I’m aware writing this of how different this post might have gone had I written it before, during or soon after my daughter’s birth happened. Time has altered my lens. That in itself is a defusion strategy I often find helpful when considering something I find both very important and very emotive – questions like how will I feel about this a year from now? In two years? In ten? In twenty? What do I want to remember about it? What do I want this moment to be about? What do I want to stand for? Its a way to get enough space from this topic to view it clearly enough to do it justice.
As a first time mum, I have the thought that I was very naive about the reality of birth. People would say ‘good luck’ and I’d puzzle over their knowing looks – I wanted a beautiful natural water birth and with my renowned high pain threshold and marathon running experience and all my exhaustive pregnancy yoga prep, listening to the pregnancy podcast and research of Mumsnet I should be able to use my ACT strategies to cope fine in the birth centre, right?
Like most first time mums I’ve discussed this with, the answer for me was NO. Nor did my labour confirm to the nice neat graph in my antenatal class. My contractions never behaved how they were meant to. My pain display didn’t match what the midwives were looking for either – which led to the assumption I was ‘coping well’. I’ve learned that I go quiet naturally when I’m in either emotional or physical pain and this can often be mistaken for meaning I’m ok. Midwives are trained that women in established labour make noise, leading to the assumption that quiet = not in established labour. For me, this meant my husband put off going to the hospital because of the worry we’d be sent home for not being very far along. When I’d vomited over enough stuff for it to be inconvenient, we went. The midwife who examined me when I arrived started with the chat about why hadn’t I tried paracetamol and a tens machine before the examination, which then showed I was indeed in established labour, just minus sound effects. I then asked for gas and air, which became my new best friend. To start with that is. The pain ramped up, and was continuous rather than those neatly graphed waves I’d prepared for. So I got told off for overdoing the gas and air and my husband took the role of rationing it. This had the benefit of making me clear headed enough to backtrack on my birth plan to ask for an epidural. The midwife didn’t do that straight away because I seemed to be coping well (aka quiet due to constantly breathing gas and air). When she did, an anaesthetist couldn’t come straight away due to dealing with emergencies (which I do appreciate writhing round in agony is not, but if my pain display was more typical maybe I’d have been in the queue sooner and suffered less). An anaesthetist then came at about 4am but immediately left just as she was about to inject me to deal with another emergency. I then eventually did get my epidural a couple of hours later and got an hour or so of sleep in before the pushing stage. Accepting I needed to change plan and accept pain relief was definitely following my reverse compass, especially when I had no understanding then of why my pain was so intense and continuous. As such, to the extent I had coherent thoughts they were about being out of control and unsafe. In the pushing stage my daughter’s heart beat dipped twice indicating she wasn’t coping, the emergency buzzer was pushed and there were suddenly a team of about twelve people there. While I’d researched what could go wrong with birth and the options if it did, I hadn’t prepared to be spoken to as a lay person. I knew I didn’t want keighland forceps due to the high risk for the baby, but because they weren’t referred to by the technical term I missed the chance to protest. We had also prepared that we would opt for a ceasarean in that scenario as lower risk for the baby. However given I thought I was choosing a straightforward forceps delivery over a caesarean I consented, my instinct being that despite my husband’s puzzlement at my apparent u turn, this was the right decision. So perhaps the most useful part of my birth prep was holding into the advice to trust my maternal instincts. Because my daughter – following my pretending the anaesthetic top up had worked to avoid a delay causjng a risk to my baby – she was born safely with no complications – albeit a bit cranky at her abrupt arrival. So my ability to be quiet during pain and choose to have pain in the service of what I value most – motherhood – was still useful for me when I needed it most, even if not in the way I planned. I also learned the reason for the continuous agony I couldn’t manage on gas and air was that my baby had got stuck in a back to back position which I now know other women also struggle to tolerate and no longer feel like a failure for needing that epidural. My daughter’s head was on the 91st percentile which also helps me rationalise my pain relief choice. I then had a post partum haemorrhage, tachycardia an episiotomy and a significant additional tear to heal which would give me lots of opportunity to use my ACT skills. I’d seen birth as the marathon – but through this retrospective lens I can see that it was only the start line – motherhood is the real marathon and where those ACT skills really come in for me.
The best birth preparation I had was pregnancy yoga at the pregnancy and parents centre in Edinburgh – I’d recommend to any other pregnant mum. I’d just offer the suggestion of holding birth plans lightly and trying to resist fusing with it, and any stories that might associate with it. I had an old story associated with natural birth that meant I would be strong, successful and womanly if I could manage with the implication of the opposites if I couldn’t – now I’m distanced and defused I can see it for what it is – just a story reinforced by some women I know, some media and some movies. My now perspective is that how I mother my children says a lot more about my strength, womanlyness and success than how my birth stories unfolded – and to the extent that anyone really has the right to judge another mother I’d prefer to be judged on my mothering skills day in, day out.