I’ve thought a lot about how my feelings and attitude towards labor and birth have changed over the course of the years. Each one of my children’s births has been very different, and unexpected factors always appear which direct the course of my labor and delivery. I feel much more open-minded and compassionate towards women who have difficult experiences in childbirth. I no longer believe that if one just tries hard enough, anyone can have an unmedicated birth.
When I prepared for the birth of my first child, I was geared to deliver unmedicated at a birthing center. I chose a group of midwives who I liked and a birthing center that felt comfortable. I paid for a home study Hypnobabies class (because I wasn’t willing to part with over $300 to go to a live class), and I watched a lot of videos documenting women successfully giving birth without using drugs or without getting episiotomies. I only surrounded myself with positive talk about the birth experience. I took a childbirth class from a respected doula, exercised regularly while pregnant, and took my prenatal vitamins and red raspberry supplements dutifully before the baby was expected to come. I didn’t get hung up about the “due” date. I knew to look at it more as a window of time and that the baby would come when he was ready. I had dreams of catching my own baby after an unmedicated labor and delivery. I practiced my kegals RELIGIOUSLY every day. I researched and learned all about how devastating unnecessary interventions could be to the progression of labor and delivery and to the mother and baby’s health. I talked with other mothers who had delivered without medication. In short, I prepared the best way I knew how: thoroughly. The downside to all of the research that I did and the videos I watched was I became very fearful of giving birth in a hospital or without a midwife. Everything I read and heard was centered around how hospitals and doctors are quick to use unnecessary interventions which often lead to the use of forceps, giving episiotomies, or cesarean surgery. These are reasons why I chose to deliver at a birthing center. This fear, however, did not go away. It stayed with me and proved to be very detrimental in my recovery from the way my baby’s birth actually happened.
One day before my first baby’s due date I came home after a day of work. I was a school psychologist and worked at an elementary and a junior high school. I was tired, as was the case most days, and I laid down in the late afternoon to rest with my husband. Not long after I had lain down, I felt a “pop!” and the next instance I felt a warm liquid running down my legs. I definitely was not expecting my water to break before labor started, let alone before my baby’s due date. But I instantly knew what it was and ran (or waddled) into the bathroom. My contractions felt weak and inconsistent for the first 1 to 2 hours after the bag of waters broke, but then – Oh. My. Goodness. They felt to be on top of each other and out of control. I felt out of control and like I couldn’t mentally get on top of them. I vomited several times while we were at our home and began to feel very weak from the loss of fluids. That whole labor felt like a blur even while it was happening. I didn’t realize that my labor could escalate that rapidly. I was planning on laboring at home for hours. But with my water breaking it seemed to just surge those contractions forward. We got to the birthing center around 9 or 10 p.m. and we were only there for a couple hours when the midwife became very concerned about the baby’s heart rate. (By the way, there was nothing that helped me feel more comfortable during that labor. I tried the tub, various positions – everything. Nothing took the edge off. I didn’t want to listen to any music I had pre-recorded and all of the self-hypnosis I practiced? I didn’t even get a chance to think about using it.) The midwife hooked me up to her little monitor and after an hour or so just looked at my husband and I and said, “You need to think about transferring to a hospital. Your baby’s heart rate keeps dropping down to the 80’s during contractions.” Here I was, wearing an oxygen mask, not even knowing how I was going to endure the next contraction, and my midwife was asking me to make this huge decision about whether or not we should transfer over to the hospital. And I couldn’t get a gut feeling or prompting either way about what to do, let alone think straight. Aren’t women supposed to have a mother’s intuition? I know what I was feeling at that time and it definitely wasn’t intuition. But we decided to go. We figured if our midwife was concerned enough to suggest it, we had better go.
The transfer stressed me out so much that on the drive over I felt my contractions slow down. Once I got to the hospital they continued but they were weak. My labor was stalling. Everything happened so quickly once we got there that it’s hard to remember what happened first. But I eventually got hooked up to an IV and Pitocin and we monitored that baby’s heart rate for hours to see if it would look good during contractions. Every time we turned the Pitocin down so that I didn’t have a labor-progressing contraction, his heart rate was beautiful. Every time we turned it up a notch to get my contractions strong enough to get things going, his heart rate went back down. This went on all night and into the early morning. My eyes never left the screen of the monitor the whole time. That’s when the MD came in to talk about surgery. It was my worst fear being played out. I was shaking so badly and so anxious about the whole experience that nothing seemed to make sense to me. The midwife stayed with us the entire time at the hospital until surgery was decided on and assured me that they had done everything they could to get the baby to come vaginally. When the docs pulled my baby boy out, he was as happy as could be and had the best APGAR scores out of all 3 of my babies. I was left wondering what in the world just happened. For days and weeks and maybe even months I kept thinking that I failed. My body wasn’t good enough. I wasn’t good enough. If I had just tried harder I could have had that baby vaginally, unmedicated. This, coupled with the normal hormonal changes after birth and learning how to breastfeed (we won’t even go there right now) and take care of a newborn propelled me in to a very anxious, emotionally dark time. Looking back, I think I may have met the criteria for having postpartum depression. It was about 6 months after my first baby’s birth that I began to pull out of that difficult time.
A couple years after my oldest was born I began to look back differently on that experience and my thoughts and feelings about it. I almost couldn’t believe that I had blamed myself so much for how his birth went. Seriously? I didn’t try hard enough? I couldn’t have done anything more to prepare myself. And now I’ve learned that you can do all that you can to prepare, but the best preparation is to be open with yourself and expect the unplanned and the unexpected. I almost laugh now when I think about all of those self-blaming thoughts. I began to view my cesarean surgery as close to the ultimate sacrifice I could have made to bring that baby in to this world. And that began to help me feel strong and proud about my baby’s birth experience. I did something that I was so afraid of doing. As I saw things in a much different light, I realized how much my ability to enjoy my newborn had been tainted by all of those self-blaming thoughts. There were definitely other factors involved in my postpartum recovery, but my regret about his birth played a huge part. Oh how I wish I could have thought differently about it all at the time!
Ok, on to baby #2’s birth. I was much more practical and realistic with this one. I chose a hospital 45 minutes away because I really wanted a VBAC (Vaginal Birth After Cesarean) – not so much that I would have been destroyed without it, but I really wanted to try for it. Although I began to have better feelings about having a C-section, I knew that a vaginal delivery is much better overall for mom and baby when possible. The hospital in town had a horrible record for VBACs so I steered clear of it. My midwives were great (which were different from baby #1 since we had moved to a new state) and the nurses were just fantastic.
My labor started (and ended) very differently with baby #2. It was SLOW to get going. I had contractions all through the night the day of my baby’s due date and then they just…stopped. It was 6 a.m. and I hadn’t slept at all. I called my midwife and she said get some sleep. They’ll probably start again later in the day. Sure enough, late that afternoon around 3 or 4 they started to go again and around 8 p.m. I was in labor. We drove the hour up to the hospital and got there around 10 p.m. My contractions slowed I think because I unintentionally held them off while on the drive up to the hospital, but as soon as I was checked in and got on the birthing ball they picked up again. As they got stronger I began changing positions. I stood in the shower for what seemed like an hour at which time my water broke. Then I walked back to the room and leaned over the hospital bed. The contractions were getting so strong and I was having a hard time allowing my body to be in the position it needed to keep them coming. I didn’t want to feel the pain! My midwife realized this and made me get in a better position. I felt incredibly cramped in the hospital room since everything was under construction. There was, again, nothing I could do to find any relief. Then I got in the tub, hoping the water would take the edge off. I was disappointed to find that it made me feel more uncomfortable. I got out and was checked. By this time it was close to midnight. When my midwife said I was at a 5, I mentally shut down. “I want an epidural” I said. Those ominous words! I did not feel like I could make it another 5 centimeters. I knew that it would probably go faster, but I wasn’t thinking about that. I just thought I was so worn out from the contractions and the vomiting that I didn’t feel I could make it. So I got the epidural.
For the rest of the night I didn’t sleep at all but watched the baby monitor the whole night and morning through, anxious still from what happened with our first baby. At 9 a.m. my midwife came in and checked me and said I was ready to push. Unfortunately, they had just given me another epidural dose and I was in no place to feel anything to know when to push. My midwife ordered it off and finally, about an hour after pushing with very little success, the effects of the epidural began to wear off and I could feel enough to push with my contractions. After two hours of pushing, a couple more times of retching, and one time of almost passing out, baby boy #2 was born! My midwife was incredibly patient with the whole process and even protectively held off the on-call MD who wanted to see more action faster. The whole team cheered after he was born. Everyone was so excited that I was able to have the VBAC. I have never felt more tired in my life then when I did an hour after this baby’s birth. I could barely keep my eyes open while I was eating the food they ordered for me. The hospital was so amazing that baby boy left my arms only once for 5 minutes (after an hour and a half of skin-to-skin) and then not again after that until we took him home. I loved it. The day after I had my baby my midwife came in to the hospital room to check up on me. I felt slightly sheepish for my choice to get drugs but she was very validating when she said, “Your epidural got you your VBAC.”
Now for baby #3. After one successful VBAC I felt more confident in giving birth, but I knew to still be realistic. I told my midwives that I wanted to try again to go unmedicated, but I wasn’t going to put a ton of pressure on myself to adhere to an ideal standard that I may not be able to keep and then feel awful about it afterward. I like a good challenge but giving birth is not the same as running a marathon. There are much fewer variables that can be controlled during the actual event of birth. Baby girl’s due date came and went and it wasn’t until a week later that I began to have any sign of consistent contractions. They were weak but they were happening more regularly and frequently. After I went in for a non-stress test one week after the baby’s due date, the midwife suggested I go to the hospital for more monitoring and to have the baby. I was at first very hesitant about this. And I was emphatic that I did not want to be induced. We all agreed that this would be a last resort, especially since I was a VBAC and it is not recommended. I always like to let the baby come when he or she is ready but I also understood that sometimes other factors necessitate helping that along. Her heart rate was borderline on one of the criteria of the non-stress tests and the midwives felt more comfortable with me checking in as soon as possible, so we agreed that we would start labor with breaking my waters if necessary instead of an induction. Our family had been experiencing a tremendous amount of stress the last 9 months but October 10th was the first day I felt like I was truly ready to have the baby, so as I was driving home to tell my husband we needed to go to the hospital, I felt good about going.
As soon as I got there I was hooked up to the monitor and for two hours the baby was blissfully fine. Both the midwife and the MD on call came in to study the monitor results and agreed – she seemed to look great. However they still gave me the option to strip my membranes. I felt so torn! I wasn’t in active labor yet, and I knew if we went that route there was no going back. I like to let labor start on its own, yet I was having consistent regular contractions and I was already dilated to a 4. My husband and I talked and agreed that if we went home, it would likely only be a matter of a day that we’d be coming back. That, coupled with the fact that there were concerns about the baby’s heart rate earlier in the day, helped us make the decision to stay. We viewed breaking my waters as speeding labor along rather than inducing it from nothing.
So we went ahead with it and about 45 minutes later I was in active labor. I felt like I was handling it very well for the first hour. And then things started to get more intense. I got in to different positions. I got in to the tub, hoping that third time’s a charm and it would offer some relief. At first it seemed to help but then I just felt more uncomfortable and I did not like how I felt my movement was restricted. As I stood up to get out of the tub I said it again: “I can’t do this anymore. I want an epidural.” My midwife looked at me. She said something along the lines of, “Now Temma you said you want to do this unmedicated. You’re doing great. Are you sure about this?” Yes, yes. I’m sure. I began comparing this labor to my last. I felt exactly the way I did with baby #2 when I was at a 5. I did not want to go further. My midwife asked if she could check me first and I made my way over to the bed. She told me I was at a 9! You would think I would be incredibly happy at that point. But all I could think was that I was too late to get an epidural and I would have to endure the rest of labor. So began the wailing and the insistence on getting some medication. My midwife again tried to convince me out of it but I insisted further. Nothing felt right about my body at that point. I don’t even know how it all worked out with how far along I was, but I was given a last minute spinal and immediately told to start pushing. The nurse and midwife insisted it would feel better, but when I tried to bring my legs back it did not, and I couldn’t! As the midwife examined the baby she found that she was posterior and her heart rate began to drop. The MD on call was standing by and I later found out this was because there began to be some concern about getting the baby out. I was writhing at that point and the spinal wasn’t kicking in. I was getting no relief and I couldn’t push the baby out. It was at that point that the midwife and James (who is a saint during this entire process each and every time) both looked me in the eyes and said, “Temma, this baby needs to come. We need you to push her out right now.” And it was at that very moment that the spinal kicked in, I found some relief, I was able to get control back of my body, and I pushed. I was still able to feel each contraction and I pushed with all my might with each one. The midwife initially tried to help the baby turn, and with each push the baby began to turn more and more on her own. After a mere 20 minutes of pushing, our baby girl was born. This felt like the most anti-climactic birth because of how fast everything went (3 hours from start to finish). I did not get to hold her immediately because she appeared to have trouble breathing. She was rushed to a resuscitation team that had come in and within less than a minute, she gave a healthy cry and all was well. So. I got medication again. I’m not thrilled about it. I would love to say that I didn’t need any medication for the last two births. But, again, and after talking with my midwife at my postpartum check-up and her confirming it, I feel it was a good decision for me in my labor.
A big takeaway for me after these experiences was that you can’t anticipate all of the variables that can occur or change during the course of labor. And you can’t always factor in how they will affect you, or how the unique combination of different variables will affect you. Should I factor in the immense stress I had been feeling several months before baby #3 was born? I think so. I didn’t anticipate that baby #3 was posterior or how that would affect me during labor. I didn’t anticipate with my second baby’s birth that I would be pushing for 2 hours or vomiting during the entire labor and delivery. And I definitely didn’t anticipate that my first baby would experience significant distress during the contractions.
I’ve come to realize that a birth is beautiful no matter how it happens. That women are strongest when they are doing their best to make good choices for themselves and their babies. That hospitals are not evil and there are good doctors out there. For the record, I still choose midwives every time. I haven’t completely abandoned all of my prior beliefs. I do agree that doctors tend to intervene unnecessarily quicker than midwives. I do shoot for an unmedicated birth every time (unsuccessfully so far 3 out of 3 times). And I do believe in trying to use natural relaxation methods during labor and in being connected to that birthing experience as much as possible. But I’m no longer afraid of giving birth in a hospital. In fact I really, really like it. I believe that either myself or my first son or both of us would have died if it weren’t for a well-equipped medical staff in a well-equipped hospital.
Another huge lesson I’ve learned is that you must be able to completely trust who you choose as your provider. I realized after baby #1 that if my midwife told me we needed to use some sort of intervention that I wasn’t initially planning on, I needed to be able to trust her advice 100% and know she had my and the baby’s very best interest at heart. Your provider is your advocate. This was very clear to me when baby #2 was born. She was quite protective of me as the MD on call kept hovering and trying to give me advice while I was pushing. I only listened to my midwife because she had earned my trust. And it made all the difference in that baby’s birth.
Also, it’s important for women to be as informed as possible, but to get information from varied sources. And talk to women who have different experiences. And don’t be afraid! Expect things to get wacky. Maybe they won’t, but if they do you’ll mentally be prepared. Above all, remember that each baby’s birth is in the Lord’s hands. If you’ve done what you can to prepare and make informed decisions, if you’ve kept an open mind and can be kind with yourself throughout the whole process, remember that in the end, the Lord is in control. I firmly believe now that my first was supposed to come the way he came. I don’t know why. I still am not totally sure why he struggled so much. I have some theories but I can’t be sure. But it was the right experience for both of us. I don’t regret trying to birth in a birthing center with him even though we had to transfer to a hospital. I felt like that was the right choice at the time. I have learned so much about myself as a result. I don’t judge other women for choosing different options. The fact that women are choosing different options is, in fact, great! It means that we actually have options and that women are taking in to account whatever unique circumstances in which they find themselves. Motherhood should be the great equalizer. I don’t understand why women sometimes compare on the pretense that they have it all figured out. I’ve come to understand that we have all climbed that steep learning curve. Why would I pretend that I know how everything should be done?
My overall purpose in sharing these birthing experiences is to hopefully give some woman somewhere a bit of validation if she feels her birthing experience was not as she had hoped for. I remember feeling so devastated after my first child’s birth, and if I can help someone avoid that self-blame and that same devastation, then I would feel so good about opening up about my experiences. Especially if it allows a mother to be able to enjoy her baby more. I also hope that the online birthing community will be more open about all ways of having a baby. I hope that online forums can focus on providing accurate, well-researched information that tries to be as un-biased as possible. And I hope that all women’s birthing experiences, whether medicated or not, whether at home or in a hospital, are celebrated. No just, “Yeah, that’s so great for you,” celebrated. But truly, genuinely, honestly, loved and celebrated. I love my body. I love that I could survive and recover from being cut open to birth a baby. I love that my body could heal and that I could attempt and be successful in having a baby vaginally two times after that. I love that I’ve come to learn more about my body’s capabilities and limitations. I love my body’s ultimate dependence on the Lord to help get me through each child’s birth. And I love, love, love the babies that have come to us with each birthing experience.