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.

Ahem.

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...

...as long as y'all will still be friends with me.