I’m putting this in a post of its own because, well, there may be some people who do not want to read graphic details about labor and delivery. If you do not want to read such details, this post is not for you. I don’t mean to imply by that that childbirth is scary, gross, or totally unpleasant, by the way — I just realize it may not be of interest to all readers. Also, I apologize in advance for the extreme length of this post. To paraphrase Mark Twain, if I’d had more energy, I would have written a shorter blog post.
I am amused at times by the phrase “natural childbirth.” When you have a noun and then a noun that gets modified by an adjective, the implication is that the noun alone is the “normal” or predominant meaning. And so in the United States, when we say childbirth, we usually mean a woman with an epidural lying on her back. That’s normal here, but it’s not really normal elsewhere. What’s normal in, say, Europe, or for that matter most of the developing world, is called natural childbirth here in order to differentiate it from what we perceive as normal. Culture! Language! Such fun. But I digress.
I knew from fairly early on that I wanted to have a natural childbirth. Well, actually, what I knew was that I wanted a doula. I didn’t know a whole lot about doulas, but I loved the idea that a doula was someone whose whole job was to support and take care of the mother during the process, and I figured I needed all the support I could get. I am a doctor’s daughter, and I grew up at the hospital, but I still hate being left alone with medical personnel, especially when they are talking fast and in jargon, or disbelieving what I say, or accusing me of one thing or another.
I also chose early on to see the nurse-midwives at the University of Iowa Hospitals and Clinics. I was 35 when I got pregnant, which is just on the cusp of where they start to consider you to be of “advanced maternal age,” but astonishingly, given my rather poor general health, I was not actually considered in any way a high risk pregnancy. Seeing the midwives meant I would have all my prenatal appointments with just the four of them, in rotation, rather than with the constantly shifting parade of residents and medical students and attending physicians and nurses and nurses in training that you get at a major teaching hospital. I was an emotional wreck, and I couldn’t bear the thought of that large a group of people talking to me. Being seen by the midwives meant I’d be isolated from all that but that I’d still be in the hospital and have the excellent OB staff available at a moment’s notice should anything go wrong.
Having a midwife and a doula doesn’t mean you must have a natural childbirth — after all, emergency C sections sometimes have to happen, and some people who go the midwife route still choose to have epidurals and so on. But they are experts at natural childbirth, and they encourage women to have agency in the whole process. That sounded good to me. And the more I read, the more convinced I was. I’m a sucker for anything that tells me that the body is smarter than science, and that’s the general theme of natural childbirth. In theory, if you don’t muck around with your body by pumping it full of Pitocin (an imitation of the hormone that causes you to go into labor) and anesthesia, you end up with this miraculous natural balance of hormones that cause your body to do everything it needs to do, and you get a fantastic high right after you give birth.
Having done it all now, I will say that that was sort of true for me, although the high may have been overwhelmed by exhaustion and relief that the whole thing was finally over.
So here’s my childbirth story, as best as I can remember.
The night of my due date, my mother, the baby’s father, and I went out for an elaborate dinner at Devotay, because, well, what the hell, why not tempt fate? It was very good, and I came home and slept in my usual fitful late pregnancy fashion. At 7 a.m., I woke up with a pain in my gut and said to myself, that was a contraction. Like, a real contraction, not one of those wussy Braxton-Hicks contractions.
I had more of those throughout the morning, ten or fifteen or twenty or even thirty minutes apart, pretty sporadically. They got a bit closer together as the day wore on. I checked in with my doula a few times and she said I should keep her posted. At some point the baby’s father came over and made spinach lasagna and we had dinner, and he started timing the contractions, which were more like six or eight minutes apart. My mom came, too, and they each read to me for a bit (I specifically requested that everyone involved in my labor bring something to read to me). The baby’s father read the beginning of The Solace of Open Spaces and my mother read “Elsie Piddock Skips in Her Sleep,” which is a very, very odd fairy tale by Eleanor Farjeon, who also wrote the song “Morning Is Broken,” which you probably know from hearing Cat Stevens sing it. Somewhere, lost to time, there’s a tape of my mother reading this same story to me when I was five or six years old, with me playing the xylophone in the background.
Around midnight, the contractions were quite close together, enough that we all decided to go to the hospital. Melissa, the doula, and my friend Caitrin met us there. The midwife checked me and said I was only a centimeter dilated and recommended I go home again for a bit and try to get some sleep. They even gave me Percocet to help me sleep. It had no effect. But Caitrin and my mom came back home with me, and my mom dozed a bit (she claims not a lot) while Caitrin massaged my back and belly and talked me through the contractions, and ran a bath for me, and made me a snack. At 5:30, she announced it was time for us to go back to the hospital. Off we went again, and this time I’d gotten to four centimeters and they decided to admit me.
I then got moved to one of the very swank delivery rooms. Assorted furniture, okay bed, lots of room to pace around, huge fancy tub, and lots of fun equipment they bring in to help you with labor. My favorite was the birthing ball. In fact, I liked it so much that at some point during that very long day, they said, “Laura, don’t you think you should get off the birthing ball? You’ve been there for two hours.” I had no memory of being on the birthing ball for two hours (two hours?!?), but then I have no real memory of time that day at all. I went into labor on a Saturday and labored all through Sunday until evening. The next day I was convinced that it was Sunday, that we were missing church. My mother had to tell me again and again that no, it was Monday — church was yesterday, and that someone had managed to restrain our rector from having everyone sing “Come, Labor On” for me.
I’ve never been in such a different space in my life. It’s a tiny bit like having a fever in the way that it removes you from the regular world and makes time seem irrelevant, but it’s also nothing at all like a fever. It’s a little bit like walking home a long, long, long way because your car has broken down, or because you don’t have bus fare, or because you just need to walk, but it’s also nothing like that, because you don’t know how far away home is.
I spent the day working through my contractions — walking, straddling the birthing ball, leaning onto a counter or the bed or the sink or someone who was unwittingly standing near me or getting into that fabulous tub. Caitrin and the doula took turns massaging me and talking me through the contractions. I’ve been doing yoga for about a year and a half now, so I’m used to Paying Attention to the Breath. I ditched my childbirth education class before they got to the breathing parts (since the first half hour consisted of a nurse reading from canned PowerPoint slides that told us we should eat lots of vegetables and drink lots of water, I felt not so bad walking out after things didn’t improve in another hour), but my doula said that yoga would see me through. Oddly, though, the breathing pattern I ended up using the most was the one I used to have to do for asthma tests at the pediatric pulmonary clinic when I was a kid. In-out-in-out-deep breath in-blow it out as hard and as long as you can. I did this instinctively, it seems, and I could see in my head the little lines on the machine going up and down all those many years ago.
Sometime in the afternoon it got to be time to start pushing. I no longer remember how I knew that, or if they told me, or what. I had been looking forward to pushing because I had heard how much some people love it.
I was not one of those people.
I pushed for four hours. I pushed standing, sitting on the toilet, squatting with my arms around the baby’s father’s neck or holding myself up with the birthing bar or lying on my side with one leg elevated. I tried every position that the nurse and the midwife and my doula suggested. I believe I also yelled at people a lot, and I am told I sweated like a racehorse. I seem to recall that at some point somebody offered me lip balm. Lip balm! Like I cared about lip balm! I just wanted to take a nap!
I’m not sure if it was before or after I started pushing that I threw up everything I’d managed to eat in the past twenty-four hours.
Finally I was too tired for anything but the sidelying pushing position, and so despite my fantasies of delivering my baby squatting and having someone catch it, I ended up on the bed. In theory through all of this I was undergoing intermittent fetal monitoring, which is to say that rather than having the monitor affixed to you at all times, the nurse just approaches with it from time to time. It seemed as though “from time to time” meant “every other minute” to me, but I could be wrong.
At some point around the fourth hour of pushing, people began to look slightly worried. I learned later that they were having a great deal of trouble getting the baby’s heart rate because he was so far down the birth canal, and when they did get it, it seemed to be fluctuating rather wildly. The midwife told me later that she wasn’t too worried but that to someone looking at the monitors outside the room, it would have looked very worrisome. She did give me some oxygen, in case the baby’s umbilical cord was getting pinched and he wasn’t getting as much as he should. It was like asthma treatment all over again!
I was at this point convinced I was going to be pregnant forever, with a not-quite-born baby stuck in me. I was waiting for someone to tell me what a failure I was, but nobody did. I thought perhaps I’d just fall asleep and they’d figure they had to slice the baby out. They said, no, no, you’re in transition — it’s the hardest part! I thought I’d been in transition for HOURS at that point. Apparently not.
What did happen, finally, after assorted consultations and some more worry about the heart rate, is that the midwife told me, “Laura, I think you can push this baby out yourself, but it’s going to take you two or three more hours.”
If I had a response other than ARE YOU FUCKING KIDDING ME?, it is lost to history.
She then said, “Or we can get the OB team in here to help you out with the vacuum extractor. You’ll still have to push, but it will help speed things up.”
At this point, if someone had told me they could pull my baby out by putting a screw in its head and using a pair of pliers, I would have said yes. So of course I said yes to the OB team. And then very suddenly there were like twelve more people in the room, all in scrubs, all kind of racing around like they’d just been hovering outside and waiting to be called upon. And yet they were amazingly respectful of me, of my midwife, my doula, and my whole entourage. (Truly, I did feel as though I had an entourage, for perhaps the first and last time in my life.) I never felt as though they were taking over, or telling everyone to clear out of the way. They came in, set up, waited (not long) for my next push. . . and then suddenly everyone was telling me I had a baby.
I saw him wildly waving his arms as someone lifted him up. I didn’t get to have the immediate skin-to-skin contact I’d initially wanted, because they had to take him off to another part of the room check on some things. My mother and his father went with, and my doula stayed with me. A nurse, who had clearly been waiting for this ALL DAY swooped in to give me some Pitocin “to speed up your contractions so you can get the placenta out.” It seemed sort of silly to me, since delivering a placenta is a lot easier than delivering a baby, but I wasn’t in the mood to argue at that point, so I did end up with an IV briefly. I tore a tiny bit, so the OB team stitched me up. And then — then they brought me my baby, and I got to hold him up against me and look at him. All around me people were taking pictures and making phone calls and sending texts. I was oblivious to it all. Whatever pain I had been in was gone, completely, and there, somehow, was this beautiful, wide-awake creature, looking around at the world and at me for the first time.
When I tell people that I was in labor for thirty-six hours including four hours of pushing and did it all without drugs, they look at me like I’m completely crazy. Quite possibly that’s true. . . but you know, it actually wasn’t so bad. Like, I’d do it again. Perhaps I say that just because of amnesia, and because the result was my baby boy. That’s surely true. And surely part of it is an unnecessary level of pride on my part. I took great pleasure in saying to all the nurses over the next few days, “No, I didn’t have an epidural.” But maybe in this life we accomplish what we can. My godmother told me right before I gave birth that giving birth to her children was the first time she really felt physically powerful. It wasn’t the first time for me, but it was one of the most intense. And for me, that was worth it. Your mileage, as they say, may vary.