PART THREE: AN AGONIZING DECISION
During that long night, a few things started to worsen in my condition — not terrible things, but small little warning signs. My urine output had gone down, they’d been monitoring it all night as it can be a sign of kidneys shutting down, and mine had lessened in the wee hours of the morning. I’d also developed a headache — another symptom of preeclampsia.
Around seven AM, my nurse T was off duty and she brought in a new nurse, K, to give her report on me. Listening to the long list of what was happening to me and what they were doing about felt a bit discouraging again, particularly when T looked over at me and asked, is there anything I’m forgetting? I mentioned the headache, and the nurses told me they’d get me some Tylenol to help.
Now that I had had Nurse T for a 12-hour shift, I was attached to her similar to the way I’d been attached to Kristin the day before. You never know with nurses, I’ve found they either tend to be super wonderful, or super frustrating. I’d tried really hard all night to be super positive and friendly and polite with any of the nurses who checked on me — as much as I could, out loud, even I was feeling grumpy inside. So far, I’d had excellent experiences. I was nervous to be meeting a new one — but K was absolutely fabulous, and played a huge part in my birth experience that day and the next.
When K said she would get me some Tylenol for my headache, I exclaimed, does this mean I get to have some water?!
I hadn’t had any water since about noon on Monday, and it was now seven AM on Tuesday. My mouth was parched and my lips were cracking. I’m an avid water drinker, even when I’m not pregnant, and going without even a sip for so long was driving me crazy. I’d scoffed at the ice chips when Kristin first mentioned them, but now they were my lifesavers. All afternoon and all night, someone had spooned ice chips into my mouth every so often — but it felt like I could never get quite enough wetness in my mouth and never for very long. I hated to ask for ice chips as often as I really wanted them — guzzling ice pretty much constantly would have been ideal. So the idea of even just a swallow of water with a pill sounded life-changing.
K laughed. You’re so excited about that! Yes, you can have a bit.
She came back with a little cup and the pill, and I swallowed the pill easily with one swallow.
Do I have to give this back? I asked her, holding the second swallow of water in the cup.
She laughed again. Tell you what, you can have it.
From that point on, the morning seemed a little brighter. The sunshine peeking in my window helped, simply because the long night was over and everyone would be awake with me again. There’s something about daytime that makes fatigue easier to bear.
And as morning progressed, more of my support team headed back to keep me company. Lauren, Jeannie, and Emi all arrived fairly early in the morning and I was relieved to see them. But things had changed a bit since they’d left. When they’d gone, I’d been upbeat, in good spirits, pretty talkative. I’d asked for nail polish so someone could paint my toe nails, and Jeannie came back with it, ready to go — and I didn’t care anymore. All I really cared about was the pain in my hips, wanting water, and the little contractions I was getting from time to time.
My hips were killing me and I couldn’t really concentrate on anything else. Emi, my fabulous doula, was again a lifesaver. She’d rubbed my hips a bit the day before, and now I just begged her to do it again, and keep doing it. She’d gather a bit of coconut oil on her hands, and massage my lower back and whatever hip was up. She knew exactly where and how to rub to take the edge off of the pain and make it tolerable for a while. All morning long, she’d rub one side in long fluid strokes, and then when my bottom hip hurt too much, I’d roll over and she’d start on the other hip. I at least got some relief on the top hip, and that relief made my discomfort more manageable.
To my surprise, mid-morning, Kristin showed up — in scrubs. I’d known from our talks over the weekend that she wasn’t on duty on Tuesday — but she came in anyway. She didn’t get paid, she couldn’t clock in — but she came to be with me and facilitate in any way she could. I couldn’t believe how selfless and generous she was being by coming in — spending her whole day helping us when she could have been home with her family.
The morning turned into another holding pattern, and that was frustrating too. I’d had a fourth dose of Cytotec, without much hope it would do any good. Since my midwife was leaving at noon, I had to wait for the doctor who’d be taking over my care to come and check me and start making decisions before anything would change. My midwife came in again, late morning, to tell me goodbye. I could tell she felt bad about leaving, and in retrospect, this is the point where the birth went from frustrating to actually bad, in my eyes. Above all, I wish I hadn’t gotten preeclampsia — but at least with my midwife there, I felt like I had an advocate who understood how and why I wanted to do what I wanted to do, and who believed in that process. I didn’t have to convince her to my line of thinking, she was already on board. And I trusted her, her experience, and her direction – if she told me I needed to do something, even if it was contrary to my wishes, I knew I needed to do it.
I’m not saying my birth would have gone perfectly smoothly if she had stayed, but we had built a history of trust between us. I think I would have felt more confident in my decisions, because of that trust between us. And I’ve seen my midwife in action, before, at other births — if I’d needed some tough love to push me through a rough or doubtful patch, she would have done it, and in just the right way. If she’d said we needed to do something I didn’t want to, I would have been more inclined to believe her. Losing her meant losing one of the cornerstones of my grip on reality and understanding how dire the situation was or wasn’t.
Losing her meant my birth ended up exactly where I didn’t want it — with a typical OBGYN experience, with a doctor who believed in as fast and practical as possible, get an epidural and get the baby out. Get a C-section if it doesn’t work. There was less spirituality and homeopathic mindset, and from this point on, I really struggled to advocate for myself at a time when I already felt vulnerable and discouraged. I found out later that my midwife had told the new doctor that I really wanted a vaginal birth — which both hurt and helped my cause. I’m so grateful that the midwife did — because she understood what was important to me and did what she could even as she was leaving. At the same time, now, I feel like that hindered the inevitable end to this birth, because the waiting dragged on longer than it maybe would otherwise. I do believe the doctor tried to give me what I wanted – but she maybe would have made the inevitable decision sooner if this hadn’t been the case — saving me some emotional grief.
But, in that moment, my midwife was sweet and came to wish me luck and tell me she was sorry she had to go. She held my hand and assured me I’d be in good hands with the doctor, who would be there as soon as she could. Then she left. She was gone.
We waited, and we waited. Lauren left to go do some work at the studio, as they were setting choreography that day. Mom, Kristin, Emi, Jeannie, and of course, Shaun were still there, and doing their best to keep my spirits up. I hadn’t eaten in 24 hours, and my body was flagging. Emi brought honey from her bees and let me dip a finger in to at least get some energy in my system. She and Shaun helped me wash my face and brush my teeth so I felt a little fresher. Emi joked as she rubbed my hips, which included my bare butt under the sheet, oh, we’re back to the cute freckle side!
I was frustrated. Beyond frustrated at this point. I’d expected to be well into labor at this point. I’d expected, noon on Tuesday, to be close to meeting our daughter. Instead, the end was nowhere in sight. I wasn’t even technically in labor, my blood pressure was still crazy scary high, my head and body hurt, my labs weren’t great, my urine output wasn’t great. I was barely dilated at all, and baby was so high, my cervix was so hard and tight. I’d wanted and planned and prayed for a natural, vaginal birth for so long — but suddenly, getting my baby out safely before something went really bad with either her or me, or both of us — that was way more important. I’d heard people say something like this before, but hadn’t really understood it until this day.
Somewhere around lunch time, the doctor on call came in. I had met with her once before, on a week my midwife was out of town, and had found her pleasant, friendly. It had been a routine visit, with no issues. I had been glad to return to my midwife’s care on the next visit, but had no issues with the doctor at the time. But I had learned that the doctor was a bit unused to my midwife’s more natural birth approaches — being surprised even to find laboring mothers out of bed and on the birth ball. I hadn’t thought much of it at the time when I heard this anecdote, but as my birth progressed under this doctor’s care, I realized how much that spoke of an unwillingness to practice a different style of birthing than she was used to.
Much like my midwife’s visits the day before, the doctor came in and greeted me, greeted Shaun, said hello to everyone in the room. She asked if I wanted anyone to leave, and I said the same thing as the day before — if anyone was uncomfortable, they were welcome to leave, but I was OK with my support team staying in the room. The doctor told me she was going to check me again and see if we had made any progress with this most recent round of Cytotec.
By now, I thought I was well familiar with this procedure. I got to roll off my side, finally, and onto my back as they lowered the head of the bed a bit. Shaun and Emi helped ease my stiff and aching joints into position as the doctor got a glove and rolled her stool up to the foot of my bed. Shaun and Emi stayed near the head of my bed — in prior checks, they had both always been near me, Shaun holding my hand, both of them reminding me to breathe and relax.
As I laid back, I settled into my deep inhales with long, long exhales, completely filling and emptying my lungs. I tried to relax my lower body, and repeated open, open, open in my head.
That familiar touch and pressure and then — pain.
Out of nowhere, I was in so much pain. It took over my whole mind and my body. I tried so hard to be a good girl — I locked on to that breathing I’d practiced — full deep breaths but I was blowing out so hard, in huge exhales. I could hear myself. I tried so hard not to fight the doctor, although every instinct in my body told me no, no, no! I tried so hard to remember every single tactic and coping mechanism I’d practiced for months — calm, relax, release.
But still — I was suddenly in so much pain. Something suddenly felt so incredibly wrong, and I had no idea what had happened. I was so afraid! God, I remember thinking, this feels absolutely nothing like the midwife’s checks! If the doctor’s checks hurt this badly — if just her checking my dilation hurts this badly — how am I going to do this?!
Shaun held my hands, Emi leaned in close, brushed her hand over my forehead. They both reminded me to breathe — they were so dear to me in that moment, doing exactly what I needed them to do — I was so afraid and hurting so bad, I was close to panic. I felt so shocked, so abruptly thrown into this. But their gentle reminders kept me on task, somehow I managed to endure that check until the doctor finished. The others told me later they immediately knew something was wrong — they had been present for checks before and it had never, ever been like this — this apparent pain and panic.
As she finished, I fell back on the bed and tried desperately not to cry. Tears welled up in my eyes and I used every last ounce of willpower to keep them from spilling over. I couldn’t even look at my doctor. I just laid there and tried to catch my breath, and not cry, as Emi and Shaun patted me, telling me, good job, good girl, it’s OK, it’s all right.
Well, you’re still at about two centimeters, I’ve stripped your membranes, I’d like to break your water and start you on Pitocin. The doctor rattled off all this, matter-of-fact, even as she withdrew her hand. I wasn’t even thinking straight, I barely heard her, could barely comprehend what she’d said.
As soon as I heard her say she’d stripped my membranes, that sudden pain made sense — and I was horrified.
Stripping a woman’s membranes is a big deal. Sometimes, it’s done before labor starts, sometimes during, sometimes it’s not necessary to manually perform at all — but for those who have had it done — you know it’s an intense and invasive experience. Even strong, stoic Emi who is made to birth babies beautifully told me — when our midwife did it to me before Jude – WITH my knowledge and consent — I came off the table hissing like a cat, it hurt so much. It’s definitely a procedure that — like even just allowing a dilation check — requires knowledge and consent from the mother before performing.
Doing it without asking my permission or even telling me was a huge breach of trust. I was absolutely terrified while it happened — because I had no idea what was going on. I went into that experience emotionally and physically prepared for a check. I had no clue that I was going to undergo a completely different, painful, status-changing procedure in addition — I had no time or even opportunity to prepare myself – as I would have if I had even just known. I wasn’t given the option of trying to deal with that experience with a better mindset and the knowledge I’d need to breathe deeper, relax even more than I already was, be prepared to fight off panic. I would have even agreed, if she’d asked me first! It was a smart step at that point – I just wished I’d been given the opportunity to know it was going to happen, and agree to let it happen to me.
(This is one of those parts in the story where I worry this sounds trivial. I worry I sound dramatic, in the grand comparison of huge and/or painful things that can and do happen during birth. The thing is — letting someone touch you “down there,” at all, ever, under any circumstances — that requires trust. It requires an understanding that whoever is touching you in whatever contexts understands the great magnitude of the private and intimate privilege they’ve been granted. Stripping membranes might seem small, not that big of a deal — but being touched, hurt, changed in such a vulnerable, private place, by someone I was supposed to trust to help me navigate this already precarious situation — it was a big deal, to me.)
And then — on top of that, the doctor was pressing even more interventions on me within seconds of stripping my membranes without consent. I couldn’t even consider what she said, it was all I could do to keep from sobbing in front of her. I felt violated and scared and confused , and suddenly, I couldn’t even speak anymore.
Emi, bless her, stepped in exactly as a doula should. She suggested we take a few minutes to let me breathe and relax after that, and asked the doctor to come back in 15 minutes. The doctor — as best I could tell with my eyes shut, panting on the bed — seemed a little baffled as to why we would ask to wait, but she agreed and left us alone in our room.
As soon as she was out the door, I started crying.
Sweet girl, you’re OK. You’re all right! Emi was immediately down on my level, stroking my face and wiping my tears away. That was not OK, that was not all right. That hurt a lot, didn’t it? That wasn’t OK.
She validated me in every way I needed to be validated in that moment. It wasn’t OK that the doctor did that, and it had hurt a hell of a lot. She had violated my body and my trust in her by doing that, and it was right be upset.
I hate to write this, because I wish it hadn’t happened but it did — I completely lost faith in those few minutes after. I lost complete confidence in myself that I could do this. I no longer felt my body was made to give birth, that it knew exactly what to do to bring my baby into the world — it clearly didn’t. I no longer felt safe and nurtured and guided through the path of labor and into motherhood — I felt threatened and scared.
I had tried so very hard to be brave and positive at every second up until this point. I had tried to stay brave and positive in the face of bedrest and preeclampsia. I tried to stay brave and positive when I learned I was losing all my coping mechanisms. I tried to stay brave despite my skyrocketing blood pressures, and the threat of seizure or stroke. I had tried to stay brave in light of my induction moving slow, if at all; and I’d tried to stay brave about losing the caretaker I’d trusted with this most intimate, important process for nine months.
But I’d run out of bravery and positivity. I felt like I was living my birth nightmare. My body and my baby were at odds — my body needing me to deliver as soon as possible, but my baby in no way ready to come out. And now, I felt trapped with what I dreaded most about an OBGYN doctor instead of a midwife — someone who didn’t respect my wishes, didn’t respect my body, and who was immediately going to push more interventions on me.
Thank God the doctor had left the room, because for at least five or ten minutes, I couldn’t stop crying. Everyone gathered around me, petting whatever they could reach; my head, my hand, my feet. With their soothing and Emi’s direction, we tried to figure out a plan on how to proceed.
My concern was that I didn’t want to rush into labor too fast. It was apparent my baby wasn’t ready to come, and I didn’t want to force labor by whatever means necessary, in such a drastic way. I felt that was unsafe for me and for my baby, and would make my long hours of labor harder to bear. My body was already struggling handling the last few days of my pregnancy, hence the preeclampsia — I didn’t want to put even more strain and danger onto myself, and even more so onto my baby. This was the worry Shaun, Emi, and I had had all the weekend before — we didn’t want to crash into labor by pumping me full of drugs and then have either Baby Girl or I go into distress. And without the freedom to move, use counterpressure or water — I wanted to slowly move into labor so I could try my best to cope with the growing pain of contractions, and not get overwhelmed and lose my focus and determination — especially now, when I was already weak, exhausted and in a starting amount of pain.
The doctor was already on my bad list because of the membrane sweep, but I knew what she was trying to achieve — to get this labor going, so we could end my preeclampsia. But I felt really uncomfortable with the idea of breaking my water already, before I was even really in labor. I felt it was rushing my body, which clearly wasn’t ready to labor yet. I didn’t feel like that was necessary, yet. I was reluctant to start Pitocin under her care — I knew it was necessary, at this point. I knew it was going to happen once I had to be induced. I had accepted that if I was getting induced, I’d be getting Pitocin. But Pitocin is one of those things that can do exactly what I mentioned above — really crash you into labor with little time to adjust and cope. Emi had assured me that inductions with my midwife were very gentle and slow — but my midwife was gone now. Given the doctor’s actions already, I didn’t feel confident that she would start me slowly on Pitocin and let it build slowly in my system. I felt like I would get it, be cranked up on it — and that scared me.
And because of that, I was also really scared that laboring under those circumstances would end up putting either Baby Girl under distress, as Pitocin and then epidurals often do – or that my already risky position would grow even worse. I was worried that we would need a C-section – but under emergency circumstances – me being whisked off to the OR without warning or time to prepare, without Shaun. I had been terrified of a C-section, but I’d been OK with the idea of going into it with time to prepare emotionally to cope with what I was afraid of. I was starting to feel like we might end up in that emergency C-section situation and I had no idea how I would cope if we did – I felt on the verge of terror even just thinking about it, and I was beginning to get scared that was the inevitable route my birth was taking – I’d heard of it happening to so many other women I knew, and I felt like I was about to become another statistic.
Even though my heart was sinking and I felt very doubtful of the situation, I still wanted to try. I knew a vaginal birth was important to me, and I felt I at least owed it an effort. So we called the doctor back in.
The discussion wasn’t ideal. Again, the doctor seemed baffled by my request that we wait to break my water, and start Pitcoin low and slow. I know from her perspective, I seemed crazy. I think she thought I was trying to avoid pain in general, which is, of course, impossible. That wasn’t it – I knew pain was a part of birth, and I had worked for nine months on developing fortitude to deal with that pain. I just wanted to try and allow my body to do as much of the work as it could, and I wanted to give my body the chance to get into gear and do it on its own. I didn’t want to go from zero to a hundred in three seconds, I wanted my body to have the option of figuring out what was necessary and starting to do it own its own if it could. I didn’t want to be rushed into making decisions just to move things faster.
The doctor seemed displeased with me, but despite her questioning, I stayed firm. Pitocin, yes. Low and slow. Water breaking, no. She wasn’t mad or mean, just baffled; and I honestly felt like an idiot. I felt like she thought I was being dumb and cowardly – and that certainly didn’t help my confidence or my trust. But she agreed, and she left again. I was back in the care of my nurses again.
Kristin was helping a lot, running and fetching and carrying as well as just keeping our spirits up. She and Nurse K worked together to get me started on the Pitocin. I believe many of the others cleared out of the room for a while at this time. I still was having a really hard time coping, a really hard time calming down. That membrane sweep had blown the lid off of the calm I’d managed to maintain all the day before and all night. Once I slipped up and let my emotions out, I was having a hard time putting the lid back on. I believe everyone but Shaun left for a while – not long, but long enough to try and give me some space, have fewer eyes and less attention on me.
Before they stepped out, I told Mom and Emi I would try and listen to some Hypnobirthing relaxation tracks as they got the Pitocin started. I was starting to feel dangerously close to out of control emotionally, and that was the worst place I could be if we were going to follow through and get this birth going. I really, really wanted to try and wanted to work hard to do what I needed to do to get my baby here – so as everyone left, I popped my headphones in, still sniffling and a few tears running down my cheeks, and Shaun sat in a chair next to me and held my hand.
The relaxation tracks really did help. I had been listening to them since the middle of my second trimester, and they always helped calm me down. If I was feeling anxious about giving birth or being a parent, I listened to one and the positive affirmations and detailed visualizations always made me feel calmer and more capable.
After maybe fifteen minutes, I opened my eyes. The room seemed much more peaceful. Anytime my midwife or the doctor had come in, they’d closed the curtains on the windows and used the medical lamp to check me – but I always asked for the heavy curtains to be opened afterwards. The thin gauzy curtains blunted the brightness of the sun, but the sunlight streamed in onto the flow and cast the room with a gentle, warm light. Shaun hadn’t left my side, and my mama waited patiently off to the side.
I feel better now, I told them, I feel a little more like I can handle this.
Good, they agreed, and they both kissed me.
The plan had been to start me on a low(ish) dose of Pitocin, and bump it up every fifteen minutes. The fifteen minutes seemed a bit quicker of an interval than I’d like, I’d hope for more like 30 or 40 minutes, maybe an hour – but I knew the doctor had a point. If I had any chance of delivering vaginally, as was so important to me, we had to get things going. I had to agree to her schedule and her pacing. Still, every time Nurse K came in to up the IV, I felt that lightning bolt of fear – worried that within minutes, agony would be ripping through me.
There was some confusion, at the time, about how much Pitocin they could dose me with, we had been told a certain number once, and then told that that was wrong and it could go higher, and then told again that it could go higher. Regardless – at the time, to our understanding, my Pitocin was cranking up, higher and higher, and still – little change was happening. I got some contractions, bigger than the night before, but not full blown contractions. I felt like, yet again, my body and my baby weren’t ready to give birth. I felt like we were pushing Baby Girl and me down a course neither of us were ready for – we needed time, and the last thing we had right then was time. It felt like everyone was in a rush, except Baby Girl and me.
This whole time, turmoil bubbled within me. This next part was absolutely the hardest part of my birth, emotionally and spiritually. I am trying to write it out now, and my heart is racing, my anxiety is in full force as if it were happening again to me right now.
I was struggling, at this point. Not just physically, although that was a large part of it. I felt, at this point, something was wrong. Bad wrong. I felt, very firmly, in my gut that we were headed down a scary and dangerous road. It is hard to describe, it is hard to explain – if you are reading this and are a person who believes very much in their intuition and instinct, maybe it will be easier to understand. I fear so much in writing this that people won’t understand my reasoning for making the decisions I did from this point on. But on that afternoon in July, I felt my intuition was screaming at me. It had been talking to me, firmly, since that Thursday before, the day after we’d been sent home from monitoring and put on bed rest. I feel like I knew in my heart at that point that Baby Girl wasn’t going to be born vaginally. It was a truth I did not want to accept, and so I stifled that voice day after day. I acknowledged it, I prepared for it – but I was still determined to do everything in my power to avoid a C-section. I still wanted to exhaust every avenue available to me to have that birth, before I gave in.
But through Thursday and Friday, Saturday and Sunday, I had felt this niggling feeling in the back of my head that my birth wasn’t going to go that way. After talk from my midwife on that Monday when we’d start the induction, I’d started to feel a C-section would be necessary – if my midwife was talking like it would probably be necessary, I knew that was serious. And on this Tuesday afternoon, after a day of Cytotec and hours on Pitocin with almost no result – I felt like a C-section was necessary.
I hated it. I hated the fact that I felt that so strongly. I felt cowardly. I felt like I was betraying myself, betraying everything I had worked so hard on for months and months. I could not believe that I was considering this. I could not believe I felt like I needed to ask for this.
As the Pitocin had continued, over those hours, my support team had trickled back in – Shaun and Mama, Jeannie and Emi and Kristin. (Lauren had gone to the dance studio for a couple hours and would return when we called.) They were all camped out in my room, and everyone was quiet. There wasn’t any lighthearted joking anymore. There weren’t offers to paint my toenails. Everyone was very solemn, and I realize now, after – very scared. We were all scared of how this was progressing. Bless them all, bless them so much – they did such a good job of covering their fear and worry. They did such a good job doing exactly what I had asked of them – stay calm and positive, so I could stay calm and positive too.
But they were doing such a good job of being positive that I felt crazy as I broke the silence in the room. I felt crazy to bring up this conflicting idea that bounced around in my head and insisted on being heard. I didn’t want to say anything, but the words came bubbling out whether I wanted them to or not.
How – how do you all feel about how this is going? I think that’s how I phrased it. I still didn’t want to open with what my heart’s intentions were.
It is impossible to describe the next hour or two in detail. It was, as I said, the absolute hardest part of my birth. For other mothers, that hardest moment — that moment of reckoning, that moment of am I willing to do the hard work, where you search within yourself and find the strength to become a mother – that usually comes in transition, in pushing. For me, that moment came in these two hours that we spent debating what to do next.
The Pitocin still running the entire time, I finally admitted what my instincts were screaming at me – I felt I needed a C-section. And I felt horrible saying that. It was agonizing to even admit I was considering it.
My support team was so gentle with me. They let me ease out what I was trying to say. They listened, they validated me, they voiced concerns and they also considered alternatives. Shaun told me he felt such relief once I vocalized the idea that I might need a C-section. Good, he’d thought, at least now the option is on the table and we can talk about it. And he wasn’t the only one that felt that way – apparently everyone had been thinking this, but as long as I was firm in trying to avoid it, they weren’t going to contradict me.
I told them that I was fearful of the direction this birth was headed. Not fearful in an I don’t want to do this sort of way – fearful in an I sense something bad is going to happen way. I felt we were on borrowed time at the moment. I don’t consider myself a birth expert, but I’ve done a lot of research. I’ve read a lot of birth stories. I’ve read a lot of books. I’ve aspired to be a birth worker, I have gathered up as many experiences and as much knowledge as I could. Learning about birth didn’t begin for me when I found out I was pregnant. I’d been researching and learning about birth for literally years.
I felt as certain as if I could see it laid out on a roadmap in front of me. The way it appeared to me – I could stay on Pitocin. They could continue to crank it up – and they would keep cranking it up, keep it there for hours to get labor going. I felt, particularly with my blood pressure continuing to be scary high due to the preeclampsia, that either Baby Girl or I or both would go into distress – and we would be rushed for an emergency C-section. Baby Girl had been holding steady throughout the last 48 hours, but I remember someone telling me later, after, that she was starting to flag. She wasn’t in distress, but it was almost as if she were getting tired.
Or we would labor and labor for hours, maybe days – Baby Girl had showed no signs of engaging in my pelvis, and I felt like if we did ever get to the pushing stage, she wouldn’t drop, she wouldn’t engage, and we would be rushed off for an emergency C-section. I had heard of this happening to so many women who had gone down this same induction path I had.
And one of the things that had stuck with me most during this struggle was the story of a very dear, dear friend of mine who’d given birth earlier in the year. She too had had big plans for a natural, vaginal birth. She too had gone into her birth a little differently than expected and ended up on some Pitocin at a certain point to speed things along. She had ended up with an epidural she hadn’t wanted, and she was another one of those cases I just mentioned – she finally got to the push stage, but baby wouldn’t drop or engage. Even after a couple hours of trying, the birth wasn’t going the way the doctors wanted, and finally, beyond exhausted, just absolutely drained – she had to go for a C-section. Our mutual best friend was present, and she described to me this mother’s pain in that moment when she finally had to give in and take that route she didn’t want. It had broken my heart then, when I heard about it, and it broke my heart all over again as I lay in that hospital bed, in a similar situation, poised to go down that same road. I couldn’t stop thinking about her and the emotional pain she had suffered.
For the record, that mama’s C-section went great, her baby was healthy and she was healthy. All the biggest goals were met – healthy mom, healthy baby. But I also knew, even at that point, that day when I was giving birth, and even more so afterwards – how much that affected her, emotionally. How she still struggled with her emotions from that experience, days and weeks and months later. I knew it had been traumatizing to her. Part of me felt that if there was a way I could avoid having that same experience as she did, I wanted to do it. She was so brave and so strong, and she rolled with the punches and dealt with her less-than-ideal circumstances like a champion, like a queen – but I also know if she could have avoided that stress, that emotional agony, that trauma – she might have considered it.
I didn’t want to push myself to the point of danger and panic. I didn’t want my goal of a natural, vaginal birth to blind me so much that I nearly killed myself just trying to achieve that accolade. I didn’t want to make how I brought my baby into the world more important than getting her into the world safely. I had known already that I was terrified of a C-section under any terms. It was literally my worst case scenario. I knew that if I labored for hours and hours through agony and exhaustion and fatigue, and then was forced to go for C-section when I was at my lowest, lowest point both physically and emotionally – it would be devastating for me. I knew I would end up having a panic attack, I would end up having to be put under anesthesia, it could be hours or even a day before I could recover and see and hold my baby. It would take me days and weeks to recover – not just physically, but emotionally. I was terrified out of my mind to elect having a C-section, but I knew if I had to have a C-section under emergency circumstances, it would be an incredibly horrific experience for me.
All of this – my support team and I discussed, for a long time. I cried. I cried so much. I felt so defeated, and yet also so curiously strong in my convictions. I felt so strongly that a C-section was what needed to happen – but I hated that fact. More than anything else, I hated that I was in this situation in the first place. I do remember saying – if we could go back in time, and there were an option where I didn’t have preeclampsia – that would be the best situation. But we can’t do that, we have to deal with THIS situation and not any other. My preeclampsia made my body need to have that baby that day, but my baby was not ready to come. We were in a circumstance where I had to have my baby that day, and under these circumstances, I had to do what I had to do.
We went around in circles discussing. I think at that point, I knew in my heart what I needed, but I still wasn’t ready to admit it. I think I didn’t want to be the one to decide I’d be getting a C-section. I had wanted my midwife or the doctor to tell me it was necessary. I didn’t want the guilt and the burden of deciding to pick the exact thing I hadn’t wanted. But at what cost? How far was I willing to go to force someone to tell me I couldn’t have my baby vaginally? How dangerous did I need it to become? How scary did I need it to be for me, for my husband, for my family and friends watching me and supporting me? How bad would it have to get before it was enough?
As Jeannie told me later – most of my support group had thought I might need a C-section, but as she put it, we didn’t want to be the ones to tell you that you couldn’t do this. As long as you felt you could do it, we wanted to support you. It makes me tear up, yet again, thinking about that – my support team was so on board with my wishes. They were scared for me, they felt I needed to amend my plans – but as long as I was on board to try, they were behind me 100%. I think that was honestly one of the things that made it harder to admit – they had been so good and firm and strong for me, I felt like a crazy person suggesting that I needed a C-section. They hadn’t shown a second of fear to me, they had been so steady – I felt like I was being a big baby, a cowardly woman who was shying away from doing real work.
And so, in some ways, finally speaking up was a relief. Turned out many of them had considered I might end up with a C-section – some of them were shocked they hadn’t taken me for a C-section on Monday when my blood pressure had spiked 180. They had been scared, but they had waited with me, and once I spoke my feelings out loud, they were quick to validate what I was saying.
In some ways, what I needed more than anything was to hear that Emi and Kristin supported my decision. I knew my sweet love Shaun would support me in any decision I made. He wasn’t emotionally attached to any sort of birth plan – he simply wanted me to have what I wanted, and he wanted me to be safe and Baby Girl to be safe. I knew my mom and even Jeannie and Lauren were in the same boat as Shaun – again, they wanted me to get the experience I wanted, but they wanted me to be safe.
Emi and Kristin were my birth gurus, they were my pregnancy and birth coaches. They were the ones who knew what it felt like first hand to have this desire to have a natural, vaginal birth – and oddly, they’d each been on either side of that desire – Emi who’s had three natural births and knows the work and reward they bring, and Kristin who had an unwanted C-section with her first, which led to an unwanted C-section with her second (and, since Ari was born, a scheduled C-section with her third that she said was her most positive experience yet). More than anyone else there that day, I think those two understood what was at stake for me making this decision. They were the ones who had helped me work on how to cope, how to push through fear and doubt to get that birth – and so I felt I needed those two to tell me it would be OK to have a C-section, that it was necessary, that it was the right decision – and they both helped me so much, each in their own way.
I have been a doula for years, Emi told me, during this long discussion, and I have never been more pro-C-section than I am now. I have never ever been pro-C-section if I thought it could and should be avoided. Never. And I am pro-C-section right now. I think it’s what needs to happen.
And at one point – Kristin, who had been standing on the opposite side of the room as I talked to Shaun and Emi next to me, Jeannie and Mom perched in chairs beside us – Kristin came running over, crying. I don’t know that I had ever seen her cry before.
I’m so sorry, she said, hugging me, I’m so sorry. I know exactly how this feels. I know how horrible this feels.
It shook me to my core, at that moment. I needed that, so much. I needed acknowledgment that even just standing at this crossroads, regardless of what I ended up deciding, even just standing here was an agonizing feeling – what was at stake was a dear and precious dream of mine. A dream I’ve had for years to have a beautiful, natural birth that I could be proud to share. I wanted so much to be able to have that experience and hold it my heart. I wanted so much to have that experience so I could share it with the world. I wanted so much to be able to say I had done that, because I wanted to be able to say, first hand, to other women, other mamas-to-be – I did it, and it was beautiful, and you can do it too. I wanted to carry that honor and share it with other women, I wanted to help them believe in themselves the way Emi had helped me believe in myself up until this point.
And what I was facing in this moment was the reality that I was not going to be able to have that dream. I was going to have to give it up, one way or the other. I was looking at a difficult vaginal birth, or I was looking at a C-section. There would be no dreamy laboring at home, walking among the trees in the early hours and leaning on my husband for support. There would be no breathless exhilaration of my water breaking. There would be no hushed excitement as my family and friends packed up the car for me. There would be no intense laboring in the birth tub, or the shower. There would be empowering transition, no listening to my body as I guided my child into this world.
I remembering just crying as this realization swept over me. I couldn’t even look at anyone. I talked to them, quite a lot, but I lay on my side in my hospital bed, pressing my face against the railing – the railing that had been padded in case I had a stroke – and I cried. I mourned, I grieved. I couldn’t face anyone because I felt so guilty and ashamed for coming to this place.
At some point, Jeannie gracefully suggested that she and Mama leave the room for a bit, to let Shaun and I talk with Emi and Kristin alone, since they had the most knowledge about what was at stake and what would happen. I found it easier to be calmer, somehow, when the room emptied for a bit. I asked Jeannie to call Lauren and let her know what was going on, and that she probably needed to head back from the dance studio to be with us.
In the quieter room, I was able to breathe for a moment, and reflect on every single thing that had been said by me, by my husband, by my mother, by my sister, by my friends. I knew what needed to happen, but I still didn’t want to say it. Emi and Kristin spent a lot of time reassuring me, validating me, over and over again, as much as I needed it. Kristin even offered to get Nurse K and get her opinion, as she had ended up having C-sections herself. Everyone was very gentle and kind with me, but they still couldn’t make this decision for me. I had to be the one to say it, and I just did not want to say it. I just did not want to give in, even though I knew it was what was necessary to me.
I had said that I wanted my birth to be empowering and that I wanted to feel like I had explored my options and considered everything carefully – and that, more than anything, is maybe what won me over. As Kristin, Emi, K, and Shaun talked with me, I reasoned that we had done exactly that, and that making this decision was indeed empowering. At every step – from the monitoring the week before up until this very minute – I had made sure we slowed down and considered what we were being told. I had made sure we discussed any options and what they would mean, what consequences would be. We had always made sure to state our preferences and ask what would happen if we did or didn’t take a step. We had made every single nurse, technician, midwife, and doctor explain our choices to us. And what could be more empowering than deciding I didn’t want to give myself a dangerous, traumatizing birth? What could be empowering than choosing – choosing – a joyful, peaceful birth – even if that joy and peace didn’t come about in the exact manner I’d imagined it?
Finally, I could say it. It still hurt, it still chafed at me – and it still does, to this day – but I knew what needed to happen, and it was my decision that I made mindfully, supported by my loved ones.
I believe I need a C-section, I told Nurse K. It was now official.