Monday, August 25, 2008

birth is biology

After taking the birth survey, I started to ruminate on my experiences giving birth to Geekygirl and Geekybaby. I was incredibly fortunate in that both babies arrived into the world after exhilarating, empowering labours and deliveries, with little medical intervention.

It appears a little incongrous to some of my friends that I feel so strongly about eschewing intervention in childbirth. After all, I have a career devoted to developing pharmaceuticals, a belief in modern medicine, and many friends who are medical professionals. I just don't think childbirth is a pathological condition. It is part of our normal biology, something our bodies know how to do, much like digesting our food (OK, maybe a bit more dramatic and life changing than than eating a bag of chips, but it is not akin to having open heart surgery either.) And since we still don't fully understand the nuances of hormonal and neurological signaling that occur when we do something as simple as eat a sandwich (I work in this area, its amazing what your body and your brain do when you eat!), I would hesitate to say that we understand the process by which we give birth to a child well enough to interfere with it with synthetic hormones and blockers of neurotransmission unless absolutely necessary.

I believe strongly that everyone should be able to make an informed choice about how they give birth. I just don't think our obstetricians here give us the right information to make those choices. For example, apparently 80% of women here are given pitocin (synthetic oxytocin) at some time during their labor. It just can't be the case that 80% of American women don't make enough oxytocin. I have noticed that attitudes toward childbirth are very different here in the US, where the majority of women (and their doctors) assume that they will give birth in hospital and have an epidural, compared to in the UK, where most people aim to try for as few interventions as possible.

When I became pregnant with Geekygirl in San Francisco, I sought the care of a hospital midwife rather than the more typical obstetrician, since midwife care is more usual in the UK where I'm from. I learned from friends who had given birth about the value of having the support of a doula during labor, so I hired the amazing Germaine Reidy, who now works in Ireland. If anyone reading this is planning on having a baby in Ireland, check her out! The picture on her site here is of me taking her infant massage class with Geekybaby.

I went into labour gradually with Geekygirl. People always ask 'how long was your labour?', but I am not sure how to define when it actually started. I had contractions while climbing the stairs from the dog beach at fort funston on Saturday, decided to redo all the planting beds in the back yard on Sunday, and went into what was clearly labour that night, which watching a Wallace and Grommit film. I laboured at home with Germaine and Geekydaddy for most of Monday, ending up in a very peaceful inner place, rythmically rocking on my glider chair for a couple of hours, and ultimately made the dash for the hospital while I was going through the transition phase of labor (I realized after the fact). The back seat of our Subaru was not the most comfortable place to be at this time and I think Geekydaddy thought, as we hit every red light in rush hour traffic, that I was going to give birth in the car. When I got to the hospital I was thrilled to find I was 9cm dilated, though quite dehydrated. IV fluids and a few whiffs of 'gas and air' (Nitrous oxide, this being one of the very few US hospital that offers this wonderful elixir) got me through to 10cm, and to the birthing stool, where I pushed for about forty minutes, being transferred to the bed to deliver Geekygirl, 6 lb 12 oz, so tiny and so perfect.

Until that moment when I saw her I don't think I had truly believed, despite the 9 months of pregnancy, that I was really going to become a mum, that I was actually having a baby. The euphoria of that reality, of her shear amazingness, stayed with me for days, and I can still summon back traces of the feeling when I reminisce.

Though I still think Germaine gave us good advice when she suggested I get to the hospital well into labour in order to avoid interventions, with Geekybaby I wanted to avoid the frantic 'We're about to have a baby in the car' experience. Though there was a long, long ten day wait for it to start, after being in labour for a couple of hours my water broke and recognizing the feeling from the last time, I knew the baby was clearly on its way, so we headed to the hospital. This time the car ride was much more relaxed, and after I checked in to the birthing unit at UCSF  I was able to focus on the panoramic views from the 15th floor as I breathed through contractions. Germaine being in Ireland, we had had another doula,  the fabulous Jessica Berman. Jessica's acupressure technique (on my hand, between thumb and forefinger) allowed me to foregoe even the gas and air this time. I had it brought into the room, and was comforted by its presence, but with Jessica's reassurance that it would just be a few more contractions until pushing time, I never actually picked up the mask. She also kept me hydrated with energy beverages so I didn't need any IV fluids. It felt great not to be hooked up to anything.

Our wonderful nurse brought out the birthing stool, and gave the medical residents attending the delivery the confidence to get down on the floor and assist me in delivering him right there on the stool, in less than ten minutes of heroic pushing. I was amazed at how quickly this stage went compared to the last time, I was prepared for a marathon pushing session and I had hardly got going before he was here, delivered right into my hands. My first impression of Geekybaby was how much bigger he was than Geekygirl (he was 8lb 6oz, and 22 inches long. I'm 5ft 2). He was bright pink, vigorous if a little squashed looking, and immediately demonstrated his functioning kidneys by peeing all over his dad. Meeting the fantastic new little person the second time around was just as incredible as the first.

I enjoyed my labours, and not just because they brought us our babies, I enjoyed the actual process. I admit that the power of endorphins must have blunted my memory of how much it hurt, and though I know intellectually that it was very painful, I don't really remember the pain,  I just recall the incredible intensity of the experience. Surrendering to the power that my own body has inherited over the millennia since the first placental mammal gave birth brought me, the biologist, in touch with my own biology, and helped me to see that being strong is not necessarily about being in control.

I won't have any more babies myself, and I'm actually sad that I will never experience labour again.  I want to try and spread the message that giving birth is not just something to be endured, but something that can be enjoyed, and embraced. It was a chance conversation with a friend, shortly after she had  given birth but long before I thought about children myself, that opened my eyes to this concept. I had never heard anyone wax lyrical about the wonder of labour before. I hope I can pass it on.


Iota said...

"... being strong is not necessarily about being in control" - I've never thought about it like that, but it makes absolute sense. Beautifully put.

I enjoyed this post. I had two births where I felt empowered, and one (the second one) where I had to be monitored, and with limited mobility, contractions were slow. The midwife wanted to speed things up, which made it too violent by far. I so much preferred the 'let nature take its course' way. But at the end of the day, I was just so grateful for three healthy babies, safely delivered.

jfb57 said...

I only had one child & wish I had known I was only going to experience the whole thing once. I'd have paid more attention to it all!

lifeasweknowit said...

Hi found your blog on Blog gems! I too had both my boys without any intervention through both labours and it is so empowering! Something to be very proud of I think! xx great post!

@jencull (jen) said...

I had my first two without intervention, my third was in distress so I was prepped for a c section with an epidural but she arrived without the assistance. I remember on my first having that feeling that you mention, the 'Oh, is that a baby? Did I DO that? Is he really MINE?' feeling of wonder and awe :D Thanks for joining in blog gems. Jen

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