This ain't no competition: on Birthing

I seem to have a strange habit of looking back at the whole birthing thing around about a year after having kids. It might be a bit of a coincidence, or maybe not, but with quite a few of my friends coming close to their own due dates, I guess there is a bit of birthing chat going on these days.

As a bit of background: For all my life, I'd been absolutely scared of giving birth. So much so that for most of my life, I didn't want to have any kids. As soon as I got pregnant for the first time, I searched and searched how to deal with this fear. I went down the route of a HypnoBirthing course, totally tried to find out every information on birth, was addicted to reading birth stories, and I also took part in an NCT course.

Both the NCT and HypnoBirthing of course advocate a natural birth, if possible without any pain relief. I totally bought into it. Two long drawn out labours later, with one instrumental birth and one emergency c-section, (and trying out most available pain relief) I still long for that natural, serene, birth experience. You know, the one where you actually have a sense of birthing rather than having the baby taken out of you.

I felt totally disempowered first time around, and totally empowered the second time. The first birth, though more "natural" than the second, was a massive disappointment. With all my hope, preparation, longing to have a natural birth, it didn't happen. I kept going over it, analysing where it went wrong. In contrast with the second birth, an even longer back-to-back labour, hours of pushing without any movement, I was begging for a c-section. I was exhausted after labouring two nights in a row (and the day in between) and had had enough. Shame for that natural birth I never had but you know what? Having had a child before I knew there was much more to having babies than the birth and it didn't matter so much.

I'm not saying of course that birth doesn't matter. It does. What is important though is that with all the encouragement towards natural, drug free births, preferably at home, it doesn't become a pressure or competition to have such a birth, and above all, no woman should be made to feel a failure for not achieving this ideal. It may come as a surprise (hear the irony bell?), but different women labour differently, and it may well be that in times gone by with lesser health care, our outcome might have been a much worse one. It's only looking back after two births (and the parenting in between) that I realise it's not all about birth. Birth is important, every woman should be informed and be able to make choices about medical intervention and those choices should be respected. The thing is, it's also ok to choose pain relief, to choose a hospital birth or even an elective c-section. It's ok and doesn't make us a better or worse parent.

The choice though should be based on information, knowledge and weighing up of risk without scaremongering, and facilitated by non-judgemental staff. I had a great experience in that respect at the Southern General Hosptial. The surgeon visited me on the postnatal ward to discuss the c-section and answer any questions I may have. She also reassured me that none of the previous choices I had made would have made a difference on the outcome. In both labours, my birth plan was given due attention and followed to the word (so much so that I had to wait 2 hours for the decision to have an emergency c-section after I had given up all hope that this baby would come out on its own accord, the staff never failed to encourage me, had me upright and moving, and did everything to enable me to have that natural birth I was hoping for). However, I have heard of different experiences in other hospitals, where choices women make were questions, where birth plans were ridiculed.

It is one thing to encourage women to be better informed and make decisions on  that basis, another to recommend and push for a natural birth, which it appears the NCT at times seems to be guilty of from what I have heard (not in my personal experience I hasten to add). Because the damage of unmet expectations and hopes can be quite significant and contribute towards negative feelings after birth. In my own case, an empowered c-section might actually have been better than a non-surgical birth where expectations were not met. And as to bonding post c-section - it's all relative. Again, it's more about how one feels about the birth experience than what it was actually like. I felt a failure after the first birth and didn't think twice about the c-section after the second, and found bonding, breastfeeding and general adjustment much easier second time around, though admittedly I had a more serious case of the baby blues (which I attributed to my slight panic of having to look after two kids, which at the time seemed impossible - it wasn't of course!).

Of course, if I had a real choice I'd love to have given birth naturally, but, heyho, it's just a day in the life of a baby and a mother, and there are many more that count just as much. Too many important days to waste time on what ifs and if onlys. There are enough pressures on women and mothers, let's not add the one of having to birth naturally as a rite of passage to it. Becoming a mum is in itself a right of passage, and that's plenty to deal with on its own.

(and for anyone who has that failure blues: For 9 full months YOU grew a baby. How effing amazing is that? Give yourself a massive pat on the back!)

Agent of Birth

I resisted Make do Mum's post. I can't resist Single Mummy.net's post.
The big question is that of birth plans. Or not. With just over 4 weeks left (or maybe more or less) I guess it's particularly relevant for me right now. Having the benefit of hindsight, I'm a bit more informed about this all than I was last time, but in principle, my views haven't changed.

Draw back the clock 4 years ago when I was just pregnant, and one thing that was overwhelming was my fear of giving birth. It was bad, it was ugly, there seemed no way out. I was scared of a c-section, especially being awake through it. I was scared of labour and the pain, and all that comes with it. Neither natural birth or a c-section were something I wanted to ever experience.

I knew I had to do something about it and I did. I informed myself about birth, the process, complications, options, choices. I embarked on a HypnoBirthing course and did an NCT course. I faced my fears and worked through them. I signed up for some forums, including one on homebirths. I really and truly considered all options and made sure I knew what my preferences were.

Thanks to HypnoBirthing, I entered labour without fear, but with excitement and confidence. I also had a lengthy birth plan which was along the lines of natural birth, no epidural, birthing pool etc. My main worry was that of a c-section - the one thing I hoped to avoid at all costs and I was confident I would. And yes, things went different - a long labour, and prolonged second stage which needed intervention. I was very close to the knife but managed to do with the forceps (and boy was I thankful for the last minute spinal). I did manage to avoid a c-section, I did manage to do labour without an epidural (for whatever that's worth), I found out that labouring in water works wonders for me, gas and air is odd but not to be dismissed, and that diamorphine is shite.

This time around, I'm much more open to the idea of an epidural because at the end of the day, when you're labouring forever and are tired, it doesn't help to be so categorically against it. Diamorphine did more damage to my mindset than an epidural would have done. I'd still try doing it without, just to be able to stay in the pool, but rather have it than go through the last 3 hours of my last labour again.

I do have a birth plan this time. It's shorter, to the point and much more flexible. I still find it important because it establishes me as a person who has choices and a say in birthing. This is something not to be taken for granted. Consider this: everytime I tell someone that Cubling was 15 days late, I hear the sentence "I didn't know they would let you go that long over". I'm sick and tired of the implications of this turn of phrase. I was offered induction at 39 weeks because I felt rotten. I refused because there was no medical indication. This was my choice - and if another woman had chosen the offered induction, that would have been fine as well. No woman should feel or actually be "made" to have an induction because "they" don't "let" you go over a certain number of days (or refused one because she hasn't reached that point yet but has real reasons for requesting one). It's the woman's body, the woman's choice, the woman's baby.

I was scared of induction and refused to have one before 42 weeks as long as baby was doing well. Baby was monitored and was doing just fine. It was my choice to have an appointment for induction at 42 weeks because of the higher risk of stillbirth from that point onwards. Labour started at 42 weeks exactly, so I didn't need induced.

Due dates aren't an exact science, but it shocks me that women still feel totally at the mercy of the medical profession when it comes to what is supposed to be a rather normal occurrence, that of birthing a baby. It's great we have good healthcare, midwives and medical intervention if needed. However, we also have choices, and should be informed about risks and options to base our choices on. Of course there may be circumstances where we have to adapt - when Cubling got tired and a c-section was advised, I questioned this. We discussed it for 10 minutes and I still struggled to sign the consent form (because I didn't feel I could consent to it). I did it though-for the baby. And in those 10 minutes Cubling finally moved down the crucial amount to make it out by forceps.

I struggled for about a year with this less than perfect birth, not having felt her being born, not having pushed her out by myself. And then, suddenly, I realised that it didn't matter. What mattered was that I tried to do my best, I did the best I could, we were both well and giving birth is nothing but the start of a much bigger adventure and challenge - that of parenting. It's important though to take ownership of how we birth and not be subjects of the medical profession. It's not so important how it all ends up. I'm very much at ease with how Cubling's birth went now, and positive about what's to come.

Above all, I'm glad I did have a birth plan, it made me an agent in this event, rather than a subject. And that's a good thing, surely.