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psocopteraI was at the midwives yesterday, and she asked me if I was planning an unmedicated birth, and I said that I planned to try it, and she put me down as "open" and warned me that if I was "wishy-washy" going in, I was going to end up with the epidural, so I really needed to think about what I wanted, or some such.
I have thought about it a lot; I have thought about it enough that I have way too many thoughts to discuss in a routine is-everyone-still-ok appointment. And I guess I'm kind of curious about how many of those thoughts seem completely ludicrous to people who actually know of what they speak, so, here are a bunch of things I secretly believe or expect about labor, behind the cut.
When I think about labor, I expect it to be hard in three different ways: pain, fear, and exhaustion. All of which, I believe, feed into each other in a fully reciprocal sort of fashion, such that coping with any of them should help to slow down the otherwise escalating spiral into complete ohgodtheonlypossiblewayoutisdrugs terror and agony and meltdown. (If that sounds ridiculous, that's okay, because I'm assuming that pretty much 100% of laboring women either *cope effectively* or *get the fucking epidural already*, which I am defining as "the acceptable outcomes, Plan A and Plan B, respectively.")
I don't have any great comparative experiences for labor. Pain, in my experience, is bad in two ways, the first way of which is that it's really distracting and stops you from doing anything else you might want to get to do. I won't be doing anything more important than being in labor, when I go into labor (honestly, in terms of Major Life Events, I'm not sure I'll be doing any single thing more important this *year* than being in labor - there could well be some Other Moment between me and the meeple that will surpass birthing it in importance, but birth has got to be pretty near the top), so the whole "waste of time" issue is not an issue. (The second way pain is bad is that it is horrible, which, alas, I expect to still hold.) But this makes it hard to compare the pain part of the labor-suffering-triad to any other experience of pain.
Minimizing the question of pain, though, the best comparative experience I do have, the one that is My Big Mental Metaphor for labor, is going up the cables on Half Dome. I'm sure hardcore marathoners or climbers will laugh at my invoking the cables, but they were a big deal for me, and, you know, at some level, I am the only person for whom this metaphor needs to work.
So, the cables. If you have no idea what I'm talking about, there's an enormous curved-sided granite peak too steep to walk up, so there are two metal cables strung up one side that you can use to pull yourself up, with boards every five feet where you can brace your feet to stand relatively securely. It is very very exposed (= a long way down and looks it) and if you were to fall, you might well die.
For me, being on the cables was fucking terrifying. I am enough afraid of heights that my body was VERY SURE I was in GREAT DANGER and it wanted to be sure to keep telling me I was in GREAT DANGER in case I forgot and maybe I should just FREEZE and NOT MOVE because if I moved I might FALL TO MY DEATH due to the GREAT DANGER... you get the idea. I imagine that when I'm in labor, my body will be warning me that ALL THIS PAIN is a sign of GREAT DANGER and I am NOT OK but honestly, I am not sure that is going to register as a higher threat level than YOU ARE ABOUT TO PLUMMET HUNDREDS OF FEET STRAIGHT DOWN. My sister can confirm this, that when we got to the top we were wobbly and crying and crawling and shaking and hugging the rocks for dear life and about one vomiting and/or pants-pissing apiece from hysterics.
I feel that I should interject here that hiking Half Dome and conquering those fucking cables is ONE OF THE MOST AWESOME THINGS I EVER DID, FUCK YOU DANGER ALERT SYSTEM. Perhaps you start to see why I am considering unmedicated labor.
There are a bunch of specific things about how I managed the cables that I think might be useful guides for labor too:
- preparation: I was as prepared as possible. I knew what the situation would be like, I had read about other people's experiences, I had put together a good set of equipment (hiking boots with good grippy soles, and batting gloves for gripping the cable). I feel like I've done this with labor, too - I've read books, I've read stories, and I sort of think of the midwives as my "equipment", supporting me and making sure my effort isn't wasted.
- setup: I wanted to approach the cables with as much energy left as possible, so I broke the hike, which most people do as a day hike, down into a two-night backpacking trip. Unfortunately I don't expect to be able to break for the night while in labor, but I think there's something useful here about conserving energy early on and being as well-rested as possible going in. And the basic hiking rules of staying hydrated and fed seem to apply almost directly (except that in labor it's going to have to be clear liquid calories. I know some people don't want to eat during labor but my body has never ever been any good at running on empty and I can't see how I would do hard physical work without having something to burn.)
- condition: I trained pretty seriously for the Half Dome hike. Sadly, I would really like to be going into labor in good physical condition, but I just don't see how I will at this point: I was in terrible shape when I got pregnant, I haven't managed to do much exercise while pregnant, my strength and stamina are pretty much for shit. I have, however, put some time into yoga and prenatal yoga, which I think has given me some fairly good training in mindful breathing, which I hear can be a helpful coping tool. (My mom was very concerned that my childbirth ed class wasn't spending enough time on practicing breathing techniques - I didn't tell her that I inevitably ended up doing yoga breathing instead of what they did have us practice, because it's so much more automatic to me at this point. It can't be that bad for childbirth or we wouldn't be doing it in prenatal yoga, right?)
- focus: for me, on the cables, it was not really helpful to look back at how far I had come (ack! eek! down! do not look there!), or ahead at what was coming (ack! eek! steeper! ohgod!). Well, it was occasionally inspiring to try to estimate what percent of the way we were, but mostly what worked for me was to take it one board at a time, and not worry too much about what (steeper! ohgod!) segments might be coming. I actually broke it down further, into the hand-over-hand steps I took while pulling myself up the cable. "One two three four five", I would count out loud. That was usually about what it took from one board to the next, a not-rushed "one two three four five." It's a popular hike and so the cables are *busy*, people going up and people going down. You advance to the next board when the person in front of you gets off of it (or you can go partway and get stuck hanging between boards, which sucks and is awful), so you're sort of this slow queue working its way up (on the way down, some people are going much faster than others, so there is a whole bunch of extra business with letting people by, but I'm focusing almost entirely on UP in this metaphor).
The guy in front of me was clearly much more relaxed and blase about the GREAT DANGER we were in, and I guess my counting perplexed or irritated him, to the point where he asked me why I kept doing that, and I tried to explain that this was very hard for me, but I could do anything for a count of five, so I could start my five steps and get through them and be ok and then start over and not have to do more than that at once. I'm not sure this made him any less exasperated with my counting, but I'm totally trying out "one two three four five (ohgodohgodohgod), one two three four five (ohgodohgodohgod)" as a labor mantra. (The ohgod part I don't actually say, it's what I think while gearing up for the next five-count. Also, I know contractions won't divide evenly into fives, but it turns out that five is how high I can count when I'm really freaking out, so I figure I will five my way along until "one two three ahhhhhh" rather than try to get all tricky with the big numbers. And the constant restarting fights acceleration, the one. two. three fourfive sixsevenhyperventilate problem.)
So, yeah. "One board at a time," and not letting myself get psyched out by the anticipation of even steeper, harder parts further on, is my personal key to how I intend to approach this unmedicated labor thing. The thing not to think is "hey, this part is hard, what happens when it gets harder, maybe I should turn around, maybe I shouldn't be doing this, what if I get too far and I can't handle it, I want to quit"; the thing to think is "next board: one, two...". I don't know if this works as well for pain as it does for fear, but my secret, maybe totally wrong belief is that if I can manage the fear and the exhaustion, I can get through the pain, that it will be enormous and horrible but it can't actually do anything to me other than be horrible.
So... I would not describe this as a "wishy-washy" approach. But here's the thing. Well, two things. One is that when I hiked up Half Dome I was absolutely determined in my mind that I was going up the cables, no chickening out, as long as the conditions were appropriate. I was also fully prepared to call it off in case of bad weather (lightning and slipperiness-when-wet are the two main reasons people die on Half Dome) or personal impediment (twisting an ankle on the trail, say). I was pretty invested in the trip (cross-country flight, back-country permits, expensive new boots, etc), and it would have been really sucky to lose my shot at getting to summit, but that is where stupid happens, and as absolutely as I was not letting myself chicken out of the cables, I was absolutely not letting myself be tempted to do something that wasn't safe. In my mental metaphor, "safe" on Half Dome is somewhat equivalent to "effective" in labor (since I assume that "safe" will be entirely out of my hands), and the way that I had to be "open" about whether I would actually get to do the cables, I have to be "open" about whether I will actually be able to labor all the way through unmedicated labor. I knew there were a finite number of boards, and as long as I kept going to the next one, I would eventually get up all of them. Labor is not actually like that, if I am stalled out, if next board and next board and next board is just going on endlessly without ever actually moving me up the damn mountain, then, to me, that is not a condition in which "no chickening out" is the right rule.
Two is that I honestly don't know what I would have chosen if the CCC had built a fucking staircase with a handrail up the back of Half Dome, and also left some interesting cables for the adventurous and/or insane. Getting up the cables was immensely satisfying, yes, but a huge part of that was having taken the risk and made the effort *for the huge reward* of being on top of fucking Half Dome and having one of the most spectacular panoramic views I will ever see in my life. Which is the "being handed the baby" part of the metaphor. If I could have gone to the top in a safer, less terrifying way, would I have? Quite possibly. And yet, I always like to climb the ladder and crawl through the tunnel and scramble up the boulders and whatever interesting little bits of path there are, even if there are nice wide walkways around. Maybe I would look at the stairs and the cables and realize that I couldn't resist the chance to experience the cables, even knowing I was going to be shaking and crying by the time I made it up the cables. There is something about that extremity of experience that attracts me, that it was so far beyond day to day life or even "normal" hiking and sightseeing. It took me to a place in my brain that was not a *nice* place, but was a very powerful, primal place. I imagine labor tapping that. But I also imagine not being able to get to that place if I know I can step off in a few more boards and take the fucking stairs. So we will have to see.
I have thought about it a lot; I have thought about it enough that I have way too many thoughts to discuss in a routine is-everyone-still-ok appointment. And I guess I'm kind of curious about how many of those thoughts seem completely ludicrous to people who actually know of what they speak, so, here are a bunch of things I secretly believe or expect about labor, behind the cut.
When I think about labor, I expect it to be hard in three different ways: pain, fear, and exhaustion. All of which, I believe, feed into each other in a fully reciprocal sort of fashion, such that coping with any of them should help to slow down the otherwise escalating spiral into complete ohgodtheonlypossiblewayoutisdrugs terror and agony and meltdown. (If that sounds ridiculous, that's okay, because I'm assuming that pretty much 100% of laboring women either *cope effectively* or *get the fucking epidural already*, which I am defining as "the acceptable outcomes, Plan A and Plan B, respectively.")
I don't have any great comparative experiences for labor. Pain, in my experience, is bad in two ways, the first way of which is that it's really distracting and stops you from doing anything else you might want to get to do. I won't be doing anything more important than being in labor, when I go into labor (honestly, in terms of Major Life Events, I'm not sure I'll be doing any single thing more important this *year* than being in labor - there could well be some Other Moment between me and the meeple that will surpass birthing it in importance, but birth has got to be pretty near the top), so the whole "waste of time" issue is not an issue. (The second way pain is bad is that it is horrible, which, alas, I expect to still hold.) But this makes it hard to compare the pain part of the labor-suffering-triad to any other experience of pain.
Minimizing the question of pain, though, the best comparative experience I do have, the one that is My Big Mental Metaphor for labor, is going up the cables on Half Dome. I'm sure hardcore marathoners or climbers will laugh at my invoking the cables, but they were a big deal for me, and, you know, at some level, I am the only person for whom this metaphor needs to work.
So, the cables. If you have no idea what I'm talking about, there's an enormous curved-sided granite peak too steep to walk up, so there are two metal cables strung up one side that you can use to pull yourself up, with boards every five feet where you can brace your feet to stand relatively securely. It is very very exposed (= a long way down and looks it) and if you were to fall, you might well die.
For me, being on the cables was fucking terrifying. I am enough afraid of heights that my body was VERY SURE I was in GREAT DANGER and it wanted to be sure to keep telling me I was in GREAT DANGER in case I forgot and maybe I should just FREEZE and NOT MOVE because if I moved I might FALL TO MY DEATH due to the GREAT DANGER... you get the idea. I imagine that when I'm in labor, my body will be warning me that ALL THIS PAIN is a sign of GREAT DANGER and I am NOT OK but honestly, I am not sure that is going to register as a higher threat level than YOU ARE ABOUT TO PLUMMET HUNDREDS OF FEET STRAIGHT DOWN. My sister can confirm this, that when we got to the top we were wobbly and crying and crawling and shaking and hugging the rocks for dear life and about one vomiting and/or pants-pissing apiece from hysterics.
I feel that I should interject here that hiking Half Dome and conquering those fucking cables is ONE OF THE MOST AWESOME THINGS I EVER DID, FUCK YOU DANGER ALERT SYSTEM. Perhaps you start to see why I am considering unmedicated labor.
There are a bunch of specific things about how I managed the cables that I think might be useful guides for labor too:
- preparation: I was as prepared as possible. I knew what the situation would be like, I had read about other people's experiences, I had put together a good set of equipment (hiking boots with good grippy soles, and batting gloves for gripping the cable). I feel like I've done this with labor, too - I've read books, I've read stories, and I sort of think of the midwives as my "equipment", supporting me and making sure my effort isn't wasted.
- setup: I wanted to approach the cables with as much energy left as possible, so I broke the hike, which most people do as a day hike, down into a two-night backpacking trip. Unfortunately I don't expect to be able to break for the night while in labor, but I think there's something useful here about conserving energy early on and being as well-rested as possible going in. And the basic hiking rules of staying hydrated and fed seem to apply almost directly (except that in labor it's going to have to be clear liquid calories. I know some people don't want to eat during labor but my body has never ever been any good at running on empty and I can't see how I would do hard physical work without having something to burn.)
- condition: I trained pretty seriously for the Half Dome hike. Sadly, I would really like to be going into labor in good physical condition, but I just don't see how I will at this point: I was in terrible shape when I got pregnant, I haven't managed to do much exercise while pregnant, my strength and stamina are pretty much for shit. I have, however, put some time into yoga and prenatal yoga, which I think has given me some fairly good training in mindful breathing, which I hear can be a helpful coping tool. (My mom was very concerned that my childbirth ed class wasn't spending enough time on practicing breathing techniques - I didn't tell her that I inevitably ended up doing yoga breathing instead of what they did have us practice, because it's so much more automatic to me at this point. It can't be that bad for childbirth or we wouldn't be doing it in prenatal yoga, right?)
- focus: for me, on the cables, it was not really helpful to look back at how far I had come (ack! eek! down! do not look there!), or ahead at what was coming (ack! eek! steeper! ohgod!). Well, it was occasionally inspiring to try to estimate what percent of the way we were, but mostly what worked for me was to take it one board at a time, and not worry too much about what (steeper! ohgod!) segments might be coming. I actually broke it down further, into the hand-over-hand steps I took while pulling myself up the cable. "One two three four five", I would count out loud. That was usually about what it took from one board to the next, a not-rushed "one two three four five." It's a popular hike and so the cables are *busy*, people going up and people going down. You advance to the next board when the person in front of you gets off of it (or you can go partway and get stuck hanging between boards, which sucks and is awful), so you're sort of this slow queue working its way up (on the way down, some people are going much faster than others, so there is a whole bunch of extra business with letting people by, but I'm focusing almost entirely on UP in this metaphor).
The guy in front of me was clearly much more relaxed and blase about the GREAT DANGER we were in, and I guess my counting perplexed or irritated him, to the point where he asked me why I kept doing that, and I tried to explain that this was very hard for me, but I could do anything for a count of five, so I could start my five steps and get through them and be ok and then start over and not have to do more than that at once. I'm not sure this made him any less exasperated with my counting, but I'm totally trying out "one two three four five (ohgodohgodohgod), one two three four five (ohgodohgodohgod)" as a labor mantra. (The ohgod part I don't actually say, it's what I think while gearing up for the next five-count. Also, I know contractions won't divide evenly into fives, but it turns out that five is how high I can count when I'm really freaking out, so I figure I will five my way along until "one two three ahhhhhh" rather than try to get all tricky with the big numbers. And the constant restarting fights acceleration, the one. two. three fourfive sixsevenhyperventilate problem.)
So, yeah. "One board at a time," and not letting myself get psyched out by the anticipation of even steeper, harder parts further on, is my personal key to how I intend to approach this unmedicated labor thing. The thing not to think is "hey, this part is hard, what happens when it gets harder, maybe I should turn around, maybe I shouldn't be doing this, what if I get too far and I can't handle it, I want to quit"; the thing to think is "next board: one, two...". I don't know if this works as well for pain as it does for fear, but my secret, maybe totally wrong belief is that if I can manage the fear and the exhaustion, I can get through the pain, that it will be enormous and horrible but it can't actually do anything to me other than be horrible.
So... I would not describe this as a "wishy-washy" approach. But here's the thing. Well, two things. One is that when I hiked up Half Dome I was absolutely determined in my mind that I was going up the cables, no chickening out, as long as the conditions were appropriate. I was also fully prepared to call it off in case of bad weather (lightning and slipperiness-when-wet are the two main reasons people die on Half Dome) or personal impediment (twisting an ankle on the trail, say). I was pretty invested in the trip (cross-country flight, back-country permits, expensive new boots, etc), and it would have been really sucky to lose my shot at getting to summit, but that is where stupid happens, and as absolutely as I was not letting myself chicken out of the cables, I was absolutely not letting myself be tempted to do something that wasn't safe. In my mental metaphor, "safe" on Half Dome is somewhat equivalent to "effective" in labor (since I assume that "safe" will be entirely out of my hands), and the way that I had to be "open" about whether I would actually get to do the cables, I have to be "open" about whether I will actually be able to labor all the way through unmedicated labor. I knew there were a finite number of boards, and as long as I kept going to the next one, I would eventually get up all of them. Labor is not actually like that, if I am stalled out, if next board and next board and next board is just going on endlessly without ever actually moving me up the damn mountain, then, to me, that is not a condition in which "no chickening out" is the right rule.
Two is that I honestly don't know what I would have chosen if the CCC had built a fucking staircase with a handrail up the back of Half Dome, and also left some interesting cables for the adventurous and/or insane. Getting up the cables was immensely satisfying, yes, but a huge part of that was having taken the risk and made the effort *for the huge reward* of being on top of fucking Half Dome and having one of the most spectacular panoramic views I will ever see in my life. Which is the "being handed the baby" part of the metaphor. If I could have gone to the top in a safer, less terrifying way, would I have? Quite possibly. And yet, I always like to climb the ladder and crawl through the tunnel and scramble up the boulders and whatever interesting little bits of path there are, even if there are nice wide walkways around. Maybe I would look at the stairs and the cables and realize that I couldn't resist the chance to experience the cables, even knowing I was going to be shaking and crying by the time I made it up the cables. There is something about that extremity of experience that attracts me, that it was so far beyond day to day life or even "normal" hiking and sightseeing. It took me to a place in my brain that was not a *nice* place, but was a very powerful, primal place. I imagine labor tapping that. But I also imagine not being able to get to that place if I know I can step off in a few more boards and take the fucking stairs. So we will have to see.
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no subject
Date: 2009-02-13 03:57 am (UTC)no subject
Date: 2009-02-14 03:33 am (UTC)Lunch logistics in email, and no worries about not replying, I've been terrible about writing back lately.
not either/or
Date: 2009-02-13 04:05 am (UTC)no subject
Date: 2009-02-13 04:09 am (UTC)(I'm not sure what conclusions I would draw about labor from either answer. :^)
no subject
Date: 2009-02-13 12:05 pm (UTC)no subject
Date: 2009-02-17 05:59 pm (UTC)no subject
Date: 2009-02-13 03:21 pm (UTC)Either way, good luck!! Breathing and focus seem to the key steps, from what I hear, though doing some light pre-natally approved ab work is also recommended.
no subject
Date: 2009-02-14 03:47 am (UTC)I think the main person I will have to fight about the epidural is *myself*, since my assessment of the benefits of not doing it may be rather overshadowed by my experience of the downside... the midwives are definitely fine with not medicating. (And yeah, the midwives are my medical care providers in this situation, there is nominally a doctor on call too but if things go smoothly I'll never see them. (If things go less smoothly there's a whole surgical team...))
no subject
Date: 2009-02-14 03:44 pm (UTC)no subject
Date: 2009-02-13 08:31 pm (UTC)I like that you've thought so much about this and who you are in terms of your preparation. I continue to say that the mantra of childbirth should be "every childbirth is different and that is what makes the world interesting and fun". Our mutual friend M, mom of L and C, was in labor very little time and did really well with managing the pain.
I remember being scared at having planned one way and having the dr say (with B) that we needed to take the baby out NOW and being rushed off to the OR in very short order. I remember being mildly amused that M. was determined to come despite being early and having a very clear c-section plan.
I planned on drugs even when I planned on delivering B. but it really was a respected choice when I went to the hospital.
I don't know what to tell you except that if you concentrate on the idea that the huge reward is the baby at the end, and that you have considered thoughtfully what you might want and who you are, you will live in to the adventure of getting there. Thinking of you.
no subject
Date: 2009-02-14 03:56 am (UTC)From your other stories about M., it does seem as though he is a kid of decided actions... ::grin::
no subject
Date: 2009-02-13 10:14 pm (UTC)I mean, this is a totally awesome entry. People should definitely write totally awesome entries like this more often, and it's one of the great tragedies of the internet that they don't. And I love the comparison between the two big, scary, dangerous but not necessarily life-threatening ordeals — it's not one I would've thought about, and I think it works really well.
no subject
Date: 2009-02-14 03:58 am (UTC)no subject
Date: 2009-02-14 01:33 am (UTC)(My epidural-related advice: The medicine can make you throw up. Be sure to have someone around to take the baby if that is about to happen.)
no subject
Date: 2009-02-14 03:23 am (UTC)Am I a bad person if I find the idea of throwing up on the baby sort of funny? I mean, I assume it will throw up on *me* enough times...
no subject
Date: 2009-02-14 03:33 am (UTC)