Monday, 18 June 2012

Birth plan - a response to Mia Freedman

When I was pregnant with my first child I tried to do all the right things. I got a spot in the public Birth Centre and discussed my preference for a water birth with my midwife. I also attended the birth preparation classe (although I did leave one class before the subject of medical pain relief was discussed, because I'm scared of needles and figured that wouldn't change anytime soon). Besides, I told myself, labour only goes for a few hours, how bad could it be?

My midwife gave me a video of a water birth to watch to prepare for my own, but I felt uncomfortable with the intimacy of it all and never watched it. Instead I guzzled parenting books and focused on the long term - the task of parenting the baby I would be birthing.

It was early in the morning and 11 days past my due date when labour finally started. I was so over being pregnant and so ready to hold my baby that I greeted the pain warmly. I told my partner that my contractions had begun and we started to record them so we'd know when they were regular enough to justify going into the Birth Centre. Hours passed.

It was another 12 before we went into the Centre (arriving at 8pm) and 14 more before my beautiful baby girl was born. The pain and utter exhaustion shocked me. By 2am I'd been moved 'upstairs' (into the hospital) to have an epidural and collapsed into a grateful sleep. (My fear of needles quickly became irrelevant. I would have let them chop off my leg if they'd promised it would help).

When it was time for me to push they dialed back the epidural enough so that I could squat on the bed, but I couldn't feel my contractions and so timing the pushes was tricky. After two hours an obstetrician came in to check and told me that the baby's head was starting to swell. She was posterior and firmly wedged in my narrow pelvis. He recommended an emergency c-section or high forceps delivery. I chose the latter.

It took an hour for him to stitch my third degree tear, but I honestly didn't care as I was holding the most beautiful being in the world and high on the adrenaline of meeting her.

In the weeks that followed the pain did start to matter. It made it impossible for me to lift my newborn baby. Walking was also a challenge. Even sitting hurt. Worse still Lily had awful reflux and would bring up most of her feed in great gushes of breast milk, or scream in pain for hours when silent reflux came instead.

We were finally referred to a cranio-osteopath who found a deep indentation on her skull where the forceps had squashed her little head. It was pressing on the area of the brain responsible for assisting the body to digest fat and partly responsible for her reflux. After two treatments the projectile vomiting stopped.

My memories of the labour were raw for a long time, but I told myself there wasn't a lot I could have done differently. I told myself that posterior back pain and the length of the labour were not something I could have prepared for and I felt better.

That all changed when I fell pregnant again. Suddenly thinking that there was nothing I could have done made me feel powerless and worried. I didn't want to go through that again - particularly not the aftermath. Labour may only last a day, but the first few weeks of a baby's life are too precious to be dedicated to surgical recovery and pain.

The first thing that I did was to admit that actually I had totally failed to prepare for my first labour. I'd read almost nothing about it. I'd decided against medical pain relief (despite constant well-meaning advice from others to order it immediately) but had failed to inform myself about alternative coping methods. I'd basically stuck my head in the sand and hoped that it would just go away.

Then I started reading. The best resource that I found were Ina May Gaskin's books on birthing. The stories of other women's labours gave me inspiration for how I wanted mine to go. They also made me realise that I wanted more support. My partner had been amazing the first time around, but there were things that I didn't want to ask of him and others that he didn't know how to do. So we hired a doula who knew how to guide me through the birth process and could show me a whole range a ways to cope with my contractions and fear.

My experience of birthing Charlie was completely different to my experience of birthing Lily. Sure, some of that was due to the fact that he was my second, but far more significant was the fact that I had a plan. It wasn't a rigid script that had to be followed. It was a story that played out in my mind and carried me through the process.

With Lily's birth I was a passive agent in the process. I didn't prepare and came out the other end sore and bruised. It was like joining a marathon and forgetting to do any training beforehand. You can imagine how hard that marathon would be to run and how much you'd hurt the next day.

With Charlie's birth I decided to train first. I attended prenatal yoga and I trained my brain to relax into my contractions. I also gathered a support team around me. As a result the experience of the birth was genuinely exhilarating and, yes, empowering, and I carried that feeling of strength and joy into mothering my children.

I'm dismayed that anyone would describe me as a Birthzilla for planning to have a positive birth experience. I'm also flabbergasted that they could imply that it would have been better for my children if I had kept my head in the sand and handed over all agency to the hospital system. This kind of rhetoric is unhelpful at best and dangerous at worst.

Why do so many people think that women lose the right to control their bodies when they fall pregnant? Anti-choice activists are the worst offenders to my mind, but those who seek to control what pregnant women do with their bodies or how they birth their babies are buying into the same dangerous logic.

Making a plan for how you would like to birth your baby should not be controversial. To say that exercising choice over your body is a first world indulgence is highly problematic. It's even more galling when it's written by a highly privileged woman who is well-placed to expect the system to treat her with dignity and respect. That is not the luxury of all women in our country.


Alli @ Ducks on the Dam said...

Well said. I agree - our bodies, our birthing experience. Without going into too many details I had two amazing experiences. I was well read, well talked, well researched but still taken by surprise. In a way I did "hand things over" to the midwife both times but the decision to do so was mine - I was happy and confident to be guided by her and we had a fabulous result both times which certainly spilled over into the early months of parenting. Whether you natural birth, free birth, home birth, hospital birth, epidural, pain killers, c sections - whatever it is - the decisions should be informed from a variety of sources and should belong to the parent/s. Choice is what is needed :)

Madeline said...

I totally agree with you and related to this post as someone who did a LOT more preparation and had a FAR better experience the second time round. The first time I was willing to just 'go with the flow' the second time I planned to have more control over that flow.

mamabook said...

I am not sure how I learned about doulas before I birthed the first time but she truly was a marvel. My 1st birth went off the rails too but I really didn't feel that there was anything I could have done differently - I was v lucky to have found a team of OBs who weren't threatened by my list of questions about their stats and approaches and I felt respected during the process.(There was no birth centre option available to me in the US so it was hospital birth or homebirth with uninsurable midwife.)
I hate that you were left feeling like you were at fault or failed somehow but how great that you put everything in place to make sure that second time around was a different and better experience for both you and Charlie.
My last birth was in Australia and I did have the benefit of a birth centre. Oddly enough I found the prenatal care less satisfying because I had to meet so many midwives and was pretty much left alone to birth whereas I like a lot of support. Plus my doula had somehow turned her pager off so she never showed (she was v embarrassed). But having said that this birth was v straightforward and unlike in the US I delivered on hands and knees on the ground rather than on a bed.
Completely agree with your sentiments about the hideous terminology employed by Mia and her general failure to ever look beyond her own experience or acknowledge that she comes from a position of enormous privilege.

Gill said...

Thanks for sharing your wonderful story. As a naturopath I've seen the birth plan go out of favour over these last twenty years. Not sure why the obstetric industry wants to disempower women, but it seems to be working.

Choice, training, osteopaths, doulas, many of my favourite things!


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