I woke up this "labor day" and began thinking about my own labors - my Labor Day-ish baby will be five in two days. I picked up Tina Cassidy's "Birth" and read a passage about influential but misunderstood obstetrician Grantly Dick-Read and how he, along with Dr. Joseph deLee, both though fear could hinder and negatively transform the birth process.
I thought back to my pregnancies and how fear took hold, both in pregnancy and labor. A negative attitude or word of discouragement not only gave me doubt about my body, but doubt in my care provider. I never received a "You can do this!" or "Good decision, you'll be thankful!" at any time during my care, except perhaps when I naively decided to have a repeat cesarean (I later changed my mind). It was only after the fact, after the VBAC that went well, that I heard "Good for you!"
"I do not want to be doing this." That is what one midwife told me before my second birth. She spent more time talking about how much she liked my haircut than the philosophy of birth, and didn't hesitate to tell me that she felt my decision to VBAC would be exposing her to more risk. I was taken aback and thought, What if I can't do this? What if something happens?
"I do not know how to do this." These were the words of a resident who 'attended' me during my last labor, during which showed a footling breech baby and a cervix that was fully dilated. While I could understand his nervousness, later I thought I should have yelled at him, "Yeah, so maybe you should LEARN!" You always hear stories of laboring women yelling at their birth attendants - I wished, for once, that I could have been one of them in that situation. I pictured him sitting in a classroom, full of other clueless students, and wondered if the dying art of breech birth would just slowly, quietly go away and no one would be the wiser. What would he do, I later thought, when a woman comes in with precipitous labor of a breechling? In other words, what would he do if he got more 'crazy' women like me?
I think of the women who had traumatic, difficult births and how those transformed them, fearfully: the women who wanted more children, but decided not to because things were handled so miserably. I have waffled back and forth since the birth of my last child on whether or not to have another baby, at one point resigning myself and saying "I just do not have the mental energy to fight the good fight anymore." Then something would change: I'd see a mother out and about with her brood of kidlets, or hear an empowering story from someone who had an amazing birth with confident care providers that supported her in every way possible. Last night my husband and I scanned the list of names in our phone book for an endocrinologist and ended up finding an OB who advertised that she specialized in home birth. That gave me a ray of hope - but of course our insurance doesn't cover her services.
The journey is an uphill battle the whole way, as I feared it would be the moment I had an unintended repeat cesarean. The nurse told me, moments before I was wheeled back to the OR, "You can have this baby vaginally, you know." A glimmer of hope, but at what cost? I wasn't mentally or physically prepared for that eventuality, and I'm not sure she was, either: was she prepared to see me through this birth by herself, in the wake of physicians who - with more power than she had - were not? Was she silently hoping I would speak up and advocate for myself in ways that so many others had not? I'll never know. I'd like to go back and ask her, though, if only I could: How were you planning on helping me?
That uphill battle, I am realizing, has more than one hill: the biggest being, do I want to try this again? I knew I wanted to lose weight in an effort to start out better than before, but hadn't really done much about it until nearly 2 1/2 years after my last birth. I realized that, had I been more serious about it, I probably would have dropped the extra pounds and been pregnant by now, if that's what I really wanted. Then I think, Well, maybe not - I consider this time one of reflection not on just "Do I want another baby?" but "How can I gear up for this process? Am I ready to climb those hills?", of which there are several. The biggest fight of all is finding a supportive care provider who is willing to climb those hills with me. After hearing so much discouragement, I wasn't sure if that was even possible.
I know Drs. DeLee and Dick-Read said that a woman's fear in labor can negatively impact her birth. But I also know a care provider's fear, transferred to the patient, can too. I wonder if I wouldn't have more confidence, and less fear, if I were cared for by someone who "gets it" and doesn't allay her fears and insecurities to you. Instead of hearing "I do not want to be doing this" you hear, "I want to be doing this as long as you do, and I will be here for you."