Sunday, December 11, 2011

Exit strategy

My circle of friends includes a surprising number of women who have given birth naturally without any pain relief whatsoever. Surprising especially when I consider that statistically 95% women who deliver where I delivered la cocotte and will deliver cocotte's sibling opt for an epidural. Perhaps I know so many drug-free laboring women because my circle of friends is dominated by runners... runners have high pain thresholds, good endurance, good musculature, make smaller babies, so the thinking goes and are therefore more likely to tolerate a drug-free delivery.

I have listened to my friends describe the experience of drug-free birthing in complete astonishment. Having had a c-section the first time around, a drug-free birth was not really an option. (Even the mentally toughest of runners generally does not submit to being cut through multiple layers of tissue without some form of anesthesia.) One of my friends described the contractions as pain equal to bones being broken separated by complete, glorious numbness. She told me about pushing and the ring of fire. She said she felt connected to the generations of women before her who had given birth in pain and that it had been so important to her to have that experience and to feel every sensation from start to finish. The way she described it was moving and poetic. I am so happy for her that she had that experience. That being said, I cannot think of anything I would ever want LESS for myself.

All around me women seem intent on de-medicalizing the birthing process. Women seem united in their desire to give birth at home, naturally, with a midwife. And to those women I say, in all sincerity, you go girls! I don't understand their desire but do admire their courage and ability to endure. As for me? I want bright lights, stainless steel, white, institutionalized sheets, bad food, hissing, aging radiators and pipes, a cramped room, a harried, overwrought nurse and everything that else that reassures me that I am in a hospital with a wide array of glorious, glorious drugs at hand. If I had my choice, I would start the epidural in the parking lot. But before I started the epidural in the parking lot I would get a hit of something else to make the epidural ITSELF less painful.

I am probably biased by my first birthing experience. Without going into the gories... I was late (41 weeks), la cocotte's growth had slowed, I was not even slightly dilated, la cocotte was nowhere near the "set" position but it was decided that an induction was the best course of action. The first 6 hours were fine, drug-free (except for the pitocin of course). Felt nothing. Then a pinch, a stronger pinch, I asked a doctor for a tylenol... I told him a tylenol would be enough for the amount of pain I was experiencing. I had this brief fantasy that maybe I was one of those remarkable women for whom labor was simply not painful or... even better, that this level of pain was what other women described as unbearable and I was just some sort of superwoman with an insanely high pain threshold. My water broke. 10 minutes later I was puking and screaming for an epidural (which due to logistics I had to wait about 2 hours for... I know, not long compared to some). There was no gradual build-up of pain. No acclimatization. It was zero to 10 on the someone-kill-me scale in ten minutes. Far worse, there was no respite between contractions, there was no wonderful lack-of-sensation to slip into, there was simply a valley of pain (and not a very deep valley either) between towering peaks of pain. Got the Epiural. Bliss. Many more hours passed. No progress. La cocotte's heart rate was dropping with every contraction. C-section decided on. La cocotte born with an apgar of 10 (and no, I am not mis-remembering that. It was 10 immediately after birth and 10 ten minutes later. It is written in her health booklet so I am not romanticizing after the fact. And while I know it is totally obnoxious to brag about one's offpring's apgar score, I do so only to counter the notion that epidurals are bad for baby. Though yes, I realize la cocotte is only an n=1).

So here I am, 2 years and 4 months later,almost 7 months pregnant. I need to decide on an exit strategy at some point in the near(ish) future. My ob is essentially leaving it totally up to me until such time as a given strategy is clearly medically indicated. So I weigh the paths in front of me: VBAC, scheduled c-section, trial of labor following by either VBAC or unscheduled c-section and wonder what to do... what to do. Ideally I would like to NOT push out a baby but also NOT have to recover from surgery. My research so far indicates that this is not currently medically possible. There's not really a ton of choice when one gets down to it. Simply put, there really aren't many exits to choose from. I remain undecided. I still have time to ponder but only a finite amount.


  1. When it comes to me giving birth, I want all the drugs they have or at least someone to knock me out with a wrench. I believe than woman body ceased to be build to give birth when our ancestors started to walk upright, which lead to narrowing of birth canal. Thus for me giving birth is not completely natural because it should not be that painfull.

  2. Just have to say, as a "mentally tough runner," that I've had surgery without anaethesia - did it myself, too.

    Recently made friends with a woman who's a midwife; she has a completely different view than you do. And I see she's just sent me something about CNN's person of the year (has something to do with childbirth and Indonesia).

  3. If I did it again, I would take the epidural. And, in response to Steve Q's comment, I do believe having an appendix removed without anesthesia would be less painful than birth. In fact, I'm almost 100% sure of that and no one would be made to feel unnatural for having anesthesia during that surgery. I guess if I were you I would try to go for the VBAC with the epidural. The recovery time after vaginal delivery is much shorter. But you are so informed, that I am confident you will figure out what is right for you.

  4. I had almost the exact same experience with my first. 10 days past due date, baby wasn't dropping, I wasn't dilated, petosin induced contractions that went from nothing to off the chart in no time and with no breaks and I still had to wait hours for an epidural and I was begging my husband to just hit me over the head to make it all stop....then a perfect baby boy who scored a 10 on the agpar test. I wish I could have done it naturally and all but it worked out for the best in the end. With my second the doctor has told me that if I were his wife and with the trouble I had with my first there is absolutely no way he'd let me try to do vbac so I'm having a scheduled c-section. Part of that makes me sad because I feel like my body is failing me but part of me is relieved to know I won't be going 10 days past my due date and I won't be in labor 20 + hours before having to have another c-section.

  5. When my wife had been told that it was too late for an epidural, when the baby's head was showing as she fell to the ground in the hospital lobby, the mkdwife told her she had to be strong. There was no time for anything.

    She screamed and pushed and a new little human came out of her. It was wild how focused she got during the pushing, which lasted less than 5 minutes. She became this instinctive animal, and I doubt she remembers those 5 minutes. It was perfect the perfect birth and we when we walked home 4 hours later, I thought of her as some superwoman.

    But. When the nurse and midwife said: "you did so well. You did it without painmeds!", she replied: " it was the most horrible thing that ever happened in my life. I never want to go through that again!"

    Not exactly what we were expecting her to say.