I'm glad I didn't have an epidural

I gave birth to my first son in 1992. A lot has changed in those years, but a lot hasn't, too. Now, 17 years is a long time to hold on to a birth story, and I didn't keep a journal of experiences in those days so much as I kept a journal of emotions, so I know that during my pregnancy I was incredibly depressed. I was 21, for most of it, and had married that February and gotten pregnant on the honeymoon--the same honeymoon that we had to cut short because we found out my then-husband was losing his job. I spent the entire pregnancy on WIC, food stamps, and Medicaid. Thank you, taxpayers of Virginia.

I remember more about the birth itself the closer I get to my due date, now. I had been flirting with toxemia; my blood pressure and weight gain were the biggest concerns but I was starting to show protein in the urine. But I was already showing signs of effacement and dilation, so the doctor made a decision to go ahead and induce me the following Tuesday with an amniotomy.

I remember coming in on what felt to be the coldest day of the year. It was blustery as my then-husband dropped me off at the door; he parked, we went up together. I don't recall checking in, but I do remember getting set up in the bed to be induced. The nurses started an IV. Ten minutes later, the doctor walked in, and asked why they had started an IV. They were visibly startled; I was just impressed. "I want to see how she does after we break her water. I have a feeling she won't need Pit."

I honestly can't recall how insistent I was at that time for a low-intervention birth, but I must have made myself clear at some point. The amniotomy itself didn't bother me; it struck me as a physical intervention rather than a chemical one. But what surprised me was what the doctor said upon examining me. "She's already 3 centimeters. She's having this baby today anyway." I had been in labor all morning and not felt a thing--something that is common to my mother and my grandmother. He performed the amniotomy; I didn't feel that either. By 10 a.m., labor was well established. "No need for Pit," the doctor said again.

I called my mom. "You'll have this baby by 1:30," she said. We all had a laugh, but it turned out she'd be right--I was ready to start pushing around the time that everyone else was finishing up lunch. Suddenly, the entire world turned round: my eyes, my mouth, my soul was all formed into a perfect "O" shape--and everything I could see *felt* round. (I'm prone to synesthesia, so in hindsight that makes better sense than it did at the time.) The head was out, and the nurses were pleading with me to pant, because one of my son's shoulders was hung up on my pelvic bone, a condition known clinically as shoulder dystocia. The doctor deftly worked him up, then down, then up, then down, rocking him past the barrier--and then my son came into the world, all 9 1/2 pounds of him.

One of the nurses who was helping me breastfeed made an offhand comment to me that has stayed with me ever since. "It's a good thing you didn't have an epidural," she said. "Oh?" I replied, asking her to explain. I was 6 weeks past my 22nd birthday at the time, and didn't have any more of an understanding of labor other than what I'd gotten from "What to Expect," my childbirth education class, and my mother's tales of carrying me and my brother. But I suppose I was influenced by my mother's explanation of the difference between her birth with me, done under twilight, and with my brother, done completely natural. I showed up in five hours; my brother in 3. (We're wondering, actually, whether I will have time to even get to the hospital at all, if I don't know I'm in labor until I get to 5 cm and I roll through dilation half as quickly as I did with Elder Son.)

The nurse explained that she'd seen cases where an epidural actually caused a labor to drag on and on. "Your baby was so big, that it was a good thing you and all your muscles were fully present to work with your baby and your body to get him out. I think, if you'd had an epidural, you'd have wound up having a section."

This made me curious, even then, about whether we should always trust in medication. Sometimes I think we're taught to be afraid of the pain, so afraid that the epidural looks like an attractive option. So many women in my childbirthing ed class this time around have the attitude of "pass me an epidural as quick as you can!" And while I'm a huge advocate for allowing women to make their own choices about pain management in labor, there are times when I wish this aspect was made more clear to women. Interventions have a funny way of cascading. I feel like I'm lucky that my doctor was Pitocin-averse, at least in my case--because I've heard so many stories about how Pitocin creates unnaturally strong contractions that leaves a woman begging for epidural relief. Then, sometimes the epidural creates a difficult environment for pushing; other times, the pitocin makes it such that the oxytocin rush that I think I felt in that O-moment of birth never happens. Either way, it can lead to that nebulous diagnosis that scares me so much: failure to progress.

As if women didn't have enough "fail" pressure in their lives, right?

So anyways, the point is: in 1992, I was told--after the fact--that having an epidural would have made my life more difficult. I'm glad I turned it down. And will do so again with this pregnancy, even though I'm 17 years older.