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"People are not born once and for all on the day their mother puts them on to the Earth, but...time and again, life forces them to enter a new world on their own." Gabriel Garcia Marquez
Lying in a hospital bed on the maternity floor in North Central Bronx Hospital, I received a text from a new mom friend I recently met. She wanted to know if "my baby girl was born yet." I replied she "arrived three days prior and, with uncontrolled tears, I texted that I had a c-section." She replied, "Congratulations! Welcome to the C-club." My kneejerk reaction was that this was not a club I wanted to join. I was not supposed to be the 1 in 4 women who have c-sections every year.
"I was not supposed to be the 1 in 4."
When I became pregnant back in January, my plan was to have a homebirth. I was a homebirth. When I was growing up, my mother shared wonderful stories about my birth. You could say home-birthing was in my cellular memory. It was who I was, and aligned with how I tried to live my life: naturally. I envisioned bringing our baby into the world in the comfort of our new home, with little to no medical intervention.
We were fortunate to have found two incredible midwives and a doula. Our homebirth midwives were upfront with us from the very first visit. They explained they don't usually take 1st time mamas since the transfer rate to a hospital is high is pretty high at 30-50%. However, I presented as a very low risk client. Although I was considered a "geriatric pregnancy" at the ripe old age of 37, I was healthy and very passionate about birthing at home. The pregnancy started off as many do: lots of nausea and fatigue. By month four, I felt like a new person, as the nausea completely lifted. We started to tell more and more people the good news and it all felt more real. I was feeling the elation that often kicks in during the second trimester (aka the happy trimester). Yet, by the middle of month five, I started developing a lingering pain in my pubic symphysis, the joint in the middle of the pubic bone.
About 1 in 300 pregnant women (the statistics are likely much higher) experience a condition called Symphysis Pubis Dysfunction, caused by the surge of the hormone relaxin. As the name implies, relaxin loosens the ligaments around the pelvis to allow baby to come down and out. As the ligaments loosen, misalignment of the pelvic bones can occur causing debilitating pain. As a trained dancer I have developed a high threshold for pain over the years, so I continued to push through physically demanding culinary jobs and hiking, my favorite activity. Alas, pregnant body always wins out. There is no fighting the intensity of this time while hormones take on a life of their own to help baby develop. The pain became so severe. Lifting my foot more than a couple of inches off the ground was impossible. I had to stop working and put myself on bedrest for many weeks in the 3rd trimester.
"The challenges of pregnancy prepare you for labor."
Each day of the 3rd trimester was measured by the degree of pain I was in. I used breathwork, ice, tea, weekly chiropractic treatments, epson salt baths, healthy foods, meditation, and journaling to get me through the long weeks. Forty weeks came and went and still no baby. For any mama that's gone full term, one can understand how the anticipation to birth baby reaches a mental peak. Hypnobirthing exercises helped get me through sleepless nights and anxious thoughts as I awaited the day. Forty-one weeks to the day I went into early labor in the late hours of the night. It sounds funny, but I was filled with relief as each surge filled my body. The discomfort felt minor compared to the pain my pelvis I experienced for 5 months. It's true what they say: the challenges in pregnancy prepare you for the physical and mental demands of labor. What I didn't expect was how the events of birthing my baby would prepare me for becoming a mom.
Everything in the labor started off as we imagined, slow, steady, and quiet. Since we had no plans on going to a hospital, we could relax into the momentum of labor. I went back to sleep for a few hours, and then woke up leisurely, took a shower, and ate breakfast, all the while checking in with my midwives and doula. By 10am the surges were getting a little closer and I was ready for my doula to come over. From the moment she arrived, she did not leave my side, whether it was to remind me to focus on my breathing or massage my back. Just after noon, one of my midwives came over, the second midwife soon followed with their birthing assistant. Our team was in place. The dining room table acted as central station, in which they could lay out all of their materials and instruments and do continuous record keeping of my progress on their laptops. I remember how quiet they were, as this was one of my wishes for the environment of the birth. It was six of us in a very small house, but it often felt like just two; that's how quiet and relaxed the atmosphere was.
As the labor intensified, I went deeper into my breathing, mantras, and visualizations that I practiced for so long, calling on my body's wisdom to birth. I listened to my body, moved from room to room, as I shifted every hour from ball to bed to birthing pool. I was in a cocoon of love and support from my husband. The protection and infinite trust I felt from my birthing team was like none I've ever felt before. Ten hours passed. Sixteen hours passed. Twenty hours. My and baby's vitals were good. But after 24 hours of laboring, I was stalled at 8cm for longer than the midwives liked. Finally, at 1am they made the decision to call for a transfer to a backup hospital. They believed it was the best solution for me to get some pain relief and preserve a vaginal birth while I still could. I was crushed to have to leave our home, but all I cared about at that point was my baby's safety and health. Knowing I would soon be in the hands of the hospital system, with set procedures for labor and delivery, my goals quickly shifted from having a home birth to just being able to have a vaginal birth.
"Birthing prepares you for becoming a mother."
When we got to the hospital, every intention of our birth plan went downhill. Before I knew it, there were tubes hooked up all over me, bright lights, and hands poking and probing me. Even though the hospital we chose was midwifery driven, they did regular vaginal exams on me, something that was on my birthing "do not want" list. It's hard to say if it was from the vaginal exams, the epidural, or having been admitted fairly dehydrated, but I began to run a slight fever as we waited for the Pitocin (artificial oxytocin) to kick in.
The OB that had just come on that night was not happy with how things were progressing (or not progressing). Baby's vitals weren't accelerating as should normally happen as a result of the epidural and Pitocin. She would call for a C-section if things did not move along. While she was out of the room, my attending midwife checked me one more time, as she too was rooting for me to have a vaginal birth, if possible. I was fully dilated at this point. She asked if I wanted to try pushing. Of course I did. Numb from the epidural, I drew from my birthing books and witness at my sister's births to get my body to push with all her might. Everyone was cheering me on, as it was looking like baby's head was coming down and that we had a real chance. After three pushes, it wasn't looking good. Our baby was opposite posterior, which means her head was down but she was facing the wrong way, and her arm was raised by her head making it too wide of a diameter for entry. It would have taken hours of pushing and this could have put both of us in danger. That was it. My chance for a vaginal birth was over. It was determined that a C-section was in order.
Every last bit of strength I had vanished and I melted in tears. It felt like I lost something special and sacred in an instant. I did. I lost the incredible gift women are given, to feel their baby move from the womb into this world. After so many months working through the physical pains of pregnancy and staying focused on my birth plan, I felt defeated. I looked into my husband's eyes at this point and I didn't have to say anything. He knew how much a natural birth meant to me and told me with his eyes how sorry he was.
Baby's microbiome, or bacterial ecosystem, is first inoculated as she passes through the birth canal. I couldn't help but think about her immune system being compromised so early on. Having studied the long term health risks of babies born by C-section, I had all I could do to not go down the rabbit hole of fear, but stay focused on what was happening right then and there. Because I was running a fever, there wasn't even the possibility of doing a "vaginal seeding," a way of slathering baby with mother's microbes to promote a healthy microbiome post c-section. Furthermore, we'd be separated almost immediately without skin to skin time, which is so very important in the first hour of life.
I was whisked away to the OR, overmedicated, sobbing, scared out of my mind, and cold, so cold with labor shakes. My husband sat next to my head and before I knew it, a sheet was put in front of me. Ten minutes later (that's how quickly they pull baby out) I heard the cry of my baby girl. They put her fresh, soft cheek against mine and in that instant I felt like a mother for the first time. All I cared about was that Olive was safely with us, no matter how she got here. She was healthy and big at 8lb 8oz.
She was taken to the NICU for the next 48 hours where she was put on a dextrose-based IV drip, and three different antibiotics. Every intervention I could have possibly hoped wouldn't happen for her happened. It was as if at each turn, we were delivered another blow. The first night the NICU pediatrician demanded she be given formula since I wasn't producing enough colostrum to take her off the IV. I spent two nights pumping as much colostrum as I could, in effort to minimize the amount of formula, and went down to the NICU every two hours to feed her. Fortunately, by the the third day, she was discharged to our private room and started nursing like a champ.
It felt incredible to arrive back home with our sweet bundle four days later. Yet something wasn't right in me. I was overjoyed to be Olive's mother, but I was breaking down suddenly during the day. I kept replaying the events of the labor, C-section, and recovery. I couldn't accept the facts of what happened. It felt like I was living someone else's birth. How did my perfect birth plan go so far south? Whenever I told people close to me that I was transferred to the hospital and had a c-section, the response was always the same: "all that matters is that you have a healthy baby." I didn't agree that was all that mattered. There is baby's birth and there is mother's birthing experience. Both need to be honored. I didn't know how I was going to get past the disappointment; a sense of failure hit me like a ton of bricks. As a mother I felt like I failed my daughter. And as a health practitioner I felt like I might be seen as a fraud or a pariah, not fitting into the idealized model of birthing that is often depicted today in the media.
"Disappointment is a good sign of basic intelligence. It cannot be compared to anything else: it is so sharp, precise, obvious, and direct. If we can open, then we suddenly begin to see that our expectations are irrelevant compared with the reality of the situations we are facing." Chogyam Trungpa
In order to be the best mother I could be to Olive, I started working through the disappointment. I was fortunate to have people around me like my husband, my mother, midwives, doula, and therapist to discuss the post traumatic stress I was feeling day to day. There were many things I learned about myself along the way, a few of which I'll share because I think many people can relate to the disappointment felt after doing the best they can for their health and their families.
"Nothing in life is certain. All we can expect of ourselves is to try our best."
There is the notion in our culture that our best intentions will always manifest the outcome we desire. We can set out to eat a clean diet, regularly exercise, and cultivate a healthy lifestyle, believing this will make us immune to all ills. This illusory idea can set us up for failure. Some things are out of our control. All we can expect of ourselves is to try our best.
I see very idealistic messages in my nutrition and medical circles all the time. For example, the Goddess Myth, "that she is built to build a human, that she will feel all the more empowered for doing so as nature supposedly intended and that the baby’s future depends on it," is a message I admittedly bought into. My mantra to help me through the disappointment of birth was that we did everything we could do. We did everything we could do. No stone was left unturned. We can't escape our environment and the "perfect" images in social media, but we can be more aware of our reactions and how we absorb such inputs.
One of the greatest gifts we can give ourselves when healing from disappointment is lovingkindness. If you were to see a child or friend in pain, think about what you would say or how you might touch them in comfort. We can take that feeling of love and extend that to ourselves. Lovingkindness meditation is a practice in planting seeds of love in our heart so we may open more fully and flow through life with greater ease and less suffering. We repeat the phrases over and over again until we feel our hearts soften.
"May I be filled with lovingkindness.
May I be safe.
May I be healthy.
May I be happy."
Coping with disappointment is not about denying our intentions, but recognizing where they come from and understanding how they serve us. I no longer see the birth as something it wasn't. I now only see the beautiful baby girl I birthed and a more forgiving, vulnerable, wiser woman who emerged.
If you've been disappointed by health challenges, I encourage you to find a way to
work through your thoughts and feelings. You may discover a new relationship with yourself that you never knew was there in the shadows.