Saturday, November 27, 2010

Informed Consent

Being infirm, as I am, I finally did watch a movie on Netflix, The Business of Being Born. Y'all are a pretty savvy crowd, so maybe you've already seen it. The combo of my a) never watching movies and b) having lived through my own home birth (from which I'm still recovering more than a decade later) has precluded me from seeing this film till today.

I watched it alone - Scott and M are out for dinner - and I have to say it was rather affecting, if mainly in a PTSD kind of way.

Let me start by saying, I am not the poster child for home birth.

Oh, I've been a yoga teacher since I was 19 and my parents are holistic health practitioners. I see a naturopath. I believe in the body's ability to function and heal. I know, beyond a shadow of a doubt, we are - most of us - designed to have children without intervention, with all of the intensity of the natural experience.

But there seemed little naturalness about my child's unmedicated birth and, on some level, I've been grappling with it ever since.

I have written about my parenting ambivalence, post-partum depression and anxiety and the challenge I faced in bonding with my daughter after she was born. I haven't talked much about the birth itself, to some extent because I don't remember it very well. I've pieced it together from stories told after the fact by my (insanely competent) midwives, my husband and my mother.

My story is complicated by a potential (but not actual) health issue my daughter was thought to be experiencing a couple of days after her birth (as I was desperately trying to recover and adapt), which resulted in a) days at the hospital and invasive procedures of the like I had so stridently tried to protect her from by having a home birth and b) a moment where doctors prepared me for the possible death of my newborn (because they didn't know what was wrong, if anything).

It goes without saying that I am eternally grateful for her health. She has thrived despite her slightly unusual physiology. I am grateful to every practitioner who worked to confirm her health. I am profoundly grateful to my parents (who, bizarrely, experienced a very similar thing with my sister at her birth - the birth, on some level, I was trying to avoid in my decision to have M at home). They stayed by my side and supported me and my husband. My friend Hilary came back from a stint in BC to be with me at the hospital and to advocate on M's behalf (she's a neonatal specialist).

But this is about the birth, not the aftermath.

It started off well - M was 2 weeks early. I passed the mucous plug early in the morning (warning - this post is not for the faint of heart) and waited for the labour to begin. By about noon I felt contractions. I could manage them. I used yoga technique. I have a high pain tolerance (my sprain, for example, which is terrible to look at, has only necessitated the ingestion of 2 Advils and 3 Tylenols over the past 60 hours. The hospital has prescribed 2 xs Advil and 3 xs Tylenols 4 times a day...)

We called the midwives as the contractions intensified. They arrived an hour later, at 2 pm (it was Easter, if I remember correctly), at which time I was in transition. The midwives decided it might be best, given a few factors, including M's slowing heart beat, to break my water. I agreed. From that point on it was all. fucking. over.

I'm not sure if you've ever experienced intense pain. I can tell you that the intensity of the pain I felt after the midwives broke my water was like nothing I have ever felt. I had a back labour from that point on. I tried getting into the tub, which only made me want to kill myself and everyone around me. I felt like I was falling up - so massively ungrounded was I. The only person I could tolerate was my husband who needed to simultaneously push against me and prop me up (with serious muscle power) seemingly endlessly. I would regularly vomit - pain didn't even register at a certain point, this was my body's way of managing it.

Between contractions I mentally bargained with God. I begged for increased duration between episodes. M's heart beat kept slowing and the midwives were increasingly concerned. They gave me oxygen, they urged me to push. I could barely register their instructions. I was stunned by pain. Eventually (though this happens only in 2% of midwife-assisted childbirths) they told me they would have to give me an episiotomy. Without any pain medication. I was so far gone, I didn't even care.

My 6-hour labour, while very fast by all accounts, was the longest, by hours, that any woman in my family has ever encountered. At this point, I was in hour 5.

By hour 5 and some, one (of my 3) midwives called the paramedics. I won't tell you of the shocking things my mother and husband were instructed to do to encourage contractions.

The midwife put her hands inside my body (both of them) to pull out M, at which time they discovered what they'd expected. She had the cord wrapped tightly around her neck 4 times. Nonetheless, due to my midwife's skill and foresight, M was healthy. She scored high on the Apgar test almost immediately.

The paramedics burst into my bedroom as all of this was happening. I don't remember it.

As soon as she was born, M started to cry. My husband and mother, the midwives, were all incredibly relieved to hear her. I felt utterly overwhelmed, half-dead. I screamed at them to get her out of the room. I heard M squeak from the other side of our condo (where we lived at the time). I just wanted her to be quiet. To leave me alone.

They almost had to transfer me to the hospital to sew up my bits (and because they were worried about hemorrhaging). I had 27 stitches - I told you this was not for the faint of heart. It took them an hour to suture. For that, you may be happy to know, they gave me medication. Happily, they did an awesome job and I was entirely healed in 2 weeks (a miracle). Far easier births can result in reproductive and other problems that persist for years... Interesting side note: Part of the problem, in terms of delivering M, was that I had done so many "perineum strengthening" yoga moves and kegels during my pregnancy, that my pelvic floor was an inflexible rock. So I guess you can be too fit. I shook from shock for an hour.

This was all before the hospital experience that followed 2 days later.

By the time my kid was home again, a week after her birth, I was so afraid of everything I could barely function. The only impact, as I can tell, that oxytocin had on me, was to make me freakishly hysterical about the germs that might touch (and kill) my child - who, frankly, I couldn't bear to be around, anyway. For a year, I wouldn't allow meat into my house. (Somehow I felt that meat would transfer germs to M's food and poison her.) I couldn't sleep for worrying about her dying. But as I watched over her, in my delusional fatigue, I only wanted to find the peace I imagined death would bring. Don't get me wrong. I wasn't suicidal. Suicide was the luxury of non-parents. Parents were simply strung into an existence of terror and sleep-deprivation, of loss and being trapped.

It was a truly terrible time during which I should have been medicated. It lasted for 3 years.

So as I watched woman after woman sagely giving birth in tubs during The Business of Being Born, I couldn't help but feel really fucking cheated. That's what I'd signed up for. I knew it would be impossibly difficult. I was cool with that. I felt I owed it to my child, to my body, to feminism, to nature. I was on board.

I didn't rush to the hospital to be induced then numbed then induced more then numbed more, only to have an eventual C section. I dimmed the lights, people. I eschewed medical intervention.

I don't kid myself. Had I been in a hospital I'd have been candidate no. 1 for a C section. After it was all over (and to this day) I like to tell people, were pregnancy to happen to me again, which it won't, I'd be knocked out and woken when it was over.

And yet, fundamentally, I believe in the alchemical miracle of natural birth. How could I knowingly deny myself or my child the one-time opportunity to live that primacy, to be there unobstructedly at the first, tremendous moment of extra-uterine life?

Except that didn't happen. I went through all that shit and I came out the other side hormonally unprepared, loathsome of parenting and more fearful than I'd ever been. It changed me for the worse in so many ways. It robbed me of myself as it changed me. I did not look in my newborn's eyes with love. I felt panic tinged with resentment.

To this day, even as my tweenie child is a compelling, charming, hilarious and loving soul, I don't know how to make sense of it. I suppose I should just buck up and be grateful that it all worked out alright. And when I'm not watching movies about the miracle of natural birth, that's generally how I roll.


  1. Wow. Just---wow.

    I'm so sorry it went like that for you. Sometimes even the best of preparations aren't enough, I guess.

    I can relate to the water-breaking---I went from coping with the occasional moan to screaming my head off for an hour and a half straight and screaming for an (unavailable) epidural. That being said, everything else went well, so I mustn't complain.

    I really can't watch any of the birth-stories I've seen on TV. Maybe it is triggering, I'm not sure; all I know is I either end up enraged or jealous or crying, and quite possibly all three.

  2. This is such a brave, well-written, moving post. I'm so sorry for your experience. To commit so fully to a natural home birth and then go through what you did must have felt like a horrid betrayal on so many levels. Followed so quickly by your daughter's health crisis, that sense of betrayal would have been amplified, and it's amazing to me that you got over it as well as you obviously did (not minimizing what must have been a horridly long period of depression and anxiety) -- your family unit is strong and your relationship with your daughter sounds great. Kudos and Hugs. Take Care.

  3. I hear you on the birth experiences; I totally feel cheated with the two (and the pregnancies) I had. One - back labor and hours of pushing followed by a c-section after all; two - half the pregnancy in hospital, followed by a preemie, followed by hemorrhage and operations (on me). I definitely feel the universe owes me a "normal" birth! Still, I was lucky, able to bond and not severely depressed. Glad all is well with you after all.

  4. It sounds harrowing. I remember around the time I first became pregnant there were shows on TV romanticizing and consumerizing childbirth--marvel at the full closet of clothes waiting for the baby; fetishize the designer crib ruffle--but without much attention to the very real pain of delivery and the often shocking aftermath, even when one feels prepared for parenthood. Am glad you have come through your tough experience (would never say "got over it") and are all the stronger, cliche though it sounds . . .

  5. Hmmm...I empathize with the feelings you had post-partum. I wish I could tell you a story about that but since it's not my story to tell, I'll shut up. I just know how hard it is.

  6. Trauma affects us in so many complex ways. I'm so glad that you published this story in full. I think writing about trauma helps with processing it and I think you'll help women who have equally complex feelings surrounding birth trauma.

    I'm really sorry. There's nothing more difficult to understand than going into a huge situation expecting certain scenarios and having it turn upsidedown on you. I think more women have experienced some sort of trauma surrounding birth than we ever hear about - or talk about.

    Oh, blah, blah. This is about you and the trauma you experienced and your grieving process. Take all the time and writing you need.

  7. I didn't watch it. I felt sure I couldn't take the trauma of watching it. Now I am sure I was right. My fantasies about childbirth and the magical joy that I might have felt were clearly fantasies.
    I am so sorry, K-Line, and I so admire your courage and honesty to share your very difficult experience.But I am so happy you have that compelling, charming, hilarious and loving soul.
    Hugs to you, lovely.

  8. Wow. Well done for writing all that down. After the trauma of my first birth (and it was not as traumatic as yours), I imagined throwing my sweet new baby against the hospital wall. My obstetrician observed that she perhaps could have prepared me better for the realities. Then she told me to read 'The Mask of Motherhood', which from recollection was pretty good, if you want to give it a try. I'm so sorry you went through all that. I only just found your blog and expected to find sewing stories, haha! Yeah, birth is natural, but death of mother and child during birth is also a common 'natural' occurrence. I'm glad you and your daughter are alive and well today, and I appreciate your honest account of your experience of the complex and individual process of birth.

  9. I am sorry you had to suffer so much. It sounds horrible.

    I can't watch birth films because they trigger a similar memory of an awful birth experience, which fortunately was the second one as if it happened the first time I wouldn't have wanted more children.

  10. Tanitisis: Thank you for your comment (I was worried no one would want to tackle this one!)

    mater: I think I got over it incredibly slowly and half-assedly :-) Part of the problem is that I didn't realize how sick I was. Psyches are strange that way!

    Uta: OMG - you have to write a post on this! Seriously, those are 2 very harrowing experiences and I'm amazed and thrilled for you that you didn't have PPD...

    Miss C: I hate those shows. Hate.

    Wendy: I suspect I know who's story it is. It's amazing how many of us have them...

    Stacey: You are so right about processing info by writing. And I'm really not in the minority, by the looks of things.

    Bel: You should not watch it.

    Jane: Thank you for the honesty of your first sentence! I promise, this is usually a blog about sewing and fun things. Stick with it :-)

  11. It's amazing how some things--a movie, brings it all back. Even though it never went away. What a brave post. Thank you for sharing it with us. xo

  12. Thank you for this very truthful, real (and slightly chilling) tale of the very personal world of child birth. As someone who's nearing closer to 30 every day, I find my mind wanders to this topic often. I am, in simple terms, ABSOLUTELY TERRIFIED. I know if I have to do it one day, I'll do it and carry on as if it wasn't such a big deal. But I'd be lying if I didn't say I was scared poopless.

    I love that I can talk about this with my boyfriend and he doesn't get utterly creeped out. A keeper, that one.

    But you my friend, are a wonder woman. Never forget that. xo.

  13. This movie was on my netflix queue. Thanks for candidly sharing your story it gives me another perspective. I can identify with the desire to want natural childbirth to experience, to use your words, "that primacy". To my suprise my wee one came early and I had to be induced. I'm telling you once they gave me petosine to start my labor I was all too happy to have the epidural (that stuff's a beast). My birth was 6 hours and the delivery was perfect. All was well. Then I got home and realized that I was on a rollercoaster ride I couldn't get off. Nursing was the biggest challenge of my life but we eventually made it work, but not without alot of bumps. I see you've had alot of your own bumps. I'm appreciative of you and your child for all you had to go through. I guess it's those bumps that make us look look back over the back and appreciate all we survived. I tip my hat to you my friend---because you are just that. BTW, I always enjoy reading your posts. you have such a gift at being so brutally honest and extremely descriptive. I just get sucked in.

  14. Marinka: Is no medium safe??

    E8: You are so kind. I was worrying about freaking out all the mothers-to-be. Don't worry, terror or no, everyone's experience is unique. And mine was particularly crappy xo

    Victoria: Oh, I didn't even start on nursing! (It totally didn't work for me.) But you make a really valid point. You can have a totally fab labour and delivery but it doesn't mitigate the stresses of new parenting. Very good perspective...

  15. You told that story so well. I'm sorry it happened to you and I think your reaction is perfectly valid and could be considered normal given everything. Why do we think anything other than almost-medicatedly-calm is not normal.

    I didn't watch the film. I don't want to.