Friday, October 8th 2010
My IVF story: labor and childbirth
This is the third post of four on my experience with IVF and pregnancy, and my thinking on its broader meaning to the public and to anthropology. Find the first post here and the second here.
“Why are you just standing there?”
Last time, I ended with my water breaking all over my bedroom floor. Thankfully, it was a hardwood floor and was easy to mop up. But I’m getting ahead of myself.
I slept terribly for my entire third trimester. My doula serenely said it was my body’s way of preparing me for sleepless nights with a newborn. You will be happy to know I didn’t strangle her. I ended up having to take a nap every afternoon to even approach five hours of sleep for every twenty four, because I was uncomfortable and restless at night. Unfortunately, I often even struggled to read or work at night, because the discomfort that kept me from sleeping also kept me from concentrating.
So when I got a decent night’s rest on the evening after my due date, and found myself roused once groggily in the night, felt a little wetness that made me worry I had peed myself, and decided to drift back to sleep, I hope you won’t think too ill of me.
Chances are good my amniotic sac started to tear sometime in the night, and the movement of standing up blew open that tiny rip.
I looked down at the floor. Brendan looked down at the floor. We looked at each other. I started to laugh. “Why are you just standing there?” he asked incredulously.
“What should I be doing?” The more I laugh, the more I leak.
“I don’t know, get in the tub or something!”
So I do. Brendan hands me the phone while I’m standing in our bathtub, and I call the birth center. The midwife is pleased to hear my water has broken, is unconcerned, and says to keep her updated in terms of if and when labor starts. She wants me to come in in twelve hours to do a non-stress test, but otherwise recommends I go about my day.
This one of many major differences I experienced with a midwife versus a doctor. Hospital protocol is to bring a pregnant woman in if her water breaks, even if labor hasn’t started, and they are a lot more aggressive about inducing labor if it doesn’t start on its own.
I convince Brendan to go into work for a few hours so he can do some things that really needed to happen that day, and I lounge around a bit. By mid-morning I am having very mild contractions that are seven minutes apart or so.
Brendan and I spend the day grocery shopping, baking cookies, and going for walks along the Charles River. I was feeling triumphant and strong. I was kicking ass at this whole labor thing. It must be my athletic background, I told Brendan, and my high pain threshold, that is making me have such an easy time of things. I was buoyant, even as I started to need to pause and concentrate on the contractions when they happened.
Around six in the evening we went to the Birth Center, where I completely believed they would check my dilation and say I was at four centimeters. I had been laboring all day, after all. My midwife checks me. “Maybe one centimeter,” she says.
Are you kidding me? I begin to feel nervous, like maybe my vision of hanging out in the birthing tub while playing cards with my sister and husband was not going to happen. Maybe I had underestimated labor a little bit.
My non-stress test comes out fine. I’m starting to really feel contractions, and my body keeps trying to move away from them. I have back labor, which isn’t so great.
At this point, time starts to feel different. I know we went home for a while, where my sister joined us and she and my husband got some good. I know I lay down on the floor, then the bed, that I tried to take a hot shower, and that nothing really worked. I was starting to feel miserable, and a little panicked. I am a perfectionist, and I had had this idea that somehow labor would be different for me, than, you know, the millions upon millions of women who have come before me.
Time to go
I asked to go back to the birth center, probably around eleven at night. We get there and I’m maybe three centimeters dilated, and I can’t be admitted until I’m in active labor, which is at least four centimeters. We hang out in the lobby with my two midwives (one is in training). They inject little subcutaneous sacs of water into my lower back that burn horribly, but reduce my back labor pain by half. I am starting to moan with each contraction, and while I want to be holding someone’s hand, I don’t really want to talk. I really start to wonder what I was thinking with this whole natural labor thing.
By one thirty or so in the morning, I am considered in active labor so we can go upstairs to one of the birthing suites. No one else is there that night so I get the best one (though all three are great). I get into the tub as soon as the water is ready. Nothing feels right, the water temperature feels wrong, it doesn’t seem deep enough, I can’t position myself to get comfortable, I hate everything. Over the next few hours the pain gets worse. Yes, contractions are like menstrual cramps. They are like menstrual cramps that cover several orders of magnitude more surface area, are several orders of magnitude more painful, and they come in waves of pain that crest, only for you to know that in another minute and a half you’ll have another one. I am a natural birth advocate, but I am not going to tell you labor is fun.
There were some highlights, of course, like the times Brendan carefully smoothed the hair from my face and got me to sip some water, like the way he and my sister watched out for each other over that long night. The moment I opened my eyes between contractions to see every midwife and doula sitting on the floor of the bathroom, reading their own copy of my birth plan while they waited for my next contraction.
After a while, the midwives smartly decided I needed to move from the tub, since a change of pace might help move my labor along. I labor on all fours on the giant king-size bed for a while, but am starting to panic about the pain and how long everything seems to be taking (again, it’s actually all taking a normal amount of time). The midwives suggest a gentle intervention – how about an injection of Benadryl? It won’t harm the fetus and will make me a little sleepy, which will help me rest between contractions. Amazingly, it works: I am alternately screaming and sleeping for a few more hours, giving me the strength I need to ride out my dry back labor.
Transition
Those of you who know anything about birth know how women act during transition. This is the point at which a lot of women tell everyone, in no uncertain terms, that they have decided not to have the baby and are going home. They start packing their things or otherwise give up on the process. For me, I started apologizing. I thought, though no one had indicated it in any way, that I was about to be transferred to the hospital for an epidural, that that was my fate. “I’m so sorry, Brendan. I can’t do it. I’m sorry.”
“You are doing it, though,” he said. “You are doing it.”
I thought I saw a hint of a smirk in the face of my doula and midwives, who have seen hundreds more births than we have. They got me to move to another position, and told me maybe I might feel like pushing soon, and if so that I could. They also said, gently, maybe we should go over to the bathroom again. You can pee, and maybe we can set up the tub for you again.
So I pee, and then when I get up I get the URGE TO PUSH. The URGE TO PUSH, to me, was the most delightful, empowering, wonderful part of childbirth. Labor is all about getting out of the way of your body so it can do its job of dilating your cervix. Pushing is something you get to do. Of course it hurt. But it was also one of the most awesome (not as in awesome, dude, but awesome, full of awe) things I have ever done.
It turns out I am good at pushing. So when I felt the URGE TO PUSH I started to push my baby out. I felt the well-named ring of fire as the baby’s head crowned. “Wait, wait!” my midwives yelled. “We aren’t ready!” They sprinted to get everything together so they could catch the baby.
And that is how I ended up giving birth to my amazing daughter standing up, at 9:45am on a drizzly day in March 2008, holding on to my husband’s shoulders, standing by a toilet.
Bonding to our baby
This gorgeous baby troll (let’s just be honest, all newborns are a little troll-like) was passed to me from between my legs where my midwife had caught her. I looked at the baby. I looked at the baby again. “It’s Joan!” I shouted. “It’s Joan!” It was a baby girl, a rather purply-blue baby girl, but a girl nonetheless.
We had wanted to let the cord pulse a bit more and not cut it while I held her, but the midwives were understandably concerned about the color of our daughter, so they encouraged us to cut the cord now so they could warm her up and make sure she was breathing well. Brendan cut the cord, then followed the midwife to the bedroom where they put Joan on a little warming table and ran some oxygen near her face. I am guessing that the reason Joan came out looking a little blue was due to my rather overzealous pushing, rather than there being anything inherently wrong with her. They slowly walked me away from the bloody massacre of the bathroom over to the bed, where I could push out the afterbirth and hold my baby.
Because I had lost so much blood (they estimated I lost 500cc, which is the technical definition of postpartum hemorrhage), the midwives decided to give me an injection of pitocin to speed up the afterbirth so they could be sure I wasn’t hemorrhaging. I pushed out the placenta and thankfully I was fine, but it was a smart intervention anyway.
There are so many other pieces of this story I could tell, from the sound of my sister crying with joy as she videotaped the birth, to the doula who held my hand as I was sewn up (I had a second degree tear). All the grandparents got their moment to hold Joan. Brendan went to Christina’s to buy us milkshakes (this was a very important part of our birth plan). And I sat in a darkened room, staring and staring with a mix of fear, delight, and unadulterated love at the bright pink, eight pound three ounce baby in my arms. We were home by five o clock that same night, where the grandparents greeted us again and we celebrated our wondrous, gorgeous, perfect child.
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In the final installment next week, I’ll reflect on the experience and broader issues around sexism and overpathologization regarding both IVF and reproductive choice.
