What Happens When You Don't Talk about Intervention

I wanted a natural childbirth. No epidural, no intervention - the whole, glorious nine yards. To that end, I took a (useless) 12 week Bradley class, religiously read books like Husband Coached Childbirth and practiced my relaxation techniques exactly as instructed.

Many of you are probably nodding your heads right about now. You all know what comes next; you’ve heard the story before. Big shocker here: my birth didn’t go according to plan. And when things went sideways - when I needed medication and intervention - I had no idea what my options were or what I was getting myself into. I was so sure and so set on a “natural” birth that I didn’t allow myself to learn about a plan B or C or D and that left me feeling alone, scared and uninformed when things didn’t go as expected.

The first hiccup came in the form of continuous fetal monitoring. I had planned to be periodically monitored and “off” the monitors for most of my labor. I was absolutely baffled and frustrated when the nurse said I would be continuously monitored. But I hadn’t been taught about when fetal monitoring might be a good choice and when it might not, so of course I did what the nurse said because I thought it was the safest option for my baby.

At 8 centimeters, I began to experience back labor. I coped with it for a while but it became so intense that I demanded something for the pain and was given a drug through my IV line. I had no idea what medication it was or what the potential side effects could be. At the time, I didn’t like not knowing but I didn’t feel like I had any other options.

It turns out I’d been given narcotics for the pain. I didn’t know enough about narcotic pain medication to know that they do not take away pain - that they merely take the “edge” off.  When I still felt pain, I was not a happy camper, as I had expected the narcotics to make things better. I didn’t know anything about epidurals, either, but when the narcotics failed to provide adequate pain relief, I demanded one.

Because I knew nothing about epidurals, I didn’t know that there are different types of epidurals and that with the correct dose of medication, I could have been free of pain but maintained a feeling of pressure so that I could still push effectively. Instead, I let the anesthesiologist do his thing without asking any questions. What was the use? It wasn’t like he had time to give me a full crash course in epidural options and side effects.

Three hours later I had been pushing flat on my back for over two hours. I had absolutely no sensation in my legs or pelvis and no idea what I was doing. Without warning, my midwife looked up at me and said, “I don’t think you’re going to be able to get your baby out by yourself. We need to call the OB for some assistance.”

If I’d been educated about epidurals, I would have known that there are tips and tricks you can employ to facilitate progression with an epidural but because all the natural childbirth books, articles and classes I exposed myself to never talked about epidurals, I didn’t know I had other options.

Photo by Kala Bernier used under Creative Commons License. 

Photo by Kala Bernier used under Creative Commons License

I felt completely defeated. How could the birth education I worked so hard to get be so one-sided and completely useless? I had read and heard so much about empowering births but at that moment, I felt utterly disempowered. No one had ever mentioned how to cope with and why to use interventions. I felt disempowered not because I was using interventions and medications but because I didn’t know anything about those interventions and medications.

The “assistance” the obstetrician had in mind was a vacuum assisted delivery, which I’d never even heard of it. She went through the steps of explaining how a soft suction cup would be placed on my baby’s head and that she would gently pull as I pushed but I still felt like I had no idea what I was consenting to as I nodded my head and signed some forms. I had no idea what a vacuum looked like or what the risks could be. I certainly didn’t know it was associated with significant perineal tearing. And when the OB told me that I had a 4th degree tear, I had to hop on google to see what degrees of tears even meant! It wasn’t until months later that I found out that tears and vacuum assisted deliveries can go hand-in-hand.

Now after all that, I felt absolutely beaten and traumatized. I had dreams, flashbacks and anger about my birth story. I experienced postpartum depression and I absolutely believe that my birth story was a huge contributing factor to it.

What if I’d utilized various pushing positions with my epidural? What if I’d known more about the different types of epidurals? What if I’d known that continuous fetal monitoring probably wasn’t necessary in my situation? Would things have played out differently?

I’ll never know, but this doesn’t have to happen to other women. Even if you know how you want your birth to go, find out about all other contingencies. If you’re planning an unmedicated birth, study up on interventions, too. If you want an epidural, learn some basic comfort measures. It’s never a good idea to stick blindly to one option. Because when you fail to open your eyes to all possibilities, you risk feeling alone, powerless and scared. And that’s never how a birthing woman should feel.