My First Birth: An Epilogue About Dealing with the Pain

So hear I am, three days away from my due date with my fourth pregnancy, and it took a little longer than the last few times, but I’m finally starting to read birth stories again, namely my own. Reading through them, I feel like I am right there again reliving the moments, and I am so glad I took the time to write them down in detail.

The one that stood out to me the most was my first born Ruby’s birth. It brought tears to my eyes as I remembered the pregnancy, the researching, the not knowing, the fear, the anticipation, the l-o-n-g labor, the pain, oh god the pain, and the sheer and utter joy of meeting our sweet little angel that had been nestled inside of my body and our minds for so long.

I just wanted to write a little epilogue as a reminder to myself before I enter the throes of childbirth again, and to anyone who has read my birth story before giving birth the first time and thought “Yikes!”, or to anyone else who might be scared about childbirth and researching what it’s like to give birth for the first time…or anytime. While first births do tend to be long, I do not think that I should have had to go through so much pain, and I just wanted to talk a little bit about why I did and if I could go back in time, what I would have done differently.

1. Labor at home as long as possible. When I was laboring at home, the pain was WAY more manageable. I was so comfortable putzing around my house, but as soon as we had to awkwardly get me in the car, drive for 20 minutes, get to a strange new place in the middle of the night, be scrutinized by someone who didn’t think one of my contractions was “good enough” to be admitted, and then have nothing to do but walk the strange hallways and watch the clock, it started to feel like things were out of my control. I know that memories fade over time, but when I remember Ruby’s birth, I don’t remember things being very painful until we got to the birthing center.

2. Have a home birth. There are tons of articles that can scare you into the all of the things that could go wrong in birth and why you should be near medical staff who can provide all of the interventions that cause the United States to be ranked 34th when it comes to infant mortality, and there are also some wonderful articles, like this one, about how giving birth at home is actually safer and requires less medical intervention. But I want to talk about the feeling you get from being home versus being somewhere foreign. We were at a birth center with a team of caring midwives, comfortable homey rooms, soft lighting, plenty of snacks, and no interventions, yet it still wasn’t comfortable enough.

The best thing about being at home is that you already have an entire system in place for relaxation. When I am feeling stressed at home at any normal given time, I know that I can light some candles, take a bath, grab one of my favorite beverages from the fridge, put on my favorite playlist, and let the problems of the world melt away. But in this foreign place, we had to figure out how to hook up our ipod, where to put all of my “comfort items” that I brought from home (and yes, I brought a deck of cards – just in case we got bored!), dim the lights, try to remember from our tour how the kitchen was set up, and orient ourselves with our new surroundings. And while things may have appeared physically comfortable, they weren’t mentally comfortable.

That brings me to the next best thing about being at home. You can putz around your house doing menial tasks that will totally help you to clear your mind in between each contraction. My nesting instinct always hits really hard right before and during labor because I want everything to be just so when my precious little angel enters the world. The beautiful thing about labor is that while contractions do have about a 15 second peak of really intense pain, the pain will completely melt away in between contractions and this enables you to handle them one at a time. Unless, that is, you are like me with this first birth and start to panic and feel like the pain will never leave and you’ll be stuck there laboring forever. Giving birth is just as much mental as it is physical. If you’re considering a home birth, I highly recommend watching The Business of Being Born and reading Ina May Gaskin’s Ina May’s Guide to Childbirth.

3. Have the option of an epidural if you’re not going to give birth at home. I kept thinking that time would go fast, or that my adrenaline would kick in, or that my endorphins would allow me to handle the pain, but none of those things happened. I kept trying to do everything I could think of and because I was in this foreign place, I was trying to rely on my head instead of my body. Whenever I have labored at home, I have been able to let everything else melt away and focus very intently on what my body is telling me. Should I get on the exercise ball, get on all fours, wiggle my hips, request pressure on my back from my husband, walk around, get in a warm bath, eat something or rest?

As much as midwives, doulas, husbands, nurses, and doctors are there to help and support a woman in labor, it’s really just an internal experience for the mother. She has to find her inner strength, she has to learn who she is more deeply than she ever has before, she has to get in touch with the parts of her mind and body that are locked far far away, and in doing so, she opens up to the part of her that is giving birth not just to a child but to herself as a mother. This is an incredibly difficult thing to do when you have a bunch of people shouting directions at you or making you feel like a watched pot. This is why I recommend that if you’re not going to give birth at home, just get the dang epidural. Sure, you’ll have to deal with the fact that you are paralyzed from the waist down and lose your ability to listen to your body, but how can you be expected to do that in the first place in this foreign place with foreign people trying to learn how to do something completely foreign to you? If I could go back in time and give myself an epidural, I most certainly would!

4. Don’t rely on what you’ve read or what you’re being told, rely on your instincts. I just want to reiterate this again because it is so so important. Your body knows what do to. Women are designed for this process and our bodies are made to open up and give life. Women around the world and for centuries before this have been giving birth long before epidurals were even invented. It is a process that unites all women and it is an amazing and incredible experience that will transcend you and leave you completely changed from the person you were before…for better or for worse.

When I started to panic and felt like the pain was more than I could bear, I started thinking about things I had read like, “I should squat because it opens up the birth canal by 20%. Or, I should sit backwards on the toilet because it helps to give women the urge to push.” Instead of relying on my instincts, I was relying on the professional advice I had gleaned rather than on my natural instincts. If you can enter a mental state where you can really and truly listen to your body, find your inner strength, and do what comes naturally, you will be able to have an experience that is exciting, beautiful, and pure rather than something you just want to be over.

5. Don’t let anyone check you internally. I know that most women are uncomfortable with the idea of checking themselves, but I highly recommend that you get familiar with your body either before becoming pregnant or when you first find out so that you have a comparison and check yourself regularly so that you can track your progress. When you check yourself, you are very in tune with what feels okay and what hurts. When I was internally checked during this birth it was VERY painful! I think before the midwife checked me she asked if she could “do something to help things move along more quickly” and even though I have no recollection of understanding what that meant in any sense, my husband said I grunted something that sounded like, “Sure!” I’d say it’s best to keep everyone’s hands out of there except your own. It’s not fair to ask a woman who is going through something like this if they are okay with having their waters broken, cervix stretched, or membrane’s stripped when they don’t fully understand what the ramifications will be.

I have found that the best way to learn how to check myself is in the shower. I am right handed, so I prop up my left foot as high as I can and position my left hand palm up and my first two fingers extended. Then I reach up and back as far as I can. Now, first of all, I can tell you that my cervix has been much easier to find with each pregnancy, probably because it’s not as high as it once was. But it is still possible to find with your first pregnancy. You just have to reach really really far. In the beginning, your cervix will feel like a nose, kind of sticking out and down with a firm but soft texture. In the middle, you’ll find the opening of the cervix. With your first birth, you probably won’t feel much of an opening until much later in the pregnancy, but with subsequent births, it always seems to be dilated to at least 1 cm. As you enter labor, your cervix will efface which means that it will thin out and flatten. It starts out as being 0% effaced and when it’s completely 100% effaced and your cervix is dilated to 10 cm, you will be ready to push the baby out. With Ruby, I was about 1 cm dilated and about 40% effaced for the weeks leading up to her birth. Now with my 4th, I have been about 2 cm dilated and about 60% effaced for weeks.

During labor with Ruby, I checked myself regularly before we went to the birthing center. My husband found a google image that looked like a bullseye chart showing what the cervix would look like at each dilation. Before we left, I predicted that I was dilated between 4 and 5 cm. When the midwife checked me upon our arrival, I had been right on. I remember checking myself with our second birth, Elliot, when I was in the bathtub and even though I was dilated to 5-6 cm, I was in denial that the birth was really happening and convinced that I would still go to sleep that night. With our third birth, Ophelia, I remember checking myself right before I pushed her out. I was brushing my teeth in between contractions and I announced to my husband, “I can’t feel any edges, I must be dilated to 10 cm!” I can’t tell you how empowering it is to be able to check yourself and know exactly what your body is going through rather than having to rely on someone else to do it for you.

6. Don’t let anyone stretch your cervix during labor. I’m sure that there are times when this intervention can actually be helpful, and I’m not saying to NEVER do this. I would just encourage you to research it before you go into labor so that you at least know what you are being asked to give up when this happens. Whenever the midwife stretched my cervix, I believe she gave me what is called an anterior lip (it is also possible that I already had an anterior lip, but whatever she did made things hurt much much worse). This happened to my mom too when she had her cervix stretched by her midwife during the birth of my twin sisters and the results can be very painful. Basically, the baby’s head will push down on the cervix and evenly dilate it so that it forms a nice perfect circle. When your cervix is stretched in the throes of labor, however, it can cause it to open in an oblong shape which can become enflamed and continue to dilate unevenly. This becomes VERY painful and can prevent you from opening up all the way when it’s time to push thus resulting in further interventions.

7. Don’t let anyone bully you into speeding up your labor because they have somewhere else to be. When we transferred to the midwifery at 31 weeks, we barely had time to meet each of the five midwives who could potentially be at our birth. This resulted in us having someone at our birth who we had only met one other time and who we had not had the time to build a relationship with. With our next three births, we have had three different midwives (because of our constant moving), who we got to know each one really really well throughout the entire pregnancy, which resulted in an incredible experience every time. With our first birth, I felt like our midwife was slightly annoyed at being called up in the middle of the night and not looking forward to the long slow progression of a first time mom. When she wanted to stretch out my cervix to “speed things up” I have to wonder, was that really for me, was that really in my best interest? Or, was she just hoping to get home a little sooner?

8. Keep hydrated and nourished. I don’t know what all of the hospital policies are, but I have heard that they only allow ice chips in case you have to have to be rushed into surgery so you don’t vomit. Once again, something that is good for the doctors, but not for the woman in labor. I have read many stories of laboring mothers whose births have stalled because they simply ran out of fuel. Now personally, I didn’t feel like eating anything during labor and during transition I actually vomited up all of the food I had eaten anyways, but my husband and midwife kept my water bottle constantly full of Recharge which really helped me to keep my energy up. During my third birth I ate a nourishing bowl of soup right before labor and it energized me completely throughout the birth.

In conclusion, I just needed to give myself a little pep talk as I try to mentally prepare for this upcoming birth and remember that I can do this, my body is designed to do this, it will start, I will manage the pain one contraction at a time, it won’t last forever, I will rely on my instincts and find my inner self and my inner strength, and then I will be able to bond with a little person who will join our family and change our lives forever.