In the private sector there were mumbled discussions about individualized care, options, choices, birthing in places other than a sterile delivery room --open and exposed and thought of as little more than a cervix and vagina. I was cared for, but I was not a partner in my care.
My unmedicated labor was still rationalized to need a full IV and fetal monitors -both external and internal. There was a decision to artificially rupture my membranes, there may have even been the use of some Pitocin. There was no option to move, to walk, to labor in any position other than upright in a hospital bed.
I remember speaking out only once, in some feeble attempt to exert a bit of myself. I asked for an extra pillow so that I would not have to push entirely uphill against gravity.
I remember, and will always remember, the eyes of the OB peering at me from behind his mask. A doctor I had never met, never seen until this moment. A doctor I had watched pacing around the room as I pushed my first child through my pelvis and down while everyone else in the room was busy. A doctor who, when he finally noticed that my perineum was bulging and my babies head was almost crowning, looked over his mask at me and with disdain in his voice said, “So, you don’t want an episiotomy?”
You see, the multitudes of pregnant women being managed in this system were told that they had choice, were told to bring a birthing plan, were told that they had options. The reality was, that primips (first time moms) where the easiest to manage, the easiest to talk into interventions and also the easiest to talk out of choice. I had a birth plan. I had tried to exercise choice. It was only later that I had to laugh in astonishment as I realized that in the midst of this system so proficient at removing my autonomy these providers had actually read the plan.
“So, you don’t want an episiotomy? This would go a lot quicker if you had one.”
I had an episiotomy. My self worth had been blasted and nothing was left at that point. There was no reason to argue. There was nothing left but to end this because I wanted nothing more than to have my baby, to leave this place and to never have an experience like that again.
I became a mama for the first time on an August afternoon. My daughter was safe. She was alert. She was beautiful. I called her name and she turned to look into my eyes, directly into my eyes. Nothing else mattered at that point.
I worked hard to find a female provider who would follow me exclusively and provide my care. She was open and respectful of my opinions and my training as an educator. We worked as a team and made decisions together.
I knew that during labor I would face some challenges with the system itself. My body did what it needed to help. I arrived at the hospital at 5 cm dilated with strong contractions. I made some concessions, but I don’t feel as if I ever compromised my beliefs or position. I allowed a Heparin lock rather than be tethered to a full IV. I had fetal monitoring, but I moved anyway. I sat on the side of the bed, I stood by the bed. I challenged the rule of continuous monitoring and won. I walked, and labored, and breathed, up and down that very same corridor that had marked my transfer from labor room to delivery room just a few years earlier. I made certain that my care provider was called immediately when I was admitted.
As 2nd stage began the staff saw something they didn’t like on the monitor and began to grumble about a possible move to delivery. Just 15 minutes later my son was born on the bed, in the birthing suite, into the hands of MY doctor. I was in a sitting position, without stirrups, without drapes, without being moved. My doctor barely had time to slip on gloves. My son was immediately placed on my chest, skin-to-skin, even though the staff was reluctant and wanted him handed over to be checked. Touching him without fear of being reprimanded for sneaking out from under the sterile drapes felt like a milestone had been reached. I had no episiotomy. It wasn’t necessary because I was not pushing uphill.
Birth is never a competition, never a game to win or lose, but secretly -in the early morning just nine hours after beginning my second labor- I felt like a winner.
Later that night, finally alone and in the quiet, my son peed all over me and the bed. I guess this mama needed to be reminded that little boys can be wild, and that I still had some things to learn.
Sometimes however, when we want something so badly, obstacles seem to pop up around every turn. My husband was rather unsupportive of my plan to use a midwife and have a homebirth. He couldn’t understand the need to fully close the first chapter, nor could he fully reconcile the idea that finding a way to pay for a birth was necessary, so much more important than enduring a system full of uncertainty for fully covered care.
This child, my second daughter, also fought to challenge my plans. Just weeks before her due date, and confirmed by my midwife what I already knew, she presented as breech. I cried. I was heartbroken. I did not know if I would be willing to risk attempting a home delivery of a baby in this position. Then I made a plan, and with my midwife alongside, an obstetrician performed an external version, turning that girl onto her head, where she stayed.
The day that she was born, having early contractions, I took my older children to school. I came home and labored. My midwife and birth team arrived. I walked. I ate and drank. I labored in the tub. My children came home shortly before I began pushing. Nine and a half hours after my labor began I pushed out my daughter, lying on my side in bed with her two siblings watching and welcoming her into the world. She took a few moments to begin breathing and find her own voice.
There was no IV, no monitors. A simple doppler allowed us to hear a strong heartbeat. My membranes ruptured spontaneously. I was never told to push any specific way. I birthed this baby as was right for me with a team who supported my choices. She, like her brother and sister before her, was perfect.