It has taken me almost eight months to write this. But the other day as I was driving, I realized that the trauma that marked my beautiful son’s birth is still far too raw. And so on my first mother’s day, I feel compelled to tell our story.
I had the perfect pregnancy. I thought I would have the perfect natural birth as well. There was really no reason I shouldn’t have: apart from my “advanced maternal age,” I was fit and healthy. And I was doing everything I could to prepare myself for it: regular exercise, perineal massage, kegels, and towards the end I was taking my evening primrose oil and drinking my raspberry leaf tea. Ken and I took an awesome childbirth class that provided us with an arsenal of methods for natural pain relief. I had my birth ball, massage equipment, yoga mat and music ready to go, along with my very elaborate birth plan that specified that I wanted a water birth with no pain relief… I was so idealistic, so naive. I had such a romanticized notion of what my son’s birth should be like. In the end, it was everything I hoped it would not be.
I am an advocate for sexual and reproductive health and rights: I’ve made a career of it. I work to influence policies globally that help to expand women’s access to sexual and reproductive health services and enable them to exercise their sexual and reproductive rights. I know that pregnancy is not something to be taken lightly; I know that too many women die from preventable causes during pregnancy and childbirth. I just never thought that I would almost become one of them. So I’m writing this blog post because I feel that we have to have honest conversations about pregnancy, childbirth, the risks we face, and the choices we have. And a little selfishly perhaps, I’m writing this to help me process what my little family went through.
If you decide to have a natural birth, it almost feels as though you are joining a religion. We write and read books about the virtues of natural birth and avoiding unnecessary interventions. We tell ourselves our bodies know what to do. We promise ourselves that we will not do everything we can to avoid pain medications so that we can truly experience our births. We put high premiums on ensuring we have that magic hour with our newborns and breastfeeding right away. And we secretly judge women who cannot do it or choose not to. At least I did.
Although I had written a section in my birth plan about what I wanted on the off chance I needed a cesarean, I never once really allowed myself to really consider the possibility that that is how I would deliver my son. I was just so convinced that if I did everything right, nothing would go wrong. And I think because of that, when things did go wrong it was deeply traumatizing.
My waters broke a couple of weeks before my son was due. Usually when women’s waters break, they go into active labor naturally and relatively quickly. I didn’t. I was having gentle contractions, with emphasis on the gentle, that just weren’t progressing. And if you are giving birth in a hospital, once your waters break, the clock starts ticking: the risk of infection and complications increases over time and although studies have shown that delivery within 48 hours is generally safe, many obstetricians and midwives are not willing to take the risk. When I checked into the hospital 12 hours after my waters initially broke, I thought we could wait longer before beginning interventions. My obstetrician felt otherwise. And then my baby’s heart rate decelerated for a few minutes and that changed everything.
We negotiated a course of action that would hopefully accelerate my labor so that I could stick to my birth plan as much as possible. We started by stripping my cervical membranes. Then, a foley balloon: a balloon that is inserted into the uterus and filled with water. It essentially forces the cervix open when the uterus contracts to expel it. Next we tried breaking my waters again (although my amniotic sac was already leaking, it was still pretty full). And as time progressed but my labor didn’t despite the increasingly painful interventions, my obstetrician told me that in order to avoid a cesarean I would need to start pitocin. Pitocin brings on contractions; hard, powerful contractions. I was hoping to avoid it, but in the end I felt I could no longer say no.
Within minutes of starting pitocin, I started having strong contractions. At first I could handle them, but as the dose of pitocin increased, my contractions became powerful, painful and relentless. There was no break. I was throwing up from the pain and shaking uncontrollably. I asked to get into the hot tub, hoping that would help me relax and help ease the pain. It did nothing and eventually I broke… I remember my partner telling me that the nurses were sure I would deliver by midnight; I looked at the clock and it was only 7pm. That was five hours. I couldn’t take it anymore. I asked for an epidural and felt like a complete failure.
The epidural brought sweet relief; I relaxed and became fully dilated almost immediately. But then my baby’s heart rate decelerated again. And this time it didn’t come back up quickly. He was posterior; my pushing was not going to get him out in time. My obstetrician told me his heart rate was “incompatible with life” and that we would need to do an emergency cesarean. And within minutes we were heading for the operating room. My tiny son let out a cry as soon as he was pulled from me, which was exhilarating. But there was nothing more painful than seeing him whisked away while the neonatal team checked him from head to toe. They placed him on my chest for just a minute or so before taking him away to the neonatal intensive care unit, dashing my dreams of our magic hour and early breastfeeding.
As I lay on the operating table while they stitched me up, the doctors and nurses were congratulating themselves on a job well done. They had saved my baby, and I was immensely grateful. But I was also incredibly sad: I was mourning the birth experience I so desperately wanted, but did not have. And as I looked up at the ceiling, painted with clouds and the word “breathe,” I saw my blood splattered all over it.
A few minutes after I was wheeled back to the recovery room my blood pressure plummeted. I started shaking uncontrollably and vomiting again. I was hemorrhaging. The sense of panic in the room was palpable as they worked to try to stem the bleeding. I knew all too well what was happening: postpartum hemorrhage is rare, occurring only 2-4% of women, but it is deadly. It is one of the leading causes of maternal mortality. And it was surreal. Ken stood next to me, holding my hand, watching it all. He was projecting a sense of calm, but I knew from his eyes that he was terrified. When they finally got the bleeding under control hours later, I had lost almost half of my blood and was severely anemic and weak.
Despite it all, there was only one thing I wanted: my baby. I found it difficult to sleep that night as I played over the day’s occurrences over and over in my head. I was terrified that we would have trouble bonding and difficulties breastfeeding. And my heart ached for my baby, who was in a crib in another room and not with me as he should have been. When I finally got to hold him the next day, we bonded instantly. He found my nipple and latched on and my fears about being unable to breastfeed subsided. I looked at his tiny little face and fell completely, totally in love. I was not going to let him go.
Our stay in the hospital extended from what should have been one night to two, then three, then four. When we were finally discharged we were hoping that would be the end of it all. We were looking forward to starting our new adventure as parents of our beautiful, tiny baby. But then a few days later I woke with a headache that would not go away, no matter how much I slept or what drugs I took. So I called my obstetrics practice and was told to go back to the hospital for evaluation. They ushered us back to the maternity ward, did some bloodwork and kept us in overnight so that they could observe me. I had an MRI and saw a neurologist the next day, but they found nothing wrong with me. They sent us home, my head pounding a little less, with a new painkiller prescription in hand. I have to admit I felt a little foolish for wasting everyone’s time when it seemed clear that my headache was just a result of the lack of sleep that comes with being a new mum.
Then a few days after that my headache came back with a vengeance, this time with a racing heart and 103.6 degree fever and back to the hospital we went. My white blood count was off the charts and I was admitted, this time into a progressive care unit for very sick patients. My scared partner and our tiny baby went home together that night. Meanwhile, I cried myself to sleep in a lonely, cold hospital room with an IV in my arm getting pumped full of broad-spectrum antibiotics. It took a day and a half, cat scans, MRIs and lots of blood tests, to figure out what was wrong with me: I had a blood infection. Sepsis is another major cause of maternal mortality and here I was battling it as well. It felt like I had been dealt a cruel hand. But I admit that I felt a little relieved that it wasn’t all in my head.
There is nothing worse than being separated from your newborn. For the four long nights and equally long days I was in hospital, Ken, my amazing partner, cuddled, fed and cared for our tiny little boy on his own. I know it was the hardest thing he has ever had to do and I ached to be there with them both. I pumped and dumped religiously every two hours so that I could eventually resume breastfeeding once the worst of the antibiotics were out of my system, and looked at the pictures I had of our beautiful son over and over and over.
When I left the hospital that time, I vowed I would never go back. I was leaving that trauma behind and was intent on recovering as fully and quickly as possible. We were hitting the reset button and starting over. My dear little boy was thrilled to start breastfeeding again a few days later and we haven’t stopped since. And Ken and I have loved nurturing him and watching him grow into the happy, inquisitive, and energetic bub he is today.
Childbirth is serious business. It can be complicated and dangerous. It is not something to be taken lightly. By all means, plan your natural birth. But be very aware that things can and do go wrong. And know that if they do, it is not your fault. That, dear friends, is the hardest lesson I have had to learn.