the endgame: birth “choices”

So I suppose I am 36 weeks today. I am not cheerful. I’m hot and anxious and my belly has been itching something terrible. Really terribly. I’ve tried every solution, and they help temporarily but the second I get a little warm, the itching starts again. Argh. Stupid sensitive dry skin.

I remember from last time that these weeks were tough. Although I am ostensibly a normal pregnant woman now that we’re approaching term, I know too much about what can happen to really relax. That’s the minus part of the pluses and minuses to having blogged extensively during my pregnancy with Samuel. Back then, I knew bloggers who’d experienced every variety of infant death and pregnancy loss, and sometimes had multiple seemingly unrelated heartbreaks. And since I’ve been gifted again with an anterior placenta, kick counting is not a fulfilling endeavor.

Assuming we make it to the birth day without tragedy and mishap, I’ve been thinking about delivery. Last time with Samuel was so healing in so many ways. With no complications other than it taking FOREVER, and the need for a short burst of pitocin (which was my choice after contractions stalled and I began to have some intense anxiety), I had what I look back on as a pretty simple, easy and joyful experience. We worked with a supportive hospital and nursing staff and a doctor I trusted in Michigan. None of them rushed me or really displayed any of the traits I hear about from critics of hospital birth.

I’ve chosen the best doctor I can in town, but the hospital policies and culture make me nervous. I’ve heard, for example, multiple times that the hospital does not want women to walk around after their water breaks. I also know the hospital has a high c-section rate. I intend to talk to my doctor about this this week–I know I should have done it earlier. But frankly, I cannot talk normal labor before such a thing seems possible.  Cannot do it. I am very efficient and confident in discussing options for preventing pre-term labor at any point, but have to hold onto this one until the end. Now, a living baby is our priority, clearly. Yet I would seriously like to avoid a c-section. I also want to avoid an epidural, because I am at risk for complications with it because of my platelet issues–not a large risk but one nonetheless. I certainly feel it wasn’t random that I had a spinal headache after my cerclage (which involved a spinal block). I am also afraid that whereas using pitocin last time didn’t turn into a slippery slope of interventions, that it won’t work the same this time, in this place.

I have a hell of a time, however, communicating with people here before I’ve had many interactions with them, and there’s no guarantee I’ll have my OB with me at delivery. Part of me thinks, I’m a rather good advocate for myself and no one’s going to TIE me to a bed if I don’t want to lay down. But then another part of me thinks, I had to YELL at the nurses and hand the phone to my husband to get attention for my headache. So when my “Yankee” self shows up in the hospital, I really hope we get a genuinely nice and not fake-nice paternalistic group of nurses and doctors who will listen to me.

With this in mind, I bought a book recently. It’s called Natural Hospital Birth: The Best of Both Worlds, by Cynthia Gabriel. I was excited that it was written by a doula from Ann Arbor, because of the connection. The book has some good strategies, but as so often happens when I read and talk about birth, I felt marginalized. She describes the many reasons a woman hoping for an unmedicated child birth can end up having a c-section. As part of this discussion, she includes “previous trauma” as a contributing factor (and all the obvious medical and physical complications). I entirely believe that. I massively panicked during my labor with Samuel. Although my reason steps in here and says–I more than massively panicked with Natan and that didn’t stop a thing. Of course, in that situation no doctors were eager to get things moving.

Anyway with Samuel, we got it under control pretty quickly, but I worry that my reduced faith in the nurses and hospital here are going to be a factor. What bothered me in this book though, were the types of trauma she listed: disappointment in earlier labors, miscarriage, sexual abuse, and other types of pain and loss. Not included ANYWHERE in the book that I could find: labor/birth trauma that resulted in a baby’s death.

Fighting for days upon days to stop my labor with Natan was hideous–excruciatingly difficult and painful. He was premature, but he didn’t die just because of that, he died because his cord prolapsed. My body made things progress too quickly to remedy it.

I keep my mouth shut when women describe labor pains as rewarding or something your body is “meant” to do. In real life, I sympathize with and let them have their victories. But I get pissed off at being excluded from the birth experience by books like this one, which still is in many ways so much better than The Business of Being Born.

Books and movies that treat labor as something your body “knows” how to do are only telling a partial truth. It’s utterly natural for babies and women to die, too. Science and medicine, not women’s knowledge and synchronicity with their bodies, make  it possible for the authors and producers of birth materials to brush over our experiences by calling them so rare. I’ve said this before. It sucks to be invisible. It sucks to feel like my bad experience has to be hidden so that others can more fully enjoy their good ones. I’m still looking for strategies for avoiding panic during this next labor, but every time I search out some method–breathing, massage, hypnosis–something in the literature or philosophy runs up against reason and my experience.

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7 responses to “the endgame: birth “choices”

  1. For what it’s worth, I read every post. There are prayers and thoughts for you in this little part of the world here.

  2. “It sucks to be invisible. It sucks to feel like my bad experience has to be hidden so that others can more fully enjoy their good ones. ”

    I could go on all day about this, but I won’t.

    You’ve probably already thought of this, but I’m wondering if it’s still possible (at 36 wks) to have a doula with you for labor and delivery. I would think it might be a challenge anyway, given your geography, but I’ve heard that they can be wonderful support and can advocate for you if you are starting to get panicky. And she can support Josh, too.

    While we contemplate relocating (where? good question), one of my main concerns is where the nearest hospital is and is it any good? I’d like to not have a repeat of the band-aid station here, and even the 3 “great!” hospitals in the closest city do not instill any confidence in me. Maybe it’s because of all the trauma — multiple traumas — that I am so wary. It’s so hard to know, hard to trust, in a place, a culture that is still too new to really read.

    Okay, rambling a bit. Thanks for sharing this. Give ’em hell. Give’em Yankee hell. xo

  3. “Books and movies that treat labor as something your body “knows” how to do are only telling a partial truth. It’s utterly natural for babies and women to die, too. Science and medicine, not women’s knowledge and synchronicity with their bodies, make it possible for the authors and producers of birth materials to brush over our experiences by calling them so rare.” This is such a powerful and incisive critique of these discourses and this literature. Well said!

    Regarding your hot itchies…oatmeal bath?

    • Thanks Lady. Believe me, oatmeal bath has been tried….But fortunately I went back on steroids for my platelets and that actually, as my doc suggested it would, seems to have helped the itchiness.

  4. I am so sick of being invisible to my former natural-birth crowd. Our experience is just too much of a challenge to the “pregnancy and birth are inherently natural and beautiful” mentality. No, sometimes they are beautiful and natural and sometimes they are tragic. That said, if I had the option this time around I would be trying to avoid a c-section, too. The recovery from surgery sucks. I hope you find a way to successfully navigate your local hospital culture.

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