Friday, March 17, 2006

What I Never Expected When I Was Expecting


Note: Thanks to good friend Snarky Squab for letting me guest-post the following, and for the nice intro below, too. --S.

The other day when Snarky Squab wrote about childbirth, it got me thinking about my own experience giving birth to my daughter almost two years ago. Reading Snarky Squab brought back a lot of memories and musings—which went far beyond the question she raised of natural vs. medicated childbirth. I swear I am not writing this to scare any soon-to-be mothers. Nor am I posting this as a self-pitying rant. I truly feel that the things that we don’t tell each other about childbirth, the questions we don’t ask because we don’t know to ask—all the stuff beyond the usual “did you have an epidural?”—these are also the things that we need to know the most. After having my baby, I was above all shocked by what I had been through, and at how unprepared I was beforehand.

Granted, my childbirth story is surely atypical. I went into labor on Monday and did not give birth to J. until Thursday, some 60 hours later. Though I adored my OB, she was not on call at the hospital the entire time I labored, so she was not among the 10+ health care professionals who saw me over those days. None of the things I learned in childbirth class about coping with labor helped at all---not the warm shower, not the birthing ball, not the photograph to focus on, not any sort of breathing. I got an epidural when I was in so much pain that despite my best efforts I could not keep myself from screaming loud enough for anyone far down the hall to easily overhear.

At some point in the middle of the 3rd night, I was put on oxygen. I remember suddenly being terrified because it occurred to me that I didn’t know what it really meant to push. They told me later I pushed for 3-1/2 hours, but J. was stuck in the worst position and she couldn’t move. Her birth was vacuum-assisted, at the last minute, with a room full of residents, nurses, and various specialists in attendance. It was 5:45 in the morning. The vacuum gave me a 4th-degree laceration that took almost an hour to stitch up. I was discharged the following day, after only one post-birth night in the hospital, because my insurance covered a stay of 48 hours from the time of the baby’s birth, and it was unfeasible to discharge me at 5:45 a.m. So they made me go home the evening before, even though I hadn’t slept in over 3 nights and could not walk.

It took me 14 months to medically recover from J.’s birth. As the fog of exhaustion and trauma slowly faded, questions began to form in my mind, such as: Why was my labor allowed to go on so long? Why wasn’t anyone talking C-section? And why didn’t it even occur to my husband or me to ask? Who was watching out for us? Did all those nurses and doctors who changed shifts during the time I was in labor even realize I had been there for days already? Did they read the whole chart? Why wasn’t an episiotomy done? Why, not hours after the baby was born, did the first nurse to care for me tell me gravely that “many women with pelvic floor damage this severe have permanent incontinence problems when they get older”? Did I really need to hear that then?

So what would I do differently, if I could go back in time? I would ask more questions of my health care team. I would demand to know the contingency plan for a long and difficult labor—even if I assumed it would never happen to me. And as much as I adore my devoted husband, I would not assume that he would be in any better shape than I to be lucid and clear-headed during an unexpectedly complicated labor. I would make arrangements ahead of time for someone—a friend, a parent, a doula—to be at the hospital with us in the event that pain and/or sleep deprivation rendered us unable to think clearly and advocate for my care. I would expect the unexpected.

What does my story say about health care and childbirth in our country today? Was the fact that I was not offered a C-section, despite days of labor, some sort of attempt to counter the controversial trend of skyrocketing C-section rates at major medical centers across the U.S.? Why was their no consistency in my care over those 4 days? Why was I discharged so incredibly quickly? I wish I knew the answers to any of those questions, but I don’t.

I also don’t wish my childbirth experience on anyone, but I do hope it might serve as food for thought for other women.