Thursday, August 16, 2007

Finding Inner Strength. . . If you can call it that!

I've been struggling for some time now (since I discovered that I was pregnant, truthfully) with the prospect of labor. Having had the same scenario play out with both pregnancies so far--membranes rupture or leak, admitted to hospital, no contractions, can't stimulate contractions, pitocin administered, pain unbearable, epidural, wait the requisite amount of time, baby!--I fear the same scenario will occur again, but I also fear the possibility that the same scenario will NOT play out again, and that I simply won't be able to cope with labor. From the beginning I had moments of panic--they went away, but are resurfacing--and I feel that I am just not up to this challenge. Now, I am a very determined person. For me to so completely lack personal resolve--or to waver the way I have been--and to have the urge simply to cave in without a fight is totally uncharacteristic and deeply disturbing. And the reason I say "cave in without a fight" is because truly, I do believe that natural childbirth is my preferred option. But my mind keeps telling me, "I just can't. . ." With the other two pregnancies, I always felt that I could muster up the strength when I needed to. This time, I guess I still think that deep inside, but since I know I don't really have to--that is, that medical intervention is waiting for me to wimp out--I just focus on the fear and the memories of the last time and conclude that I'm not up to the challenge. Sad.

So I am enrolled in "Active Childbirth" classes--or something--currently, which is the closest to real Lamaze that is offered in this area. Actually, it rather skips the patterned breathing of Lamaze, instead focusing on deep breathing and focused relaxation, very much like yoga, so I'm pretty much in tune with it there. My problem is that watching births and hearing about certain stages of labor--Transition in particular--fills me with such deep anxiety that I REALLY NEED the focused relaxation by the end of the class. I take this as a really bad sign. When we discussed Transition on Monday night, I really had a hard time because Transition is the stage of "natural" labor that most resembles (emotionally and physically) the experience of intense, no-epidural pitocin-contractions, at least in my experience. Especially the feeling of not being able to cope. Yes, pitocin is perpetual Transition. I just had to write that because of the oxymoron.

Last night I asked my husband if it seemed defeatist just to resolve to go as long as I can naturally. He didn't think so. That resolve alone lifted a burden, although I have never said definitively that I would refuse the epidural at all costs, not even with previous pregnancies.

But today, I think I may have discovered a source of determination. I think it was there on the first night of classes, but it went away. And that source of determination is from the depths of my ornery being: I find strength in resolving to fight others. This is not something I'm particularly proud of, but hey, if it works. . . So in thinking about writing the birth plan and fighting for my rights with the hospital staff, I find a kind of inner strength. Not a peaceful inner strength, but it's something to build on, I guess!

17 comments:

Jennifer @ Conversion Diary said...

Thanks for your honesty here. I too am struggling with some trepidation about the whole birth process. In theory I'm fine with getting an epidural, but I just have this thing about medical procedures, particularly those that are millimeters away from my spinal cord, and it just stresses me out to think about it.

On the other hand, I did a midwife out-of-hospital birth with my first, and he ended up being compound presentation (his fist was on the side of his head) so it was a really bad experience. The pain literally drove me out of my mind. If I had been in a hospital I'm sure it would have ended in C-section. So...while epidurals freak me out, so does the prospect of natural childbirth.

The only thought I have to throw out that might have a remote chance of being helpful (though it probably won't), is that I discovered with my second labor that I am not a relaxation person. I know that many people have a hard time believing this, but for me, relaxing makes the pain worse. The best pain management technique I ever tried was asking everyone to leave the room and listening to rap music on my iPod (mainly Tupac) and getting all energized and excited. The doctor was stunned when he I was dilated at eight cm, and he looked at the chart showing my massive contractions and asked what my secret was (I don't think he believed me when I told him). I really didn't feel like I needed an epidural, but only got one because they pressured me to because they thought there's no way my "pain management by Tupac" technique was going to hold out. Again, I know that this would not be the case for 99.9% of people in the world, but I just thought I'd throw it out there that relaxation might not be the best way to handle pain for everyone. :)

Anyway...my main point is just that I can relate, and it's something that I have a lot of conflicting emotions about as well. Hopefully I'll find some resolution in the next 12 days.

Literacy-chic said...

The trick with the epidural is to be in so much pain that you don't think or care about the whole spine thing. 15 minutes of pitocin should do it. I know that's not helpful since you have to be induced, but I have had the same reservations. I think if they just say "pitocin," though, I'll just offer my spine. :P Truly, though, I have confidence in the expertise of the anesthesiologists, even though I've heard a couple of not-so-great stories. You have to factor in how often these particular tricky procedures are performed. It creeps me out, too.

Hmmm... I guess my Led Zeppelin strategy might stay in reserve after all! ;)

I'm hoping my resolve will strengthen as I get closer. I hope the same for you!!

Kate said...

I'll agree with Jennifer that classes or no, you need to find your own way to cope. My 'mantra' so to speak was "no way out but through". I didn't distance myself from the experience or my body in any way, the way some methods encourage - entirely unplanned, I found that the only way for me was to be completely present to every thing happening in my body, to identify the aches and twinges and spasms and say, "my body is working hard. My body is doing what it is supposed to" and just work with it.

I hate the idea of any interventions and the thought of a episiotomy scares me silly, let alone a C-section. I know if I am convinced that some intervention is needed for my baby, I will do it and not sweat it (not all ways 'through' are the same). At the same time, I would hate fighting my caregivers! I really hope I don't have to, since I know I need to be able to totally go inside myself to get through, and I don't want to be distracted by anything! Fortunately, my husband has a wide protective streak and he's already gearing up to fight for me. :-)

I think you can do this. I think, if you can stay off the intervention wagon, you'll find sources of inner strength when you need them. And remember - transition ends. Even if it hurts, it ends when you get to the productive pushing part.

I feel like a cheerleader. :-) You can do it! You can do it! Rah Rah rah! Maybe we should buy your husband some pom-poms. ;-)

Entropy said...

You can do this! Natural labor is not going to be near as bad at having the Pit. You're going to do fine either way. Maybe you should just put off going to the hospital for as long as possible. They can't make you have pitocin if you aren't there. *grin*

John said...

I wouldn't advise about avoiding the hospital. It's always nice knowing baby is doing well. Besides, sometime intense or unbearable pain is an indication that something is not quite right. No one can ever relate to description of the pain I went through and it's because the baby was in distress. It was a good thing I was at the hospital as early as I was. Trust your instincts; go to the hospital when you feel you need to go. After all, you are paying them for looking out for baby and you. There's my 2 cents.

-C

Literacy-chic said...

At the same time, I would hate fighting my caregivers!

Yeah, Kate, that's a reservation I have, too. I mean, how can I relax if I'm having to fight every step of the way? It's a grim prospect. I've been unsure whether I'm up to that task, too, but it feels a bit more like I'm in charge when I think about bullying nurses.

Maybe you should just put off going to the hospital for as long as possible.

I was thinking this, too. As long as things are moving along in the expected way (and I'm not gushing all over the carpet of the rental with my 10-year-old gawking & freaking out), I'll try my darnedest to stay home.

But, C, I have advised people to go to the hospital against others' recommendations when things seemed to be getting serious, so I'll be careful! It's all about finding te right balance, I think.

Feeling better. Thanks & keep 'em coming!!

Jennifer @ Conversion Diary said...

15 minutes of pitocin should do it.

Actually, these were Pitocin contractions. My second had to be induced as well (that's when I had the DVT). So, maybe that could give you hope -- I know it's different for everyone, but I found the contractions manageable as soon as I cranked up Pass the Courvoisier. The only reason I agreed to the epidural was because there was no way to know if this baby would be compound presentation as well, and those two words strike great fear in my heart.

I have confidence in the expertise of the anesthesiologists.

Yeah. With my last I talked with the anesthesiologist and I felt very confident and comfortable with him...and then his nurse, who looked about 22, came and did the procedure. He wasn't even in the room! She had already started when I realized that it was just going to be her, and I have a thing about not insulting people while they have needles right next to my spinal cord, so I didn't want to say, "I want the doctor to do it!" :)

Jennifer @ Conversion Diary said...

Oh! Sorry for all the comments, but I just thought of something that might be helpful...

Have you read a lot of birth stories? This sounds odd, but it gave me great strength and confidence to read over and over again about other people's experiences. It just got it through my head on a deep level that, "hey, women do this all the time, I can totally do this."

...I highly recommend the ones in the back of the Sears Birth Book since they're all written in a constructive, positive way (as opposed to just reading birth stories online, in which case you may encounter some horror stories that aren't helpful).

Anyhoo...that was a big help to me so I thought I'd throw it out there.

Literacy-chic said...

Thanks, Jen!

I have NEVER had a nurse give the epidural!! That's awful! I guess whether or not I let her go ahead with it would depend on how far along she was and how much pain I was in. But I would be VERY upset about it!

Okay... I didn't realize you were talking about pitocin contractions. Wow! So maybe I'll ask them to start me off on the lowest setting (birth plan!) assuming they listen to me and don't do what they want anyway to rush me out of the Labor/delivery room. :/ I have so much faith in people--especially LD nurses. :P

I have read quite a few birth stories. Reading them is better than watching them, I have to say. I will look for the Sears Birth Book!

And don't worry about making lots of comments. It makes me feel important! ;)

mrsdarwin said...

I was going to say, since you had talked about finding strength in needing to fight others, that perhaps you needed an ornery nurse to rile you up, but I can also see how it would be exhausting to be in combat mode during labor.

Here's how I managed pain: I took it one contraction at a time, watched the second hand go round the clock, and said an Our Father, a Hail Mary, and a Glory Be very slowly. It's all in getting through each contraction. And in counting the seconds until the contraction is over.

Also, keep in mind that labor often goes faster with each subsequent child. Perhaps with your third you'll find things moving much faster, and you'll be able to skip the "wait the requisite amount of time" stage.

Literacy-chic said...

I'd love to skip the "water breaking" and "pitocin" stages! ;) But yes, faster would be good, too. I think I could bear it if the hardest contractions were only to last for a short time. (Who couldn't?) ;)

Your strategy sounds well-suited to a Catholic hospital (which is where I'll be delivering)! Maybe the LD nurses would be easier on me! (Except the Evangelical Protestant ones, I mean...) ;)

AcadeMama said...

As someone implied, every woman's body responds to pitocin differently. While you haven't experienced labor without pitocin, you have reason to believe that your body takes the stuff pretty hard, so I don't see why you couldn't deliver your birth plan to your doctor well in advance and ask a) to go without pit for as long as possible, b) begin with the smallest dosage, and c) only continue with it as needed. Your doctor should also be able to give you an idea of how your specific birth plan will be accepted and followed (or not) by those in L&D.

In regard to the epidural, it seems like the decision keeps getting represented as an "I can do this on my own" or "I cannot do this on my own" because I'm weak, or a 'wimp' (or some other equally self-deprecating term). I really don't understand why this is the case, though. Of course women "can" do it without an epidural, they've been "doing it" without epidurals for centuries. But, as someone who had an epidural both times, it was a choice I made after reflecting on how I'd dealt with pain in previous life experiences: I don't deal well with it. At all. I wanted to be able to focus on doing what I needed to do to deliver a healthy baby - preferably sooner rather than later - without simultaneously trying to cope with the pain. I know I *could* have had natural childbirth; my body is built quite well for that function actually. But just because I *can* doesn't mean I *have to* or *should.*

That is, it's not a competition. It's not a contest with others, nor is it a contest with myself. Nobody gives you a Big Blue Ribbon for doing it "naturally" (as if natural automatically equals no pain meds). There is no parade. No prize. No Strongest Mommy in Labor award. (Similarly, nobody came trooping into my delivery room calling me a big fat loser for having an epidural. Not that I would've cared.)

I feel that, in the end, it's about doing what you feel will make things easiest for you because you are the only one who has to feel each contraction and struggle with every push. And there's *nothing* wrong with making things easier for yourself (physically or emotionally).

Literacy-chic said...

Academama,

Thanks for chiming in.

Perhaps I'm representing it wrong...

What I mean to say is, "can I do this without giving in to the medical intervention that I KNOW is an option?" or "is it even worth the effort to try, since I am likely to acquiesce?" "Am I giving up too soon?" or "Will I really believe that I stuck it out as long as I can?" or even, "Do I care, or am I just looking to get out of this the easy way, which comes from early ambivalence about the pregnancy and may shadow my new baby experiences?" (Okay, the last one is harsh and may be a bit far-fetched.)

Without spreading the implications over to anyone else (gee, I seem to a real problem with that), I need to find a place of comfort FOR ME. And that means confronting my own fears about myself. I tend to judge myself harshly, hence the "wimp," which I thought was CLEARLY hyperbole. It will be a triumph if I don't have pitocin, even if I do have an epidural. But I would PREFER not to have an epidural, as long as I can believe in my own strength. At present, I can not believe in my own strength. I am caught up in past experiences.

About pitocin affecting me badly, yes, when the nurse starts me off too high. With my son, it took a few increases before I was feeling it at all. With my daughter, the b**** of a nurse was trying to get me the h*** out of there and started it on HIGH. Even with my 9 lb. 6.5 oz. son who was facing the wrong way and causing back labor, the pitocin didn't hurt as badly as with my petite 7 lb. daughter (no back labor). But I have DEFINITELY provided for all of that in the birth plan, and I hope to have my doctor's backing. We'll see...

Literacy-chic said...

Some relevant points from teh original post"

For me to so completely lack personal resolve--or to waver the way I have been--and to have the urge simply to cave in without a fight is totally uncharacteristic and deeply disturbing. And the reason I say "cave in without a fight" is because truly, I do believe that natural childbirth is my preferred option.

I believe VERY firmly in avoiding unnecessary medical intervention. The operative word being "unnecessary." So I did NOT have my daughter tested for a kidney disorder or urinary reflux because she had a urinary tract infection at 9 or 10 months. I did not see the need--regardless of the Academy of Pediatrics--to subject her to pain and trauma without further indication of a problem. Similarly, I turned in the light therapy table before getting the doctor's permission when I realized that the jaundice treatment was making her too tired to eat.
I did not have my son immunized for chicken pox, and I object to that and all other unnecessary immunizations. I was no big fan of hormonal contraceptives, even before becoming Catholic. They do nasty things to the body. These are just some examples. So to avoid an epidural (see Jen's & my comments about needles in spines) is just in accord with my overall beliefs about the place of medical intervetion.

Medical intervention is waiting for me to wimp out

Which it is. The nurse mocked my outcries from the pitocin after the fact, since of course she had been pushing me all the while to have the pitocin and clearly did not see the point of natural child birth. I changed doctors with my daughter when she laughed at the prospect of natural childbirth and made a derisive comment about it being my decision. Yeah, it's my decision, but I object to having others so strongly pressure me into the right, easy, or comfortable decision. As I said, though, I have always allowed myself the option of an epidural, and I have never felt that my birth experience was a failure, or any of that nonsense. I'm far too much of a pessimist to give in to that optimist bologna and believe that everything has to be perfect.

See what I mean? I start sounding really confident when I think about fighting something. Great. I need a "Labor Antagonist." That's a new concept...

Literacy-chic said...

P.S.- Isn't feeling in control of your body supposed to be empowering or something? Sounds like a good prize to me. ;)

Kate said...

I don't know what an epidural does to the sensations of childbirth, but my last experience has left me determined not to accept any pain meds. In the last contraction before I pushed my son out, I shifted position and felt something was wrong. But it was my first time, I had been expecting it to hurt and so I didn't want to complain that I hurt at that point in the process, and I really wanted to birth the baby. So I didn't say anything, and I kept the position through the entire contraction. Gui was born soon after.

But after resting for a bit, I noticed that my feet looked funny - they were lying heel - to - heel and my legs were flopping outwards. I couldn't get my toes to point up without concentrating on it. It turned out that I had torn my symphysis pubis. It took a few weeks before I could walk again and several months of chiro treatment before I felt normal.

Upon reflection, now that I know the difference between normal labor and something doesn't feel right! I have a great interest in ensuring that I can still feel pain. Pain is a great way for your body to communicate urgent matters to you!

So there are other reasons for wanting to avoid the epidural other than a desire to prove your toughness. Though I did get a very funny card from a friend that said, "natural childbirth. The female version of 'macho'" :-D

Literacy-chic said...

Well Kate, you have taught me the merits of complaining! ;) You must have a really high tolerance for pain. It really is about being in tune with your body, isn't it? I admit that your situation kind of scares the heck out of me on a level--but it's not something I'm going to dwell on. Thanks for sharing!