push, the pushing stage of labor takes longer. When it takes longer, you’re more likely to be exhausted. When the baby is “stuck” and you’ve been at it for hours and hours, more and more interventions become necessary. I also preferred to minimize the drugs ingested by our newborn.
So we were aiming for a natural birth, but we really had no idea if it was realistic. If we learned anything in the months leading up to D’s birth, it’s that there are millions of storylines that result in a healthy baby and that the plot is largely out of our control.
When our classes discussed coping with pain, it was hard to relate. How can you know what kind of pain tolerance you have and whether your most painful experiences relate in any way to the anticipated pain of birth? The most physically painful experience I could recall was tearing my ACL (knee ligament) when I was 17, but it was incredibly difficult to actually remember the sensations, which is probably for the best. When I thought about the concept of coping, my first Montreal winter leapt to mind. For better or worse, my mental refrain was “it’s just going to get worse, it’s just going to get colder” and before I knew it five months had passed and I was enjoying the balmy 1 degree Celsius weather at a Saint Patrick’s day parade and getting some color in my face from finally spending more than 10 minutes outdoors. I really do remember feeling warm at that parade.
Birth Story
Fast forward to 10 days after D’s due date. We went in to the hospital at 8 am for our scheduled induction. We knew I was already significantly dilated but I still wasn’t feeling the contractions, though they had been happening for weeks.
They started me on the hormone Pitocin at 10 am to strengthen the contractions. It worked. We walked around a little bit. Then we played a card game I particularly like. Then I threw up, which is one of the lowest points of my memories. Then my water broke and things progressed rapidly from there.
At 2 pm they stopped the Pitocin due to fluctuations in D’s heart rate. I was happy to let my body set the pace because the contractions continued with a bit more time in between them.
At 6 pm D was born after less than an hour of pushing, which is apparently pretty quick for a large, first-born baby. I am so grateful that the part of labor I felt lasted only as long as a workday.
So what were the coping techniques we used?
- Jack held my hand pretty much the whole time
- I took off my glasses and closed my eyes somewhere in the middle, leaving me with a type of inner focus I’ve never otherwise experienced, and no concept of time. I rested like a champ between contractions, and it felt like the kind of near-sleep where your eyes roll back a little bit.
- I did deep breathing.
- I made a few sounds and did a little bit of counting but didn’t really get into a rhythm with them.
- I focused on keeping my lips and my facial muscles loose, because they say that if your face is loose, so are the muscles of your you-know-what.
- In the last few hours, the visuals that spontaneously came to me were imagining myself as a puddle of mercury on the floor or a melting glacier.
I would say that my Montreal winter pessimism method worked. It did get more painful, but I still had something left when it was over. In other words it was not a 10 out of 10 on the pain scale.
It was really important to me to know that the drugs were available if I wanted them. I think that actually helped me focus.
The teacher of our birth class, Penny Simkin, made a super important distinction between pain and suffering. Pain is physical but suffering encompasses your whole self. My suffering was minimal. I didn’t feel fear at all. I didn’t think I would split in half or that D wouldn’t make it. Jack didn’t think I was dying. I had no desire to lash out at the people around me.
Support People
At both the midwifery practice and the OB practice, patients have appointments with several practitioners during pregnancy and then deliver with who ever is on call. The labor and delivery nurses are the ones who take care of you most of the time, which I didn’t realize until I started reading in the fall. It has also become popular to have a doula, which is a non-medical labor support person. Having a doula has been shown to improve and speed up birth, so we considered it but opted not to because we didn’t want to work the dynamics of a new relationship.
Doulas are particularly helpful for laboring at home before going to the hospital, a typical step that we completely skipped. Since our induction was a normal business hours affair, we actually had a student nurse and a student midwife, in addition to our primary nurse and midwife so we had a full room of absolutely phenomenal support. We had met the primary midwife once or twice before and it really didn’t matter that we hadn’t met the others.
Saving the best for last, Jack was the most incredible support person I could imagine. He was calm, consistent, informed and familiar. I think the only time he let go of my hand was when he caught D at the moment he was born and put him on my chest.
One month later, D’s birth is a treasured memory.
