Words On Childbirth

She was in my arms, but she was out of reach. Twelve hours into natural, unmedicated childbirth, the pain stood between us like a barricade, and though my hands were on her shoulder and under her chin, and she was sitting between my legs in the tub, I couldn’t get to her. “I’m here. You’re not alone, I’m with you.” I whispered into her ear as I felt her grimace below me, the next contraction coming on.

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We decided on a natural childbirth partly for the well-being of our child, and partly for the opportunity for Kirsten to confront this challenge and this very pain, and overcome it. It was to be an experience that would build her confidence and character going into motherhood, and deepen the bond between her and the child for whom she’d sacrificed so much. We found a Catholic birth center run by midwives, and immediately upon touring it felt that it was the right place for us. Everyone was so supportive, genuine, and knowledgeable. The birthing rooms were humble cottages with large bathtubs, the grounds were full of flowers and walking paths.

“Insanity,” she was told by friends and family, “why would you not get an epidural? Why would you not be in a hospital?” Our response was typically that she simply felt it was the right path. And besides, look at how hospital childbirth runs in the United States.

Standard hospital childbirth in the United States is handled much like any other operation. The mother is anesthetized, most commonly by an epidural, which is an injection under the dura of the spinal column, entirely cutting off all feeling below that point. The baby is pushed out by the uterus, which is often induced into contracting by an injection of pitocin, a synthetic hormone.  Most hospitals keep laboring mothers hooked up to monitors during the entire procedure. Signs of trouble, a “dip” in the vital signs, even momentarily, often cues hospital staff to order a Cesarean Section procedure, in which the mother’s abdomen is cut open, internal organs are lifted out of the way, and the baby is physically pulled out of the uterus. Emergency C-Section rates are skyrocketing as hospitals struggle to shield themselves from lawsuits. Sometimes a vacuum device or forceps are used to accelerate vaginal delivery – Google those if you dare; the amount of force used is discomfiting to say the least. I was delivered by forceps, and my dad still talks about how primitive and brutal the procedure was.

Advocates of natural childbirth will tell you how very unnatural all that is. Their narrative encourages pregnant mothers to view themselves as a mammal – built for vaginal birthing and capable of thriving through it. They will talk about how all over the world, for centuries, and even today, mothers gave birth safely and well without hospital interventions. While absolutely true to an extent, the skeptic in me pointed to the steep decline in infant and mother mortality since the advent of modern medicine. We give birth in hospitals for a reason: mother and baby are less likely to die there. We give epidurals for a reason: Mother typically experiences less pain when she receives one. Yet these are broad statistics, averages by the thousands, and you will find countless women who have experienced near-painless, serene, comfortable, natural births, and just as many women who gave birth under epidural anesthesia and were traumatized by the pain, regardless.

We attended a 12-week course in the Bradley Method,  which is a leading technique for natural childbirth, the distinguishing feature of which is that it is husband-coached. As husband, I was front and center, alongside the midwife. I was touching Kirsten nearly every minute of the 15-hour labor, talking to her, encouraging her, suggesting new positions and movements, massaging her, holding her up, and generally being her primary emotional and physical support. That is something unheard-of in standard hospital childbirth. The husband can normally be present and sometimes talk to his wife, but Mom is bound to a hospital bed, on her back, and the nurses run the show. I was warned multiple times that I would find the birth difficult, because my wife would become a different person in the throes of active labor. “My wife cussed me out, hit me…” wrote one husband. “You need tough skin; I told my husband awful things in the most intense moments,” said one mother. Having worked with juvenile delinquents, I’ve been called far worse and more foul names that my wife could dream up, so I was not worried about that aspect of delivery. To her credit, though, Kirsten never spoke a harsh word to me or anyone else during labor. She was gracious and kind, and thanked her support team individually multiple times, even when the pain fully engulfed her.

Relaxation is the key to the Bradley Method, and most other natural childbirth philosophies. Pain is a mental manifestation, and when the person in pain compartmentalizes it and relaxes through it, its intensity subsides. So the thinking goes. We practiced long guided meditations and spoken affirmations. Kirsten is a trained yoga instructor. She was very adequately prepared. Yet every time we practiced, we knew in the back of our minds that there was simply no way to be fully prepared. You cannot know until you are in the moment. The intensity of pain is entirely subjective. There is no way to compare the pain of one person to that of another. One person being pricked by a pin may experience that pain as more acute, more intense, than it is felt by another person under the same circumstance. But there is no way to precisely convey that pain to another, no way to truly understand the pain of someone else. No scale can be accurate, as no reference point can be established.

That subjectivity and variability is one of the greatest things I learned about childbirth: no two births are the same, and no one can truly understand another’s birth experience. No two mothers can be guaranteed to have the same birth experience. Even the same woman is unlikely to have a similar experience on her second delivery. The first birth tends to be longer and more arduous than subsequent deliveries, but even to that trend there are so many exceptions that it is almost rendered a myth (my mother, for one: my older sister’s delivery was a breeze, mine was a terror). Thus, testimonials only go so far. Mothers who love natural childbirth or abhor it, who swear by epidurals or induction, cesarean sections or water births, can only speak for themselves, and not even that- for their previous births. My older sister was born naturally. After that easy experience, my mother was sure natural was the way to go, and birthed me naturally. Not sure she would make the same decision after the long hours of agony I put her through.

My wife suffered pain far beyond — in intensity and duration — what either of us anticipated. We had been told several times that average first-time labor duration was about 12 hours, and labors lasting 18-24 hours were not terribly uncommon. But no matter how often you’ve been told that, when you or the one you love most has been agonizing for 10 hours, you start to feel that it has to be abnormal, that your birth must be exceptionally long. The midwives did a good job of assuring us that everything was proceeding normally, but at some point you wonder whether they’re just saying that so you don’t get discouraged.

I constantly reassured her that she was indeed progressing. Every little sign of change was held up to her as a regular signpost: “This means we are progressing. The birth is moving closer. It’s coming. He’s coming. You’re getting there.” Deep into active labor, discouragement set in at times, and when it did, a definite change was observable in her aspect. From intense and determined she would change to desperate and scared. Starting with “Am I going to need to be transferred to the hospital?” and evolving to “I can’t do this. I can’t do any more.”

Heavy discouragement like this is a defined stage of the birth process called transition. As the mother transitions from Stage One of labor (in which the baby is descending into the birth canal without the mother deliberately pushing) to Stage Two (conscious, intentional pushing), the pain intensifies, additional hormones flood in, and there are extreme emotional side effects. This is when the cursing and shouting and regrets tend to surface. I reminded her of this fact when she was most deeply discouraged: “This is transition. This is what we learned about. This is all normal, you are supposed to feel this discouragement. We were expecting it, now let’s get past it.”

There are only so many loving ways to say “Just deal with it” which is the essence of a natural birth coach’s message. As confident as I was in the process, in our birth team, and in my wife, I eventually felt discouraged almost to the point of breaking. I’m normally terrible at hiding my emotions, but somehow was blessed that when, on our drive home, I told Kirsten I had been crying through many of the later hours of labor, she was surprised; she never had any idea. I had to be her rock, her steadying hand with unflinching confidence in her. Because of the trust I had in our midwives, I knew that I did not need to be worried until they were, but the pain of a loved one does awful things to the mind and heart. I wiped tears and swallowed the lump in my throat to only show her a face of confidence in her and in the process.screen-shot-2016-12-03-at-4-39-22-pm

 

 

 

 

 

 

 

 

 

I thought to myself, in a couple moments, about the logistics of transferring to a hospital. It would take at least 20 minutes in a horribly uncomfortable car with no freedom of movement. When Kirsten floated this idea to one of the midwives, the response was simple and reassuring: “You can, but just be sure that’s what you want. As of now you’re still experiencing a completely normal birth. It may not seem that way, but I promise you- nothing you have experienced is abnormal for birth.” Sure enough, moments later, that wave of doubt had passed, and another infusion of courage and determination had come. She pushed forward.

The main obstruction to delivery was a matter of simple mechanics. As the baby descends through the pelvis and down the birth canal, his head has to slip underneath the pubic bone. Our son’s head was coming down at an awkward angle, so as the uterus squeezed him down from above, his head was being crammed into that bone, causing excruciating pain in Kirsten’s abdomen. The uterus is a phenomenally strong muscle, and its contractions were involuntary, starting every two minutes and lasting over 75 seconds each time. Kirsten told us that the pain and pressure were so intense in those contractions that she felt like something was going to “happen”, like the pelvic bone would crack in two, or her abdomen would burst. The only way to get past this deadlock was for the head to shift down or turn a bit, perhaps a fraction of an inch, and continue through the canal. The way to get that to happen is for her to constantly change positions, move her legs around, stretch, squat, and generally try to widen the pelvis and shuffle the baby to facilitate his passage under that bone and out. It is almost like those old wooden puzzles, where you need to dislodge the blocks from each other, and they only come loose when they’re turned at exactly the right angle. Try as we might, for hours she remained in the same brutal situation.

That simple problem is what made it so painful. Not lack of preparation or poor planning or lack of monitoring or medicines. It is so basic, so primitive; the same problem that has certainly happened to women in hospitals, in birth centers, in the back seats of cars, in fields, in warzones, in caves — anywhere babies have been delivered — since the beginning of humanity. Babies are autonomous creatures, even in the womb. The uterus is not under conscious control. The pelvis of each woman is slightly different in size, shape, structure, and angle. The baby shifts and turns throughout his 40 weeks of gestation, and comes out differently in each instance. These variables all interact and collude to make delivery successful or problematic. If we could rewind the clock, reroll the childbirth dice of fate, and have another go at it, he may slip under the pubic bone without a hitch and pass into this world to a mom who was astonished at how easy it all was. Or, he may come breech (bottom first), or he may pass away during the trauma of delivery. There are too many variables and possibilities to securely predict anything.

My coworker’s wife had a natural birth by accident about a month ago. By the time she was admitted to the hospital, she was 9 centimeters dilated, too late for the epidural she’d planned to receive. She had her first contraction at 8pm, and the baby was in her arms shortly after midnight. And that is exceptional, but not necessarily abnormal. Not a cause for concern. Her next baby could take 15 hours, and be deadlocked in the same way Kirsten was. She may cry and scream and flail, curse out her husband or faint, because the pain — which only she and no one else can understand — drives her to it.

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Kirsten was looking forward to a feeling of accomplishment from having passed through natural birth gracefully. She wanted to hold our son, fully lucid and unmedicated, exhausted but invigorated, and feel connected to him on a sacred level that only can be achieved by extreme sacrifice. She didn’t feel that way, and neither did I.  We didn’t feel an overwhelming gratitude for all our preparation, or for our choice to birth naturally. She felt skeptical when the nurses told her how strong she was. She had yelled and moaned, cried tears of desperation and anger, and resented the baby at moments for causing her such agony. I felt a despair and helplessness that I never thought I would experience. I always pride myself on coming to her aid, taking care of her, alleviating her burdens, and fixing situations. If I can get to her, I can help her. But in that birth, in the moments when her voice rose in panicked torture, I had no remedy for her, and that was terrifying.

This is the part of the story where I am expected to talk about how baby Leo is asleep and idly fiddling on his chest. About how his hair and skin have that blessed sweet smell that only babies carry.  About how his eyes twitch as he sleeps and I wonder what he’s dreaming. I’m expected to say that all the struggle and uncertainty of birth is but a small thing, because of our miracle, our son. I will not say that, because I hate cliches, because it isn’t true, and because it is so true that it goes without saying. Though our birth team mostly consisted of strangers, the Bradley Method made childbirth a deeply intimate experience. There was no bleeping machine, no call button, no other patients next door. She wore a swimsuit top, not a hospital gown. She was free to move and walk, and did for most of her labor. She labored multiple hours in a bathtub and in the shower. We had options, and we had each other. Striving with all my mind and heart to comfort her or guide her to her own comfort bonded us even more deeply after three years of marriage. She had to trust me physically, emotionally, and spiritually to respond to my coaching and push past the pain with the techniques I was suggesting. It was so personal that at times we felt alone. It was a powerful test of our relationship, and I am thankful for it. It was an experience of such unfiltered, animal humanity that it shocked us both, and to some extent we’re still reeling from the trauma, but I would not erase it if I could.

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Today, as Kiri suffers more pain through breastfeeding, and as we are soothing and latching and feeding and changing this human, this budding life, it is harder and harder to feel back to the day of his birth. His completeness as a person is astonishing, down to the tiniest eyelash, and his dependence on us demands all our focus. The Bradley Method taught me so much about conception, gestation, pregnancy and birth that I have a far deeper reverence for it than I would have if we’d gone the traditional hospital route.  I’m thankful for that. The Sister Mary bungalow in which we delivered, and grounds of the whole birth center will remain sacred ground for the rest of my life, and our midwife, who provided strength, knowledge, confidence, and comfort for the entire duration of labor, will remain an angel to us.   I’m thankful for that, also.

The operative question is this: would we do a natural birth next time? First, the answer to that question is firmly in my wife’s realm, not mine. My feeling though, is maybe. Sure. No. Definitely. Absolutely not. Who knows? Who can know? Does it make a difference? Will we regret it? Would we regret not trying it again? The answers to those questions are as unknowable as her pain during labor, and mine. Every birth is so, so very different, and there is no possibility of full preparation or control. We prepared all we could, we were in the right place with the right support, and we had a life-altering, magnificent, horrifying, and traumatic experience. We grew as individuals, as a couple, and as a family. I hated it, it tortured me and my most beloved, and it is sacred to me.

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4 Comments

  1. Kaylee Heath
    December 6, 2016
    Reply

    Michael, I read and loved every word of this. Thank you for sharing, and especially for how you focused on the individuality of every birth. I have tried to explain my experience, and have come up short and disconnected. I didn’t know why until I read this and realized it is because no one else has ever experienced mine. Your wife is a warrior. Congratulations to the both of you!

    • Michael Wayne
      December 6, 2016
      Reply

      Kaylee-
      I’m glad you appreciated it. My wife and I thought and talked a lot about the fellowship of mothers, which she was joining and could draw strength from. But we found that the individuality/uniqueness of the birth experience can make it feel quite lonely. No one can completely empathize. But that also makes it sacred, and gives the opportunity for connection with the only One who truly knows how it felt.

  2. Liz Benson
    December 8, 2016
    Reply

    Beautiful!

    • February 22, 2017
      Reply

      Thanks for your thhtogus. It’s helped me a lot.

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