Saturday, October 8, 2011

It Hurt. I Screamed. I'm Still Legit.

Walking while in labor. Pre-screaming.
Ok, I might piss some people off with this. There is something in the natural birth community that annoys the heck out of me sometimes. I need to vent a little.

It's pain and the attitude towards it.

You see, in the natural birth world, there are many who believe that a natural birth should not be painful. It shouldn't hurt. You should only feel an intensity that is almost a relief. Something you work with. Furthermore, everything should be gentle. You should birth your baby in near silence with a serene smile on your face. Bonus points for popping an orgasm while you're at it. Pain and/or screaming is a sign that the woman is not prepared for her birth and that she is afraid. It's a sign that she has let fear take over the labor. Screaming will make the pain worse. Screaming will scare your baby and scare that precious child for life.

I call bullshit.

Now, I am not knocking how anyone else gives birth. Please know that this is not an attack on anyone who was smiling serenely or having an orgasm. I completely support a woman's right to educate herself and empower herself to have the birth of her dreams. I'm totally behind those who want to use hypnosis, orgasmic births or other techniques to help them through the process of labor and birth. What I'm knocking is the holier-than-thou attitude that can be seen in many discussions of pain in labor and birth. This idea that if you're feeling pain then you're doing it wrong.

I'm serious - those words have been typed out by some of my fellow hippie, loving, gentle natural birth comrades. You are doing it wrong if it hurts. You are too afraid. You don't know how to give into the intense sensations of labor and let your body take over. It's only painful because you are calling it, "pain." It's only painful if you don't know how to cope and if you let it "get to you." It's painful because you are not educated enough and you don't know what to expect. If you don't imagine that your vagina is a beautiful lotus flower slowly unfolding, petal by petal, then it's going to hurt. The worst I've seen is some women telling other women that normal births are not painful.

It makes me want to bang my head on my desk when I read these things - but, that would hurt. It's true that your emotional state plays a part in your labor. It is most certainly true that fear can hinder labor. And I definitely advocate for women to be educated about the birth process, partly to eliminate that fear. But having pain and even experiencing fear do not equal failure. It's not an all or nothing scenario. Birth is not black and white.

I gave birth three times. Twice to live, full term babies and once during my miscarriage @ 12 weeks (baby died at 8 weeks and, yes, that was "real" full-blown labor). Guess what? It hurt. No, it really fucking hurt. I screamed. All three times. I screamed.

My first birth was in a hospital. It was a last minute transfer. I did not have a single medical issue that needed a hospital. I was supposed to give birth in a birth center, but the head midwife closed it down that weekend because she had a horsie show to attend and didn't want her sleep interrupted. The other midwife was not able, per birth center policy (and the law, I believe) to attend my birth at the birth center on her own. So, I had to have my birth at the hospital with her. In all, it was 27 hour labor with a posterior little boy. I spent 8 hours of that labor in the hospital. My labor was fine and manageable at home. I got to the hospital and let her check me - 4 cms. Things began picking up and my contractions became more intense. They were - gasp - painful. They remained painful for the rest of my labor, until that little guy slid out (more like rocketed out) into the world. I was able to deal with the pain through position changes, a little dip in the birth pool, walking and saying "fuck" as many times as possible. I dealt with the pain. the pain had a purpose. I don't remember the actual sensations of pain, but there was pain. Pain was part of it. I screamed while pushing. Like I was being murdered. I pushed for about 45 minutes. Looking back on it, I wondered if my pain was caused by the fact that I was in the hospital. I was upset that I wasn't having the birth center birth that I had planned for nearly half my life. That could have been part of a lot of things. That may have made the pain worse. Would I still have had pain at the birth center? Would I scream at a birth center?

My second labor was to birth my angel baby, River. River died at 8 weeks, but the physical miscarriage didn't happen until 12 weeks. I had chosen to allow it to happen naturally as opposed to getting a D and E. My midwife told me to expect "real labor." It was her experience that miscarriages after 8 weeks were more likely to feel exactly like any other labor. I was prepared for that. I tried so hard to manage that labor - all 6 hours of regular contractions and actual transition - as gently as possible. Once I knew it was really happening, I got into the tub and prayed (the "Hail Mary" is my go-to labor mantra, until transition when Mary is replaced with "fuck"). It hurt like a mother fucker. Of course, I was birthing death. In a few hours, the last of my physical connection to this little baby that I had bonded with in 8 weeks would be gone. There was emotional torment like you wouldn't believe. Of course that contributed to physical pain. I later wondered, would it have been painful if I was giving birth to a live baby at home?

My third labor was just two months ago. This time, I had a homebirth attended by two midwives, one of whom is a best friend and the midwife who delivered my son. I had been telling myself for my whole pregnancy that I was going to have a pain-free, 5 hour labor with one painless push. Positive thinking, you know? I had no fears about labor. I even studied some hypnosis techniques. My labor was about 17 hours from the time my water broke until the time my daughter was born. I slept during the early part of that labor. My midwife/friend came over late in the morning and we hung out while I contracted. My contractions were definitely manageable with movement, especially belly dance. I walked, I prayed, I cursed, I ate, I took showers, I pooped. I moaned beautifully like a humpback whale in heat. All the fun stuff. There was pain and I worked through it. Then transition hit and OMG it hurt like a mo-fo. Transition is the point where I'm almost certain I will die unless I get an epidural. So I ask for an epidural. I have done this through all three labors. It feels good to me to ask for that epidural. Before the birth of my first son, I was told that the moment where I feel like I can't do it anymore and that I need an epi is when it's almost over. So, feeling like I needed that told me that I was close to the end and I embraced it. But, it still hurt like a mother and I began my usual screaming. From transition to pushing was barely an hour. I began to whine. My other midwife arrived at that point. I whined to both midwives that I was "supposed" to be that woman you see in all the natural birth videos who just smiles through labor and doesn't feel pain. I said that over and over until both midwives said, "Jenn, that's bullshit. You're doing great and this is almost over." I pushed for about 15 minutes. And screamed. I screamed that I was going to die. That I gave up. I screamed that I just knew she was going to get stuck. I screamed because pushing that baby - all 6lbs 8 ounces of her - hurt so freakin' bad. The dialogue inside my head was slightly crazy. I'm going to die. I'm not going to die. This hurts like hell. She'll be here any minute and it'll be over and you'll forget the pain. She's stuck. Oh my God, the ambulance will have to come and take me to the hospital. They'll take me out of the house on a gurney with her head halfway out and all my neighbors will see my vagina and that I missed a spot shaving and...oh God, she's going to be stuck. I'm going to die. Oh my...and she's here. That was the actual dialogue inside my head while I was screaming. And then my daughter was here and all that pain was worth it. My placenta - the part I dreaded because I remember it hurting when I gave birth to my son - slipped out 5 minutes later without so much as a single second of discomfort. Well, there was the painless birth, I guess.

My question had been answered. I gave birth at home. No hospital. My baby was full term and alive. No sadness. I was educated and empowered. It still hurt. It may just be me. That might be what I need to get motivated to push a baby out of my vagina. It's part of my physiological make-up. I experience pain in labor. It doesn't stop me from birthing naturally. Yet, I had a little nag inside my head. One one hand, I was proud of myself for having the homebirth I had desired for so long and for rocking it. I was proud of the sweet little girl nestled up to my breast. I was an awesome birthin' mama. On the other hand, I wondered why I screamed. I went into this with the specific intention of not screaming like I did with my other labor. Why did I scream? Then I felt like I failed. I felt a sense of failure for allowing myself to feel pain, for not being able to get into some peaceful, serene or hypnotic state. I felt like I failed myself and my baby for screaming. Then I worried that I scarred her because the last things she heard while in my womb were, "fuuuuuuuuuuuuuuuuuuuuccccckkkkk!" and my pain-induced bellowing. Within days after her birth, I actually googled to see if other natural-birthin' mamas were screamers. I came across a blog entitled "Judging Birth." I'll let you read that, and the following comments, without expanding on it too much. In essence, she says we need to stop judging how we labor and that not all of us are quiet birthers. It made me feel better to read that blog and then the comments. And then it made me mad. Why was I seeking "acceptance" for my birth behavior? Why did I feel the need to justify why I felt pain and why I screamed? I was mad that I allowed myself to feel like some sort of failure. Yet, to read many of these blog posts, comments, discussions on facebook, you will feel like a failure if you admit to feeling pain or having the slightest fraction of fear during your birth. We need to stop this.

I find it funny that the natural birth community can actually have these discussions. Aren't we the ones telling women to empower themselves to have the birth experience that's right for them? Aren't we the ones fighting to make sure women feel supported with their births? Aren't we the ones who admonish the OB who tells a woman to "hush" if she is too loud in labor? Aren't we the ones who yammer on and on and on about how birth is a normal, biological and very primal event? So why are we judging women who are, in fact, acting very primal? Why judge someone who feels pain? It's upsetting to me. We talk all about empowerment, but then we rip each other apart if our birth wasn't the right kind of natural. It's the granola wars, man. We're not helping anyone. We have mamas who are going to have natural births and feel pain and want to scream. They'll feel good because they gave birth naturally. Then they come online and read these comments that if they felt pain then something was wrong with the way they gave birth. Or you have the mamas who are pregnant and reading all of this before labor. So they hype themselves up into thinking they must have a completely painless labor. When it doesn't go that way, they feel like they failed. Those of us who feel the pain and scream it out fail Birth 101? Bullshit. This is no different than women feeling like failures because they ended up getting induced, getting epidurals and having c-sections. Only this time, we don't have an OB or evil hospital to blame. This time it's the woman's fault for allowing her psyche to take over.

Again, I have no problem with wanting a painless birth. I don't doubt that there are women who give birth without pain. I've seen it. I've seen women birth without making a peep because it wasn't hurting them. That's awesome, but those same women should never turn around and tell another woman that she failed because she felt pain...that it wasn't normal because she felt pain...that she wasn't educated enough to be pain-free. I'm very educated when it comes to birth and have been for a very long time - way before my first child was born. I grew up with a mother who worked in maternity and told me that birth is just plain old normal and natural. I know birth isn't something to passionately fear. I know all the biological, chemical, emotional and mechanical processes that are part of birth. I know what they say about high-pitched birth noises vs. low-pitched noises and I understand why that works. But, I also know that fear is a normal response. No, you shouldn't be in absolute horrified fear, but you shouldn't feel like you're doing something wrong if a moment of anxiety happens. You can't tell me that I wasn't educated or empowered. You can't tell me that I was a fraidy-cat. It's not true. Yet.I.Still.Felt.Pain. I still had moments of fear. In fact, those moments of fear may play an important role towards the end of labor. Check out this article by Michael Odent.

"A typical fetus ejection reflex is easy to recognize. It can be preceded by a sudden and transitory fear expressed in an irrational way ( “kill me”, “let me die”, etc.). In such a situation the worst attitude would be to reassure with words(5). This short and transitory expression of fear can be interpreted as a good sign of a spectacular increase of hormonal release, including adrenaline. It should be immediately followed by a series of irresistible contractions."

If you can birth with nary a fearful thought or moment of ouch then you go girl. If you start feeling the pain and you lose your rational brain toward the end then embrace it, work with it and know that your sweet little baby is so, so close. Don't feel like a failure if you didn't hypnotize as planned. Don't put yourself down for crying and telling everyone that you can't do it because you're going to die. You didn't fail. We all experience birth and pain differently and no one is better than the other because she did or didn't feel a certain way.

On another note, there is a lot of criticism of the natural birth community. There are blogs dedicated to trashing us or trying to debunk us. There are trolls who visit our blogs and facebook pages to stir up trouble and controversy. A lot of people see us as crazed hippies. They don't see that we're striving for better outcomes for mothers, babies and families. They don't see us for the good work that we're trying to do - for wanting to change such a failed maternity system. They see us as judgmental and insane. It doesn't do us any good to judge one another on this subject. It doesn't help get our message across. It just feeds the criticism and turns people off to the message.

Judging is for crappy reality shows, not childbirth.

Peace and much love.
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