the way we birth

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When I was preparing to give birth for the first time more than 11 years ago, I made a birth plan with my husband and our midwives. I deeply believed in my birth plan. I was going to have my baby naturally and at home. I was going to eat and drink if and when I wanted to. I was going to walk around my apartment freely, unencumbered by an IV. I was going to trust my body and my baby to know how to do this. I was going to breathe, as I’d learned in our homebirth class, for as long as it took. I was going to avoid bright hospital lights and cold floors, doctors I didn’t have a relationship with. I trusted myself, I trusted my baby, I trusted my partner, and I trusted my midwives.

And none of that trust changed. But the plan did.

I did labor at home – for 32 hours. In between contractions, which were all in my lower back, I took occasional bites of bagel with jam and drank juice diluted with water. I sat on the exercise ball in the shower with scalding water aimed at my back for so long that I had scars afterwards. An acupuncturist friend came around hour 28 and put 16 needles into my lower back for the pain. I got to 8 centimeters but no further, for hours.

Then I looked at my husband and our midwives and said with 100% conviction and clarity, “I want to go to the hospital.” It was noon on a Tuesday.

I left the dark cocoon of our bedroom for the first time since the previous day at 5:30am to get into the car. It hurt. And the outside world – going about its business as usual all around me – felt surreal, like it was moving full speed while I was in slow motion. My sister dropped us off, my husband got a wheelchair that I didn’t use because it hurt too much to sit and I’d already been sitting for 20 painful minutes. I walked into the room and lay down on the hospital bed. I got an IV and a monitor was wrapped around my belly.

When the anesthesiologist walked in, it was as if an angel had just entered. “You’ve been laboring for how long?” “32 hours,” I replied. “Let’s get you that epidural. We’ll skip your blood work and get on with it.” All these years later, I can’t begin to describe the sensation when the medicine began to take away the pain I had been in for a day and a half. All I remember is relief, and the colorful woven hat that the anesthesiologist wore on his head.

Finally able to relax, I dilated to 10 centimeters and the doctor said I could push whenever I felt ready. Then she stepped back and let me do the work, guided still by my midwives. My daughter came out an hour later, pink and beautiful, head covered in black hair, right hand coming out “fight the power” style immediately after her head. She was pregnant herself, the doctor, 32 weeks with her first. She was a third year resident so less experienced than my midwives, who had between them attended so many births. She watched the whole thing, respecting the relationship I had developed with my midwives during my pregnancy, and the work I had done already at home.

My daughter almost did a flip off the little metal table as they checked her Apgar scores. They gave her tens, clearly this one was just fine. Four hours after she was born, the three of us were back home in the bed where I had labored. Parents. A radiantly healthy energetic baby who hated swaddles and slings and anything constricting from the second she was born. We were a family of three.

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With everything I’ve experience related to birth since then, I can’t help but view my first daughter’s birth through rose colored glasses. It wasn’t what I had planned, but it had turned out so well. Immediately following her birth, however, I gave myself a tremendous amount of grief that I had given up” and stopped laboring at home, that I had chosen to have an epidural and go to the hospital. I told myself that if I had just kept going, I could have had the homebirth I had planned.

I held this disappointment for two and a half years, until I took an 8-week midwifery course with one of the world’s most renowned homebirth midwives. I sat with her during one of our lunch breaks and told her my daughter’s birth story, and I asked her if she could tell me what had happened – why I hadn’t been able to progress past 8 centimeters no matter what I did, no matter how much time went by and how many contractions I endured, no matter what my midwives tried or what position they guided me to labor in. And her eyes got wide and her body got really still and then she popped out, “Deep transverse arrest!” “Deep transverse arrest?” “Deep transverse arrest! Go home and research that this week and you can teach the class about it when we meet again.” And I did.

A deep transverse arrest is when the baby’s head is engaged a little off in the pelvis so that its head doesn’t hit the cervix quite right. This means that the cervix, which relies on the pressure of the baby’s head along with the mother’s contractions to open fully, can’t open fully. My daughter’s head was turned just slightly, and her right hand was next to her left cheek for most of my labor (causing the painful back labor). Her head was engaged enough to get me to 8 centimeters, but no further. And with each contraction, instead of relaxing to open and create space for her to move, I literally contracted and tightened and she got more wedged in.

“You were right to go to the hospital and have an epidural, because then you could relax and make space for her slightly turned head to shift into the right position. Your body knew what it needed and you listened,” she told me, this decades-long experienced homebirth midwife. In that moment, all of my doubts and disappointment in myself dissolved and I felt peace.

****

It amazes me how much we are capable of torturing ourselves as mothers about the ways in which we failed to follow our birth plans, our supposed hopes and dreams for the beginnings of our babies’ lives. It amazes me how deeply my ego was invested in the outcome of my plan – and how much of it all is just that: ego. The idea that we can actually plan how our children’s births will go, that we have any control.

I planned two homebirths and had none. A few years after my daughter was born, I miscarried another pregnancy at 10 weeks. A few years after that, I was pregnant again with Tikva, and again I planned to birth at home. And again the universe laughed. Tikva was diagnosed in utero at 21 weeks with a life threatening birth defect. She would not only be born in the hospital, but she would be born in the operating room, so that a team of neonatologists, obstetricians, anesthesiologists and nurses could be prepared for anything she needed. So that she could be put on a ventilator within minutes of her birth because she wouldn’t be able to breathe on her own.

An hour into my labor, I asked for an epidural. My labor was short – just a few hours long – and for weeks after Tikva was born I second-guessed myself again, thinking I had not needed that epidural, could have birthed her without it. But this is the thing: In that moment, I was terrified. I was about to release from the safety and warmth of my body a baby I knew would not be able to breathe or eat on her own. Inside me, she had been safe – I breathed for her and ate for her and could hold and protect her; outside, she was not. She could live for just a few minutes after her birth, or she could live a whole lifetime – none of us had any idea what was ahead, and I was scared. And I was stressed. And I did not want to be distracted by the pain of labor. And I didn’t think this through in actual thoughts, I just knew. And I fell instantly in love with that anesthesiologist too, an amazing third year resident who was so gentle and precise, and who gave me just enough medicine so that I was still able to feel the moment when Tikva came out.

The second she was out and the cord was cut, she was whisked away through a window in the wall into another room where she was put on a ventilator and given paralytic medication so she wouldn’t destabilize herself. I would really see her about an hour or two later for the first time, intubated, feeding tube in her nose, IV in her arm. My beautiful girl.

And then, our real story together began. 58 days long and every day since she breathed her last challenging breath almost 7 years ago. For those few months we were a family of four.

****

Three years later I was pregnant with twins. Twins! Twins that came to us with help and with work. Twins who were all promise, all hope, all healing – for their mother, their father and their sister. Twins who would bring a beautiful whirlwind of baby energy into our home. Twins who would be closely monitored to ensure a safe pregnancy, ultrasounds and amnio and bloodwork and frequent appointments. Ten weeks in, one of them stopped growing. At 18 weeks – on Valentine’s Day – I no longer felt the other one move. A few days later, I went to the hospital to be induced and 24 hours later I delivered my very small babies-to-be. And a few hours later, after holding the one who had grown enough that he was fully formed, only just the size of my hand, we left the hospital without our babies. These beings I had also labored to birth, whose ashes I would sprinkle on the same beach where I had walked during the very beginning of my very first labor so many years before.

****

I birthed my son in my heart, and another woman that I will forever be grateful to conceived and nurtured and birthed him from her body. He came out 6 weeks early by C-section. He was tiny and he was perfect. He always breathed on his own and he learned to take a bottle in a few weeks and we brought him home. He never breastfed, but I nourished him with my love and formula till he was ready for food. Two years later, he eats like a teenager and is so heavy I can barely carry him.

And we have been, once again since his birth two years ago, a family of four, surrounded by the beloved spirits of the babies we lost.

****

This is the thing: You may be able to set an intention for how you’d like things to go, and you may be lucky when it all goes “right,” but it’s all just so random and out of our hands. I thought I was responsible for how healthy and strong my first daughter was, that it was all because of how well I had taken care of myself during pregnancy. But then that means I was also responsible for how fragile and sick my second daughter had been. I have no idea why her diaphragm didn’t form correctly, and neither do the doctors. I have no idea why my twins didn’t make it, or why I miscarried all those years ago and again before we adopted our son. What I know now, though, is that when it does work out well, and that healthy baby is born – it’s an incredible amazing miracle of life. And that miracle is as arbitrary as when things go another way.

I cry tears of joy and relief every time I learn about a baby who has been born healthy. If I know a friend is in labor, I take a deep breath and I exhale when I hear that all went well.

****

There’s a way we talk in our culture about birth after it’s happened, and I think that way is skewed. I’ve heard it from men who have witnessed and supported their partners’ labors, referring to the women as warriors because they labored naturally, at home in a birthing tub, without pain medication or medical intervention, and gave birth to a healthy 9 pound baby that immediately knew how to suckle and nurse. I’ve also heard it from women who have been through labor – talking, like I did, about the ways in which they felt they had failed – because they hadn’t been able to do it naturally, because they had needed help, or because their babies had died. So we are warriors if it goes one way, and we are failures if it goes another. Or we are warriors in the eyes of everyone but our own critical selves.

But this is the thing: We are all warriors. We are warriors when we birth, however we birth. We are warriors when we need help to birth. We are warriors whether or not we nurse. We are warriors whether we wear our babies or sleep with our babies; whether or not they sleep through the night. We are warriors when our babies are conceived with assistance. We are warriors when we are not able to conceive or carry a baby to term. We are warriors when someone else carries our babies for us. We are warriors when we miscarry. We are warriors when our babies are born still. We are warriors when we mother by caring for our babies’ graves. We are warriors when we choose not to have babies and we love in other ways. We are warriors when we are allies for other women. We are warriors in how we nurture the world.

We are warriors because, in some way, we choose to love. Whatever that love looks like. However it is birthed.

Happy Mother’s Day to all of the warriors out there. I hope you know who you are.

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