When Natural Labour Isn’t Ideal

When Natural Labour Isn’t Ideal

By Anonymous

This is a birth story about the last time I brought a baby earthside. This is also the story of something I’ve learned along the way bringing my first two sweet miracles into the world. In order for this story to make sense, I’ve got to explain what led up to it. Really, this is my three birth stories in two parts. Warning: some details may be a case of TMI for some people. Further, this is my story. By writing my story I am not saying that my experience is, or should be, the same experience as anyone else who has been through the same things I have been through. Maybe my experience will help someone, maybe it won’t. At the end of the day, I am recounting things as they’ve happened to me.

Part One:

I was sexually abused when I was very very very small. Besides working through a lot of mental/emotional issues that were wired into my developing brain, I also ended up with some physical baggage. My husband is a sweet and patient man of character.  He taught me that a man could love me without ever wanting to take something from me or use me. We shared our first kiss in front of the 100-ish people at our wedding. After we got married though sex eventually became something I feared. Even though I wanted to share intimacy with my man, my body made doing so a painful experience. I asked my doctor for a referral to a gynecologist.

When I saw the gyno I explained what was happening and that I was previously abused. When she examined me physically as soon as she touched the entrance to my vagina all my muscles tensed up and seized. She told that unfortunately she sees this regularly and that I wasn’t as bad off as some women who will shrink to the size of a test tube. She explained that muscle has memory. That even in cases of people abused when they are very small who may have no actual memories of the abuse their muscles can still remember it. She prescribed devices made of wax that would slowly stretch my muscles out and train them to not react to the pressure of penetration. We opted to use lots of prayer and slowly stretch things out with my husband. Again, he is a patient, patient man and for that I am very thankful. It took time, but eventually we worked things through and sex wasn’t painful anymore.

We were excited when we found out we were expecting our first little one. I believed strongly that natural labour was the best way to go if at all possible, and I thought I was pretty informed. We took prenatal classes together, toured our local hospital, talked about our hopes for labour and delivery and overall felt that we understood as best we could what we would prefer our labour to look like. I wrote up a “Birth We Would Like to Try Do” list. We didn’t want a set in stone idea of how things “had to” go as that seemed to be the most common scenario for everything to go wrong. We were fortunate to have a Doctor we had a really great rapport with who would thoroughly answer all our questions and was quite hands off overall. He did follow certain policies he was bound to though and I was never told I could simply say “No.”

Thus, as I approached the magical 10 days past my “due date” when he said that was the time we induce as the placenta starts to deteriorate I walked into an induction. I had been at about 3 cm for a week. He explained that he would essentially be using a tampon of hormones that would help my cervix to finish thinning and ripening and if things got too intense the beauty of this method was he could just pull the thing out. What I didn’t know was that however much hormone my body had absorbed still had to be worked out in my system once he took the insert out. Suffice to say, after progressing throughout the day and making it to nearly 8cm I ended up being steamrolled by continuous contractions. One would start before the last one ended. Then to boot, when I was next checked I had gone backwards in dilation by multiple centimetres. Our doctor was concerned that my contractions, while being pretty continuous and somewhat painful, were not being very effective in moving baby down. He said he would be starting oxytocin shortly to help them be more effective.

At this point my husband and I had a meeting. If my body was reacting to the level of pain (which wasn’t incredibly terrible) I was in by clamping down and closing up (knowing my previous history with all the muscles down there we figured that’s what was happening) then how would kicking things up a notch not lead to a disaster and possibly even an emergency caesarean? We made the decision that before any oxytocin got anywhere near me I would have an epidural (I’d had nothing up to this point). We decided that while we wanted to remain drug free, more than that we wanted to avoid a preventable caesarean. I ended up getting the epidural, my body was able to relax, and only a few hours later I pushed out the miracle that would turn me into a mother.

In the days and weeks that followed I felt let down that I hadn’t gotten the natural drug free birth I believed would have been most ideal. While I knew we needed to make a decision, and believed we had made the right one, I also regretting not preparing waaaaayy better for dealing with the actual pain of labour. Really, I’d had no clue what I was doing. I was trying to tell my husband to press here or there or massage this or that, while hoping I was guessing right and often I was totally wrong. Doing his utter best to support me I ended up feeling alone and abandoned by him when I needed him most. I thought that perhaps if we had been better prepared and able to cope better we wouldn’t have needed the epidural. That I would have been able to experience all that I had read about when women described feeling empowered and strong etc. when they birthed their babies without any interventions. I did more research and decided that next time things would be different.

Jumping to pregnancy number two. We hired a doula (If you are thinking about getting a doula but aren’t sure if you should bother with the expense, get the doula. Just do it!), I took a much more thorough prenatal class, and I watched episodes of “One born every minute”. I reminded myself over and over that women give birth every day and I could too; that I already had. My husband and I were now aware that my body might react unfavourably if I wasn’t coping well and were committed to making sure I was well supported and didn’t feel abandoned or alone in the delivery room. My husband had started a new job over 1100 km away but was due home a couple weeks before my “due date”. Given that I went post dates the last time and other women in my family have done the same, we were confidant he would be there before baby came.

One week before my husband was due home I had bright red show. I immediately saw my doctor who confirmed I was in early labour. I cried, then called my husband and told him I would appreciate if he was with me for this. He threw his things in the car and started driving. I called my doula and let her know I’d be phoning sometime in the next while, and I went about my day. I had so much confidence that time that I didn’t have with my first baby. Confidence that I had a team to support me, confidence that my body could do this as I’d done it before. Confidence that we had a better plan in place. Confidence in my ability to recover well afterwards. Just a lot more confidence. At 1:00 am my water broke while I was lying in bed. My sister came to drive me to the hospital. We arrived at the hospital I would deliver at by 3:00am and met my doula there. She hooked me up to a tens machine with a boost button (which was awesome), I put on the gown I had sewn, and we laboured. My husband arrived at 4:00am following his 12.5 hour drive. I knelt facing the raised head of the bed and with each contraction my husband and sister leaned into my hips and my doula pressed my lower back.

Then I hit a point where I felt like I’d had enough and said I didn’t need to be a hero and could certainly have an epidural. The doctor (same one as my first baby) turned to my sister and said “We’re about to start pushing. They always say that when we’re about to start pushing.” And sure enough, I was complete and in fifteen minutes or so of pushing out came my second miracle. While holding my newborn baby and saying over and over “I did it” in a somewhat dazed and surprised head space, I remember two things very clearly. 1) I did not feel any rush of accomplishment, power, or realization of how strong and amazing my body was. I did not experience any sort of joy, euphora, or otherwise “birth high” sort of feelings, 2) I was overwhelmingly relieved that it was all over. I didn’t realize at the time how deeply upsetting this labour was to me. I was soon caring for a newborn (with undiagnosed silent reflux; this was very challenging) and an energetic toddler and had a number of other things going on that prevented me from really taking the time to process everything through. I was, however, terrified of ever being pregnant again. I had never had panic attacks up to that point.  Just the thought of ever conceiving again would lead to a minor panic attack.

Fast forward through an awesome experience that led me to being willing to try again (we have always wanted a big family) and we were pregnant again. My second born’ was diagnosed with silent reflux and was being treated with appropriate medication for his condition and was also finally sleeping through the night. I had both the time and mental clarity to think about and process my previous labour.  As I looked back on it in I realized fully just how traumatizing that delivery was which was somewhat puzzling to me. I had achieved my ideal drug free labour. I had been awesomely supported and birthed in a quiet room with nobody telling me how to push or what to do. On a scale of one to ten I would say the pain never got past a 5-6. My husband made it in time and my body didn’t go backwards. I had gotten everything I had hoped for and yet, I felt overwhelmingly traumatized. I thought about and talked through everything with my husband trying to figure out why I was so incredibly upset by such an ideal labour. Trying to figure out why I hadn’t experienced any of the euphoria I’ve heard described, or even the level of “birth high” I felt after my first baby.

And then one night I stumbled across it. With my first labour, once I had the epidural I was no longer dealing with pain in areas of my body where I had experienced trauma as a small child. I could feel all the pressure of that baby being born, but nothing hurt down there. With my second, I could feel all the pain and just had to cope with it. It didn’t matter that I coped well, it didn’t matter that the pain was never as enormous as I thought it would get. While talking and processing what came out was “I just felt so violated! I was being subjected to pain in the most personal parts of my body and I couldn’t do anything but hold on until it was over!” and then I burst into tears. That feeling of being violated and just coping until it was done was buried somewhere deep in my being and having a completely natural labour with my second baby had fully brought it to the surface.

After that chat I became much more aware that labour itself could dig up some pretty deep wounds in me. So, we prepared more. We read more, we planned more. We had moved since our last delivery and were blessed to get on with a midwife who was terrific. We put together a great birth support team. And we waited. I was now fully aware that I was free to decline doing anything I didn’t want to do during my pregnancy/delivery. Thus as 10 days “post dates” I signed a form that I do not consent to be induced and we continued to wait for baby to be ready to meet us.

That story coming finally…

Part Two:

I was 43 weeks + 1 day. My husband and I had chatted and decided that we weren’t comfortable going much past 43 weeks and so the previous few days I had been using a breast pump on and off, walking lots, and even tried taking herbs, and using an essential oil a friend gave me. Nothing really worked. When I was walking I would have decently strong contractions, but as soon as I stopped they petered out. It was Friday, and my in-laws were set to arrive to be staying with us for a time. My husband and I took kids to an indoor family fun carnival in the evening, and the whole time we were there I felt strongly that I wanted to see my midwife. During the carnival I remember holding my baby boy (soon to be middle child) and being acutely aware that this was the last event where he would be my youngest. I wanted to cherish every moment of the evening.

As things were winding down I told my husband that I wanted to call the Midwife as I was now a day past 43 weeks, couldn’t seem to kick labour over into go mode, and hadn’t felt bubs moving as much as usual that day. While I was confident my littlest one was simply tucking in for what lay ahead, I figured it would be wise to make sure. I spoke to my Midwife and she said we should come in and be assessed and monitored for a bit and that she could sweep my membranes too. Not sure if a membrane sweep would push things over into real labour, we called our friend who was doing our birth photography (but didn’t have a car at the time) and said we’d be able to pick her up shortly. My in-laws had arrived at our house while we were at the carnival. We thus dropped our kids off with them, said a quick hello, and headed for the hospital an hour away.

Our midwife met us at the hospital. She assessed me, and we monitored bubs for a bit. I don’t actually remember if I was already dilated or how much if I was, but she said I was soft and certainly ready for labour. She also said that now she had us there she didn’t want us to disappear again. She performed a stretch and sweep and we made arrangements to stay overnight in town. I had some decently strong contractions start up, and was having trouble trying to fall asleep with them. I was starting to wonder if we just needed to head back to the hospital when I finally drifted off. I woke up the next morning (Saturday) with no contractions at all. We also woke up later than we’d thought as we were normally up by 7:00 or so with the kids, but without them there we had both slept in. We rushed to get ready and back to for the 9:00 am meeting we’d agreed to with the midwife to discuss what to do next.

Our midwife said she would be happy to rupture my membranes and was confident things would progress well if we went that route. I was hesitant to start that way as it was my understanding from my previous labours that once my water broke I would be “on the clock” and after somewhat arbitrary amounts of time could be pressured to allow further interventions. I was not quite fully awake and put together and didn’t express any of my concerns though. I just asked what other ways we could try kick things up a notch. Our midwife consulted with the Dr. on call (she had to as per hospital policy) and said she could order an oral dose of cytotec to start labour. When the nurse came in with the pills I remembered the contractions that I’d ended up being steamrolled with my first labour. I was tired from how long it had taken me to fall asleep, hungry from not having eaten breakfast yet, and given our haphazard and rushed morning I felt that everything was coming at me too fast. I chatted with my husband and essentially said I didn’t want to take the pills and would like to leave the hospital, collect myself, eat some breakfast, and then reconvene with the midwife. I remember saying to my husband, “Nobody is holding a gun to our heads saying we need to start labour now. A few hours isn’t going to make or break this.” When we told the nurse that we didn’t want to take the pills and wanted to leave there was some confusion when she relayed our desires to the midwife. The midwife (who was doing training in a different part of the hospital) came back and asked if it was true that we wanted to refuse care from her (essentially firing her from our labour). We assured her that was not the case and clarified what we wanted to do and she was fine with our plans and said she’d see us in a few hours. So we went downtown, met up with our photographer friend and another friend who would be supporting me during labour, and had some food. I collected myself some, and returned to the hospital much more composed and confident. Once again, while walking contractions would get strong, but once I stopped they disappeared.

When our midwife returned she again brought up that she would be happy to rupture my membranes. This time I was able to express my concerns about being “on the clock” and she assured me that wasn’t going to be the case. She said as long as baby and I were looking good then there was no need to add anything else unless it had been quite a long time and I hadn’t made any progress. I didn’t need to fear any 10 or 12 hour arbitrary timeline. I was very relieved and decided that we would just break my waters then. When she was preparing to do so, she noted that baby was still sitting high enough that there was a very real risk of prolapsing the cord if bubs wasn’t lined up right when my water broke. (We later realized this was probably why nothing would ever turn over into sustained labour. Baby was just sitting too high). The doctor on call was called in, and she stabilized my little one while my midwife broke my water. The doctor guided bubs to drop down into place, and I was safe to stand up.

And then I walked, and sat on the bed, and sat on the toilet, and made wonderful progress. I eventually got into the bathtub and laboured there a while and quite appreciated it. My husband did an awesome job of supporting me and I was so thankful for our friend who was also a terrific support. Things started to get harder and I felt shaky and ill and recognized that I was in transition. I focused on making sure the muscles in my face were and thighs were loose and used a low voice to repeat “Mooooovvee down baby.” Throughout everything from the time my water was broken I felt calm, confident, and very well supported. As I progressed through transition though things started to feel different. I couldn’t find a position that was working to manage the contractions (which were only about a 5 on a scale of 1-10 for pain). I started to feel like they were coming at me more than I could cope with. I tried to remain focused and breathe, and relax but it just wasn’t working. I broke down and said I needed a break from everything. My midwife suggested a quick acting narcotic (which I had never thought I would agree with but in the moment was fine with) and I was given a dose of fentanoyl. As the pain abated and I could reflect on things apart from the pain two things hit me. 1)I was terrified of all the sensations coming back, and 2)I remembered this terrified feeling from my last labour. With much more clarity than I probably should have had on a mind altering drug I knew that what I had been overwhelmed with was that same feeling of being violated and just trying to hold on until it was over. I had been trying not to focus on it, and hoping that I could cope better with it this go round. I had hoped that with each contraction I would get a handle on it and it would eventually go away. The feeling wasn’t going away though, it was getting stronger. I knew I did not want to go through the same emotional trauma as my previous delivery and I told my midwife I wanted to get an epidural.

My midwife was a tremendous support and she assured me I was doing well, and encouraged me to keep at it. I told her that I was serious and I wanted an epidural right away. My fentanyl was going to be wearing off shortly and I did get a bit panicked so she ordered a second shot while we sorted things out. I continued to repeat that I wanted an epidural please and thank you. My midwife took my husband out into the hall and had a chat with him. She explained her that she has had many women regret getting an epidural at this stage and that some have even “blamed” her for “letting” them get one instead of continuing to encourage them to carry on. She was concerned that I was being hit hard by transition and might regret having gotten an epidural so close to the end of everything. We had prearranged for our medical team to check with my husband if anything came up where they needed clarification on our birth plan/desires. My husband and I had talked at length about every aspect of our delivery and I figured that while I was in labour I wasn’t interested in trying to explain things to people. I also trust my husband completely and knew he would stick to what we had talked about. I am thankful that our midwife took the time to ask my husband if what I was saying lined up with our desires for this birth, and he assured the midwife that if I was insisting on an epidural I had good reason and that it would be better for me to have one than not.

I remember the midwife coming back into the room and letting me know she needed to check me to see if I was 8 centimetres or more in which case it was too late for the epidural. I said (through tears) “But you’re just going to tell me I’m 8 centimetres and that it’s too late to get one.” In hindsight, when she initially told me that I was doing so great without the epidural and could keep going I felt like she didn’t want me to have an epidural. That wasn’t the case at all, and she was doing her best to support me in what she was thinking was a moment of panic that I might regret. However, this feeling spilled over into thinking she wouldn’t be honest in telling me how far along I was, which was totally irrational. She had not given me any reason to disbelieve her character during my whole pregnancy and I felt bad for essentially accusing her of setting up to lie to me.

Labour makes a person say crazy things!

She gently disagreed with me that she would tell me exactly how far along I was and wasn’t about to make anything up. Then she checked me and said that I was just under 8 cm as I had a lip on my cervix that was keeping me from dilating further. I have not had a lip on my cervix at all in my two previous labours. I honestly believe it was the grace of God on my life that kept me from progressing further as a smidge more of dilation and I wouldn’t have been able to get an epidural. To confirm what she felt she had a nurse check me as well, and the nurse agreed that I was just under 8 cm with a lip on my cervix. The midwife thus called the anaesthesiologist and said she hoped he was able to make it soon. By that time of day the anaesthesiologist was not physically at the hospital and had to be called in to come from home, somewhere in town. I was told it could be 30-40 minutes, but in a much shorter time he was there with his wonderful caddy of needles and other stuff and I rejoiced. I sat as still as I could and tried not to think that a needle was about to puncture into my spine. He numbed my back and then I felt the pressure of a push. But then I felt the pressure of a second push a minute later. I thought to myself “He did two???”. It turns out he didn’t like how the first puncture placed so he did a second try. I had absolutely no side effects from the epidural (I had a terrible pressure headache from the one I got in my first labour) so I think he did a stellar job. Shortly thereafter the tightness and pain started to fade away and it was like I could breathe again.

I was a bit weepy right before and after the epidural.  I remember apologizing to my friends that they wouldn’t get to see a natural labour and telling them I was sorry but it wasn’t my fault and that a very bad man hurt me when I was small and I just couldn’t cope with the feelings this was bringing up from that. They were all great and as the epidural really took I got chatty about all sorts of stuff. Both during this labour and when I had my first baby once the epidural was fully working and was masking all the pain I could still feel and had control over both of my legs. I could also feel all the pressure of baby being so low, and this time I could feel the tightness of my muscles contracting.

As it were, we sat around chatting and then eventually my midwife checked me again and said I could start pushing any time. The bed was up in a seated position and I tried a push and really just felt like not much of anything happened. It didn’t feel like baby moved at all. My husband and I had talked a lot this labour about pushing in alternate positions (I had previously only ever pushed in a seated position with the back of the bed up and the bottom broken down) and I felt like it could be good to try something different. I said to my midwife “I’ve read some good stuff about pushing while kneeling. Do you think that would be a good idea”. She told me I was free to try any position I liked. So I turned around and knelt leaning against the raised head of the bed (as my epidural didn’t prevent me from moving around, thank goodness!). I tried another push and immediately knew that this one was effective. I don’t remember my total number of pushes, but I remember that it wasn’t long before bubs was crowing (My midwife said “Baby has dreadlocks, like me” and I though “Ahh, this one has a lot of hair, eh.”) and then the head was out. My midwife said to breathe a bit and try relax and not to push for a minute to let me stretch some. I remember asking my photographer to get some pics of what was happening and replying to my midwife that “I have a baby’s head sticking out of me and you want me to relax!!” but I did my best to wait a bit. And then I pushed again and bubs was out!! It was 15ish minutes from when I did the first push while kneeling to when my precious new son was on the bed between my knees. My midwife said “This kid has gotta be 5 kilos!!” I guess he was a pretty big newborn compared to the ones she typically sees. She was completely right. Later when we weighed him we learned he was exactly 11 lbs (5 kilos).

I turned around and sat down and they tried to lift him up onto my chest. His cord was pretty short though, so he would only make it up to my belly. I sat, holding him and stroking him and my whole being swelled with joy at this beautiful squalling miracle of life that was now not in my belly but on it. I remember being so happy I could have cried, and simultaneously being so so so thankful to experience that happiness. After a couple minutes the midwife said his cord had stopped pulsing so if we were okay cutting it I could pull him up further onto my chest. My husband (as with our first two babies) cut the cord and I got to hug and hold my sweet little one in a far less awkward embrace. He had meconium on him as he had pooped near the end of the delivery but he was fine and suffered no ill effects from it. I didn’t care that there was poop in his hair. I loved him, and loved that I could feel that love for him as soon as he was born. We dealt with my haemorrhaging (I haemorrhage every time), sang over our sweet baby (we always have a guitar there and songs picked out), stitched me up, and ordered pizza. It was quite the party. Bubs nursed, our friends went to get some much needed sleep, I had a glorious shower, and then we settled in to the rest of our first night with our new son.

I don’t for a second regret getting the epidural. I didn’t regret it when I asked for it, I didn’t regret it five minutes after he was born, and a year later I still don’t regret it. Unlike my first labour where I processed, grieved about, and ultimately made peace with having gotten an epidural, I have never been anything but completely okay with how this delivery went down. Because of that epidural I didn’t spend the last portion of my delivery being clawed at by deep and dark hurts. I didn’t go hollow inside while trying to hold on until everything was over. I didn’t feel ambivalence towards my precious new baby in the moments following birth because I was simply trying to collect myself while being flooded with relief that it was all over. Because of that epidural I did not feel violated and helpless. Because of that epidural I could focus on my precious new baby. I could experience joy, and happiness, and such a deep welling up of love for my husband as he looked on in wonder. I could tune into the weight of this fresh new body on my tummy, then chest. I could marvel at his uniqueness and explain to everyone in the room what his name was and why we chose it. Because of that epidural I have healed so much from the trauma that characterized my previous “ideal” natural labour.

I am not saying it is wrong to desire, or even have a natural labour. I have read a lot of research and recognize that from a purely physical health perspective it is “ideal” to have a labour free of interventions and medications if possible. I think it is sad when women have interventions that they were neither informed about nor had any say in. We hope that in the future if we have more children I will be able to overcome my scars and progress through labour without things breaking down as they have. And, if that doesn’t happen and I am overcome with hurts from my past that I have no control over, I need not carry any guild or shame for the epidural I will get again. Yes, a natural drug free labour can be ideal, but it just might not be ideal for me; an I am perfectly okay with that!  

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