Pepita

Birth Story

I’m a big fan of modern medicine. I have found it to be efficacious in everything from the treatment of allergies to the management of depression. I have generally had doctors that I like and trust—people who have seemed to regard me as an intelligent individual capable of making sound choices—and I have, for the most part, felt like an active participant in my healthcare.

While I do tend to prefer free-range eggs, organic produce, and dairy products that have not been enhanced with antibiotics and rBGH, my faith in the “natural” is neither pure nor total. There are a lot of reasons for this, some of them better than others. The first is conceptual, and it’s the reason for my use of quotation marks above: I went to a progressive, liberal arts college in the early 90s; postmodernism and deconstruction were much in vogue at the time; and I have difficulty believing in concepts like “natural”. Indeed, I tend to distrust any claims that rely upon an essential, unchanging, non-contingent understanding of “nature”.

I also find any suggestion that the natural—I’m dropping the scare quotes now, but they should be regarded as implied henceforth—is unambiguously and fundamentally good. Malaria, tuberculosis, typhoid fever: These are natural phenomena. One might also argue that high infant mortality rates and death in childbirth are also natural, given their prevalence in historical periods and geographical locations without modern obstetrics. I think it’s ridiculous to rant against the perceived failures of allopathic medicine without acknowledging its successes.

Finally, I have no tolerance for sanctimony. Thus, I often have a gut-level aversion to much natural-childbirth advocacy. And it’s not just the judgmental tone that bugs me: I have often felt that the natural-childbirth cohorts have clung to a combative, outsider status that no longer makes much sense. For example, when I was consulting my copy of Our Bodies, Ourselves—not the latest edition, but the 1998 edition—I discovered that the first-person anecdotes of obstetric malfeasance were the same as those in the edition of Our Bodies, Ourselves I used to read at the Stow Public Library when I was a kid, an edition from the 70s. I feel that it is disingenuous, at the very least, to submit stories that are 30 years old as representative of contemporary medical practice, and I have often felt, when I have encountered other natural-childbirth arguments, that the patriarchal medical establishment decried in these sources is a straw man, a ghost of medicines past. It has seemed to me that many women’s health advocates would rather identify as embattled revolutionaries than take justified credit for changing the attitudes and practices of doctors, nurses, and expectant mothers.

My Childbirth Soundtrack

Animal Collective, Feels
Beastie Boys, Paul’s Boutique
Big Star, #1 Record/Radio City
Built to Spill, Keep It Like a Secret
De La Soul, 3 Feet High and Rising
Al Green, Greatest Hits
Kristin Hersh, Strange Angels
Looper, Up a Tree
Modest Mouse, The Moon & Antarctica
Joanna Newsom, The Milk-Eyed Mender
Nirvana, Unplugged in New York
Sinéad O’Connor, The Lion and the Cobra
Liz Phair, Exile in Guyville
Elvis Presley, As Recorded at Madison Square Garden
Elvis Presley, Memories: The ‘68 Comeback Special
Elvis Presley, The Complete 50s Masters (Disc 1)
Mary Timony, Ex Hex
Ali Farke Touré & Toumani Diabaté, In the Heart of the Moon
Unrest, Perfect Teeth
U2, October
U2, Boy
U2, War
U2, The Unforgettable Fire
Gillian Welch, Time (The Revelator)
Wilco, Yankee Hotel Foxtrot
X, Los Angeles-Wild Gift
Various Artists, Millennium Funk Party
Various Artists, Ted & Jessica: Jul 17th 2004*
Various Artists, Sweet Tea**

Frances Elizabeth Jernigan-Clayton

With much drama and excitement—amniotic deluge! plummeting fetal heart rate! emergency c-section!—Frances Elizabeth Jernigan-Clayton was born the afternoon of Wednesday, July 12. She weighed 8 pounds, 9 ounces, and she has a wonderfully large head, just like her daddy. Consensus among the nurses was, with a noggin that big, the surgical delivery might have been a blessing in disguise. Frances is a natural when it comes to nursing, she and her father enjoy sticking out their tongues at each other, and everyone who has met her agrees that she is, really, just the best baby ever.

[MORE PHOTOS AT FLICKR.]

Induction

Last night, I called my friend Kate. She’s a pediatrician, and her specialty is intensive care. What I wanted to know was this: Does she spend a lot more time rescuing babies who have been induced than babies that haven’t been induced. Her answer was “No.”

So, this morning I went into the hospital for a dose of cervidil. It definitely helped to ripen my cervix, and I have been having strong, regular contractions for the past few hours. Previous experience tells me that these contractions may stop at any time, but, well, who knows? Maybe I’ll go into labor for real tonight. If that doesn’t happen, Ted and I are going back to the hospital tomorrow morning, at which point I’ll either try another dose of cervidil or start pitocin. I haven’t decided yet.

Let me just say that I am not looking for advice or anecdotes at this point (but I do appreciate all the kind and helpful thoughts contained in the comment threads for my last few posts). In fact, I really don’t want them. I’ve done my homework, and I feel that I know the arguments for and against induction. Throughout my pregnancy, I’ve tried to acquaint myself with the medical side of every issue and the “natural” side of every issue. The problem is that both arguments seem persuasive, and I’m not an expert, so, most of the time, I end up trying to split the difference. I am still a bit stumped by the whole induction thing, which is why I called Kate.

Childbirth educators talk a lot about the “positive birth experience,” and, sure, I’d luv to have one. And I’m quite aware that nobody has a swell time on pitocin. But it’s also true that, at this point, I’m not having a positive birth experience anyway, and I’m not at all convinced that continuing to wait is the best way to rectify the situation. That’s all really beside the point, anyway. I’ve known all along that births don’t always—or even usually—go the way we want them to go, and I’ve known that the positive experience I really want is a positive outcome, which is to say: a healthy baby.

Week 41

For the past 40 weeks, I’ve eaten well and taken my vitamins and gotten gentle exercise. I stopped all forms of self-medication—a whole winter without red wine, a whole summer without gin and tonic—and prescribed medication when I found out I was pregnant. Yes, I’ve complained about the so-called “morning” sickness and the cankles, but not too much. Despite dire warnings from all the pregnancy resources I’ve consulted, my temperament has been remarkably stable—a little depression, yes, and a little anxiety, but no rages or rowdy mood swings (Ted—a very relieved and grateful Ted—will back me up on this). I have, in short, been a pretty good sport about this whole pregnancy thing.

So, what I want to know is: Is it too much to ask that my baby actually get born?

The past week has been a bit rough. Yes, there have been some lovely days, days of quiet, awe-filled contemplation and rare relaxation—days that felt like a gift. But I’m not really good with unlimited, unstructured time, and I am, truly, more than ready to have this baby. The waiting is wearing me out, physically and emotionally.

Ted and I went to see the ob/gyn this morning—not my doctor, who is on vacation (the nerve!), but one of his colleagues, a colleague entirely lacking in what are known as “people skills”—and we decided to go to the hospital tonight and start cervidil. At the time we made this plan, I just really wanted to get the show on the road, but, as soon as I got home, I realized that I am still really uncomfortable with the idea of inducing, and I changed my mind. Now I’m waiting for the doctor to return my call so that we can discuss how long I can reasonably go without inducing. Thus, I am waiting to talk about waiting.

I’ve got to tell you, waiting sucks.

Labor Strike

Well, the strong, steady contractions of yesterday evening went away sometime in the night, and today has been rather uneventful, uterus-wise. So: No baby yet. I’ve spent most of today reading and sleeping and drinking limeade.

Ted and I continue to wait. I’d be lying if I said it was an entirely enjoyable kind of waiting, but I think I can honestly say that it’s been more relaxed and mindful than anxious.

Labor

Ted and I went to see the ob/gyn this morning. The baby passed her nonstress test, although it did take a little prodding: When it looked like the baby was taking a nap, the nurse poked my belly with a device that vibrates and makes a loud buzzing noise, which got the baby jumping and got her heart rate up. The doctor also measured my amniotic fluid, which seemed to be sufficient.

The doctor explained that, since the baby I and appeared to be doing just fine, there was no medical reason to induce labor even though I had passed my due date. We had talked about early induction when it looked like I was going to have a giant baby. It turned out that my baby’s freakish rate of growth slowed down after we went on a diet (I didn’t starve myself or my baby, in case you’re worried; I just cut out the buttery pastries and ice cream). While we waited to get another estimate of the baby’s size, though, Ted and I had already pretty much decided against induction. The rationale for inducing early was to avoid a c-section necessitated by a big, big baby. It appears, however, that trying to goad a body into labor before it’s ready often leads to a c-section—a c-section after hours of intense but unproductive contractions—anyway. Indeed, it’s not just the natural-birth advocates who make this claim; my doctor said as much, too. He just wanted us to have all the options.

So, anyway, despite my desire to get this show on the road, I rejected the idea of inducing again this morning, and made an appointment to go to the hospital for another nonstress test on Friday. Ted and I went home prepared to wait. We went for a walk—it was a beautiful day today, warm and sunny and breezy. Ted got a haircut. I sat in the back yard and read a book I’ve been meaning to read for awhile.

Then the contractions started. I’ve been having fitful, half-assed labor pains for a couple of days now, but these were stronger and more regular, and they only became more so. After about an hour, I called the hospital to see if I should head in, but they told me I might as well chill at home until the contractions get strong enough to dilate my cervix. That was about 3 hours ago.

We ordered a pizza for dinner and watched a couple episodes of The Simpsons. I think I’ll take a bath, and then maybe try to sleep. I hope that, by this time tomorrow—or thereabouts—I have a baby.

Overdue

My due date—July 2—has come and gone, and I’m still waiting for the baby. This is not a surprise: I know that forecasting due dates is hardly an exact science, and, when Ted and I had our last visit with the obstetrician, we learned that my body wasn’t really showing signs of being ready to spring into labor. Nevertheless, the uneventful passage of my due date is a slight disappointment.

Ted and I both organized our schedules around the due date. I finished all my freelance work last week, and told my various employers that I would be taking the month of July off, so I’ve got no work I have to do. Ted just finished revising an article and sent it off to a journal, and he sent his editor the first chapter of the book he’s writing, and he’s not teaching because it’s summer. I would like to view this time as a gift, as a little extra space in which to be myself before I become a mom, and in which to enjoy being part of a married couple before we become a full-blown family, but I can’t quite seem to get that contemplative, and neither can Ted. He’s spent the last couple of days reorganizing his baseball cards, and I’ve been distracting myself with a variety of small and inessential tasks—scrubbing the baseboards in the kitchen, baking corn muffins, knitting another pair of booties. I kind of feel like it’s the day of the prom and I got dolled-up at like, 10 in the morning, and now I’m just sitting around in my fancy dress with nothing to do but get anxious.

It’s a singular kind of anxiety. Although I have enjoyed being pregnant—despite the morning sickness, despite the mood disturbances, despite the cankles—I am quite ready to have this baby. But, once I have the baby, I will have a baby. It’s not like the successful completion of childbirth is the end of this project; it is, of course, only the beginning, and I am still not quite used to the hugeness of becoming a parent. I am kind of eager to give birth, and kind of afraid to give birth, and I am apparently incapable of doing much of anything until I do give birth.

Book Review: Easy Labor: Every Woman’s Guide to Choosing Less Pain and More Joy During Childbirth by William Camann, M.D., and Kathryn Alexander, M.A.

Perhaps no woman entering her eighth month of pregnancy can resist a book called Easy Labor. I certainly couldn’t, and I’m glad I didn’t. I found this book to be informative, well-organized, and eminently sensible.

Written by the director of obstetric anesthesiology at Brigham and Women’s Hospital in Boston, this book offers a thorough, up-to-date introduction to medical pain relief during childbirth, and it explains the benefits and risks of various drugs and procedures, including various types of epidurals. It also provides detailed descriptions of alternative, or complementary, pain-management techniques like Lamaze, aromatherapy, and birthing balls.

Technical information is augmented with testimonials from mothers, physicians, midwives, and doulas. There’s a section in which caregivers recount a variety of real-life childbirth scenarios, and each story is followed by some interesting analysis of what went right in that situation and how things might have gone better. There’s also an entire section devoted to caregiver’s stories of their own experiences giving birth.

The book proceeds from the premise that there’s no single, correct way to give birth—which I appreciate—and from the idea that education and communication are the best ways to insure a positive experience in the delivery room. All of the caregivers seem to agree that women should be aware that childbirth is painful, that they should think about their pain-relief options before labor begins, and that they need to be able to trust the people helping them give birth. One doctor put it this way: “Everyone associated with the process of childbirth, from the parents-to-be to the obstetric anesthesiologist, has as his/her primary concern a safe, happy outcome.” I think that this is an important reminder, because so much of the information I’ve encountered as I’ve researched childbirth seems to assume an adversarial relationship between the mother and medicine, while my actual relationship with my ob/gyn has been one of mutual respect and clear communication. My doctor has birthed a lot of babies, and I feel that I can benefit from the wisdom of his experience. I don’t think he’s going to try to trick me into procedures I don’t need and don’t want; if I did, I would have searched for another healthcare provider.

The other lesson that the doctors and doulas assembled here want to drive home is that women need to be flexible when it comes to giving birth. A birth plan is an excellent tool. It provides guidance to everyone involved in the delivery, and if it’s the product of careful, well-considered research, it means that the mother is probably as prepared as she can possibly be for the experience of childbirth. But a birth plan isn’t a script, and women should be ready to reconsider if her caregivers suggest that another course of action might be better—not just more pleasant, but safer—for the woman herself or her baby. Again, trust and respect are critical: Caregivers should honor a woman’s wishes for her birth, but the woman should be willing to trust the knowledge and expertise of her caregivers, too.

Having read Easy Labor, I feel better prepared to talk to my ob/gyn about pain management during childbirth, and I feel much more confident about having a birth that’s good for me and for my baby.

248 Vaginal Deliveries

In a recent post, Cecily over at and I wasted all that birth control… explained her growing concerns about childbirth and her recent thoughts about a scheduled c-section. She asked readers to share their own birth stores, and, boy, did they ever.

Not only does the comment thread for this post contain a wealth of anecdotal information about the messy, scary miracle that is childbirth, but, in a follow-up post, Cecily turns all this raw—and some of it is raw indeed—data into an eye-opening array of statistics. Altogether, it’s a fascinating snapshot of what to expect in the delivery room.