Wednesday, September 22, 2010

Define "prepared" ...

The Irish fella tells me to not always believe what I think. What he means is, when we are seeking the expert opinion of, say, a realtor, we should not spend half the meeting hearing what I believe is going to happen with the housing market. Ditto for consultations with plumbers, tax advisors, lawyers, and city hall clerks.

Both pregnancy and labor are things I previously knew little about beyond the broadest of strokes. Before becoming pregnant, I mostly associated the condition with sacrifice—one that took away wine and sushi and left your breasts like two windsocks on a still day. As for labor, I associated it with terrible pain, and assumed my pregnant friends spent nine months fearing the inevitable.

But it’s remarkable how little I really understood about the process. For example, I can’t remember when I didn’t know that a woman in labor had to be fully dilated before she was ready to push, but I didn’t know exactly what had to be dilated. Yes, it’s embarrassing. I just hadn’t given it any thought.

When you aren’t preparing for labor, you don’t bother to break down the details. You keep it abstract. You hear the term “birth canal” and picture Moses himself slowly bobbing his way down the Nile, even though with a spot of consideration you understand the journey to be more a matter of width than length.

I looked to experts. Early on in my pregnancy, the Irish fella and I sat side-by-side reading books I’d bought. His was explaining the importance of knowing the various stages of labor and what happens at each, and mine was telling me there are no stages of labor, that it is best understood as one fluid process.

Another book suggested we would be better prepared for labor if I put the Irish fella on the floor and covered him with a blanket, and then slowly removed it to reveal him again. In this scenario, he is the fetus and the blanket is the cervix. I’m fairly open-minded, but it’s hard not to be cynical about advice like that.

Time went on, and as one pile of books warned me against the advice given in the other, I stopped reading. It wasn’t hubris; I just didn’t want to learn anything and then be told to unlearn it. But when people asked what I was doing to get ready for labor, particularly for the drug-free home birth we’re hoping for, I felt like a slacker.

I do not think of labor as something that will happen. It's something that I will do. So it’s not that I didn’t want to prepare, I just wasn’t sure what preparing meant.

Studying too much about how labor will work and what must be done at (or by) what point makes birthing seem like a one-size-fits-all process. My midwife told me some women hold their breath and push until the small capillaries in their faces burst because they are told it is time and they must. But this is ineffective if your body isn't ready, regardless of how dilated you are. Not to mention it wastes valuable strength and disrupts the flow of oxygen to the baby.

In labor, women can feel vulnerable, and we can unknowingly resign ourselves to behaviors and procedures that are dictated by doctors or by our own ingrained expectations rather than an attentiveness to what is actually going on with our bodies. We forget to believe what we think. To trust what we feel.

A friend of mine began to scream during labor, startling her midwife, who asked her why she was making so much noise. My friend realized she didn’t actually feel the need to scream; she was doing it because it’s what she thought she was supposed to do. Television is a terrible labor coach.

Another friend, when her midwife asked her to push, realized she had never been told what to push, or from where exactly, or how. She panicked and labor abruptly stopped. When she relaxed and gave over to her own body’s instincts, she had no trouble at all.

Trusting your own instincts also means believing that you know how to breathe. There are breathing methods you can learn, such as Lamaze and its infamous “hee-hee-hooos” that are said to help ease the pain of contractions, and there is the Bradley technique, which consists of long, deep breaths to relax a woman between contractions.

I don’t dispute that these can be effective—but they have to be learned and remembered and executed properly. A doula—a trained labor companion—told me she does not recommend these methods to women because they are too easily forgotten in the throes of labor, leaving women without the trusty pain management system on which they’d planned to rely.

The same doula has coached woman in prison through labor, women who had no birth preparation, some of whom were in handcuffs while delivering their babies, and she said they breathed beautifully, all on their own.

Relying on—and asserting—your instincts seems to me paramount in labor and beyond. You can’t parent if you don’t trust yourself. Looking to experts to inform yourself is good, but in the end you have to be able to filter what you read and hear and decide for yourself. Otherwise you just react, and toss your logic out the window.

For example, months ago, the Irish fella and I read in several publications that it’s no longer safe to put blankets in cribs. We stocked up on sleeping “bags” that are recommended for the baby to wear to bed instead. When the kraamzorg—the nurse who will visit our house after our baby’s birth—asked us if we had a blanket for the baby, we very confidently said no.

She looked at us blankly, and we explained that babies were suffocating. She searched for the words. Finally she just said: “But it will be cold.” Then she used layering hand gestures to illustrate: mattress, baby, blanket. I’ve never felt myself plunge from informed to inept in such a short time.

So to prepare for labor, I’m thinking of it as a joint effort of baby and me. I know what it will require for him to move from the uterus to the midwife's arms, and being able to visualize this helps me understand what positions and motions make the best use of gravity and of the shape and workings of my own body to make this passage easier for him and for me. I trust that my body is made to do this. I trust I have the physical and mental capacity to endure it. That's just what I think. But I believe it.


  1. I babysat 10 month old Kevin last weekend. I guess I must have also read that piece about blankets suffocating babies because when they told me just to put a blanket over him, I got very nervous. I made them tell me EXACTLY how to lay the blanket, do I tuck him in, do I not... Of all the instructions they gave me, I couldnt let it go, and when it came time to put him to bed, I stood over him and watched him for a while, then had the video monitor attached to my hip. All because I was terrified of the blanket!!

  2. In Holland they instruct you to buy these metal bottles, they look like miniature milk cans, that you fill with hot water, place in cloth pouches, and put in the crib with the baby. And we are afraid of blankets!

  3. This is an amazing post. A good friend of mine is a midwife and she said something that has always stuck with me and resonated: each birth is its own experience. There are no two that are the same.
    I think your decision to trust yourself and your body is brave and true. It's something you "do" rather than something that "happens." I've never realized that until I read it...and now it seems obvious.
    10/10/'s on my calendar. a hopeful day.

  4. I swaddled Lilya for the first 3-4 months of her life. She loved sleeping like that. Then I put a blanket on top of her that I tugged in firmly on the sides. You are also supposed to put them close to the bottom of the cot/bassinet, so they don't accidentally slide under the covers. However, a swaddled baby doesn't move very much... She started sleeping in a sleeping bag once she slept soundly without being swaddled (around 3-4 months).
    Have a look at Harvey Karp. He is an American pediatrician. His 'methods' are very natural. And I totally think he rocks. You can look him up on YouTube, but I can also recommend his book 'Baby Bliss.'
    As far as labor goes, I can tell you that it's going to hurt like hell (so far, I've only talked to one woman, who had 'some period pain' and then delivered the baby within half an hour). But, I think you are in good hands with your midwife. They rock. And every contraction you experience is one less to finally meeting your little bub. Every woman is different in how she deals with it all, and you cannot know how you are going to deal with it. However, your midwife will have seen it all. So, she'll be able to coach you. Personally, I thought, I'd be better at dealing with the pain. Ha ha...silly me. However, two days after delivering, I already thought about definitely having another baby.
    When pre-labor started, I really liked using a heat-pillow. Also, a warm bath is nice during labor. Here in Australia they recommend hiring a tens machine ( You attach it to your back and press a button that sends electrical charges, every time a contraction hits. Sounds nuts, but it does help.
    Don't know, if they have them in Holland.
    Good luck with everything. Been thinking lots about you.

  5. You follow my blog? I'm posting crap! Really.

    This is brilliant and by "this" I mean, the writing! You know Lorrie Moore, well...okay, you're traca de broon. Of brown. Okay, but stylistically I am pointing something out and it feels urgent.

    But I will miss reading these from you and I say I will miss reading your posts here because blog time will take a seat east then west then back with just the two hour feedings....

    Let me say only that you will want to cover your Irish fella in things different from a blanket. It's what I hear. I don't and I won't ever know for sure myself personally. I'll know instead through other women what it means to trust myself ;-).

    Really, the male fetus will want out and as canals go he's on the right part of the earth. There's osmosis. For instance, play The Who to your womb.

  6. Thanks, Roota! I have read about TENS machines in UK publications. I'll look into it here. Thanks for the advice and support. I tend to be brave and confident during the day and then get a cramp at 2 am and think, I am so tired, if this starts now, I will never stop crying. But it has to be done, I suppose!

    Ginab: I will endure 50 hours of intense labor if it means Lorrie Moore comparisons. Actually, I'll get back to you on that ... but thanks, that's high praise. And your blog is not crap.


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