Empowered birth
My male readers saw this title and thought, “Oh, no, chick talk!” Sorry, guys. To make it up to you, here’s a link to pictures of the 10 greatest moments in the NFL. Anyway, quite a few friends who are pregnant with their first children have been asking me about childbirth, so I thought I’d do a post about it to collect all my thoughts in one place. Here we go!
Discovering “Empowered” Birth
I used to be horrified by the idea of childbirth. In movies and TV shows I’d seen all these depictions of women in labor as screaming, confused and helpless, lying flat on their backs on hospital beds, hooked up to IV tubes, begging their doctors to rescue them from this awful situation. It sounded horrible.
Shortly before I became pregnant with my first child, however, I came across writing from people who boldly claimed that birth does not need to be treated as a medical emergency, that it is a perfectly natural process that typically requires little to no medical intervention. They talked about “empowered birth,” the idea that it’s better for both mom and baby when women take charge of their own childbirth experience. I pored over great books like The Thinking Woman’s Guide to a Better Birth, Ina May’s Guide to Childbirth, Natural Childbirth the Bradley Way and The Sears’ Birth Book and became not only less fearful but hopeful and even a little excited about the idea of giving birth. I became a walking encyclopedia of statistics about hospitals’ disturbingly high rates of cesarean sections, episiotomies, use of forceps, etc., and I shook my head at how often women were encouraged to get epidurals rather than being given the support to work with their bodies to have a natural birth that would leave them free of the risks and side effects that came with epidurals.
When I found out I was pregnant with my first child I signed up for a Bradley Method class and made an appointment at the local midwife-staffed birthing center. I was going to have one of these empowered births I’d heard so much about.
The birthing center was not in a hospital and had no major medical equipment on-site so going there was basically a homebirth, just at someone else’s home (we lived in a downtown loft that wasn’t exactly the most ideal place for childbirth, otherwise I would have had the baby at my place). When I finally went into labor on a warm September evening, I didn’t have any worries. I’d done so much research on childbirth that I felt like I knew what to expect, and I was happy to be going to the birthing center where the midwives would allow me to be in control of my own birth.
Seventeen hours later, however, I didn’t feel quite so confident. It turned out that the baby was compound presentation, meaning his fist was up against the side of his head, which made labor extremely painful and difficult. None of my Bradley techniques for pain management worked, and the last five hours of labor were excruciating beyond description. When my son was finally born I was so exhausted and stressed that I only vaguely remember those first few hours with him. I went home about four hours after he was born, so tired that I was borderline delusional.
A Change of Plans
When I found out I was pregnant with our second child, I planned to go to the birthing center again. None of the hospitals in our city allowed midwives to have hospital privileges at the time, so a midwife birth in a hospital wasn’t an option. Even if it had been, I doubt I would have considered it. I’d unintentionally fallen into a sort of “us vs. them” mentality when it came to childbirth, and, ironically, in my zeal for empowerment I’d limited my own options by developing a very narrow view of what birth should look like.
But then, a monkeywrench was thrown into my plans.
When I was eight months pregnant I developed a life-threatening blood clot in my right leg called a deep vein thrombosis (DVT). To make matters worse, testing revealed that I have a genetic blood clotting disorder called Factor II which makes pregnancy and birth dangerous for me. Both my midwives and the physician who diagnosed the DVT agreed that I had to have a hospital birth with an obstetrician who specialized in high-risk cases, with additional monitoring by a hematologist. I did my homework on the risks involved and agreed: I’d never be able to have an out-of-hospital birth again.
After the first obstetrician’s appointment I found out that labor would have to be induced in order to manage my blood thinning medications, I’d have to be hooked up to an IV, and I would have to wear special circulation-boosting boots that would keep me tethered to the hospital bed. In other words, I’d be the classic “woman strapped down to hospital bed at the mercy of her doctors.” I started sobbing. I was grateful that my daughter would be OK, but felt angry and frustrated that my dreams for having a natural, empowered birth had basically been flushed down the toilet.
When the big day rolled around it was all overwhelming — I’d just met this doctor, had never even visited this hospital, and I’d been in too much pain from the DVT to research what to expect from a hospital birth. I felt completely helpless. I ended up getting an epidural at the very end of labor because the nurse seemed to think that I would need it, though looking back I think I could have done without it. The overall experience was fine — the doctor and nurses were friendly, and I was happy that the baby and I made it through safely — and I sadly accepted the idea that all that empowered birth stuff just wasn’t an option for me anymore.
Finding Real Empowerment
Baby number three came along shortly after baby number two, and this time I felt a little more comfortable going to the hospital. I’d gotten to know my doctor better and I knew what to expect this time. I ended up opting to get an epidural, and this time it was without any pressure from anyone. I just wanted it. Once again, in the end I felt that I had missed out on something because it was such a thoroughly “medicalized” birth from beginning to end, and especially because I’d gotten an epidural and therefore given up a lot of control of the process. I had wistful thoughts about being able to go back to the autonomy that came with natural childbirth.
But when I walked into the now-familiar hospital to have baby number four, after making a few jokes about needing one of those frequent customer punchcards (“Have four babies here and the fifth is free!”), something finally clicked. As I relaxed into the hospital bed as the nurses hooked me up to the circulation boots and monitors and an IV, it occurred to me that something was different this time:
I had stopped seeing self-reliance as one of the most important aspects of birth.
One of the things that had come of all my research into natural childbirth is that I’d unconsciously developed an assumption that a key aspect of a good birth experience (after the wellbeing of the baby, of course) was self-reliance. With all talk about women trusting their bodies and being fully in control of their own labors, I had unintentionally fallen into the mentality that ceding control of the birth process to medical professionals in anything other than a serious crisis was always a negative, and that medical intervention except in true emergency situations was always a less-than-ideal outcome. None of the books I read or people I talked to explicitly stated that opinion, and it wasn’t something I’d articulated either; rather, it was a vague, unspoken feeling that had developed in the back of my mind after hearing so many stories of women and babies who had bad birth experiences due to unnecessary medical intervention.
Labor with baby number four, our sweet baby “Joy,” ended up being my best birth yet, even though not everything went smoothly, I was hooked up to all sorts of tubes and equipment, I requested an epidural, and I didn’t ask a ton of questions about the doctor’s decisions. It was truly empowering, not because I did or didn’t give birth a certain way, but because I finally realized what it’s really all about. After thinking a lot about it, I’ve come to believe that truly empowered birth comes down to these six things:
- Knowing what your options are for giving birth, and researching the pros and cons of each one
- Carefully choosing doctors, midwives and/or doulas whom you can trust to have your best interest at heart
- Educating yourself about your anatomy and the process of birth so that you understand what’s going on with your own body and can have discussions with your doctor or midwife
- Having the courage to stand up for what you think is important, but also…
- Having the humility to respect the knowledge and experience of your care providers
- Remembering Who’s really in control
I think that what made it all click for me was #6. As baby Joy’s due date approached I was increasingly worried about everything that could possibly go wrong, and my reaction was to go into ultra-controlling mode: I had images of haranguing my doctor with tons of questions about every decision he made, launching a campaign with my OB and hematologist to avoid induction, insisting on different monitoring techniques, etc. And then I read this excellent post from Elizabeth Foss where she pointed out that we’re kidding ourselves if we think that we have the power to single-handedly control the outcome of anything, let alone birth. “Sometimes,” she wrote, “handing over all illusion of control is really a greater skill than learning how to ‘manage’ labor without drugs or ‘manipulate’ the medical community. Sometimes the hardest thing to do is to do nothing — but trust.”
That has been my experience as well. It’s important to feel empowered, in the sense of not feeling helpless or fearful about childbirth, but don’t make the mistake I did and confuse empowerment with total self-reliance. The truth is that you can’t control your way into a good labor, and making a conscious, educated decision to turn over some control to medical professionals or accept a medical intervention that makes things easier on you is just as empowering as having a great all-natural birth. If I’ve learned one thing from having four babies in five years, it is this: Regardless of how or where you have your baby, a good birth experience is going to involve a lot more trust than control.
I’m sure others have some thoughts on this topic as well, so feel free to share. My friends expecting their first babies will be reading and looking for tips!
Answering your questions: Part I
Here are the answers to the first few of the questions to this post:
Q: “How in the world do you have time to blog with all your kids?” - Kimberly
A: This is the #1 most frequent question I get. Heck, sometimes I look at my archives and ask myself that question. Here’s the answer:
- Naptime. My one-year-old and three-year-old usually take nice, long afternoon naps (and on the rare days they don’t I expect them to have quiet time in their rooms), so every day I have a block of time in the afternoon where it’s just me and the five-month-old. My husband and I agreed that with everything that’s on my plate I should use at least most of that time to unwind and relax, so most days the baby bounces on my lap while I read write posts and read others people’s blogs.
- I have help. When we first found out we were pregnant with our first child, my husband and I took great pains to make sure that we had a support system to help us out. Because of those efforts, my mom now lives in my area, and my mother-in-law comes to visit fairly regularly. So I have bits of free time here and there when, say, a couple times a week the older kids will go run errands with my mom, or when my mother-in-law comes up for a few days about every other month.
- It’s my main hobby. I have no talent for cool things like sewing, gardening, knitting, etc., so reading and writing are really my only hobbies.
- It’s easy. I think that part of it is that I’m just meant to talk about my conversion right now. I’ve done plenty of other writing in the past, and writing posts for this blog takes less than half the time it would take me to write anything else of the same length. At this point in time, I have the opposite of writer’s block: when you go from being a complete atheist to being a practicing Catholic, there’s a LOT to say.
Q: “I am curious about your husband in all of this as well. I think you mentioned he also entered the church at the same time (last Easter). Did he research and read, like you did? Were you on a similar time line?” - Jill
Q: “You said your husband converted at the same time you did…How did you broach the subject of religion with him? Was it hard to convince him that Catholicism is true? Were you convinced before he was?” - Sarahndipity
A: This is the #2 most frequent question I get. One of these days I’m going to put together a post that tells this story, but the short story is this: it would be hard to find someone more excited about the Catholic Church than my husband is today. But becoming Catholic was almost as much of a change for him as it was for me (just this weekend we were remarking about how funny it is that he wrote this email just a little over two years ago.)
When I met my husband I had no idea he really believed in God — I doubt I would have dated him if I’d known that. But the longer I knew him, the more I realized that, though he wasn’t involved in religion at all, he did firmly believe in some sort of Creator. He is extremely intelligent, so this piqued my curiosity and was one of the factors that made me start to open my mind to the possibility of God.
In the beginning he counseled me that there’s not much to know: the universe is obviously designed, there’s some sort of Creator, there have been prophets throughout the ages who were more in touch with some sort of spiritual realm the average person (Jesus, in his mind, being one of them)…but that’s pretty much all we can expect to know. He recommended that we just find some local church to join so that we could be part of a spiritual community. Since he was raised Baptist he wanted to stick with Christianity, so we began visiting Christian churches of all denominations — except Catholic. Because we were looking for churches that mirrored our own personalities and values, and we vehemently disagreed with the Catholic stance on certain issues, when we told friends we were open to joining any kind of church we’d always add, “Anything but Catholic, of course,” with a chuckle.
It was at some point during this process that I started reading and reading and reading. I remember one night after reading some apologetics book I set it down, and said to my husband, “You know those stories in the Bible about Jesus being the Son of God, and rising from the dead and stuff?”
Amused that this was actually new territory to me, he said, “Yeah, I’m familiar with them.”
I hesitated because I couldn’t believe I was actually saying this, but I went on: “I think they might be true.”
“What if it is? What are we supposed to do with that information?” It was when we began to try to answer those questions that he and I both had the same realizations: that there might actually be a lot on the line here; that religion might be about a whole lot more than just finding a nice group of people to hang out with on Sundays; that maybe real, objective truth about God and his relationship to humans exists and could be known; and that maybe we both needed to stop everything and start searching for truth.
To be continued…
Q: “Is there anything you miss about being an atheist?” - Anonymous
A: No.
Q: “How did your various doctors solve the dilemma of your blood clotting disorder vs. NFP?” - Rebekka
A: Another question that deserves its own post. Here’s my attempt at a quick answer: when I first had the DVT and was diagnosed as homozygous for Factor II during my second pregnancy, my cardiologist, hematologist and obstetrician all strongly warned me not to have any more children (even my midwife, whose services I could no longer use because of the DVT, hinted that maybe we should stop at two). When I told them about my issues with Coumadin and explained that I was in the process of converting to Catholicism and probably would not be open to taking contraception, my relationship with a couple of them became adversarial. I think they were annoyed with me, I was annoyed with them, and my trips to their office were usually tense. (My posts on those subjects can be found here).
Rather than addressing any one of the go-rounds I’ve had about being told not to have more children, not being able to afford the astronomical cost of Lovenox, the Coumadin issues, etc., I’ll offer a general statement about the entire issue: the more I’ve worked with my doctors, the more I’ve gotten to know them and they’ve gotten to know me, the more I have found that none of these issues are as black and white as they were once presented. At some point I began to approach my relationship with them in a different way: I was more confident and firm and my unwillingness to consider anything that was against this newfound belief system of mine; yet I was also sympathetic to their fears of doing anything other than the standard treatment for cases like mine. The more I approached our meetings with a confident, positive, friendly attitude, the more I found they were willing to “think outside of the box” for me. Everything has worked out surprisingly well.
Though my options were presented as being starkly black and white, I discovered a lot of gray area. I just had to go looking for it.
Q: “Sometime ago you mentioned (on your link blog) an inspiration that caught your attention. Something to the effect of…’unhurriedness is one of God’s characteristics‘. I’ve been waiting to hear your thoughts.” - Tausign
A: That was a very timely insight as I first began to try to bring peace to my daily life. The subject really needs a separate post. I’ll try to get to that soon.
Q: “How did you manage to get so many readers for your blog?” - Sarahndipity
A: “So many readers” is subjective — I don’t think of this blog as having all that much traffic. I’m no Amy Welborn or Curt Jester. But to the extent that it has grown over the past couple of years, it was an organic process. I’ve never made a big effort to publicize it. Actually, I try not to place too much value on the number of readers of this blog because it’s easy for me to get caught up in trying to write with an eye towards increasing traffic instead of writing to give an honest account of my thoughts and experiences.
Q: “How’s your scorpion problem?” - Adoro te Devote
A: To everyone who worried that I solved the scorpion problem once and for all, I have good news: it is likely that the only reason I haven’t seen a scorpion in the past few months is because it’s colder. Scorpion season starts again in about two months. I’m getting my Caps Lock key ready.
Part II coming soon…
Coumadin, clotting disorders and contraception — oh my!
I saw my hematologist last week and he reminded me of something that I can’t believe I’d forgotten about: that the whole Coumadin issue is going to be on the table again as soon as the baby’s born.
For those of you who missed the fun last time (some highlights here and here), just a few weeks after I came to agree with Catholic teaching on birth control I developed a blood clot whose treatment requires a medicine that is completely incompatible with getting pregnant — if you conceive while you’re on it it is very likely that the child would have severe birth defects, if it lived at all. It’s so urgent to prevent pregnancy while on this drug that many doctors counsel women to consider tubal ligation before they start on it. Not what you want to deal with when you’ve been trying to live by Church teaching for all of two weeks.
Anyhoo…it turns out that the clot was caused by a clotting disorder called Factor II (similar to the more common Factor V) which I miraculously inherited from both parents. The odds of that are about one in a zillion. It makes me wonder if my parents are telling me the real story behind how they met (“the truth is, Jen, we were at a family reunion…”). Especially that I have both copies of this gene, any kind of high estrogen state is risky and requires preventative blood thinners, hence the shots in the stomach every day during pregnancy.
What I had forgotten all about, however, is that breastfeeding also puts me in the risk category, and the shots I take now, while safe for pregnancy, are not safe for breastfeeding. Coumadin (also called Warfarin) is what I should take for while I’m breastfeeding…but Coumadin is incompatible with becoming pregnant.
So, I’m back to that dilemma where my options are:
- Breastfeed, take Coumadin, disregard Church teaching and use contraception;
- Breastfeed, take Coumadin, practice NFP very carefully;
- Don’t breastfeed, in which case I wouldn’t need Coumadin;
- Breastfeed, take Coumadin, and practice abstinence until weaning (which would probably mean weaning fairly early);
- Breastfeed, don’t take Coumadin, and accept the risk of a another DVT or pulmonary embolism (which are really dangerous, often fatal, and generally something you want to avoid);
- Pray that there’s some alternative I haven’t thought of!
After a lot of prayer and consideration, the first two are out.
I really would never consider the first option. Not only has Catholic teaching on birth control gone from something I accepted on a purely intellectual level to become a personal, heartfelt belief, but there’s also the very compelling point that was originally pointed out to me by commentors here on this site: no form of contraception is 100% effective. You can’t count on anything but abstinence to completely avoid pregnancy — and at least with NFP it’s likely that you’d be aware of a pregnancy sooner and therefore could discontinue the medication immediately and mitigate the damage. So it’s not like using contraception is the perfect, worry-free answer while taking an FDA Category X drug.
And after a lot of prayer and thinking I decided that option #2 is just not worth the risk. Even if I practiced NFP conservatively and the risk were small, the prospect of conceiving a child who would be severely harmed by a drug I was taking that I knew full well caused birth defects is just not something I can have on the table. It’s not worth taking even a slight chance.
That leaves me with options 3-6, and a lot to think about. Frankly, I’m really holding out hope for #6.
So why am I writing a post about all this?
First of all, my commentors are always so full of good advice that I thought it would be interesting to hear what others have to say.
But the main reason I write this post is just to get it out there in case my story is helpful to anyone else. I’ve intentionally written it in a Google-friendly way and welcome emails from anyone else who faces a similar dilemma, even if you’re reading this months or years after I originally wrote it. Back when I first faced this issue one of the most difficult parts of it was the lack of support and resources that were compatible with Catholic teaching.
So anyway, I have a lot to think about in these coming weeks. Although, with my new philosophy on worrying, I’m probably not going to think about it all that much. I’m going to pray for guidance and just see how I feel about it after the baby arrives, and trust that God will clearly lead me down the right path. Everything that happened last time only brought me closer to God and deepened my faith, so I believe that the only thing I really have to do is prayerfully seek God’s will, and trust.
Coming out – Part II
Though the final decision about my faith may not have fully been made in my head (though it’s close), it’s been made in my heart for quite some time now. As I’ve said before, when I try to picture myself going any route other than becoming Catholic I get stuck. I literally can’t imagine it. In some ways it feels like it’s not even my choice: my doubts are still there, but that indescribable, intense pull is stronger than ever. I feel like I have no choice but to resolve my doubts since I’m obviously going to end up being an orthodox, practicing Catholic.
So that leaves me with the next step — one that, thanks to these medical issues, I must make sooner than I’d planned: “coming out” as a Christian and a Catholic. And I hadn’t anticipated how difficult it would be. I’ve never made a firm verbal statement of faith. I’ve talked about it on this site but nobody I know personally reads it. To my husband and the few Catholics I know I’ve come really close to defining myself as a Christian Catholic but always manage to blurt out a bunch of qualifiers like, “I guess I’m sort of a ‘Christian’ because my husband and I are, you know, pretty much Catholic, mostly.” And to my family and most of my friends I still skirt the issue and don’t dispel the impression that we’re just going to church every Sunday because we think the priest is an interesting guy.
I can hear most of you thinking, “Why on earth is it a big deal to tell people about your religious beliefs?” It probably isn’t if you haven’t spent most of your life wrapped up in the Church of Atheism.
One thing that you’ve probably noticed about atheists (the people who vociferously describe themselves as such, not necessarily all people who lack religion) is that their beliefs are founded on pride. The reason they love to “debate” religion is because they think it’s an opportunity to show everyone how smart they are. The quality they prize above all else is intelligence, particularly their own, and they spend a lot of time making sure everyone else is aware of their reasonableness and intelligence. And they fancy that announcing their lack of belief to the world is great shorthand for, “Check out how scientific and smart I am: I don’t believe in anything I can’t see or measure or prove on paper because there is nothing in the universe that’s not understandable to clever people like me.” A glance through the comments on the Raving Atheist or other theological debate sites will show you what I mean. It would not be incongruous to tack on “Check out how scientific and smart I am:” to the beginning of almost every anti-religion comment made on the site.
And, I’m embarrassed to say, I was always one of these people. I didn’t even fully realize it until I tried to tell the hematologist of my religious beliefs last week, but I’ve spent my whole adult life building my ego around the very fact that I didn’t believe in God. It’s what made me smart (so I thought), and being smart made me valuable — and, if I did say so myself, quite superior to the average Bible-beating yahoo. So when I went to tell the doctor that I needed him to take a moment to discuss alternatives to Coumadin because I’m Catholic and don’t believe in contraception, the words got stuck in my throat. Those old demons jumped back up to yell, “You’ll sound like some unreasonable, superstitious fool!”
Ah, pride. I now understand why they say it’s the most dangerous sin. It’s what kept me away from God for so long, and what keeps me from proclaiming my beliefs now. As I said in Part I of this post, my medical situation would be a lot less complicated if I would just be open about the fact that I’m Catholic and my beliefs are non-negotiable. I think one of the reasons I’m excited about finding a Catholic doctor is so that I can slink away from my current medical team without having to stand up to them for what I believe. I guess I’d rather them see me as a flaky patient than a religious nutcase.
Obviously, this must stop.
So I’m in really new territory here. Becoming Catholic in my heart was an experience unlike anything I’ve ever known. But, oddly, becoming Catholic to the world is an even bigger change, because it has an even bigger impact on my ego. It involves a 180-degree change in the way I’ve always presented myself to the world, and one the requires a whole lot more humility.
This is why St. Augustine’s advice, “Seek not to understand that you may believe, but believe that you may understand,” is the only path to God for lifelong atheists like myself. As I heard Fr. John Corapi explain the other day, faith must come first because it forces you to set your pride aside and admit to yourself that you don’t (and can’t) know it all, that your little brain cannot comprehend everything about life and the universe. And when you’re willing to shut up and admit that you don’t know much at all and that you need help finding the answers, a whole new world unfolds before your eyes.
Life as a Catholic for me is, truly, a whole new world. It’s more gratifying and fulfilling and calming than I could ever describe, and I look forward to telling the world about it.
[RCIA starts August 28th]
