Imagine you are driving down a road- it is not clear where you are going. The weather outside is beginning to be unpredictable. You turn on the radio and the commentator keeps saying he does not think the road is open ahead. In fact he says multiple times you may be able to drive down the road but that does not mean you will be able to get through this huge roadblock ahead. You may have the gas to get there- you may have a car that works to get you there- but it does not mean you will be able to get through the roadblock.
A passenger in the car may encourage you that you can do it. But all you can see ahead is a red flashing light saying STOP! TURN AROUND!
I want to share with you the language used in two births I attended recently. One was a mom attempting a VBAC (vaginal birth after a previous cesarean) and one was a first time mom having her labor augmented. I want you to consider the mind body connection and how this type of language can interfere with a mom's ability to believe in her body- her baby- and her birth.
The doctor came into the room and after suggesting that Pitocin was needed commented, "He can get anyone to dilate but that did not mean you could get the baby to be born vaginally."
Later he came in and said, "He was sure this baby was over 9.5 pounds and the baby’s head was molding a lot. But he was unsure if this baby really was going to fit." (the baby weighed 8# 14 oz)
He returned an hour later and said, "He hates pushing cause he knows the damage it can do. He has to do so much reconstructive surgery on women due to pushing out big babies."
After having to stay in the hospital all night since she was a VBAC, he made the comment, "That there was no financial viability in doing VBACs like this. It was not cost effective for him."
He later came in and shared how awful it was to have to bump a doctor out of the OR for his planned cesarean deliveries when a mom waited til just before 7am to have her cesarean called. He told her he would not impose that schedule change on another doctor as he hated it when it was done to him. He would be calling this before he had to do that.
He was certainly surprised when only an hour or so later when she pushed her daughter our vaginally into the hands of her supportive midwife. He even said, "You certainly surprised me!"
The next mom had a doctor who was very gentle and encouraging for the most part. He would come in and although she was not progressing he would offer that she could do nothing and keep going. But he would offer the caveat that she was an older mom- she was 34 years old. How our uterus was really meant to have babies in our 20's.
He then would return and say almost identical to the first doc, "I can get you fully dilated, but that does not mean this baby is going to fit out your vagina."
He would encourage her to keep doing what she was doing but would end each statement with, "I don't think this baby will fit."
He would also offer up that in Ireland they are doing active management of labor. "The active management of labor, first introduced by O'Driscoll et al in the 1960s at the National Maternity Hospital in Dublin, Ireland,5 is a group of interventions initially devised to ensure short labors in nulliparous (never having given birth before) women. In addition, active management of labor was noted to be associated with a lower cesarean section rate,6,7 which was thought to be due to a decrease in the number of cesarean deliveries performed for dystocia. Three randomized studies have been done to evaluate the efficacy of active management of labor.8,9,10 These studies have demonstrated significant decreases in the duration of labor and the incidence of infectious morbidity, as well as a trend toward lower cesarean section rates." What this really means is they gave moms huge amounts of Pitocin after breaking their water and pushed their labors into a short but frenzied labor. There was no discussion of how the Pitocin may effect the baby or mom. Nor was there any consideration for the type of birth experience this left the mom with. But he said it is catching momentum with doctors!
So after not progressing for several hours, this mom had her water broken and then active labor began. She did get fully dilated but after a little more than an hour with constant comments on how this baby, "was not going to fit." and a declaration that the baby had a capput- the swelling of the soft tissue on his head, a cesarean was strongly encouraged.
I am not sure if this doctor felt the same way as the first about having his surgery schedule messed with- since the call was made just before 6am and the scheduled cesareans begin at 7am. I am unsure if this doctor was just tired of waiting. I am unsure if this mom really could not fit this baby through her pelvis. (The baby was just under 8 pounds.) I am unsure we will ever know.
But what I do know is it is hard to keep driving forward when the red flashing lights are blaring at you. It is hard to keep moving ahead when those you feel are in authority are saying you can get there but you will never make it through the roadblock that they see.
The mind body connection is a strong one. But it is also so hard when you are feeling so vulnerable. When you are second guessing your ability, when the ones you believe can guide you best are not believing the dream you had planned, it is shaky ground. It is a highly emotionally charged time. You do not know the decisions that are right all the time- when you look back later you wonder... but you have to make the decisions that feel right in that instance. It is not black and white. There is no clarity. It is easy for those on the outside to second guess your choices. It is awful when someone says you made the wrong decision. They were not there! They did not feel what you felt!
And what about the baby? What about the mom's intuitive spirit? One mom hoped she would be able to birth her baby vaginally this time and she did. One mom had no idea she would be having a surgical birth. Some of her friends had opted to do so without labor. She had discussed this early in her labor with me. I thought it a curious conversation at the time. I wonder if her body was letting her know something. I wonder if she needed to know that laboring first before a planned cesarean had its benefits. When later she felt something just was not working, it makes me wonder if that came from her internal spirit or was it a seed this doctor had planted. We won't ever know for sure.
But when you are driving down a road- it is not always clear where you are going. The weather can be unpredictable. Those in authority may believe you will not be able to get through this huge roadblock ahead. You must believe what you have come to believe as truth. You must shut out the negative voices around you and give it your best try. Then you will either find out they did not speak the truth for you- you either do make it through the road block or indeed it is one that is insurmountable. But what you will know is this- you gave it your best. You did not quit due to non belief.
And with that I pray you will surround yourself with voices of affirmation. I pray you will surround yourself with support along the way so you can get the information you need to make your decisions. I hope you will face your roadblocks with courage.
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