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Wednesday, February 10, 2010

Getting There is Half the Journey

During my daily blog reading I came across this post from Jill at The Unnecesarean , about a Bulgarian woman going through a horribly traumatic childbirth. My heart ached for this mother, whose body was literally torn apart by rough doctors who seemed to have little regard for her or her baby. It was like something out of a science fiction movie, or at the very least, reminded me in part of what birth was often like here in the US just several decades ago.

My mother-in-law gave birth to my husband (who had a 'large head') in 1972 under many of the same conditions. Combine an already-nervous person with a labor in which you're no doubt strapped down or restrained in some way, and you get the perfect recipe for a high-forceps birth (which is out of fashion in the States now because of the increased risk of brain injury to the infant). I would ask my mother-in-law about it, but since she was drugged to the gills, she, by her own admission, doesn't remember any of it.

So many women are completely unaware to what lengths some women go to give birth in the gentlest manner possible, or even why they want to. Traumatic birth experiences, knowledge about the true nature of modern obstetrics in general, or just an innate desire to give birth more naturally might be just some of the reasons. 'It doesn't matter, as long as you get a healthy baby' is usually the mantra, as if to say you should just shut up and submit already. But for many of us 'crunchy,' 'granola' or 'fruity' moms, it does matter. One thing I don't think the 'it doesn't matter' crowd understands is that their apathy sets the tone in obstetrical care for everyone, even those of us for whom it matters very much. Try telling that Bulgarian mother that 'it doesn't matter,' because obviously it does. (I hate referring to her so impersonally, but I don't know her first name.)

This is, in part, why I chose a VBAC for my second birth, because my first childbirth experience, in retrospect, was pretty awful. Second to the morning sickness, the pain of c-section recovery was the single-most thing I dreaded about being pregnant again. I feel ridiculous even mentioning it in the same post as this woman's traumatic birth, because my experience was nothing when compared to hers.

With my first child, I was scheduled for a c-section because of breech presentation. We had picked the day, and my doctor made passing reference to me going into labor first as 'not being that bad' and 'they wouldn't let me go too long' if that happened. No mention of the risks of surgery, anesthesia, the possibility of respiratory problems in an infant after a surgical birth, no nothing.

I went into labor two days before the scheduled date (in hindsight, I thanked my body for this later, as it was 'proof' that my body could start labor on its own, a prerequisite that would be very important later on.) Despite the curtain being raised above me to essentially 'protect me from myself,' I could see my reflection in the overhead lights and did everything I could not to look as my body was cut open. After the baby was born, he was examined and weighed out in the hallway where I couldn't see him (my husband was with him) and it was surreal to hear him crying from so far away. They didn't even bring him up to my face so I could kiss or touch him, and the whole birth seemed rather detached and cold. As they were finishing the surgery, I thought to myself, "Do I even remember what he looks like?" because I had seen so little of him.

I was wheeled into recovery with the baby next to my bed. I couldn't hold him because I was still under the anesthesia, but the best I could do was watch him as he got used to his new surroundings. Once I regained sensation in my arms, I proceeded to itch myself silly from the spinal for a few hours afterward. I remember briefly holding him, I think, but no attempt was made to help me nurse him. Probably because of my own inexperience with breastfeeding, he didn't latch on for nearly 2 1/2 days after the surgery. The baby, and my husband, could only stay for a little while, and I was left alone for the rest of the night (this was about 2 a.m.) to 'rest.'

One thing I noticed right away was how much my arm hurt every time I used that ridiculous PCA (Patient-controlled anesthesia) pump. There was supposed to be Demerol flowing through my veins; instead, I got a burning, stinging sensation that felt like my veins were being filled with acid. The pump beeped intermittently, the nurse ran in and then back out again after adjusting it. I complained that I was still in pain; they ignored me.

I knew something was wrong with the IV - that explained the beeping. On an IV pump, when a line is blocked or the tubing is otherwise compromised, it will beep to let the attendant know. (After calibrating enough IV pumps during my work at a pharmacy, I knew at least this much.) Yet the nurse would flutter in and out and adjust this, adjust that, then return to her post at the nurses station to continue the discussion on the Lord of the Rings movie at 3 a.m. I remember this because I could hear everything they were saying clearly, being awake almost the entire night.

Throughout the next day I tried pushing the button for more pain meds, but nothing happened. "You can't have anymore," explained a nurse, "because you're only allowed ten doses in an hour, and you're over that limit." "But I'm still in pain," I said. That was the end of that. Never mind that, when I was supposed to rise from my bed the first day after surgery in an attempt to get up and walk around, I felt like my body was being seared in half as I tottered like an elderly woman to the bathroom.

While all this was happening, I was getting increasingly hungry. I stopped to think and then realized, I hadn't eaten breakfast. What happened? Oh, someone replied, you're supposed to go down and get it yourself in the cafeteria.  Never mind that you've just had major abdominal surgery, and I hadn't the faintest clue where the cafeteria even was. A nurses' assistant felt sorry for me and stole a turkey sandwich off the lunch cart.

Later, after my hand swelled up to about twice its size, the nurse looked at it in horror and reported, "We've got to get that out of there!" So I ventured a guess that I was managing pain with about six doses of Lortab a day, with an ibuprofen thrown in here and there for good measure. The Demerol? Who knows where that was going. At least my left hand was pain-free, in theory.

Not everyone has a terrible c-section recovery, and not everyone has a great vaginal birth. Like our pregnancies, our births are all different, and so is the way our bodies react to them. Birth is not the 'one size fits all' experience that most doctors, and patients, think it is or should be. And birth is not just about going to the hospital and pushing out a baby. Because while having a healthy baby is the main objective, sometimes getting there is half the journey. And sometimes the choices we make while on that journey can make the end result take a totally different path.


Heather Griffith Brewer said...

I don't even know where to begin.
First off, it's ok to feel bad/traumatized/upset about your own experiences. Yes, some people have had it worse, but that doesn't change the fact that what happened to you was awful.
Secondly, the attitude that having a healthy baby is all that matters is what keeps things in obstetrics as dysfunctional as they are. We can't predict what experiences are going to harm a woman weeks after. Some women, even then uncrunchy ones leave their deliveries feeling a loss that they can't pinpoint.
What's unfortunate is the fact that oftentimes women have to have a bad experience before they know that they need to seek out something different.
I love your posts btw.

The Deranged Housewife said...

That's exactly my point - my births have all been one long, continuous story, really, that seem to intertwine. I tell people once you have a c-section, it can change the way you give birth in the future, and that can change your life. My VBAC and then subsequent c-section have helped me to 'evolve' as a patient, that's for sure. Now I'm debating on #4 (assuming my husband feels like participating LMAO) and that's going to through a new monkey wrench into the works, for sure.

The big thing is that people often assume "it went fine for her, therefore it'll be fine for me, too." Meredith Vieira alluded to this in her comments about the c-section mom on the Today show - basically "I did just fine with mine, she will too" kind of crap. Argh!