Thursday, February 14, 2008

Birthing From Within (First Class): Introspection

Last night was our first pre-natal class.

I've tried three times to write this in a structured, formatted way, but I can't do it. Bullet points will have to suffice.

- It was amazing to watch Chris open his mind to the class and let the insights happen. At the beginning both he and the other dad were very much in the category of "being a good sport", but as we got more into the exercises he started to let go of his preconceptions and just be in the moment.
- The teacher commented a lot on my "wisdom" and "insight". I don't know if I am wise and insightful so much as very, very well-read. In addition to the pregnancy/birth/labour books and websites I have read, I have probably read hundreds of birth stories by women writing in their own words, which I find touch me very deeply. I've also read blog archive after blog archive, watching the story arc from "all I want is a healthy baby" to "my healthy baby is here and I'm so happy" to "I haven't figured it out yet but I've got PPD" to "a year after Junior's birth, I just can't reconcile my feelings about it". I am fully (intellectually) cognizant that our feelings and desires for birth, even when not consciously recognized, play a huge role in how we deal with the first year postpartum. So I figure consciously facing my fears and desires about birth is a good first step, and that's why I'm there.
- The pain exercise with the ice cubes is not very difficult. I want to find something harder that Chris and I can do together. He is very good at coaching me through 60 seconds of ice cube "contractions", which gives me a lot of faith, but I know contractions are going to be a lot more difficult (for both of us).
- The birth art was not as hard as I feared, thank goodness. She gave us a topic and 30 seconds to think about it, then 2 minutes to draw our reaction to it. We didn't have to show our art to anybody or discuss it with anybody - instead, we turned our pictures face down and were invited to share "what we learned about ourselves" or what ideas or images came to us in the process, rather than examining the finished work.

Going a bit deeper, here are my insights and/or things I need to work on.

I have absolutely 100% confidence that I can get through a normal labour. There is no doubt in my mind. What scares me is when things go beyond normal. Labour isn't progressing, or the baby is stuck, or in distress. This is when the caregivers will want to use interventions. Interventions scare the hell out of me. The most terrifying ones to me are forceps, epidurals, and caesarean sections. Last night after class I talked to Chris about my conviction that I can "do" normal labour with flying colours. I talked about how in cases when labour is not progressing and a c-section is looking imminent, the caregiver will sometimes present it this way: "I can let you keep pushing for 6 more hours, and then we'll probably have to do a c-section. Or, we can do one now." Then the woman (couple) is given time to process this, to grieve the loss of the vaginal birth they had planned, to prepare themselves mentally for the new path. I like that caregivers would do that (obviously not in an emergency situation where baby is in distress). It seems sacred and important.

But I told Chris that were I in that situation, I would have a lot of difficulty giving up moving on to Plan B. I would still be stuck in "mind over matter", in "I can DO this". That I feel I will need a lot of support to recognize when we have moved beyond normal labour into a situation where my body is not responding as expected, or the baby needs something beyond what I can provide. I will probably need a firm hand at that point.

And afterwards, how will I cope with the loss of The Birth I'll Never Have? I think the key is to eliminate all doubt. For example, I don't plan to have an epidural. But if the pain goes way beyond what I'm able to cope with, if my labour goes on for a day and a half and my body needs to rest, I will have one (it was very hard to even type those words). But when I get to that point where I feel I need one, Chris and our doula have been directed to go through our [yet-to-be-created] list of pain-coping strategies, one by one, and try everything on the list just one last time before accepting that no, none of these are working, and yes, I really genuinely need that epidural. Then later when I start to doubt myself and wonder if I really could have coped without it, I can reflect that we tried everything, nothing worked, and that I did need it. Same thing for any other intervention: at any point when we are getting near to using one (either because I want/need it or the caregiver is suggesting it), we will exhaust every alternative first.

One last challenge to mention is that there is only one other couple in our class, and they have a child already. The mentor, Regan, is a birth doula and a mother. So I am the only woman in the room who hasn't done this (labour/birth) already. That can make it just a wee bit daunting to go out on a limb and (for example) give Chris feedback on his coaching me through contractions. He was concerned that he was being too repetitive, that he said "You're doing great" and varations thereof too many times. I responded that I felt it was the reassuring tone in his voice, his physical presence beside me, and the undivided attention and support he was lending, much more than the actual words he said, that would help me through labour. Then I turned to the mentor and the other mom and asked if they felt this was true, since they'd done it before. It felt just a tiny bit awkward to try and suggest to Chris what I would need or want in a situation I've never been in - especially in front of people who have been there! On the other hand, I guess I need to remember that every labour/birth is different, and that there is no Right Answer.


Anonymous said...

Tell Chris that repetition is key - when I am supporting a woman through contractions, I say almost the same thing with EVERY one - ok, slow deep breaths, focus on your breathing, relax your shoulders, relax your bum, relax your face, let all your weight go and just sink down into the (bed/ball/water etc), slow deep breaths, that's it - you're doing it, it's past the peak now and fading away - and when that one's gone take a big deep breath and blow it away"

As a student, it took me a while to be so chatty while a woman was contracting, I felt that they were doing alright and didn't need me telling them what to do - but as I did it more and more, the feedback I got was "I'm so glad you were there, I could just focus on your voice and do what you were telling me". Sometimes when I think the woman wants me to be quiet and I stop, she'll suddenly say "keep talking!"

Repetition and pattern is very important to women in labour - those rituals and routines are what get women through contractions....

It sounds like it's a great class!!! :)


Anonymous said...

I should also mention that the tone of my voice is very low and I speak very slowly - often rubbing her back or shoulder or doing a hip squeeze or something.....


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