You Know the Meaning of the Word

Posted in PTSD, birth, birth trauma, natural child birth on 04/10/2009 08:56 pm by ladyleslie

I’ve been taking a lot of time to process this, and I wanted to share something with you. I wanted to let you know that I have never complained about and will never complain about the pain of childbirth.

There are plenty of reasons, of course. When I was laboring at home, in and out of the pool, I didn’t experience anything more painful than period cramps. The natural sensation of laboring is much more intense than period cramps, but I didn’t experience any pain worse than those I’d experienced before on a monthly basis.

Some women labor very painfully, and I acknowledge that. I’m not diminishing your experience if you had an extremely painful childbirth. I’m just saying that my birth experience has never been about pain.

That is a good reason not to complain about the pain of labor, but that is not the reason I choose conscientiously to abstain from that verbal jockeying.

Labor and “contractions” can actually be wonderful sensations. If a woman is supported physically, mentally, and emotionally, labor can feel like rushes and expansions. Labor can be pleasurable, interesting, empowering, satisfying, and, for some women, orgasmic. Knowing that I could have tried to re-frame my experience to be “a most interesting sensation to which I owe my full attention” as Ina May Gaskin suggests, is a good enough reason to avoid complaining about the “pain” of childbirth. Again, that is not my reason.

The fear and terror that our culture has instilled in us regarding the pain of childbirth NEEDS to be addressed. Grantly Dick-Read found the social expectation of pain during labor to be a self-fulfilling prophecy. Uneducated women associated with the poor classes during his time showed him that childbirth can be matter-of-fact, calm, and safer without an overwhelming fear which, according to Dick-Read, has negative physiological effects which cause and reinforce pain in the uterus.  The upper class women “knew” that childbirth hurt and that they were ill suited to the activity on the merit of their delicacy.  Unsurprisingly, Dick-Read’s observations showed upper class women in hysterics and great amounts of resulting pain, often needing chloroform.

Reassuring young women (and actually ANYONE) that labor does not have to be mindlessly painful and frightening is a worthy cause, but it is not the reason I will never complain about the pain of childbirth.

Complaint itself is a negative form of communication, but it’s a time-honored tradition.  How else would we let off some steam, tell our best friends about our frustrations, or get to hear how ridiculous our own complaints are once they are voiced?  Sometimes complaining is the beginning of necessary change.  Unfortunately, complaint is addictive and oftentimes just reinforces the negative thought patterns, excacerbates the situation, and lets us goad ourselves into acting in unwise ways.

Is it a distinction of classification that I am making when I say that I will never complain about the pain of childbirth?  Unfortunately, I wish that were true, but it is not.  I want the right to complain about childbirth if I so choose.  I’m not saying that I just don’t like to complain.

I will never complain about the pain of childbirth — Are you ready? — because it was STOLEN from me.

That’s right.  Someone took that option from me.  Everything was fine and dandy when we transferred.  Then things started happening, spiraling out of control.  It’s true that I made the call to start the Pitocin on the advice of my midwife.  It was my choice, and thus I have never regretted it or had nightmares about it.

We went in to the hospital, having labored for days, and my midwife was met with such hostility and suspicion that she broke our signed contract and left the hospital instead of supporting me as a doula in that setting.  She advised me not to allow the observation period and to ask for the Pitocin as soon as possible.

The nurse who was assigned to us was heavily pregnant herself.  She was kind and chatty, and absolutely amazed at how well I handled contractions as far along as I was.  She couldn’t believe how my husband and I held hands, looked into each other’s eyes, and breathed through each contraction.  She asked if we had taken classes or something.  In almost the same breath she’d used to praise my ability to cope, she began to sing the praises of epidurals.  She said, “I would never go through this without an epidural.  Lots of women come to the hospital wanting a natural birth, but they’re so glad to have the epidural when it gets bad.  Sometimes it’s too late to get it, or we have to hunt the doctor down to write up the script and that takes too long.  Why don’t I just have him write it up now, so you can have it immediately when you need it?”

I just nodded at her and let her do what she wanted.  It was easier than arguing with her.  In fact, before my midwife left, the last advice she gave me was to ask for an epidural.  I just nodded at her too.  I think she was more frightened at that point than I was, and NO WAY IN HELL was I getting a needle shoved into my back.  I was in labor, and thus unable to verbalize my extreme aversion to pain “relief.”  It didn’t seem to matter then, because I knew that I wasn’t going to ask for an epidural.

I appreciate the sensations which occur in my body.  I have never just sought to escape from the useful feedback of my sensory network.  I do not take pain pills for headaches, cramps, or anything.  I work through it.  I love my body, care for the temple which houses my soul, and (like a mother who understands that her baby’s crying has significance) attend my body’s needs, using the information that pain provides.  I believe that I have a healthy relationship to my body and the idea of pain.

It is my right to say no to an epidural.  It is my right to say no to sex.  It is my right to say no to anything that anyone wants to do to me.  I am my own person.  As I respect myself and others, so should they respect themselves and me.  I have as much right to say no to pain relief as you have right to ask for yours.  To believe that my “no” means less than your “yes” is a gross injustice.

While I labored at home, I felt nothing worse than period cramps.  When I got to the hospital, the nurse was AMAZED at how well I coped.  My answer to that is that I didn’t have much to cope with.  I was laboring naturally, except for the long delay in progress.  I asked for the Pitocin drip, and I still felt at least a little in control of the situation.

As the drip was started in my IV, I turned to the nurse and said, “I’ve read that Pitocin contractions are much more painful than normal labor contractions?  Is that true?”  She couldn’t answer me, and in hindsight, I realize that she probably did not know the answer to that question.  She had likely never seen a woman labor without Pit streaming through her veins.  It took a little while, but my body answered my question.  Pitocin contractions have nothing to do with labor.

Pitocin is not a natural product in your body.  Your brain cannot regulate the levels of Pitocin in your body, as it can oxytocin.  Yes, it hurts more.  It hurts worse.  There’s a huge difference between a good kind of pain, like the burn and tingle associated with exercise, and bad pain, like when someone is enraged and hitting you with a baseball bat.  Normal labor is like an orchestrated crescendo, each wave cresting and receding, all leading up to a peak when you crown and birth.  I had experienced labor that made sense, and pitocin was like being elbowed in the face in a mosh pit.

Let’s make this clear.  I owned this pain.  I am not complaining about it.  I am explaining, as clearly as I can, the difference between laboring naturally and laboring augmented with Pitocin as I experienced it.  Pitocin contractions were one on top of the next, sometimes there would be a small rest, then three contractions all on top of one another.  There was no time to get a breath.  There was no resting and getting ready for the next wave.  There was no use in breathing, holding hands, or eye contact.  There was nothing but force upon force.

I had asked for Pitocin, but I didn’t know at the time that I could have asked them to start it, then lower the levels to see if my labor could pick up on it’s own.  I wasn’t prepared to deal with the beauracracy and hardships associated with being “allowed” to walk around, or get into other positions to labor, so the pain was intensified by lithotomy position.  I lay on my back, tied down with fetal monitors, rolling back and forth and writhing like an over-turned turtle.

I had back labor.  The nurse and my mother took turns applying pressure on my back, and I thanked them.  I don’t remember if I was making noises, or how I was dealing with those contractions, but I did NOT want an epidural.  My mother and the nurse started trying to talk me into an one.  The doctor’s order was already written up.  All I had to do was say the word, and someone would come shove a needle into my spine to thread a plastic tube of numbing solution into my dural tube.

Who would this have helped, I wonder?  Me, who was just focused on the moment, living second by second, vocalizing naturally as an aid (the only one at my disposal) to labor . . . or the two women who were getting more and more stressed out by their lack of control over the situation?  One, a mother who doesn’t know the first thing about being a birth assistant, and the other a nurse used to an almost 100 percent epidural rate in the women she is paid to attend?

They started rationalizing.  They asked me why I didn’t want an epidural.  The nurse said it was safe, normal.  It would help.  My mom was saying, “You can’t do this any more!  You’re too tired!  You won’t be able to push when the time comes!”  The nurse interjected that there were other alternatives like IV pain medications.  She started spouting technical information about how safe and wonderful, etc.  My mom began yelling at me again.

My poor shell-shocked husband had been sent to the couch to sleep, and after a period of several consecutive days up, he slept like the dead.  I sweated and moaned through Pitocin-augmented back labor, twisting the sheets with my legs as I tried to find a comfortable position, and their voices continued.  My mother became increasingly desperate, and the nurse stuck close with quietly voiced suggestions.

I kept shaking trying to ignore them.  Then I started to shake my head, no.  Then I started to SAY, “No.”  And I had to keep saying it.  Even as the senseless onslaught of synthetic hormone caused my uterus to contract painfully over and over without rest, battering my poor unborn child, I had to keep saying, “No!”

Fentanyl. It’s harmless.  A step down from an epidural.  Do it.  You can’t any more.  You can do this anymore.  You’re too tired.  You’re in too much pain.  You will be too tired to push.  To be fair, the nurse had brought up the suggestion of the Fentanyl, but my mother was the cheerleader determined to bring the suggestion home.  The nurse watched as my mother continued to harangue me into submission.

I remember her screaming in my face, and I interruped her by saying, “I DON’T WANT IT –” and she interrupted me again.  “– BUT!  But, I’ll DO IT.  Just stop screaming!  I’ll take it!”

I gave in.

I had so carefully prepared the way for my child.  I thoroughly researched birth and birth interventions.  I had chosen Pitocin with a clear conscience, having researched it.  I knew what Pitocin was, what it could do, and how it worked.  As a college grad with a passion for biology and health issues, I had absorbed a good deal of information about birth.

Fentanyl was not on the list.  Neither was violation of informed consent or how to counter coercion techniques used on a laboring woman.  It’s something so very simple, isn’t it?  You know the meaning of the word.  Am I talking about the word “pain?”  Guess again.

I’m talking about the word, “No.”

I will never complain about the pain of childbirth because it was stolen from me.  I don’t remember much after that moment of capitulation.  The world becomes hazy.  I lose time.  Someone took my glasses.  Upped levels on Pit.  Topped off my Fentanyl.  I have nightmares in which I ask my mommy to tell them that “It’s wearing off . . .” and I can feel the pain coming back, and I get sick and disgusted with myself.

Every time I read a certain book with my son, and we hit the page “I’m as weak as a kitten.”  . . . that’s what I think about.  Me, tied to a hospital bed, weak as a kitten, mewling for more IV pain relief so that my mommy can save me again.  I’m sure she loved being the savior.  Did I imagine these scenarios?  I don’t know.  I NEVER want to ask, because I’m afraid that they’re true.  The world faded away, and I lost myself.

All of a sudden, it was time to push.  (In fact, many hours had passed before he crowned.)  Welcome to the world, dear son.  Your mother was drugged against her will, but she probably liked it and needed it.  The nurse thought so, and so did your grandma.  You were born with your mother’s blood pouring over your crown from her episiotomy (another procedure to which she did not consent).

I could have had a good birth.  I DID have a good birth, at least the first part.  It wasn’t spectacular, but up until the point that certain individuals failed to respect my right to say no, it wasn’t anything I would have had nightmares about.  I have no intrusive memories of laboring at home, or being admitted to the hospital, or saying good bye to my midwife.

Beginning after a honeymoon period of a few months, I had flashbacks, couldn’t relax, startled way too easily, insomnia, and volleyed back and forth between extreme obsession and extreme aversion to all things birth related.  Added to the struggle of being a new mother was the struggle of being a survivor.  A week living like a ghost at the mercy of the NICU, waiting and waiting to finally meet my son could only solidify the Stockholm Syndrome.

I became a traitor to everything I knew.  Only hours after the birth, I cried and shook hands with the neonatologist my mother said saved my baby.  He scolded me for attempting a home birth, and asked “What were you thinking?” in a South African accent, his dark face hovering in my hazy memories, the remembrance of a stranger staring at me as I pushed my son into the world amidst raised voices.  I cried on his hands as I shook them.

I deferred to the doctors, the nurses, and the system to such an extreme degree that I didn’t even THINK to ask to hold my son.  I just visited him endlessly at his little plastic incubator and dared only to touch him the way the nurses instructed us.  On the third day of his life, while I sat there looking at him, a NICU nurse asked, “Oh, have you held him yet?” as if it were an after-thought! I just shook my head no, and she scooped him up carefully, wires and all, and placed him into my arms, a moment that I will never forget.

So, I have not complained about the pain of childbirth.  Unless I earn the right to complain or abstain from complaint by trial of labor, I can not complain about the pain of childbirth because someone took my choice away.  I experienced pain during my labor.  Then I experienced an artificial pain on top of that.

My RIGHT TO CHOOSE was taken from me . . . and because of that, I cannot ever complain about the pain of labor.  I can’t claim to know what it truly feels like to birth my son, the moment of crowning (the so called “ring of fire”) or the intense expulsion reflex which comes in a trembling rush of adrenaline . . . I can’t claim to know these things.  I wouldn’t have chosen to birth this way just like I wouldn’t have chosen to lose my virginity drugged or stoned out of my mind.

We are supposed to be rewarded by the physical activities which help keep us alive and propagate our species:  eating, having sex, eliminating, labor and birth, breastfeeding.  All of these things are miraculously designed with positive biological feedback systems.  Unless there is something WRONG, these things are supposed to feel good.  A fully engaged, active birth which is pleasurable for the mother is ultimately the healthiest scenario for mother an baby.

This is not an issue of some women thinking they deserve a certain “experience” of childbirth.  This is about sexual and reproductive rights, evidence based medicine, and most of all, it is about basic human respect.

It’s an unfortunate situation when pregnant women have to discuss informed consent (which translates practically to informed refusal) with their OB’s, brief their husbands on their wishes, and hire labor guards in the form of doulas.  It’s an even worse situation when none of these precautions can guarantee that everyone you come in contact with will make the right choice at the critical moment.

From something as simple as trying to massage a woman in labor without her permission, to internal exams or surgical procedures, the best thing to do is to ask gently and listen patiently at every step.  The KEY to avoiding childbirth-triggered PTSD is to make sure that the laboring mother feels in control.  Make sure she gets a choice in the matter, and she won’t have nightmares which prevent her from being the best mother she can be.

Even if there’s a time crunch, give as much information as possible and wait for the OK.  Tell her, “This is what I think would be the best thing to do right now.  What do you think?”

You know the meaning of the word “no.”  Why should it mean less when a laboring mother says it?  No means NO.  Silence is NOT consent.  Always ask permission at every step, listen to, and respect the answer to your receive.  If you’re not prepared to do that, you have no place in the birth room, and I surely hope that you are not a health care professional.

And for God’s Sake, never just assume that anyone is a good choice to lend labor support!  Choose your labor assistants very carefully and make sure you’re all on the same wave length!

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Time to use your critical thinking skills.  What’s wrong with THIS article?  Discuss.

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15 Comments

  1. The fact that the importance of “no” is marginalized by those who think they know better is not only a tragedy, but a crime of thought. Sometimes it becomes a crime of action. Those who’ve been a victim of that crime remember; Remember of the smugness of those who refuse to see. Remember the feeling of being robbed of choice. It’s my personal least favorite kind of wrongness.

  2. This is an extremely powerful piece. I am glad to have read it, and I will keep your experiences in mind when the time comes for me to bear children.

    The right to say no is an important one, and that it was taken from you is inexcusable. I don’t want to speak for your mother, but that nurse should really have known better.

    I… have many more thoughts on this, many of them angry. I’m not specifically angry at anyone involved in this, but I am angry at the society and culture that allowed this story to happen. The stereotypes that pregnant women are “overemotional” and “irrational” are bullshit twice over. But it’s the good kind of angry. The go out and make things different kind of angry.

    When time comes for me to be pregnant, I plan on teaching for as long as I can, and I plan on talking about it openly with my students. I have a great way to change the world, and I want to make good use of it.

    So many thoughts! So little time! I enjoy reading your essays, Leslie. Thank you for sharing your thoughts and experiences.

  3. This is a powerful piece of writing. I’m glad you have taken the time to work through it and become comfortable enough with your experience to share with us.

    The article at the end is upsetting. I found the statement “100 years ago one in 10 women died from complications of childbirth, and [one in 10] babies” laughable as a reason to go to the hospital for birth. 100 years ago we didn’t have the knowledge and resources that we do today. 100 years ago we didn’t know so much about the importance of cleanliness and we though laudanum was a spectacular thing to give a woman who was nauseous or in pain. Of course more of them died! I understand that they don’t want everyone to think of hospitals and Obstetricians as he devil incarnate, they’re not, but putting down any alternatives is NOT going to help their case. What, are they running for political office?

  4. I really enjoyed your post. As a birth doula, I learned a lot by reading it. It helped me remember my main role as a doula is to support mom in whatever SHE wants. I feel I have done this, though sometimes it is a challenge. I really have only struggled with this when mom changes her mind during the birth, veering off of her birth plan (plans on no epidural and changes her mind during the birth) but I support her in her choice. Because it is HER choice. I would never suggest to her an epidural or any other drugs. It is one thing if a MOM asks, quite another when people are forcing it upon her. yelling at her to do it.

    I am so sorry you didn’t have the support you needed during your birth. Hugs!

  5. You wrote it far more eloquently than I ever could have. Thank you for sharing this. You shared for me too.

  6. I am not surprised at your experience. I had a similar experience 8 years ago when I birthed my son. The amount of coercion involved in peddling drugs during birth would get you arrested on the street. I was told if I didn’t lay still that they would do a C-section. I continuously turned down the epidural, but took the IV drugs. “you already have the IV it will be so easy, are you sure you don’t want the epi? It’s busy up here”

    I am now a birth doula because of this experience. I had 2 great births after my first, but his has left me very wary of hospitals and their goals. I pray that you will overcome your PTSD and find phenomenal support for your next birth.

    I will be sending clients to your story.

  7. I am shocked at your mother’s coersive tactics. The majority of women are aware that an epidural is available, and they don’t need to be pushed into getting one. If you are capable of saying you don’t need one, you are just as able to express your need for one if or when the time comes. I can’t believe tha nurse let your mother get in your face like that. Where I delivered my daughter, whether or not a person was family didn’t matter when it came to a patient’s comfort. I am hoping to be a doula when my daughter is older, and the only one I will take seriously when it comes to asking for medication is the mother. It’s sad how your mother was more wrapped up in how she was reacting to your pain than she was concerned about your desires. I have been blind since birth, and people are always assuming that they know what I need better than I do. As for the neonatologist, he was way out of line, and his judgement of you was unwarranted. After all, he had no evidence that your choice of birthplace was responsible for your son’s problems. I am sickened at the way your autonomy was stolen from you, and I am sorry and embarassed for the medical establishment.

  8. Your story is so very similar to mine. I actually wrote about it yesterday, in fact. I, too, have never complained about the pain of labor. In my situation, my hospital birth completely snowballed and resulted in a c-section. I’ve spent many years getting over the fact that my right to a natural birth was stolen from me and changed from an amazingly spiritual, physically empowering life experience to a cold, hazy, drug filled medical procedure which resulted in my child being born.

    Thank you for sharing this. I will be subscribing to your blog.

  9. Hello, I found your story through a blog trail. I just want to tell you how very sorry I am for your experience and hope you find an amazing team of people to support you and what you want for any future births you may have. It is amazing how healing child birth can be, especially after a traumatic birth like yours.
    I have birthed both of my 2 boys at home with midwives, and am also a doula (though currently not practicing as 2 little ones at home and a 3rd on the way). Birth fascinates me, and I feel I got a lot of perspective from your story, thank you for sharing it.
    I hope writing it out helped in your healing.

  10. Thank you for the articulation of your article. I had the opposite experience
    with my childbirth where an epidural was denied me when I requested it and I have
    PTSD from the expericence that keeps me up most nights – including tonight.
    I still don’t know how I made it through the ten hours until my duaghter was
    born and I can tell you I had zero endorpins from crowning. It was well over
    2 hours before I even wanted to hold my child, which is the most haunting guilt
    I can carry. However, I truly believe that choice is a right that all
    should be given during child birth, no matter the path chosen.

  11. Oh my God. Our birth experiences were different, yet the same. I still get upset even thinking about the birth I was led into, in a haze, against my will, as if I were cattle going to the slaughter. I HATED the feeling that I was not so much a woman, a patient at their most vulnerable, but a piece of meat to be dissected. It’s strange – I didn’t have a c-section, but my birth plan was pushed aside, and one invention on top of another was introduced, and I have to continue to remind myself I didn’t have a c-section. I felt like it was someone else giving birth, not me. I felt so disconnected at that point.
    My daughter’s birth also ended with a NICU stay, and similar to your experience, I felt like an afterthought there, and was so intimidated and confused at that point, I didn’t question like I should, push back as I should, or demand what I should have.

    Thank you for sharing. I feel so much less alone now.

  12. What a heartbreakingly beautiful post…I am terribly sorry that you had to experience it. I am a birth doula, and despite my best efforts, I have already had the opportunity to watch the “medical authorities” completely take over a mother’s birth. This story has helped me to better understand my role…both during AND after the birth. I will be sending clients to your story!

  13. Hmmm. As a homebirth midwife who also works with women choosing to birth in the hospital, I might have a different perspective. Probably do, actually.

    It’s obvious you didn’t have the support you needed, didn’t have someone who was your walking/verbal birth plan. If I were your midwife, I either would not have left or found a doula to come in in my place. The doula would have been briefed before walking in. I’m sorry that didn’t happen and it is a really confusing part of the story for me; I just cannot imagine leaving a client alone in labor after a transfer/transport. To me, it is up to the midwife to speak up for the client so SHE is treated well. The midwife might
    take a lot of flack, but she can suck it up and deflect the anger/frustration from being foisted upon the client.

    Having done this for 26+ years, I can tell you that women often/almost always get to a place in labor where they cannot make a decision. “Do you want some water?” Instead, offer and if she doesn’t drink, she doesn’t want it. Do we sometimes tell women/encourage them to drink anyway? Absolutely, but only when she needs it to keep going and to nourish her child. Women who get dehydrated can get a fever and the baby is affected and then a transfer can happen when all that was needed was a few sips of water every once in awhile.

    This brings me to a point. When I work with women, home or hospital clients, the goal is to develop the trust necessary to weather the moment that can come when the midwife says, “I need to give you pitocin; you’re hemorrhaging.” (Actually, I say, “I need to give you pitocin; you’re hemorrhaging. Okay?”) A midwife/doctor sometimes has to make an emergent call and it is imperative for the mother to agree in order to save her life or that of her baby. Agreement is typically implied. If she is in the hospital, she is agreeing to the hospital’s rhythm, the emergency services available.

    But trust is crucial. If there isn’t trust, that opens the room for coercion – and you experienced that first hand.

    As a provider, I have suggested an epidural for a woman. I have not manipulated or coerced a woman into accepting one. As we say in childbirth classes… epidurals are wonderful for women who are suffering, but women who are coping don’t need to be pushed into them. I am guessing your mother and the nurse assumed you were suffering and out of your mind refusing the epidural. Especially women who moan or writhe in labor can look like they are suffering. In fact, it was your mother and the nurse who were suffering and both needed another person to tell them you were doing perfectly fine and to please stop trying to convince you to have an epidural.

    Women must be muted in the hospital or the nurses would have to help each woman through her pain. Nurses don’t have time to do this. Also, it would break their hearts to sit with women needing great amounts of emotional support. It takes a special kind of person to be able to SIT with a woman in labor, not attempting to DO anything for her process. It is one of the hardest things we try to teach partners… to not try to FIX the pain, but to bear witness to it.

    The hospital would never believe they coerced you. I hear the other comments saying they can’t believe what the nurse did, but I am not surprised in the least. That is how the grand majority of nurses are; they don’t understand natural birth and have zero clue how to support a woman through it. They know epidurals. They know that women who are quiet are easier patients and allow them to get more paperwork done. It doesn’t surprise me at all how your nurse acted. She was the norm. So, the hospital gave you papers to sign when you came in and included on those papers were saying you consent to (basically) anything they wanted to do to you, up to and including a cesarean (although most hospitals do have separate paperwork for women about to have a cesarean). The episiotomy was consented to when you signed those papers. Was it right for the doctor to just do it? Absolutely not… unless the baby was crashing. You don’t talk about those last moments of birth but to say your child was in the NICU for a week. Was the baby near death at birth? An episiotomy might have been warranted. Doesn’t mean he couldn’t have said, “I need to do an episiotomy to help your baby, okay?” I cannot imagine many mothers who would say no. Would that have made a difference in your postpartum emotional/mental recovery? Just that request “okay?” It’s impossible to know at this point. Your experience was what it was.

    I tell women who have been hurt as you have and who are going to have another baby. You can’t be here unless you were there. Women who have traumatic births become fabulous birth advocates. The understand, in a visceral way, the importance of trust and consent. It is important for them not to replay their own births or to attend to women as a healing for their traumatic births; it is vital to allow each woman’s birth unfold in its own way, even if it would suck for you to have that kind of birth. But, women who become pregnant again make different choices. That can be the most healing action of all.

    It will be interesting to see how your next birth unfolds and to see if it is healing or if it continues to leave your first birth as a very sad and sorrowful taste in your mouth.

    I wish for you healing and peace with all that you experienced.

  14. Barbara,
    You are actually the person who helped me understand that the episiotomy was medically indicated. I’ve never regretted going to the hospital, and I believe that I HAD to be at the hospital in order to make sure my baby was OK.

    But the EFM’s didn’t show distress when the episiotomy was performed. Meconium in the fluids were the only indication, and that’s indication enough. (I have the medical records.) Regardless that they got strong heart tones all the way until he came sliding out, he had none after that. He had to be resuscitated.

    And for the coercion, let’s put blame where it belongs . . . my MOTHER cajoled me into pain medications with the HELP of the nurse.

    And, yes . . . it was all normal hospital procedure. And I signed papers to take “the hospital ride” because my midwife wanted us to transfer. And, even though our signed contract stated that she would stay at my side as my doula, she LEFT ME.

    And now that I’m looking into options for my second birth, I just keep remembering what I learned from this birth . . . That being afraid is OK. That even though I had a birth that didn’t go the way I wanted, I still felt SO CONNECTED. That I tasted a bare fraction of what birth COULD be, and I got hooked. Even through the drugs, the pain, the broken bonds of trust. Even through the nightmares and horror I had to drag myself out of, the sleepless nights . . . that I believe in myself, that I believe in birth.

    The following is copied from my Solace For Mothers forum:

    “03/11/09
    A few weeks ago, I lay next to my slumbering men, still awake (insomnia is one of my most persistent symptoms), and I was thinking about if I got pregnant again.

    Up until that point, I’d had a mental block. All I’d been able to picture or think (obsess about) in regards to another pregnancy and birth was how DIFFERENT and WONDERFUL it would be . . . How different and wonderful I would MAKE it be.

    But then I finally let myself feel the horror and trembling fear of all the terrible things that could happen. I thought, “I could end up at the hospital. I could UC and die from complications. I could go with a midwife and be disrespected and have my birth stolen from me. I could have placenta previa and a C-section. I could be coerced into a C-section for any number of reasons. I could have a normal, beautiful birth and then die from blood loss. My baby could die. I could die. I could get hurt again.”

    It was a huge floodgate, but I felt really energized by it . . . because, in the back of my mind, I heard a voice that said, “No matter what, I believe in Birth. I believe in myself. Things don’t go according to plans. What will happen was meant to happen. What has happened was meant to happen. No terrible incident can convince me that everything is bad, because I KNOW–because I TRUST. I know much more now, and I can be at peace with another birth no matter where, when, how, and I’ll figure out the why’s for myself.”

    “My body knows birth because it is written into my cells, in the fabric of my spirit, and on the waiting hearts of my children. I know birth because I was born, because I have borne a son, and because I am a woman. I know birth because I have opened my eyes and seen that it has many different levels of existence, just as women have layers to themselves: The faces and shells, their words, their deeds, their secret yearnings, their dark and powerful selves, and the bright and unending light of their souls.”

    Before, if I said “I’m ready to have another baby,” it would have rung untrue for me.
    Now, if I say, “I’m totally unprepared for another child,” it rings untrue. Not that I’m ready. I’m just . . . past a certain point of denial.”

    I could only have embarked on this journey of pregnancy again, with the support of my partner, with the excitement of my toddler, and with readiness in my own heart.

    So, let’s see how this next birth goes.

    -Leslie

  15. “But then I finally let myself feel the horror and trembling fear of all the terrible things that could happen. I thought, ‘I could end up at the hospital. I could UC and die from complications. I could go with a midwife and be disrespected and have my birth stolen from me. I could have placenta previa and a C-section. I could be coerced into a C-section for any number of reasons. I could have a normal, beautiful birth and then die from blood loss. My baby could die. I could die. I could get hurt again.’”

    This glared out at me! I don’t know, because you speak nothing of it, but I’d *highly* encourage you to create an “All the wonderful things that can happen” birth list. In each of your writings, the post and the last comment, it is all pinpointed towards the pain… and I do understand that, but now that you’ve disclosed you are pregnant again, I want to be there to help you turn the light from the pain and negative, opening the circle so you are able to acknowledge all the really cool things you can have happen this time. Perhaps a list of things you want? A wish-list even. Just because you write it down doesn’t mean you are chained to it, but it is fine and helpful to have the “perfect” picture you’d love if you could choreograph everyone, including your child. As the sentient being you are, you will remember there IS no choreographing everyone or every thing, but nodding and saying, “Oh, I recognize this!” when you “see” something or someone during your experience can help your walk tremendously.

    I am going to STRONGLY suggest you not have your mother anywhere near this next birth. I think working through the abandonment issue with the midwife is crucial (especially if you have the same midwife).

    An anecdote: I had a mama who needed me as a mother figure. Her own mother was mentally ill and emotionally unavailable to her as she grew up and had children. Her first birth was extremely traumatic; she nearly bled to death, so she was filled with fear during the pregnancy I worked with her. We talked endlessly, my being the soft and loving mother figure throughout. (This was earlier in my midwife-life.) I even said to her, “I am glad to be your surrogate mother during this birth. I will hold you and love you and I WILL NEVER LEAVE YOU.” Emphasis because I sealed the fate of that birth experience by saying that. 2 days of tremendous labor, a couple of excruciating, screaming vaginal exams to break adhesions and figure out the baby’s position, the decision was to take her into the hospital. As we were gathering our belongings, another mom called… her first baby’d been born in 6 hours, so it was a sure bet she was going to go fast. She also lived 75 minutes away. I had to leave.

    I had to leave.

    I held the mother and apologized profusely. She looked at me with terror in her eyes. I was sending my then-apprentice Donna with her and said, harshly and loudly, “DON’T LET THEM HURT HER WITH VAGINAL EXAMS.” And off they went.

    I sobbed all the way to the next birth. I was an exhausted mess and had to call another midwife to replace me. I hadn’t slept for about 40 hours (and for someone with bipolar disorder, that is NOT good) and when the other midwife got up to the second birth (that was taking SO LONG), I drove the 90 minutes home, passing the hospital where my first client was… as she was delivering. I debated going to see her, but I was falling asleep at the wheel as it was, so I sobbed as I drove home, spilled myself into the bed and slept for about 10 hours.

    When I awoke, I learned the first mom had a vaginal birth and then nearly hemorrhaged to death again. It was a torrential hemorrhage that was seconds away from a hysterectomy to save her life. While I had given my apprentice instructions about watching her dear vagina, I had TOTALLY forgotten to tell her to tell them of her hemorrhage history. I was so emotionally invested in her experience, I had neglected the crucial, life altering MEDICAL information of her history. I crumbled for months after this and it took over a year before the mom could speak to me. We now are able to talk about the experience, though it stings both of us terribly, in different ways.

    My second mom had an acynclitic baby and, despite having had a beautiful homebirth the first time, she transferred into the hospital and had a cesarean… with the other midwife who stayed with her. I had emotional healing to do with her as well. She remembers most when I went to see her the day she got out of the hospital and I painted her toenails. She said that was so loving… I barely remember it… but I am so glad I did it.

    All this is to share that even someone who’s considered a pretty good midwife can make stupid mistakes/decisions. That fate has a hand in what happens when we do EVERYTHING in our power to strong-arm it into submission. That words sometimes flutter into the ether as we reach to capture them… the closer we get, the more vaporous they become.

    Working on the trust issue with a midwife IS crucial, but there will be a moment… some moments… when you will have to find a way to trust. Someone. Life in this culture is wrapped in interpersonal connections. We have to trust the mechanic not to set us up by removing a bolt somewhere. We have to trust that the manufacturer of our organic clothes really does only use organic cloth. It is good to question, to research, to arrange what you can, but, in the end, trust has to come.

    Trust of your Self. Trust of the process. Trust that you will do what is right, even as things might ebb and flow in a different way than your Dream Birth.

    I fall short of saying Trust Birth because I say, “Respect Birth.” A healthy respect gets you much further than trusting birth on her own. She is like the weather and earth in San Diego. Most of the time great, but occasionally disastrous. We do the best that we can in any given situation.

    And no matter what, your experience will NEVER be the way that it was. You are not the same woman you were then. You will not allow the same naivete, lack of control, coercion and fear to collapse you. Your knowledge will guide you into a different place. It might not be perfect, but it will certainly be different.

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