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.

Week 25: Feeling Pretty, Oh So Pretty

....and that's saying a lot, considering that on Monday I felt like I was coming down with something horrible, but I did chalk it up to pregnancy fatigue, took the afternoon off, and rested up and now feeling much more glow-y than I think I have all summer. Of course, perhaps it's because I got my eyebrows cleaned up and so my face looks more normal to me than it has in a while, or perhaps it's because in 95˚ super-muggy weather without any air conditioning, of course we're all going to positively glisten. But since it's taken this long, til the last week in July, for the humidity and hot temperatures to set in this year, I'm taking it in stride.

Bunky is a very active baby but right now seems to be enjoying a siesta. I am wondering if he's starting to get into a groove of sleep and wake.  But all in all, we're doing ok. Weight gain a wee bit higher than I'd like, but a lot of it is coming on now as the baby gets bigger, and I really only have two more months of weight gain before I hit the top end of the curve. Had a minor blood pressure scare, but it was back down by the end of the appointment; I really think I'm going to start doing yoga workouts before my appointments and start doing more focused meditations. I'm through most of the pregnancy anxieties at this point and starting to process the labor and delivery anxieties--most of which revolve around a tangible fear that my first labor and delivery was so near-perfect that there's no way I'm going to be able to do a re-run. But statistics really are in my favor; easy labors (as labors go) run in my family and Elder Son's rapid arrival does more to establish that I can handle a large baby with no problem than would be the case if he wasn't around to be Mr. Precedent.

But as I was describing his birth to the midwife, her face was brightening. More people should tell their positive birth stories, she said. And she reassured me that we would work together to make sure I had another one, easing some concerns I had about being able to eat and drink in labor and her own caeserean rate (8 percent). One thing I didn't know about her that made me really happy to hear was that she had originally been a midwife in practice with the obstetrician who delivered Elder Son, and that obstetrician, other than ordering an amniotomy to trigger active labor (I'd been walking around at 3 cm with no idea I'd been in passive labor), steadfastly avoided ordering any interventions, even going as far to fuss at the nurses for giving me an IV without his asking for it.

I registered for childbirth education classes. To be honest, they are more for the Mister than for me; I'm realizing I would love to teach childbirth education, would love to be a doula, would love to be a midwife like I originally planned to do when I was 23. Because I can't imagine a health-care reform landscape without midwives and doulas. At the very least, I want to find freelance writing opportunities that fit this new passion of mine--or, rather, this reactivated passion of mine.