Mon 11 Aug 2008
the longer this pregnancy continues with merciful uneventfulness, the more amazed i am. and the more nervous. a new and different low-grade panic wells up in my gut these days…not miscarriage, not genetic disorders, not uber-prematurity and brain bleeds and oscillating ventilators. just…birth.
there’s clearly got to be a birthin’ around here sometime soon.
(me and my pet Volkswagen and an – uneaten – magic mushroom, three weeks ago at 29 weeks…by the lovely and talented Kate)
everything’s dandy with the bambino, and the weeks of crisis delivery prognoses are creeping past, therefore…the more my razor-sharp neuroses get to hone in on me.
it’s not the fear of the unknown, but of a three-peat. experience says i deliver fast, and early, and my babies have big heads for their gestational ages. i have a scarred cervix that tends to resist dilation, then tear. my placentas don’t detach properly, causing retention once, hemorrhage the second time ’round. and my body – this time, as each time before – is weakened at its core from extended bedrest.
i feel silly about my fear…ashamed, even. but it is real and grows bigger as i do. birth has marked me in ways i do not like. i do not want to dwell on those wounds, or give them power…i’d like to get beyond them. but i am not sure i can until this baby is born and this third birth confronted and endured…and hopefully celebrated. my fear is that the birth will add to the sum of baggage i need to unpack, rather than – perhaps? – being healing. i’d like healing. i’m just afraid to ask for what seems like so much.
i had what was pretty much a post-traumatic stress reaction in labour with Oscar. flashbacks, full-blown panic attack. on top of that, i had complications that knocked out my pelvic floor: some clitoral tearing, a vaginal and bladder prolapse, an unwanted fourth-degree epiosiotomy that went straight through my perineum and then tore four inches up. i was stitched three layers deep, stem to stern, and then had to be torn open again when they whisked me off to surgery to retrieve the hemorrhaging placenta. barely a quick photo with my newborn before being rushed off for the d&c, then three hours alone and shaking, still panicked, in recovery…that, after having lost Finn only hours after his birth, was probably worst.
i had a birth plan for O’s delivery…written to try to remind myself that once we passed 35 weeks the birth needn’t be the powerless, frightening, emergency event that Finn’s had been. it wasn’t a complicated plan…my only caveats were to avoid episiotomy and to be with baby after birth for at least an hour, for bonding and an attempt at breastfeeding. neither worked out, though in the first case no one ever explained why, despite my shouts of “no!”. the whole thing still turned out to be a powerless, frightening, emergency event. had any of it been necessary to safely deliver Oscar, my sense of violation wouldn’t have mattered worth shit, to me…but he was fine through the whole blessed mess. i felt like a piece of meat, ravaged and dismissed.
i do not have the powers of self-delusion to simply compose another birth plan and assume it’ll go better this time.
i see my OB Wednesday, for the first time since Halifax released me. i want to talk about birth…about what options are reasonably open to me, about what factors are controllable and what odds i have of a different type of birth than the last two. we haven’t talked about it yet because until last Friday there was an assumption i’d deliver in Halifax…though the Halifax team were hoping to get me past 32 weeks and so didn’t want to talk about it, either. but now i’m set to deliver here. with whoever’s on call, because that’s how the system works. and i wake up at night sweating.
i know my own fear is my worst enemy. i also know that i can’t think myself out of a post-traumatic stress reaction, especially if this labour comes as fast and strong as the last two. i’ve played with the idea of just asking for a c-section, except i doubt the likelihood of me making it to 38 weeks without going into labour.
i plan to take Evening Primrose Oil from about 35 weeks – orally at first, to help break down scar tissue, then vaginally after 37 weeks. the cerclage, according to Halifax, will come out at 36.
i’d also – if i have a vaginal birth – like to try delayed cord cutting in hopes of preventing placental retention and getting to actually hold this child and be with her for the period following her birth. it’s the one thing i ever really invested in, in terms of having my babies come into the world…the skin-on-skin of that first hour or two, reprieve from the work of birth. if the baby has any issues, obviously that dream flies out the window, but if we can get to 35 or 36 weeks it’s far more likely to be me and my complications that lessens that possibility. and thus i’d like to do what i can to help the placenta separate cleanly. but there’s resistance here towards delaying cutting the cord, particularly with an early-ish baby. my OB might respect my wishes, but the other docs? i haven’t been overwhelmed with some of their listening skills. thus i wonder if an induction – so as to be sure i’m with my own OB – might be wise, despite my aversion to the idea?
i did perineal massage when i was pregnant with Oscar and am willing to do it again, but don’t know what impact the significant epiosotomy/tear scar has on its effectiveness, especially when it so clearly did sweet f#ck all last time?
i want to know what you know. i’m going to end up making what decisions are open to me based on odds…odds of a joyful, peaceful, non-brutalizing delivery, however it comes about. the more people’s experiences i become familiar with, the better sense i’ll be able to gather of what those odds really are. Dr. Google isn’t really helping. so please. no holds barred.
have any of you ever had a fourth-degree tear or episiotomy that didn’t open or need to be opened again in a subsequent birth? if it did, how did the healing go the second time around?
did any of you who’ve had a cerclage try Evening Primrose Oil (or something else?) to help minimize scar tissue on the cervix? do you think it helped?
any experience with delayed cord cutting, or with retained placentas and other methods of trying to minimize the likelihood of that happening?
has anyone who’s had a prolapse not have it happen again in a subsequent delivery? were you able to do anything to impact how that turned out, one way or the other?
anybody able to compare a prolonged transition-type labour (contractions a minute apart for an hour or more) with an induction? i know the latter are supposed to be really hard to tolerate, but i’m wondering if my own labours aren’t perhaps already on that track already? would pitocin intensify that?
any general advice regarding planned c-sections vs. induction vs. taking one’s chances with the on-call docs?
is it common in many places to be allowed to hold your newborn for the stitching period after a c-section? (it is in Halifax, not here. policy. bah.)
does anyone know if ativan or some other anti-anxiety medication can be safely given during labour if panic and PTSD symptoms set in? i know it’s safe (or at least given) during pregnancy, but i’m curious about whether it’s usable so close to delivery.
i know birth is not a controlled event. i also know that nothing matters more than taking home a healthy baby. but i am still hoping, nervously, that maybe i can come out of this birth able to focus on that baby and not on my own mental and physical damage. i’d like to ask for a positive, empowering, affirming experience…but i’ll happily settle for less than wretched. so…keeping in mind that i live in a province where midwives are not certified and where the doula i met with told me that with my history she might not be able to do much to mitigate the physical repeat of past complications…tell me what you think makes sense for me. and tell me what you can about what’s been positive for you, in birth…please…no matter what the circumstances.
(just…pretty please…don’t tell me just to relax and it’ll all be fine. i will personally chew your arms from your body so that you can never, never type again. :) )