Childbirth Choices: Epidural

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baby born with an epiduralGuest blog from Christina Bartholomew who blogs at http://handsfullmom.blogspot.com/. 

[This is the beginning of a serious highlighting why women make the choices they do during birth.  In this post Christina, a good friend of mine, discusses one of our major childbirth choices, epidural versus natural childbirth, and her decisions regarding this choice.]

A year ago, one of my best friends anticipated the birth of her sixth child. She expected things would go much as they had the last five times, with labor pains slowly progressing and plenty of time to get to the hospital, get an epidural, and enjoy the experience of birth.

What she got instead was a scary, overwhelming, and painful experience. The pains came the same as usual, at first. She called her husband, asking him to wrap up what he was doing and come home to take her to the hospital. Then the pains were overwhelming, and the call to her husband was urgent, “Hurry! Get home now!” Her mother, a nurse, was there to watch her kids and help her through the pain, and soon her husband arrived for the 15 minute drive to the hospital. The baby by now was anxious to make his debut as his father drove as quickly as possible down the busy road. As they were driving, they ended up behind a car going well below the 45-mile-an-hour speed limit. Desperate, as my friend endured the overwhelming pain of childbirth, her husband flashed his lights at the car, which responded by slowing down even further!

They made it to the hospital just minutes before baby arrived, but my friend had to call on all the strength inside her to endure the agony she was experiencing. No pain management, no epidurals, just the baby arriving in nature’s painful way.

My friend’s experience has made me realize that I have taken for granted my calm, peaceful, and thanks to epidurals, virtually pain-free births and brought to me the clear reality that as fast as my labors can be, I might be in the same situation sometime. I’ve often said that if my water ever breaks on its own, then I’m likely to be giving birth on the side of the road somewhere, but until I spoke with my friend about her experience, I didn’t realize just how frightening that could be for someone who isn’t prepared.

cbart_birth2In three months, I will give birth again, and for the first time, I’m considering going without the epidural. I’m ambivalent about the decision, reluctant to do something different when I’ve had such wonderful experiences in the past, afraid that I might not be determined enough to see it through, or that I might change my mind when the hardest pains hit but that by then it will be too late. And I’m worried that I might ruin the experience for my husband, who has been by my side with every birth and has enjoyed his wife’s normal, cheerful personality throughout the process.

(with my seventh miracle)

In fact, when I first suggested the idea to him, he reminded me of what happened “the last time” I tried it, when I lost control and yelled at him. It surprised me he has such clear memories of those moments, because “the last time” I tried a natural birth, it was also my first time, nearly eleven years ago.

I was ambivalent then about the natural option, deciding I would wait and see to make that decision. I was busier than ever before in my life, working two part-time jobs and finishing my last semester of school (Lillian was born 4 days after graduation), so I didn’t have much time to ponder on my choice. I didn’t take any classes or read any books, but I knew that both of my sisters had given birth naturally multiple times, and I expected that if they could, then I could. One sister told me, “Sure it hurts, but it only lasts a few hours and it’s over.” Others offered other advice and suggestions. One friend, also pregnant, wondered aloud to me if it would mean as much if she didn’t feel the pain (later, as she experienced the overpowering pain, she decided she didn’t care about such philosophical questions anymore and was eternally grateful for her epidural). Two weeks before my due date, as I waited for my husband outside his class, a 40ish woman passing through stopped to talk to me. She asked me about my due date and then asked me if I was going to have an epidural.

“I haven’t decided yet. I think I’ll just wait and see.”

“What? Why wait? Epidurals are the best thing ever invented. You’re crazy if you don’t have one.”

I was taken aback that a stranger would be so bold as to judge a choice I hadn’t even made yet, but I also knew that decisions about birthing can be quite polarizing and that just as she would think me crazy if I went without the epidural, others would think me less of a woman if I had one.

My sisters and mother had all had early births, usually two to three weeks before their due date, so I expected the same, particularly as when I was checked at 36 weeks and found to be 3 cm dilated and 90% effaced already. I had lots and lots of contractions that month. Sometimes, I’d sit in a class tuning out the teacher as I counted the intervals between contractions, “fifteen minutes . . . fourteen minutes this time . . . are they getting closer?” I was sure I’d be making a little graduation outfit for my newborn and carrying her through the ceremony. When that didn’t happen, my mother feared my water might break while I was on stage. It didn’t. Graduation came and went, along with my due date. Four days later, anxious and desperate, and with an induction scheduled for the next day, I figured I had nothing to lose and choked down a few teaspoons of caster oil.

Whether it was the disgusting, slimy oil or my body’s natural response, I finally got those contractions to come close enough together to get to the hospital. After an overly-long admitting process, I sat with my husband for several hours waiting for things to progress. The contractions were three or four minutes apart, and it was amazing to feel my stomach tighten and squeeze at regular intervals. I wasn’t in a lot of pain and was able to read while we waited. The book I was reading at that time was, ironically, Great Expectations. But soon, it felt like an intrusion to be reading when something so impressive was going on, and I set the book aside.

I had expected to feel pain. I had expected to feel nervousness and excitement. What I hadn’t expected, at least not in the abundance presence, was far beyond any of those feelings. “Do you feel that?” I asked my husband quietly. It was the power of God’s Spirit in that room, telling me in feelings rather than words that I was a part of something far greater than I understood. I felt tears come to my eyes as I contemplated the miracle of my baby’s entrance into this world.

Soon, the doctor came in and broke my water, asking if I wanted an epidural beforehand. “No,” I said, “nothing’s been too bad so far.” My water broke in a large gush, and the doctor left the room. cbart_birth3Then the next contraction hit, and the pain was more than I could bear. I cried out, my husband rushed to my side, and I yelled, “Don’t touch me!” I was not rational or calm, and my body began to shake during the next few contractions. I was completely out of control of the situation and I was scared. After fifteen minutes and between contractions, I told my husband, “I want an epidural.”
The fifteen minutes it took for the anesthesiologist to arrive seemed like forever, and I hardly flinched as the sting of the needle went into my back. My body continued to shake uncontrollably, and I couldn’t understand why it was taking so long for that epidural to take effect. I shook and gasped with each contraction, but finally, finally, the pain subsided as the epidural took effect. I still felt the contractions, and when the time came, I felt the pressure and the need to push. I felt just enough. With some warm blankets, even some of my shaking subsided, though not completely until after the baby was born.

I felt such peace and joy during those next few hours. I felt good about the decision to get the epidural, as I could now focus on the awareness I felt of my daughter’s presence. Finally, at 11:53 p.m. on the last day of our student insurance (we had other insurance through DH’s new work by then, but we’d been paying through the nose for our student insurance and wanted to get the full benefits), my daughter was born. When I greeted her, it felt like a reunion, as if I was greeting my best friend, someone I had known for a long time and had just lately been parted from.

I have felt the same special feelings but in different ways with all my births. Each time, I have felt of the sacredness and have known that I was part of something larger than myself, the birth of a new soul into the world.

cbart_birth4

I have also come to love that particular anesthesiologist, Dr. L, and after having a different doctor give me an epidural with my third birth, I appreciated his amazing talent to administer just enough and no more. With my third, the doctor made me so numb I could hardly feel anything, and it took longer than ever before to wear off. We’ve been blessed to have Dr. L be on call with five out of our sixth births, and I’m considering scheduling this next birth, if by induction, on a day when he’s at the hospital!

I’ve also learned a few things about my births. One is that my bag of water seems to have super-strength. Despite walking around for the last month of every pregnancy at least 2 cm dilated and 70% effaced and dealing with lots of daily contractions, it has never broken on its own, even when I was expecting twins. So I am usually induced, sometimes with pitocin and sometimes without, but always with the doctor or resident breaking my water.

Which brings me to the second thing about my births. With one exception (when the baby’s head was transverse and labor halted for four hours), my births move incredibly fast after my water breaks, with the baby arriving within an hour or two of that event. With my twins, I went from 4 cm dilated to 10 in just ten minutes, and they had to hurry my doctor along and tell me not to push while they wheeled me into the O.R. (Most twins are delivered in the OR just in case of complications requiring a C-section). Allison arrived just five minutes after that, with her sister following seven minutes later.

cbart_birth5

After that “last time” as my husband put it, I have always asked for the epidural before my water breaks, and I’ve felt able to focus on the peace, joy, and miracle of each child’s entrance into the world. Birth for me is a transforming and deeply spiritual experience, and I’ve never felt that my choice to use modern medicine to alleviate the pain has diminished that experience.

So why am I considering a change that this time? Why switch boats when the one I’ve chosen the last six times has brought me peacefully to the other side of the river? I’m not sure that I will change, but I am considering it and I’ve been reading a couple of books to help me decide.

I think for me it comes down to two ideas. The first is that a natural birth is something I’ve never done before. Like running my first 5K last fall, it’s something that I know will be hard but that I’ll appreciate for its difficulty. It’s the idea of having a tough goal and then achieving it. I don’t think I’ll feel any differently towards my newborn afterwards, but I will probably feel differently about myself and my ability to cope with pain.

The second idea goes back to the “side of the road on the way to the hospital” scenario. I do worry about my ability to cope if a natural birth was ever forced upon me by circumstances. This will not be my last birth and even if all goes well this time, there’s no guarantee that I might not be caught the next time without the crutch of an epidural. If I’ve done it once naturally, or at least prepared for it and then chosen to wimp out with an epidural, then I think the thought of such a situation will not fill me with dread.

I’m still reading, considering, and discussing my options with my husband and close friends. Whatever I decide, I’m grateful that I have the opportunity to do so. Some of my friends have needed C-sections and others have had frightening experiences where they feared for their baby’s life. I realize it’s a luxury to enjoy the choices of modern medicine and also a blessing that everything has always gone smoothly with my births.
What has your experience with birth been? Do you have strong feelings about the way you want give birth? How have you coped with unexpected situations in the delivery room? Do you think I’m a wimp for having epidurals (it’s all right; I can take it!)? Or crazy for considering a natural birth? Will you think I’m especially wimpy if I prepare all I can for a natural birth and then opt for the epidural anyway?

For an update of how this birth went visit http://handsfullmom.blogspot.com/2010/05/long-version-katies-birth-story.html

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