Friday, January 28, 2011

A Confession, A Rant, and The Rest

I keep thinking that if I wait, all these things in my head will coalesce into a real post, but it isn't happening. So here comes a big mess. If you'd prefer not to see a bunch of mental clutter, here is an alternate post for you:

What should we be registering for that we've forgotten? Discuss.

Still here?

Okay then.

First, the confession part. It concerns birth stories. Yours and yours and yours and probably yours, too. Your amazing, beautiful, dramatic, powerful birth stories that you put so much care into and that I never comment on, even though I read them again and again and again. Even though I can see page after page of comments making it perfectly clear that all I have to do is say, "Amazing! Beautiful! Congratulations! Thank you!" and my work will be done, I don't write a thing and (if you think about it at all) you must assume I don't read them, since half the time I'm writing a novel in your comment box. I hope that doesn't hurt your feelings.

The truth is that I don't comment because your stories scare the ever-loving crap out of me. Half the time I have to have a little meltdown after reading them. The other half the time, I have the meltdown while reading them, to save time. I know enough to know that I shouldn't say *that* in your comment box -- I am hopelessly self-centered, but I am aware, in a conceptual way, of manners -- and for some reason I can't bring myself to say anything else.

So now you know. I read your story -- and yours and yours and yours -- probably more than once. And I was glad it was there to read, because I am an emotional over-packer, and I know that stories help me. So please accept my inadequate thanks for writing yours.

Two, the rant part.

Dr. Sears, please go fuck yourself sideways on something pointy.


Maybe I should start by talking about Wednesday's birth class instead. This week was "Interventions and Things that Can Go Wrong," and I have never been happier that we picked this class over the others we were considering. Although most of the class (at least the ones that talk about it) seem to be planning for unmedicated births -- at least half of them in the local birth center rather than a hospital -- and although the previous three classes have been all about non-medical ways to deal with contractions and so forth, both teachers were calm and even-handed when talking about monitors and epidurals and all that. One even went so far as to suggest that even though lots of people love The Business of Being Born, that possibly it had gone a tad far in its excoriation of pitocin. [Holy Moly -- I just went to youtube and watched that part, since I've never seen the movie. Heart now racing. Talk about your scare tactics! What the hell is up with that cartoon?] Our favorite teacher talked about a patient of hers who had apologized to her when requesting an epidural and told us in no uncertain terms that she did not disapprove of that decision. The only editorializing -- and it was announced as such -- was a plea to please not ask for an induction for a frivolous reason, which seems pretty sound.

When we were shopping around for birth classes, I wrote to various teachers and explained that, due to the double-cervix situation, I am at a higher-than-average risk of needing a c-section, and that it was important to me not to set myself up to think of a vaginal birth as successful and a c-section as a failure. One of the major reasons we chose this class is because I felt good about the teacher's response, and last night bore that out. The whole course has been about letting your body do its thing, asking doctors and midwives for all the options, etc. Our classmates are not the elective c-section type -- if they were, they wouldn't be in this particular class. But who can predict what will happen in labor? I loved that the screen of notes on c-sections began with "C-Section: An amazing, life-saving procedure" (or words to that effect).

None of that stopped me from weeping through the discussion of how emergency c-sections worked, of course. Possibly I have a little hangover from all the furious speed of egg retrieval day. We learned that, in the event of an emergency, the surgical team would work efficiently and fast, "just like NASCAR." I can only hope the OR isn't covered in logos for Laughing Clown Malt Liquor.

The whole evening, I was impressed with how calm and open the teachers were, talking about things that probably weren't on their ideal birth list when they decided to become midwives. I'm sure they knew that the Other Pregnant Lesbian and I have been comparing notes on epidural policies at the hospital we're both going to, because I have a nasty habit of being that person still shouting as the room goes quiet after break, but neither had anything especially bad to say about epidurals during that section of the class. They passed around an epidural catheter so we could see how slender it is and explained how to keep changing positions even with one in. It's almost as if they meant it when their response to my email said their goal was,
"to offer childbirth education that focuses on making your birth experience a satisfying and joyful entrance into parenthood, no matter what twists and turns and challenges you face, no matter what your personal desires and goals."
Go figure.

And then there's Dr. Sears.

An old friend sent us a box of baby-related hand-me-downs recently, including the Sears' Pregnancy and Birth books. I tend to agree with Dr. Sears on about 80-90% of things, and find the other 10-20% hopelessly nutso, but I decided to take a look. In a bookshop, early in the pregnancy, I'd been very impressed with how calmly and thoroughly he dealt with first trimester bleeding -- most books just say "well, it might not be a miscarriage, but PROBABLY IT IS" which is silly considering how common it is -- and rather turned off by his section on weight gain, which took the usual tack of assuming you are just itching for an excuse to become morbidly obese and added the nicely tuned guilt trip of "plus you are making your baby fat, you lazy cow." But free is free, so what the heck. I turned to the birth stories section.

The stories themselves are what they are. Only one of them makes me actively gaggy. It is an induction story, and the second paragraph begins, "Dad likes having a baby this way." (I'm all for having both partners involved and everything, but I've already told Sugar that any statements like that of the father Dr. Sears praises for saying "we had a vaginal exam" are...unwelcome. Unless she's up for hopping in the stirrups alongside me for moral support.) Okay, I also want to do a consciousness-raising session with the author of "I Witnessed Myself Become A Woman -- VBAC Water Birth," but whatever.

Dr. Sears is a proponent of "natural" childbirth, by which he means no drugs. (I hate that term, personally -- it's a bit of an emotionally loaded dichotomy for my taste -- but whatever.) I'm a proponent of letting women decide for themselves what they do and don't want to be part of their birth. This is where we diverge. I expected that, but I didn't expect quite the level of paternalistic bullshit found in the commentary on the birth story of the Woman Who Dared Ask For An Epidural.

"A Medically Managed Birth" is about a woman whose doctor tells her to go the hospital when her water breaks. Ten hours later, she gets some pitocin. Some time after that, things get intense and painful, and she starts to feel hopeless. She can't concentrate on the baby, only the next contraction. She requests and gets an epidural, feels confident again, promptly dilates to 10, pushes the baby out -- able to concentrate on it again, rather than pain -- and feels happy about it.

How dare she! Incredulous, Dr. Sears, et al., "interviewed her about whether or not this style of birth ["American"] left her "less fulfilled" as a woman." Rude much? She says no, on the contrary, she feels great about it. "
There was no doubt in her mind that she gave birth, and the fact that she didn't experience the intense sensation of a drug-free birth did not lessen her fulfillment."
Mother gives birth to healthy baby, isn't hung up about it; everybody wins, right? Wrong. Dr. Sears goes on to remind us that she didn't have the chance to have natural, gradual contractions -- okay, fair enough. Everyone says pitocin sucks like that. It's the closing that pisses me off:
"We wonder whether her Lamaze instructor mentioned the importance of taking the contractions one at a time [...] thinking of the baby, not the next contraction."

I'm going to go out on a limb and guess the instructor did mention that, since the mother mentions the loss of her ability to do that after...chronology is a little unclear, but at least 12 hours, probably quite a bit longer. Maybe, just maybe, she was trying to do that and it was too damn hard. So she should have what, tried harder? What is the big fucking problem with an adult making a decision to use a very safe drug to lessen pain? Labor pain may be "pain with a purpose" or whatever, but so is the pain of passing a kidney stone, and no one talks about how virtuous people enjoy that.

I in no way mean to denigrate women who choose to give birth without painkillers. I really, really don't. But I think that the important thing is that the laboring woman -- not some moralizing jackass judging her story later -- makes that decision. There's so much B.S. out there about epidurals -- most of which was either never true or hasn't been true in 25 years -- that the last thing I consider acceptable is telling a woman with no negative feelings about how her birth went down that she should feel bad.

You are all such clever people that you no doubt figured out 20,000 words ago what this post is really about: my fear that you'll think less of me if/when I get an epidural. Even that "if" was a pretty big lie -- birth is unpredictable, but the epi is in the plan, for sure. I've done my research, and I feel good about it from a scientific perspective: one reason I'm happy we're going to Kips Bay Mega Hospital is that their epi policies are excellent. (OB anesthesiologist on 24/7. Standard use is light-dose, patient-controlled, which all the studies agree is the way to go in terms of pain relief and side effects if you have the staff. The intent at least is to keep the dose light enough that patients can go to the bathroom themselves. No "window" -- you can have one whenever you want and the OB thinks is okay; Dr. Russian says I can have one now as far as she's concerned.) If the cervices don't behave and I need a c-section, I'd just as soon already have the epi in, and if not, I'd rather not be feeling every bit of my septum breaking, which it may well. Even without those special circumstances, useful as they are for shutting down any "your birth will be fine because mine was" stuff, I think I'd be leaning this way. I've experienced plenty of severe pain in my life, what with the migraines and the endo/GI situation, and I haven't noticed anyone giving me a medal for the times I've done so without painkillers. Other people have had worse pain than I have and make other decisions; that's okay. I'm okay with being a wimp on this one... long as y'all will still be friends with me.


  1. Holy mother-loving hell. I was reading along, nodding about how people are too judgmental about epidurals and actually if you need one you need one. And then I got to the part about your septum breaking and I almost passed out on your behalf. Get an epidural. And a couple margaritas. And probably some sort of anti-nausea drug. And if anyone gives you any shit about needing any of that you can explain in gruesome detail and ask if they'd put up with that drug-free. Just prepare to catch them on the way down.

  2. It's all about what works for you. Pro-choice when it comes to birthing. Good for you for doing your research and coming to a plan that works for you. <3

  3. I am totally 100% with you, and even though it was my intention to have an unmedicated birth, I was surprised by the level of judginess in my class about interventions, even when the instructor obviously tried to have an even tone about it. I think the BOBB (which I typoed as BOOB-- go figure) was a LOT of scare talk and propaganda. It scared the hell out of me for sure.

    The whole process is so rife with judgment and emotion, I am not surprised that you have such strong feelings about it. You should have a birth you can feel good about, and not one that leaves you traumatized with pain and horror. It sounds like you are finding the way to do just that.


  4. Oh gosh, and on the registry bit...I have found baby washcloths extremely useful for everything from diaper wipes to spit up cloths. I am happy to give you more suggestions via email if you want. Since we're living with the same urban space constraints I can definitely offer thoughts with that in mind.

  5. Can you register for liquor? And earplugs. Because no matter how much you will adore your child...

    It's funny, I actually get annoyed at the "breast is best and UNNATURAL childbirth is evil" people (were there artificial wombs involved? because pregnancy is pretty uncomfortable). I think doctors tend to push unnecessary treatments and/or fail to support other options. But personally, I fall more towards wishing they'd say "Can I set up an appointment with the lactation consultant" rather than "Your (otherwise normal and healthy) baby will die if you don't give formula TODAY". Or, you know, having stupid no-eating policies which make people exhausted during labor. And so on. But absolutely, c-sections are wonderful, life-saving procedures (though I have a hard time believing they're medically necessary 30% of the time!!!) and epidurals for excruciating pain are absolutely wonderful, especially if they help you avoid major surgery (which is still wonderful if you really need it) and if you end up needing a c-section, well, you will know that you made an informed choice and considered both your wonky anatomy AND your various options very carefully.

    There's no medal for being in pain, and I don't think it's particularly enlightening to suffer.

    In other words, what the fuck ever.

    (P.S. Bug was born at a birth center full of hippy-dippy, acupuncture-and-chi midwives, and I TOTALLY would have gotten an epidural had I not been there. Labor was fucking painful. But it was too long a ride to the hospital, i.e. 15 minutes, and I was busy, y'know.)

  6. Seriously dude, if anyone gives you a hard time about getting an epidural or whatever the hell else you want to do while YOU are in labor birthing YOUR child, tell me. I'll get all half-Sicilian-Native-New-Yorker on their ass. For reals.

  7. Pfft. Save some angst for after the kid is here, friend. As long as the baby makes it out of your body in a manner that is safe for both of you I'll be nothing but thrilled, and I say that as someone who's done it with and without the drugs and can argue both sides of that particular coin. I think it sounds like you're making sound choices based on the known variables and hope you'll keep on doing what makes the most sense for you :)

  8. We have our first birth class this week and I'm really hoping (esp b/c it's for multiples) that the instructors are as open-minded as yours have been. I would like to do a vag-birth, but a c-section is likely in my future. And I am okay with that, I just want the babies to be healthy!!! And you know what? Even if there was only one baby in there, I would be all about the epidural and whatever pain meds the doctors recommended for the safest, best birth possible. Suck it, Dr. Sears.

    Also, birth stories really elevate my heart rate, too!! xo

  9. Your birth is your birth. And everyone has a different level of pain tolerance, and really, you SHOULD enjoy bringing your baby into the world as much as possible. So you do what it takes. No judgement here. Seriously. And you've certainly got some possible complications there!

    As for birth classes, yours sounds fantastic. We haven't even signed up yet...somehow I keep putting it off, and now I don't know what's going on with me, so ... we shall see!

    Good luck, sweetie. You are going to do what is right for you, and that's the most important part.

  10. Ok, so we were all set to do a magical, unmedicated, natural and all that jazz birth. We took Bradley classes for two months. We scoffed at the idea of epidurals and drugs. We were pumped and knew she could do it. Our Bradley instructor told us point blank that forceps deliveries would harm the baby and mother and vacuum deliveries caused babies to have a much higher chance of committing suicide later in life. No joke, she said that to our class.

    So when Nutella started having contractions, we waited and labored at home as calmly as possible, waiting 24 hours until they were the requisite 3-5 minutes apart before heading to the birth center. And then they checked her- 3 cm. And she labored all through the night and then they checked her- 4 cm. 30 hours of labor...hardly any progress. What the hell happened to the beauty and perfection of our natural Bradley birth? We transferred to the hospital. IV, monitors. Got a narcotic to help with the pain and help her sleep. Hours later they checked her again- 4 cm. 36 hours of labor and still stuck. Got pitocin and it finally got things moving. Got the epidural because the contractions were so strong and she was so exhausted. 45 hours of labor and she was at 10cm and ready to push. And the baby was stuck. 3 hours of pushing and a vacuum delivery was necessary to get the kid out. And it worked. And now I have to fear that he might kill himself one day because of how we was delivered? Fuck that.

    I didn't write this to scare you (and I probably did, I'm so sorry). I write this to say in hindsight, which is impossible, we would've done things differently. Would've gotten pitocin and the epidural way sooner. And there is no way in hell I judge anyone for doing that now. You just never know how it's going to be. No judgment from me on anything really- it's your body, your birth, your decisions. Do what you have to do and don't take crap from anyone.

  11. I'll only be friends with you if you pull off giving birth squatting by a juniper bush under the full moon, surrounded by a loving circle of womyn born womyn, who will joyously witness your earth-shattering orgasm as you breathe, *not* push, your baby out.

    And then you'll have to build a fire right then and there without matches, because they are a tool of the patriarchy, so you can cook and eat your placenta while settling your baby on your life-giving breast with an instinctive, perfect latch.

    Don't forget to share that tasty placenta with all the supportive womyn born womyn who encircled you during Your Journey. Selfishness is a tool of the patriarchy.

  12. [Ha ha! Ah, starrhill girl.]

    I have massive sympathy - childbirth is scary. Do what is best for you, Bionic, simply that. Be well.


  13. Having had twins via c-section, i was sufficiently scared by other twin mommas who'd delivered one twin vaginally and then had to c-section the other. Do I feel like I didn't have a birth that empowered me or made me feel like a real woman? Hell no. Good God, we have our whole lives to question our decision making abilities as parents, this one is simply about what gets baby here safely for ALL involved. Anyone who thinks less of you for c-section or epidural or whatever (breast/bottle, cloth/dispos) doesn't deserve the beauty of your friendship.

  14. I'm having a c-section with no anesthesia, just maybe a little light hypnosis. Pain is in the mind. So I totally think you're a big sissy.

    Birth is terrifying, and having super strong convictions about what it's going to be like (and what you will and will not do) seems like a recipe for disappointment. You seem to be going about the planning just right.

  15. I think birthing must be your very own experience so if you ask for an epi I think it's great.

  16. I used to be a natural birth proponent big-time, even left working L & D because of the propaganda. Though I never berated anyone for wanting pain relief. Ended up needing an induction, getting an epi after 24 hours (I have scoliosis, my back and pelvis are crooked, and my son was posterior and never made it into my pelvis). I wouldn't call my birth story average by any means, mostly because my body is not average- and my son's pickle was a small percentages kind of thing. And your body is not average either, though it's doing its current job just fine. A section was not the most fantastic thing in the world, but it wasn't the worst. However that kid comes out, it's still you giving birth, and still your own special story. And having had chronic pain for 18 years, I assure you, my cojones are not bigger than someone else's just because quite a few of those I avoided pain relief. An epi is safe, and pit is not the worst thing ever. And it is unfair to say "all docs push unnecessary interventions". I've worked with good and bad. If you have trust in your doc, please don't be swayed by birth crazies. In ICU, there is a lot of controversy on how and when to wean someone off a ventilator- but no one gets their knickers in a knot and accuses all critical care docs of keeping you on a vent to get to the gold course.

  17. i think it's hard to comment on other peoples birth stories - be they good or bad or whatever. i always did the same - read along but never commented. When i was writing my own birth story i wondered if i should even post it. but i did. for me more than anything else. you will have your story and however it writes itself it will be amazing. and breath taking. and perfect. and all yours.
    i went in with the plan to have the wigglers however they saw fit and to listen to the doctors and nurses along the way (so long as they were saying something good or at least comical). epidural - for me, um hell yeah. best thing ever for me (and it worked out since i ended up having a c-section anyway and no not because i was induced business of being born folks). you do what you need to do for you. and the babe. and it will all work out.

  18. The thing that nobody tells you about giving birth with an epidural (or, in my case, being denied an epidural, so giving birth without one after begging for one), is that in addition to dulling the pain, the epidural also totally erases any weird psychological hangups that one might have about epidurals. They actually rock, as it turns out. It's just a well-kept secret. So my take on this is that not only do you not have to worry about whether we'll think less of you if you have one, you don't even have to worry about whether YOU will think less of you if you have one. We won't, and you won't either. Just get the baby out with a minimum of damage to everyone, whether that operation involves a band of angels singing "kumbaya," or McGyver with a screwdriver, a straw, and a bottle of vodka. It's all good.

  19. No judgement from here! You are the best person to manage your own pain and to decide on your medical treatment. I think it is great if you are able to make those decisions without fear forcing your hand, but that is much easier said than done. The fact that you are doing this with (very affectionately termed) non-standard anatomy means that you have all the more reason to listen to your body & instincts rather than various 'experts'.

    My guess is that the intensity of the experience (whichever way the baby comes out) will completely blow any concerns about what other people think out of the water. Sending lots of good vibes your way.

  20. See -- All this is why I leave the birthing to you! You're braver than I would ever be and besides, I couldn't go weeks without a live sighting of my ankles.

  21. My feeling is that the people who would judge me for making whatever decision I need to make are either a) People who have no right to make a judgement about my body/experience or b) me/'the dark side'-because it's always easiest to torture ourselves and question ourselves about doing 'the right thing.' In both cases, you are better off listening to those voices that support you and your deep-down knowledge of what is right for your body. You will do what you need to do when the time comes and you are brave either way!

  22. Oh, I am sooooo behind in my blog reading. WOW! You're almost there. So exciting, and I know it's scary. Did you read my birth story? I had pitocin, an epidural, and a c-section. And really, my birth experience was beautiful. I was never in terrible pain, I wasn't insanely exhausted from laboring forever in an attempt to avoid the c-section, and my daughter howled with healthy indignation when the OB removed her from her warm, dark home of so many months. She was in my arms within 5 minutes and was nursing within a half hour. Healthy baby and mama. That's what matters in my book!

  23. One of my friends, when speaking about Dr. Sears, always says "Dr. Sears and his long-suffering wife", which cracks me up. Maybe it's because I had twins, but almost all of his advice was either inapplicable or impossible unless I never, ever slept again and died for the matyrdom of my children. So I totally understand your feelings about him :)