© KAS 2011. K provides perspective on the vulnerability of laboring women. Before birth, women can research, plan and build a supportive team. But during birth, the other attendants can (knowingly or not) become very influential in altering the woman’s course and going against her wishes.
“My birth story of my second son:
After the intervention-filled, somewhat scarring birth of our first child, my husband and I believed we were completely on par with what we expected of the birth of our second child. I had educated myself on the concepts of natural childbirth, and although we were yet again left in the hands of an OB in a hospital that is not particularly friendly to the idea of an intervention-free birth, I was under the impression that our first experience and the information we had gleaned from the internet would be enough to secure something closer than the experience we had about two years prior.
I began to panic around five months in and hired a doula. She was the only doula in the area and ironically enough the mother of someone I went to college with back in the day. She assured me that if my goal was a birth as free as possible of interventions and medications, she would support me fully and help my husband be supportive as well.
Since my in-room support system last time had consisted of my absolutely clueless husband and my drug advocating but loved LPN mother, I was ecstatic. She and I got along famously; her dry humor and my sarcasm worked out well together. I was positive that things would go as well as possible.
Of course, as most OBs tend to go, mine was guessing weight and pushing the "induction talk" the week before I was due. Our first had been born via Pitocin and an epidural and several unpleasant doses of Nubain, so I supposed she figured that it would be a less traumatic discussion as she had overseen #1's birth and all of the interventions I experienced.
At my 39-week appointment she mentioned that she thought it looked as though an induction would be necessary, and though it was up to me of course as to how long I would wait, we would be talking about inducing the next week. I laughed it off and headed home, calling my doula on the way home and casually discussing this OB fad. This baby would come when he was good and ready.
Week 40 arrived and the day before my "due date" I headed in for yet another appointment. This time, the discussion was less talking and more telling. My beloved OB, a wonderfully understanding woman who feigned support for natural birthing as much as I suppose an OB could, informed me that my baby was likely over eight pounds, and since I had been right on the cusp of gestational diabetes my entire pregnancy, she worried that he would continue gaining weight excessively if I remained pregnant much longer.
It was, of course, she said, “my choice.” "Hardly," I thought, "it's my baby's choice!" But ideally we would schedule the induction for that night at 2AM, and if I happened to decide to not go in, I could simply call and cancel it, and not show up. Simple enough, right?
Except now this THING was lingering over my head and on my way out I called my doula in tears, completely lost as to how I had allowed my OB to walk all over me and my son that way. “I didn't want to be induced,” I sobbed, “I wanted him to be born when he was ready and without all of these drugs that had made my last labor hell.” I wanted to experience what it was like to actually go into labor and feel a real, legitimate contraction that wasn't augmented.
I wanted him to come into the world without a billion and two drugs and synthetic hormones clouding his little body. I wanted so much, and even though I knew so much thanks to my self-education, once I walked into that office it was as if I was under her control and lacked a backbone.
The worst part was my doula's reaction. "Well," she said, "it is up to you, but we need to take what she's saying into consideration." She then explained to me, as if I somehow didn't know, that my OB was a smart and respected member of the professional community, and that she had a valid point, and that my doula just didn't want to see me with a c-section, so how was I feeling right then?
I was feeling like shit.
I cried all the way home and for some time afterwards. I called my husband at work and after he came home, we discussed what had happened. He had no real advice. "You know more about all this than I do," he admitted. But he knew that something was off if I felt this badly about everything. I called my doula again and asked her what I might do to try to augment things “naturally.” I asked her if she knew of anything besides walking and sex or eggplant parm.
She mentioned castor oil and I shuddered. The reports of the awful taste and the occasional meconium-laced fluids were almost too much for me to think about right then. But I felt a sudden sense of desperation and from what I could tell, the only link in my support system, my doula, was failing me. She was supporting my OB without cause.
I knew inside that there was no reason whatsoever for me to be induced that day, or that week, or even the next week. There was no reason to doubt my body was capable of responding to my son's indications that he was ready to be born, and yet I was full of doubt and was incapable of rationalizing what I had experienced. As the hours ticked on I grew more panicked until I finally headed out to buy a small bottle of castor oil.
When I got home, I was upset and worried I felt sick. The concoction I came up with to down the half-dose of castor oil I intended on taking didn't help; it took half an hour for me to drink it, and I was sure that I would throw it all back up immediately. I mentally tried to prepare myself for what I figured would happen, which was absolutely nothing, or a horrible bout of illness that would leave me on the toilet for hours with nothing to show for it because my baby was simply not ready.
Yet it seemed that maybe luck, or fate, was on my side, as within only a few minutes of taking it I could feel the expected stomach cramping beginning. I headed to the toilet, and was surprised to find that the reaction I experienced was not as bad as I had figured it would be; I visited the bathroom only twice, and was not overwhelmed or sickened by the stuff. Instead, I found myself having fairly regular (every five minutes or so) contractions after a while, which I sped up to about every three minutes with some degree of regularity by staying on my feet. I called my doula to report this miracle of progress, and she told me that if my contractions were truly that close together, it was time to head to the hospital.
Maybe that should have been my first clue. She didn't want to come to my house to see me, or to talk to me, or see how I was doing. She didn't ask additional questions, didn't take time to find out what I wanted, and at the time none of that was information I could have thought to offer on my own, as I was only too elated to think that maybe I would be having this baby without a hospital's help. I just automatically agreed with her and we sent our firstborn off to my mother's house, packed some bags, and headed off under the impression that we were doing very well.
Once we got there, I was checked (which I didn't want) while trying to get settled in, and informed that despite my lovely contractions I was only about four centimeters and some-odd effaced - enough for them to declare that I was officially in labor, which was good, but not enough for me to feel really comfortable yet. My doula arrived, and for a while we joked around until a nurse came in and started preparing to put in an IV port. I stopped her.
"I don't need that," I confidently informed her, looking to my doula for support. She shrugged.
"Um. Yeah, well, we recommend it, because if you need anything…" the nurse began, but I cut her off.
"I won't need anything."
"Oh. Well, you might get dehydrated and need fluids, so we need to get you hooked up."
I looked at my doula. She shrugged again. I looked at my husband. He looked completely lost. I frowned.
"Please give me a minute, I need to discuss something," I said, and the nurse rolled her eyes and walked back out of the room.
I stared at my doula. I had no idea what was going on here. I had discussed this with her; it was part of my birth plan. I didn't want a heplock or IV port, nor did I want to be hooked up to any IVs. I knew that by having a heplock it would make it easier for someone to come in and hook me up to meds without me noticing, because there was a good chance I would be distracted by labor. My contractions were slowing down considerably because I was stressing out, and I could feel that sense of panic returning. It made me feel sick.
"You have to pick your battles," Doula said. I'm sure she was trying to be reassuring, but really, it felt condescending. As if I had no idea what was really going on, or what I wanted in birth. "If you let them go ahead and do this one little thing, maybe they'll leave you alone about the bigger stuff." But to me, that WAS big. It was unauthorized, unwanted access to my baby.
But things were bad enough that by that time, she had more or less talked me into agreeing to being on an external monitor for 15 minutes every hour instead of walking or sitting on my ball. Things were already going against my plans, and suddenly I saw this as though one more addition to the list of unwanted things that had happened anyway would be a very small issue.
So I gave in again.
Progress continued slowly; I got to labor in the tub in the room, but my contractions were still slow and irregular, and not what I would have called painful. Hours passed and the six centimeters I had been told I was at some time before hadn't changed. A nurse came in and informed me sweetly that my OB's student, a woman I actually quite liked and admired, would probably be coming in to break my water in the next few minutes.
I knew what that meant.
It meant no more tub, more frequent monitoring, probably no more walking. It meant more restrictions in that hospital. It meant being tied down, more things I didn't want or need, and at that I began to cry.
My husband was upset; my doula just sort of shrugged and told me that I had been stalled for a while, and maybe breaking my water would help. And, hey, it wasn't Pitocin!
I gave in to them. I felt as if all the support I thought I had with me was gone. My husband was relying on my doula's knowledge and my own broken sense of self to see if things were going in the right direction, and I was no longer able to make decent decisions for myself.
My water was broken and within minutes of pushing and poking around I was informed that actually, my son was maybe a little far up still, farther than they had thought, and was face up, too. This, obviously, explained why my contractions were irregular and not as strong as they would have liked, because he was improperly positioned and thus not putting enough pressure on my cervix, said a nurse a little too cheerfully. But I was not to worry, because if breaking my water didn't help they could just start me on a little Pitocin!
It was over, then, and I knew it. The monitoring was more constant, the nurses more pushy about it. My doula tried some pressure points to pick up my contractions, and they worked for a bit, but not long enough. My actual OB came in, told me she ordered Pitocin, it would be in soon and I'd be hooked up to it. There was no question, no permission asked. It was against what I had wanted, she acknowledged, but sometimes things just didn't work out that way. I just kind of nodded, too numb to think anything. My husband tried to get some sleep and I was hooked up to the Pitocin.
The lingering, more substantial ache that the pit caused was horrible and familiar. As though trying to encourage me that I had somehow "made the right choice" (as if I had a choice), the nurses acted delighted at the change in the strength and regularity of my contractions. They told me that things looked much better, and I just sort of sat there and dealt with the extreme difference in pain.
I was no longer allowed to move around, and could only sit up in bed and change positions in a limited fashion. I was on monitoring constantly, which added to my discomfort, and my doula seemed to be totally unconcerned. It would be okay, she affirmed, because I had done so well so far, and just because I had Pitocin didn't mean I had to have anything else, right?
More time passed. I progressed quickly, heading from six to nine within about an hour and a half, but the pain was excruciating. I had asked at one point if it could be turned up slowly, or turned off once labor had begun again on its own, but was informed that they weren't turning it up any faster than they normally would (bull), and that if they stopped the Pitocin I would probably just stop having contractions again, so it wasn't worth it, and no, the Pitocin would not be turned off once it was started.
I wanted to scream by that point, aware without being checked thanks to the discomfort and nausea that I had briefly experienced that I had passed transition. I hurt, and the contractions were one on top of the other constantly, yet I was being given orders and told to move here and position myself this way and did they have permission to do this or that? All I wanted to do was cry.
The urge to push came quickly, and without warning. I tried to tell everyone what I was feeling, and the complete inability I had to control it as I was told to not push. Why the hell couldn't I push, I demanded. I wanted to push. I needed to push It wasn't an option; the Pitocin was doing things to my body that it was not meant to do, and I wasn't in control anymore.
The drugs were, my caregivers were, and my pleas for the Pitocin to be turned off or down again were ignored completely as they just yelled at me to stop pushing, saying he was improperly positioned, pushing wouldn't do any good. I screamed and cried for someone to do something, anything, and my OB simply said, "We can still do an epidural right now."
My doula started to speak up, but I silenced her. I was done, and couldn't function well enough to start to think. I begged them to hurry, pleaded with them, told them that I knew I couldn't stop pushing. I felt as though I had lost myself in a bad way, in a haze of drugs. The order was given and the anesthesiologist arrived within ten minutes, at which point I was wishing I could just die instead of having to experience the horrific pain and terror I felt. But it wouldn't stop.
I was told to sit up, and forced into that awful hunched-over position as I fought tears and the single long, continuing contraction the Pitocin had caused. I couldn't stay in the right place, couldn't hold still because despite all that I was still trying to push. By some miracle, the poor guy managed to get the epidural in without damaging himself, or me and the physical relief was considerable and almost immediate.
But the sudden ability to think clearly without being in the horrific pain I was in didn't help my mind. I was still broken, still felt as though I had failed my son and myself. I had no support, no encouragement, and I had been bullied into every intervention I had wanted to avoid. I had felt more pain and fear than was ever necessary, had been literally scared of my body and my caregivers, and was scared to speak up again for anything. I had been offered little more than ice to suck on, felt like a failure, and had actually wished death on myself without concern for my child because of what I had been through. And it wasn’t even over yet.
Within minutes I was again pushing, but with control. Positioning tried earlier in labor had done no good for getting the baby to flip over, and though I had experienced absolutely no back labor whatsoever, he was still posterior. After a first-degree tear, half an hour of pushing, and a total of 24 or so hours of labor, my second child was born with his cord wrapped around his neck twice. To me, this explained why he had never turned over - perhaps in doing so, he had saved his own life as perhaps he was keeping the cord from becoming compressed. His APGARs were good.
Yet breastfeeding was still a struggle and I still feel like a failure and am afraid, in a few ways, of being pregnant again and having another child in a hospital. I know my story is not unique, and that others have experienced worse by far, but to me the term "traumatic birth" is what I would unquestionably call my second child's birth. No mother should still worry and fear and feel inadequate nearly two years later. But I do."