Two writers, Jessica Smock and Lauren Apfel, discuss what constitutes a “good birth.” Lauren wanted a healthy birth, her story is below. Jessica wanted a controlled birth — read her story here.
I never made a birth plan. It’s not that I wasn’t nervous about what would happen in that room. It’s not that I didn’t while away hours considering when and how the increasingly large creature undulating beneath my skin would make its way out. It’s that I didn’t particularly think any of it was in my control. My fears were grounded almost entirely in the health of the baby: The exit strategy was a means to an end, and for that I trusted in my doctors. Maybe it was naive, the kind of attitude doulas warn against, a stumble in the fight to “reclaim” the birth experience. Four babies later, three varieties of birth, and I can say hand on heart that none of them disappointed me.
Ironically, perhaps, I had the fewest aspirations for the first birth. Usually this is the one where women dream big, images of warrior-like jaw clenching swirl in their heads. Brows are mopped by supportive partners to the sound of specially selected power music. The scent of lavender infuses the air with that crucial mixture of relaxing motivation. And then, when it all goes to hell in a hand basket, as it so often does, the fantasy is abandoned in favor of a more c’est la vie approach. “The only thing I would do differently for my second birth,” a friend of mine joked in just this scenario, “is make a more detailed birth plan.”
I met this woman in a birthing class, which my husband and I joined when we were expecting our first baby. We signed up for the social aspect rather than the Lamaze one, and it’s just as well we made some great friends, because nothing I learned about breathing over that eight-week course had any bearing on my actual experience. The classes were geared toward the “natural,” but not being native to the country I live in, I didn’t know that about the organization we chose. When the topic turned to the limb-trembling, vomit-inducing “transition” moment between the third phase of labor and the pushing part, my hand shot up: “Do you still go through a transition’ if you’ve had an epidural?” Silence. And a few glares, especially from the anti-medical-intervention proponent across the room, who ended up delivering her baby in the caul.
To her, I know the C-section I went on to have would seem, somehow, a failure (or a reflection of the fact that I wanted an epidural in the first place). But, to me, it felt almost an inevitability. There I sat, bulky and impatient, watching my due date come and go like a missed train out of the station. One week and one membrane sweep later, there was a little blood that didn’t look enough like “show” for anybody’s comfort. Which led to an ultrasound, which led to the observation that the baby was running unhappily low on amniotic fluid, which led to an induction, with all of the hideousness such a process can entail, which led to the diagnosis of “failure to progress” that finally prompted the surgery. And then my son was pulled out of me, pink and screaming, and the how of it began to pale into insignificance.
Did I want to be cut open? No. Could it have gone otherwise? Maybe. I didn’t see at the time — and I still don’t — a fork in the road, where I could have or would have chosen differently. The word “emergency” was scrawled on my chart, an adjective to describe the kind of birth it technically was, but there was no lasting trauma. My baby and I bonded instantly and I went on to breastfeed him well, the difficulties I experienced down that road having nothing to do with an incision or milk not coming in. Two months later, my body had recovered from the surgery and two years after that, I was ready to give birth again.
I was curious about the possibility of a VBAC (vaginal birth after Caesarean) from the start. Not because I pined for something I had been denied previously, an empowerment of sorts, but because I didn’t like the prospect of a scheduled date with the scalpel. I had a toddler now, responsibilities that required mobility, I wanted to be able to pick him up, to get out of bed without having to do a three-point maneuver. I was allowed a “trial of labor,” which I approached with no concrete expectations. If the progression wasn’t textbook, I was told clearly, we would be rolling straight back to the operating theater.
Overriding any of my own desires for this birth was the firm knowledge that it was the medical professionals who would determine what was safe and what was not. I am a risk-averse person by nature and I had heard the cautionary tales about a fixation on the process endangering mother or child or both. “The most tragic cases,” an obstetric nurse told me, “are when labor is left too long, because the woman is reluctant for intervention.” Yes, there are more C-sections than ever before, too many now, to be sure. The problem, however, is that the line between when they are necessary and when they are merely cautious is a blurry one. On the day I am giving birth, where it is drawn is not my call to make.
It so happened that my second son was delivered vaginally. I went into labor spontaneously, which was a prerequisite, and the baby did everything he was supposed to do. It was wonderful, on balance my favorite of the births, but the recovery wasn’t a picnic, either. Though I was up and walking around within hours, I couldn’t sit down for ten days. Nor did the fact of a non-surgical birth this time prevent me from having a planned C-section with my twins, three years on — proof yet again that there is always an element of the unpredictable when a baby is born.
Ultimately, for me, a “good” birth was nothing more than a healthy birth and I was lucky to have three of them. The point of the exercise, as a doctor I know once put it, is to walk into the room as one thriving person and out of it as two (or three, as the case may be). It is an arena, in other words, where the result is what matters most. Which is not to say the means are irrelevant: How a baby comes into this world is our gateway to motherhood and this alone invests it with meaning. In the end, though, the details of your birth story often become less important than the fact that it is your birth story. And yours to tell, over and over again, to anybody who will listen.
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