As much as I had wanted a baby since I was a little girl, I didn't know anything about the birth process other than what you see on TV. What's so sad is that is the case for so many women. I didn't have a clue about how my body was made for birth and I trusted the medical establishment completely for my care. Advocating for myself was as foreign to me as the Sheik in New Delhi.
Let me paint a picture. I was a young married pregnant 20 year old without private insurance which made me eligible for state funded care--Medicaid. So in the early 90's in the town where I lived, there were no doctors who allowed Medicaid patients to come to their offices. Our "care" was given at the county health department. If you've never seen a county health department in that time frame in the summer in Alabama, let me tell you it is crowded and hot. All of the pregnant women came on their appointed day and waited long hours to have their name called to be seen by whichever doctor was scheduled to serve on that day. It averaged three hours of waiting each time.
Thankfully my pregnancy was pretty uneventful until the end. Around 32 weeks, they told me I had developed Toxemia which is called preeclampsia today. I had no idea what this was or how dangerous it could be. I had been working as a bank teller up until now but was told that I would need to be on complete bed rest, so I went on maternity leave early. There were no other tests done or measures taken other than bed rest. Today, preeclampsia is taken very seriously. Other than my regular scheduled visits to the health department, the only thing that really affected me was the enormous amount of swelling in my legs and feet. My feet swelled so much that I was unable to wear any regular shoes so the only thing I could wear to my appointments were these bright pink terry cloth house slippers. Also, since I was on bedrest and confined except for my appointments, I saw no need in spending any money on clothes so when I busted out of everything else I owned, I was relegated to ONE outfit. So, my one outfit self, adorned in hot pink house shoes made my way to the health department every week to sit and wait my turn. Are you grasping this picture yet?
I went past my due date plus another five days. At this point they scheduled an induction. There did not seem to be any concern about the toxemia. I had been told from day one that there was no way I would birth this baby because of my small size. (Please never let a provider convince you by looking at you that your frame is too small to birth a baby). So with that in my head, I already thought I would never be able birth vaginally. Compound that with so many rumors that swirled in the health department among the women about how it was completely up to the doctor on call to decide if Medicaid patients could get an epidural. To this day, I have no idea the validity of those rumors but at the time it didn't matter because the fear was already there and it was real.
We arrived at the hospital bright and early on June 30, 1993. They immediately started Pitocin and by 8:00 we were in full force. I remember having some contractions and feeling some discomfort but as soon as that happened, I was offered Demerol. Because of my fear of potentially not getting an epidural and fearing that any pain was bad, I took the Demerol. It was the craziest I'm-on-another-planet experience I've ever had. That lasted a couple of hours and even though the effects were still there, I was feeling more pain. I think back now and the pain I was feeling was real but it was really nothing at that point. (I know this because of how things went down at birth #2). So at around noon, I was begging for an epidural. I say begging, because I didn't know if the doctor on call was going to allow me to have one and I was so terrified that I would have to labor without it. I just wanted to get it approved before he or anyone else could decide not to allow me to have it. And he did let me have it even though I was only 2 centimeters dilated. (We know so much more now and getting an epidural at this early stage will only slow labor down even more. It is advised to wait as long as possible, hopefully to at least 5-6 cm where it can be the most effective).
The next thing I remember after getting the epidural is that after a couple of hours, the doctor came to check my cervix again and at that point declared that I had been laboring for 6 hours that I was only at 3cm, and my labor was not progressing so we needed to talk about a cesarean. Today this is laughable. Now we know that first stage labor progression, even with pitocin could range upwards of 24 hours. So many factors could explain the reason for the cervix not dilating--such as, cervix not being ripened, baby not in an optimal position, or quite frankly, just not enough time given. We have also learned so much about length of labors and Friedman's Curve and this Evidence Based Birth article is highly informative on the subject and I encourage any pregnant mom to read this and have the knowledge themselves. I didn't have any of this knowledge and just accepted that this would be my fate. I didn't know to ask questions or advocate for myself to allow a longer laboring process. This is one of the ways a Doula can be such a valuable resource during labor by providing evidence based information about a procedure that will allow you and your partner to make an informed decision about your care. It puts you in the driver's seat of your own birth.
At 3:43pm on that day, a precious little baby girl was born and my life was forever changed. She was taken to the nursery and it would be over four hours before I could actually see and hold her. That was heartbreaking to me. Equally as heartbreaking were the pain medications I had been given where I could barely hold up my head much less learn to breastfeed. I am thankful beyond measure for life saving cesareans when everything has been tried and probably tried again to allow a vaginal birth but to no avail. I have been there for those who gave everything but their body and baby just would not cooperate. But that is a different scenario than the one I had and I was left with not only the recovery but the trauma of all the "what ifs". What if they had just let me labor longer? I just longed to have that vaginal birth and I struggled to let go of that for many years.
This experience is just another piece of the pie of my journey to be a doula. I want to advocate and teach young mothers about what their bodies are capable of and how to get the most out of their birth experience. Not all births follow the prefered birth plan---in fact, it rarely goes as planned. But what I have seen is that moms and partners who are armed with knowledge, supported and backed by experienced doulas, come out with a more positive birth experience because they were still in that driver's seat taking control of their decisions and making informed choices that were best for their family.
I can't wait to tell you about my VBAC next..........
Just an FYI.....
Pethidine is also known as Demerol. Interestingly (and concerningly), ACOG, the American Congress of Obstetricians and Gynecologists, does not recommend the use of pethidine or Demerol because it can take a week after birth for the drug to leave the newborn’s body.