Monday, August 17, 2009

No Shoulds in Childbirth

Natural childbirth is what everyone wants; except the women who want to be put to sleep. I did have a patient recently who said she wasn't giving birth. She is due to have twins in 24 weeks. I think ( I hope ) she meant she couldn't even entertain the notion of herself, in that L&D suite, giving birth. Otherworldly. She didn't want to be imagining herself, before the fact, legs splayed and pushing out babies. She said she didn't want a Cesarean either. She is still in denial about the fact that when these babies are "cooked", she has to get them out of there. We all wonder if we will be up to the task. Most of us just dread the ordeal, but somewhere deep inside we have alot of preconceived notions about how, exactly, it SHOULD be.

There really aren't very many shoulds in life. Yes, we should honor our fathers and mothers. We should not steal or God- forbid it, hurt anyone or anything, for that matter. We should vote and pay our taxes. We should tell the truth and treat other people as we expect to be treated ourselves.

There are no shoulds when it comes to birthing our babies. They DO have to be birthed, whether we can imagine ourselves in the situation or not. But there is no right way. We can be prepared by educating ourselves about anatomy and physiology, the process of labor ( or the alternative: Ceasarean section ), focusing and the need for breathing and how to tell when it's time to go to the hospital. BUT there is no prescription for the right way to actually give birth. Every labor and delivery ( whether via vagina or not ) is very different, whether you have one baby or more and with each different baby you have. No two experiences are alike. Just like no two days are.

The point is simply that after you are prepared, you must accept that there alot of variables in the equation. Maybe the baby experiences distress ( that's why you are monitored ) and with our advanced technology and the expertise of the professionals you trust, decisions must be made that are not what you expected. Maybe your cervix just doesn't dilate; maybe you find out, later in your pregnancy that the baby is breech, where the head stays up in the uterus, near the ribcage and not head down so it can safely descend into the birth canal. Maybe your baby is really big and your pelvis cannot accommodate it. Maybe you are sick or have a complicating factor and the baby has to be induced. Often, it's not even about you and all your hopes and dreams about how it's supposed to be.

Maybe you are in labor for eighteen hours and it's best to ask for that epidural anesthesia ( even though your mom or best friend didn't ) so you can get some rest before it's time to push and actually hold and bond with the baby. Maybe the labor is more difficult than you expected and you must take advantage of the safe obstetrical medications that are available, so you are comfortable "carrying -on". Comfortable physically and emotionally and able to cooperate with the process.

I say that as long as the baby comes out, however it's happening, the way it plays-out for you and your baby, well, then you have successfully fulfilled your role: for that baby and you and your family and that experience. There are no failures in the event of childbirth, as long as the baby is born. With an epidural, with a Ceasarean- section. No exceptions. You did it; you are a mom. And you have learned a very ( if the not THE very ) valuable lesson of our lives: there is just no way to predict exactly how anything is going to be.

Be flexible, be prepared and then let it be.