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Monday, May 2, 2011

When Intervention is Neccessary

I think anyone who knows me would consider me conservative by nature. And if you've followed my blog for any length of time, you know that along with this conservatism comes the constant pursuit of doing everything as naturally as possible. Which extends to childbirth. In fact, if I could, I might even be one of those who would prefer to give birth at home, as a few of my cousins have (on both sides of my family).

But I can't. And the reason is that I can't do everything naturally when it comes to childbirth. Most things, yes, but not everything. My body simply doesn't do what it's supposed to, so I need some medical intervention to have a successful delivery and a healthy baby. While this saddens and frustrates me, I am grateful I live now and not 100 years ago--or less.

This story actually begins back when I, myself, was a baby. I was my parents' first child and, therefore, my mom had no idea what her body needed in order to give birth to me. Her own mother had no trouble, so I imagine she expected to be the same way. But she wasn't. Being the amazing woman she is, and having an incredible ability to withstand pain (and for an unbelievable length of time), she somehow survived laboring with me for 8 days. Yes, you read that right: Labor pains every five minutes for eight days! Thirty-one years later I am still flabbergasted by this knowledge. I wouldn't have been able to do the same in her position, even though I have a high pain threshold as well. And I sincerely hope that no medical professionals today would allow such a scenario to play itself out like that.

(In actuality, this story goes back at least to my maternal great-grandmother, who almost died giving birth to her first child because she had been in labor for so long and wasn't dilating enough to have him. With any luck, maybe this family "curse," which skipped my maternal grandmother, will also skip my daughters.)

As it turned out, when my mother finally refused to be sent home from the hospital again, the doctor finally gave her Pitocin, and then I was born, less than an hour later. Hearing this story my whole life, I always hoped I wouldn't be the same. Especially once I learned that Pitocin often actually makes contractions more intense and painful. But when I was one day shy of 41 weeks pregnant with my first child, with no sign of going into labor (my cervix was dilated to a 2 and supposedly very effaced, but that was it), my certified nurse midwife (CNM) stripped my membranes in an effort to get me going. A few hours later I knew I was finally in labor, but after about 17 hours, my cervix was still only at a 3 1/2. That was devastating news! And the contractions were not being consistent or productive. I was exhausted by this point and almost at the end of my rope, not to mention terrified this first time. It was recommended that I be started on Pitocin to help my contractions do their job. And my midwife, who normally wouldn't recommend an epidural, told me that she felt that in order to make it through to the end, especially with the addition of the Pitocin, I should probably have one. I agreed. (Unfortunately, this didn't prove to provide much relief at all, since the baby was posterior and, as a result, I experienced excruciating back labor, but couldn't keep moving to help me deal with the pain.)

Well, to make a long story a little shorter, the Pitocin eventually did the trick and I delivered my firstborn after 22 hours of labor--vaginally but with the help of forceps. (The medical staff determined that the baby's heart rate kept plummeting too low and they needed to get her out, even though I wasn't yet dilated to a 10.) My first daughter finally came into the world, then, but due to her being post-term and with all the pressure (literally) and stress of a long, difficult labor she was born with meconium aspiration and had to stay in the hospital for almost a week.

From this experience I learned 1) that my body, like my mother's, needs Pitocin in order for my cervix to dilate, and 2) that I don't want to have another epidural if I can possibly avoid it. (Not being able to move to help myself combat the pain was almost as bad as the pain itself--not to mention the fact that being stuck flat on your back increases your chances of having the baby rotate to a posterior position, which I think now may have actually been what made her rotate.)

And so, I found out what intervention I need. I joke that without Pitocin I would still be pregnant with my 6-year-old, but the truth is, I would probably have died (assuming there were no other possible interventions, such as c-section--which I sincerely hope never to have to have). In fact, if not for this same intervention, I probably would have died as a baby in my mother's womb, and she with me.

And so, while I wish I could have my babies completely naturally, I have learned what my body needs and am just grateful for the option. And I hope that this third time around will be as smooth and successful as the second! Because, if all goes as planned, I will be having my baby today. (Don't worry, I wrote this weeks ago and scheduled it to post automatically.)

When I was 39 weeks with my second baby, my cervix, once again, reached a 2 by itself, and was supposedly very effaced. But that was it. Again. And I felt very strongly that going overdue again would not do me or the baby any good, like it hadn't last time. So my midwife stripped my membranes and I hoped that that would get me going like it had the previous time. But other than give me more Braxton Hicks that tired me out but didn't keep going, nothing else happened. So my midwife scheduled an induction a couple days later. I was nervous about that, but up for the challenge. My midwife did everything in the right order for me: she started the medication slowly, waited before breaking my water, etc, and it worked like a dream. And from when my Pitocin-induced contractions began until our second daughter was born was only four hours. Four versus 22 truly felt like a miracle! In fact, it was exhilarating. With no epidural and a better sense for how to move and deal with the pain (and relax in between contractions and not be so scared and tense), my cervix responded so quickly to the medicine that I was at a 9 before I could even use the hot tub.

All of the above is why, despite all the studies (here's one) that say inductions can cause other (sometimes long-term) problems to Mom and/or baby, and knowing that being induced greatly raises the risk of having to have other interventions, I am one of those women who honestly and truly needs Pitocin. And this is sometimes a hard matter for me, because I believe that the percentage of inductions in this country is way too high, as it is for c-sections. And what is most troubling to me is that many of these two types of inductions are done purely for convenience's sake. Of course, there are also many other women who feel the same way I do about this, and some of them have expressed disapproval on finding out that I have a planned induction. I don't feel that I should have to explain my reasons to anyone, but at the same time I want to be understood. And I guess, in light of my own needs, I shouldn't jump to judgment on others, since I don't know all the details about other women either...

1 comment:

Carolyn Miller said...

I've had 4 induced labors past 41 weeks. Not until I had my 5th child did my body finally decide to start real labor on its own. I'm all for minimal interventions, but I too am very grateful for modern technology and medicines that can help us out. :)


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