What I Wish I’d Known Before Delivering Without Anaesthesia
I know several amazing, slightly crazy moms who elected to give birth au naturel, and I can (sort of) understand the appeal: while so much of our modern lives seem far removed from those of our ancestors, natural birth is a primal experience linking us to all our foremothers and the very origin of human life. Sounds beautiful, right?
natural birth is a primal experience linking us to all our foremothers and the very origin of human life. Sounds beautiful, right?
A nice thought - but I still wanted the epidural. I’d had one with my first, pretty much a necessity since I’d been induced into labor, which accelerates bodily changes that usually happen over a period of days and weeks so that they unfold in a matter of hours. Having never suffered anything worse than a sprained ankle, I’m also just generally pain-averse, Caring for a newborn is grueling enough - why kick-start an already trying experience via a gauntlet of bodily suffering?
Here’s what I wish I’d known before accidentally discovering what it really means to “hurt like a mother”:
Reading the signs of labor
As I’d been induced the first time around, I had kind of expected the same for my second, and even had an induction appointment set up. But two days before baby #2’s due date, as I went to bed I began to feel some mild cramping, and suspected that labor was slowly starting up on its own. (During my first pregnancy, I had expected contractions to feel different - more of an involuntary clenching, as the name suggests - but in reality they were like waves of period cramps or gas pains that came and subsided, but intensified and accelerated over time.) The next morning, the contractions continued, but were mild and far enough apart that I didn’t think to mobilize - as it was a weekend day, I was more concerned with keeping my toddler occupied, so I sent him and my husband out to the beach. By the afternoon, contractions were intensifying, but I was still reluctant to head to the hospital - we were still going back and forth on what to do with our two-year-old, and much of what I’d read and heard about labor suggested that it might still be too early. A quick Google search confirmed that I needn’t rush to the hospital until my water broke or contractions were so strong that I couldn’t talk through them. I didn’t want to be sent back home, or left to labor uncomfortably in triage. Eventually, though, I called my OB to describe my symptoms, and though she sounded pretty on-the-fence, she said I might as well come in.
Fortunately, we did make it to the hospital - a 10-minute drive away - before my water had broken, because if I’d waited for it to happen at home, that’s where the baby would have come out.
Epidurals Are Not Automatic
During labor, part of me was curious as to how far I could make it before succumbing to pain medication. Early contractions were mild, and they progressed slowly enough to be bearable up until an hour before I gave birth (when we left for the hospital). I had neglected to consider that an epidural wouldn’t be provided at the snap of my fingers; first I would have to go through triage at the busiest labor-and-delivery hospital in Hawaii, and once settled in a delivery room, would still need an IV, a blood test, a catheter, possibly some paperwork, and of course, an available anaesthesiologist. And then the medication could take up to 30 minutes to kick in. Moral of the story: if you’re adamant about getting an epidural, check in early, and be firm with your request.
Moral of the story: if you’re adamant about getting an epidural, check in early, and be firm with your request.
How to Push
Anyone who has seen childbirth in a movie knows that it entails essentially two actions: breathing and pushing. Breathing, I am sorry to say, will only help you up to a certain point, beyond which - in my experience - the only appropriate reaction to the pain is a primal, blood-curdling scream. As for the pushing, I wish I’d primed my muscle memory in advance for that specific action. A lot of people say to “bear down like you’re pooping,” which is pretty close, but I think an even more accurate way to describe delivery pushing is as the opposite, or release, of a kegel, augmented by an abdominal crunch. Shortly after my contractions intensified with almost no pause between, I felt an unbearable pressure on my pelvis, which signalled when I should’ve started pushing the baby out. But both because I didn’t recognize the pain for what it was, and because I was alone in the room (with my bewildered, immobilized husband) while the nurse had run out for reinforcements, I just waited, clenched up and hollering. In a few moments that of course felt much longer, the room filled up with people, and suddenly they were prying my legs apart into delivery position and trying to calm me down (I couldn’t think straight enough to speak at that point, and didn’t want to open my eyes), and finally I was able to start pushing properly, and he was out - head, then shoulders, then placenta - in a matter of (very intense) minutes.
The Pain is Excruciating, but It’s Not Forever
I’m not going to lie: the pain of natural childbirth is real. As my OB put it, “If men had to give birth, population growth would completely stabilize.” But if the pain itself was awful, for me, it was further intensified by fear of the unknown. “You’re not pushing because you’re afraid of the pain,” I heard the doctor say at one point, and though I didn’t appreciate her reasoning in the moment, she was right: I was scared and hurting and could not see the light at the end of the tunnel.
Planning on getting an epidural only to realize it’s too late has the nightmarish quality of boarding a train to somewhere civilized and predictable, like London, only to realize mid-ride you are actually headed to Pyongyang. Or like attending an election party for Hillary Clinton on November 4, 2016. Only, fortunately, at the end of it, instead of 4 years-to-life under the reign of a tyrannical despot, you get a healthy little baby (who may at times come to resemble a tyrannical despot, but at least has the redeeming qualities of smelling nice and sharing your genes.)
Planning on getting an epidural only to realize it’s too late has the nightmarish quality of boarding a train to somewhere civilized and predictable, like London, only to realize mid-ride you are actually headed to Pyongyang.
I think it’s worth noting that after recounting my natural birth story to several people, the only one who said “Yeah, I think I’d choose to experience that!” was the friend who’d recently completed an IronMan triathlon - in other words, a seasoned expert in steeling herself against physical suffering, and kind of a masochist. (For what it’s worth, I’d choose to undergo natural childbirth again before signing up for a triathlon!)
If and when I have a third child, I still plan to get to the hospital early and order an epidural ASAP. But I have to admit that going through a natural delivery has left me feeling not only tougher, but even more sympathetic towards all the mothers and their various experiences with childbirth - none of which is easy, and many of which are way more difficult than my own. Maybe it’s those post-delivery hormones talking, but at the end of the day, I feel so fortunate to have had a wanted baby in a safe environment. I wish the same for every mom.