My uterus is busted. But my uterus is not me. To be completely frank, that’s a very difficult image of my body to accept in our world. It’s probably a reality that divides me more than anything else from the experiences and attitudes towards pregnancy that are embodied in contemporary birth culture. I am no more, or less, impressed by uteruses than I am by feet and legs and hearts and livers, and all the other body parts that make life possible and make life difficult. It depresses me that my uterus won’t work like it’s supposed to. But it’s a medical, not a moral, condition. It’s only more depressing than a broken foot because it hurts and can kill my children. I imagine that in my case, it’s less distressing than a busted liver or a cancer because pregnancy is temporary, I can choose not to do it. Pregnancy is a means to an end. I enjoy feeling my babies move in my belly, and labor with Samuel was deeply satisfying, a wonderful reward. But I look forward to it being over, to reclaiming my body and my life. I’m not a glowing pregnant woman. Oh well, I’m also not a world-class athlete or an opera singer. My body is what it is.
My body is stressed; my body is tired; my body is injured. The cure for my broken uterus–bed rest–is to blame for much of it. This morning I decided to do some simple math to figure out how many weeks have I now spent on partial or complete bed rest, in my pursuit of living children.
Complete, under doctor’s instructions: 27.5 weeks
Partial, under doctor’s instructions: 9 weeks
Self-induced anxiety rest: at least 3 weeks
I was conservative in my estimates, and still, I ended up with about 40 weeks of nearly complete inactivity. Medical research, based on statistics and studies, in no way confirms that bed rest works. Anecdotal evidence, and my experience, suggests that in some cases it can.
First key thing to know about me, and many women, who’ve delivered their babies too early: we have no idea why it happened. We don’t have the risk factors. Because its cause cannot be determined, and because women who lose their pregnancies and children to preterm labor are often not overly concerned about medicalized pregnancy and labor, we’re very grateful when doctors offer to open up their full bag of tricks, imperfect as they are: cerclage, progesterone, bed rest, and tocolytics.
Adding to my issues, I have an irritable uterus. Yes, that is a real medical term. I’ve included a description from http://www.irritable-uterus.com
“’Uterine irritability’ is a term used to describe the phenomenon that prior to the onset of labor, the uterus can contract in a disorganized fashion (during pregnancy),” explains Dr. Laura Klein, an OB-GYN at the University of Colorado School of Medicine. “Rather than strong contractions that come and go every few minutes there can be kind of a constant low level twitching of the muscle.” Most of the time these contractions are simply a nuisance and don’t lead to labor.
Most of the time, irritable uterus turns out to be nothing. Most of the time, a woman with an irritable uterus simply experiences an inordinate number of Braxton-Hicks contractions. Sometimes, though, IU is correlated with preterm labor, or can indicate its onset. Sometimes those low-level contractions precede high-level ones that change your cervix.
At least two of the doctors who treated me in the hospital with Natan, and my OB with Samuel, think I’m one of the (un)lucky ones for whom it is a sign. Ultimately, I go on bed rest because of my IU, rather than my cervix. Because if I have a normal day of activity, just an average one, without exercise, I will absolutely be rewarded with bouts of average-strength contractions, as well as the “low-level twitching” mentioned above. My abdomen will harden and the skin will go taut while my stretch marks burn and itch. It’s really pleasant. These are the sensations my first OB told me were just part of the joy of pregnancy. Even though medical research still says he might have been right, I know that’s not true. I know it’s not true because when I’m on progesterone these contractions happen less and later in the pregnancy and I at least trust my instincts this much.
I hadn’t had a single episode this pregnancy until a couple of days before the appointment where Dr. H caught my cervix shortening slightly and told me to go on rest. I’ve only had a few episodes since, all on days I’ve taught or been a little bit active, and at my appointment on Monday my cervix had only shortened a tiny bit, within normal ranges for this gestation.
With this knowledge, any woman who can, will rest. Obviously, most mothers will do anything to give their children their best chance at the best life.
Yet, no one should be fooled. Bed rest sucks. It’s boring and frustrating. You watch the world go on without you. You watch your partner, your husband, your family go on about life, stressed out and trying to handle everything. They handle it so well you wonder if they need you. Or they get stressed out and you get upset that THEY, who can walk freely about the world, dare to complain about anything. You think you should be using this time to finish your book, to plan for a baby’s arrival even though that in itself brings emotional and financial risk because he might not. You think you should manage your family’s finances and schedules, but instead you post nonsense on Facebook all day and read absolutely every article published about Rush Limbaugh and Rick Santorum. You’re bored. You have all day to rest, but you can’t sleep at night because you rest too much. You have endless hours to feel anxious, to count the minutes until safety. If you have a job, you worry about whether you’ll be able to keep it. If you’re on partial bed rest, like me, you worry that every day will be the one that brings you to complete bed rest–which will throw your family’s finances into disarray and possibly lose you your medical insurance. You’re lonely, but you can’t go out. Invitations go rejected. You try to plan for the future, but you find yourself explaining to random acquaintances that while you are trying to find a house and possibly arrange preschool for next year, you can’t drop by their offices. Life is on hold, but your mind is very much awake. I am not the same person I was before it all began in 2006. I am not as social, as talkative, or as consistently cheerful. I am more patient, more open, more compassionate.
If it works, it’s worth it.
The rigors of bed rest aren’t all emotional, however. It is very, very hard on your body physically. By the end of my bed rest with Natan, my hips hurt so badly from being trapped in a hospital bed that I thought they might break. Ice only helped a little bit. At the end of my best rest with Samuel, my left hip dislocated and my tailbone broke during labor. My hips and tailbone already ache; I am sure I have suffered bone loss. Although, inexplicably I have less round ligament pain this time around than before. Perhaps that’s because my body overall is under less stress with the treatments and I do move around more this time than I did with Samuel. Clearly, I also gain more weight on bed rest than I would if I were able to exercise and be active, and that’s a stress on anyone’s body. My neck and shoulders are more prone to injury because of positioning. I also lose muscle mass, and that makes my body more vulnerable to injury and I believe, illness. I wonder how many of my physical problems I’ve had in the past five years are related to my difficult pregnancies and bed rest.
If it works, it’s all worth it. But it’s a gamble, and it’s the hardest thing my body has ever had to go through. No one should have to go through it if they don’t want to. Bed rest, I believe, will permanently reduce your quality of life. Its effects are forever. It will change you, and it will change your body. Forever. It’s up to you to decide whether children improve your life enough to make the trade worthwhile.