Yesterday marked the halfway point in my pregnancy. Now that I'm through the SAAW madness, I can actually focus on other things, namely my child and myself... and my pregnancy, which has been sadly neglected over the last 20 weeks!
I have been thinking a lot about Chickie's birth and how I would like to do things differently when This One (as Dan and I have been calling her) comes into the world. I know that only so much is in my control (and I learned this the hard way with Chickie), but I do feel like it's important to control what I can (duh, I'm a crazyass control freak, in case you hadn't figured that one out).
You guys probably know how Chickie's birth went-- I had an awesome labor that began at 5:15 a.m. and progressed at a slow but steady pace, and by the time I got to the hospital, I was practically in transition and was 7 cm dilated when I was triaged. I think I started to push a couple hours later (dunno-- I was in the birth time-warp la-la land place that makes you forget the trauma) and Chickie was born just before 10 p.m. I did ask for the epidural (and my doula said that I asked for it when every woman asks for it-- when you want death to come, and you think death MUST be coming, but strangely, it doesn't) but when the OB checked me, she said I was 9 cm and would push soon... and she just said, "You've come this far..." and I realized that I wanted that baby OUT and that I didn't want to be in labor any longer. 3 contractions later, I pushed.
By the time I pushed, I was exhausted. I wanted to squat or kneel, but when I tried this, I couldn't hold my own weight, and my legs buckled underneath me. The OB said she could best protect my perenium if I pushed on my back, and at that point, I didn't care how I pushed-- I just wanted that baby OUT. I looked at Gina (our amazing doula) and asked if she thought it was OK, and she said that it'd be fine. So, I pushed on my back-- exactly what I hadn't planned on doing. I had always had this paranoia about tearing thanks to my Indian mom (Indian moms lay on the guilt like NO ONE else, let me tell you)-- when I got my period when I was 12, she told me that she didn't keep tampons in the house because she hadn't been able to use them since I was born because she had a third degree tear. Thanks, Mom! (Yes, I can still use tampons... they don't quite feel the same, especially coming out, sorry if that's TMI...)
Anyway, I did it without drugs, and I tore in such a way that repair wasn't easy-- lots of little, little internal tears. Road-rash in the vag. Long story short-- the OB had a tough time seeing well to stitch because I was bleeding a lot, and after a couple efforts at different anesthetics (local, IV narcotics), I ended up going to the OR and getting an epidural so she could stitch me up.
It sucked. At the time, I was so nauseous from all the narcotics that I didn't care what the hell happened-- I just wanted the stitching to get done so we could all move on with life. At the time, I wasn't all that upset about being away from Chickie for the first couple hours of his life-- I figured I had his whole life to hang out with him, so a couple hours wouldn't make that big a difference.
In retrospect, those first couple hours away from him definitely affected my sense of self-confidence as a mom. I would notice something about him, e.g. something he was doing or the way he would move, and Dan would say, "Oh, yeah, he was doing that last night!" So, I felt like everyone knew my baby better than I did because I wasn't there for the first couple hours of his life and spent the first day of his life groggy and puking. I think all of this affected my ability to trust myself and to trust my instincts as a mom.
Here's the thing-- no situation is perfect, and I know this. There are a lot of random unknowns and "what ifs"-- what if I hadn't pushed on my back? Would I have torn the way I did? Who knows? So many women push on their backs and don't tear like that, so I can't infer causality at all. And really, what sucked isn't that I tore (everyone does) or how I tore, but rather the whole experience of being away from my baby and feeling like TOTAL CRAP for the following 12-16 hours or so.
But as I think about my next labor and delivery, these what-ifs have been circulating around in my brain, and I have been thinking about switching to the midwifery practice affiliated with the same hospital (I definitely want to give birth in the same hospital... I do think about the Cambridge Birth Center, but in all honesty, there's no way in hell I want to drive across the river having crazy contractions-- I barely could handle the 7 minute drive to the Brigham...)
I emailed Gina to get her thoughts on how things went down, and she basically validated what I had been feeling in my gut. She's trained as a midwife now and has given birth herself, and she just has a TON of experience with women giving birth in all sorts of places and situations. She freaking rules, needless to say. She agreed with my "we'll never really know" gut feeling, but she also said that going with a midwife is a great way to go if I want to go without drugs again (which I would like to do). She pointed out that most docs aren't trained to work with women who aren't pushing on their backs, and that's why the OB who delivered Chickie said that she could best protect my perenium if I pushed on my back. The vast majority of women get epidurals (NO freaking judgment-- hello, I DID ask for one!) and most OBs don't have a ton of experience with unmedicated deliveries (and this OB was young and not experienced as some may be, clearly). Midwives, on the other hand, are more used to women who don't get the drugs and are more likely to be comfortable with women laboring and pushing in different positions... because if you're not medicated, you probably don't want to push on your back-- it just doesn't feel natural (well, it didn't to me).
Gina also said that she had been with that same OB at other births and that she has a tendency to freak out in certain situations and over-react, and Gina felt like the OB was kind of freaked out because I was in a good deal of pain while she was trying to stitch me, and also that most docs don't have a ton of experience repairing tears on unanesthetized women, whereas midwives usually do have that experience. Again, who knows if the issue was with the doc or with the way I tore or what-- so many variables in the equation, clearly.
But it's all food for thought. Sadly, Gina moved to Maine, otherwise she would be at This One's birth, but we are interviewing one of her old doula partners on Thursday to see if she's a good fit... she sounds amazing, but I know she's expensive... so, we'll see. It's been good to re-process Chickie's birth as I prepare to do it all again, and no matter what, I know that everything will turn out OK in the end...
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