About Me

MoxieTopics

  • MoxieTopics
    Short PDF ebooks on specific parenting topics, in-depth and focused

Coaching and Workshops

Click through to Amazon.com

Moxie's reading

The 10-year-old's reading

MoxieTopics

  • MoxieTopics
    Short PDF ebooks on specific parenting topics, in-depth and focused

« Q&A: all kinds of toddler sleep stuff | Main | Reader Tip: stopping the nighttime fears of 3-year-old »

Comments

Cecily

Wow, that was so well said.

I, of course, do not have a birth experience, but every single thing you said proved to me again that I have picked the right provider. The support and comfort I got during the nightmare when I lost my sons made the situation so much more bearable (with the exception of my discharging doctor--he was an ass).

I feel completely comfortable, considering my history and high risk status, doing whatever they suggest. But I'm used to advocating for myself, so if I think something is off, I'll say so. But I find myself having no expectations about a birth--cause God knows what will happen.

k

i did the whole unmedicated home birth thing [as it is the norm here] and the midwife who was there turned out to be a replacement who i had never seen before in my life [oh and she was no older than 25 :) ]... so i had some initial misgivings but it turned out great...
so in my limited experience even if you get unlucky and your favorite midwife [or other birth provider] is not available, the style and standard of their practice will mostly prevail...
oh and i agree, i was so proud of my birth experience that in the difficult next couple of weeks i could really lean on that feeling when things got rough...

Brooke

I'm almost too close to the experience to say much about it, and I wasn't giving birth, but that seems to be a good description of a Good Birth.

Em hadn't wanted a routine IV, but she got an IV because she needed one. When she ceased to need it (~2 hours later) they took it out. That showed to me so clearly how much her wishes were respected.

And I think you are spot on to separate a Good Birth from a live, healthy baby. I have a post rattling around in me somewhere about how much I hated the "as long as the baby is okay" attitude we got from people. As though they somehow loved the baby more than we did, and we (specifically Em) were being totally reckless and selfish to question interventions.

And I have nothing but good things to say about getting a doula.

Em

I'm so glad you are discussing this. I have experienced depression for most of my adult life and was v. concerned about PPD prior to having my first child. I suffered PPD with all three of my babies and it has become more severe with each baby.

With my first I was in denial and was never medicated. I gradually pulled myself out of the depression over several months. With my second I was in denial until she was 6 months old. I finally sought help when I reached absolute rock bottom (#2 was a very difficult baby, which didn't help matters).

With my third (now 4 months old) I got help from day one. I am now enjoying my baby's early weeks and months in a way I never believed possible. I used to wonder how other mothers I saw could be so capable and happy with their newborns. Now I know.

I had three wonderful births - I wouldn't change a thing about any of them - and I agree having a "good birth" is a very positive and powerful experience. I will remember and treasure my "three birth days" until the day I die.

I think your preventative plan is excellent and I'm glad it worked for you. I think it also provides an excellent framework for people who do end up with PPD regardless.

I do want to emphasise to your readers that there is no reason to be ashamed of having PPD or in failing to prevent it occuring. Sometimes no matter what you do, how very carefully you plan things do go awry. Getting professional help can make a huge difference to you and your family. There is no need so suffer alone.

expat

WOW! You said it perfectly!

This is me - "you know what's going on, the people around you are kind and funny, if things start to get a little strange you're told what's happening, and the decisions about which of the available courses of action to take are up to you (with input from your provider and support people)" - what should have been the birth from hell was actually tough but doable ONLY because I had the right people around me.

It makes ALL the difference, really it does. It's all about your care provider, because at the end of the day it comes down to how you feel about it afterwards, and how good their professional judgement is.

meg

Let me preface this by saying that I know I am probably in the minority here. I don't disagree with anything Moxie has said on the subject. It all sounds like pretty good advice. My expectations and experiences were just...different. I throw this out there because there might be other women out there who feel the same way, that the actual birth experience was not so much a defining moment as simply a means to an end.

I have had two children, the first an unplanned c-section due to complications and the second a planned c-section. Neither went how I expected, except at the end I had a baby. (And, actually, that didn't go how I expected it too either. No amount of studying can prepare you for the actual baby!) And, both times the person who actually showed up to do the birth was not who I expected but someone else from the group that I didn't really know, and that was fine too. I didn't feel so much in control of the situation...the scariest thing about labor was that I, in fact, would not be in control of it. By definition, my body would be doing it on it's own and no amount of mind control was going to get me out of it. And, I like the control. So I was scared about that. So, I figured that these trained people would be in control of this part, and I could jump back in contol after.

Was it a bad birth experience? I don't think so. Could I have avoided the c-section had I fought more? Maybe. I didn't really care. If I could have gone to sleep and woken up the next day with a baby like they did in the fifties that would have been fine. I didn't really feel the need to prove something to myself by having the birth go a certain way.

In the end, I had the c-section and it was fine. It didn't effect me for weeks or months after. It was just the way it was. I know that some women agonize over this...what they could have done differently, what the doctors could have done differently. They feel a strong desire to have a "better" experience the next time and deliver vaginally. I guess I just don't see it. My sense of self as a mother simply was not intimately connected to how the birth part went.

kelly jeanie

I guess I don't have anything to compare it to, but I don't think that the birth affected how I felt about mothering in the beginning. I had an unplanned C-section, which was not my ideal. I feel more like meg, in that it was a means to an end, and given the circumstances, it had to happen. I did, however, analyze in the months afterward what I could have done differently, and I do still hold onto hope that I can deliver vaginally at some point. Back to the topic, though, I was disappointed but I don't feel that it affected my mothering. The first weeks were new, scary, overwhelming, but wonderful and blessed. We managed to breastfeed successfully for the first few months, and he was an easy sleeper. I can't see how things could have gone better if I had delivered differently. If he had been a difficult baby, however? Colic, breastfeeding difficulties, no sleeping? I guess then a birth experience might have changed things, but the way it went I'd have to say that the birth didn't color my first weeks as a mom, and now my confidence as a mom comes from following my instincts and the fact that I know my baby. I am by no means a confident person in other aspects of my life, but as the months pass I am becoming more comfortable being a mother, and if we have another, via C-section or vaginally or by adoption, I know that I am The Mother.

meg

I did have PPD, though, and while the birth itself and how it went was not my particular Achilles heel, the whole breastfeeding and support part was. Which, Moxie is getting to in future posts. I do look back at that whole part and think, "Boy, that could have gone much better." In fact, I associated the PPD so strongly with my attempts at breastfeeding that I didn't even try to breastfeed with my second child, I was so afraid of a repeat experience. Now I think that is just so sad.

Sorry, I'm jumping ahead on you! Will keep my breastfeeding stories for later!

Melanie

Ok, here goes: I had The Birth From Hell. It was horrible in almost every way, except that I had a beautiful baby girl afterward and did get excellent support (eventually) from the nurse/midwives for breast feeding. Otherwise, I can quite honestly say I had absolutely no control over anything that happened to me.

Because of complications with IUGR, I was induced at 37 weeks with pitocin. And no epidural, since we live in Japan. Again, because of complications, I was constantly monitored and so was forced to be flat on my back, which eventually went into spasms. They tried two 9 hour days of pitocin, before saying "Come back next week and we'll try again." Then, the following week, two 12 hour days of pitocin and a cervical balloon, to reach 4 cms. Again, constantly monitored and severe back pain. By the end of the second day, I begged for a c-section. BEGGED. Sobbing. In Japan, that means a verticle cut and no possibility, ever, for a VBAC. I have since had pain every single day for the last 9.5 months and no one can tell me why.

For the first few days after the c-section, my daughter was in the NICU, and I was forced to allow supplementing since my milk was delayed and she was so tiny (IUGR baby, 1880 grams at 38 weeks). Eventually, with the help of the nurses, I established an excellent breast feeding relationship and things started going better. In all, we stayed in the hospital for 10 marathon days.

Add to all of this a language barrier and the fact that I hated my doctor, but didn't have a choice of another doctor (in Japan, if you have a complication you are referred to a specialist and no one else will take you unless that specialist will refer you on, which he didn't and wouldn't). Most of the time I had no idea what was going on. It was terrifying and one of the most stressful events of my life.

But. Even so. I know I did have residual emotional effects of this birth, but quite honestly (and I mean no disrespect, Moxie, cuz I love your blog) not in the way you predicted. Rather than think I wasn't "the best person to care for [my] child", I felt the other extreme. I felt like I was the only person who knew how to take care of her properly. I struggled with the constant urge to snatch her back from everyone when they tried to hold her -my mom, who came to help, my husband, my friends, even the doctors- with thoughts of Goddammit, you aren't DOING it right! GIVE her to me! Don't TOUCH her! I became a tiger and so territorial that I alienated almost everyone. It was so completely intense.

Did I suffer from PPD? I don't think so, so probably not. I had a fierce case of the baby blues, though. And since IUGR babies are often very high needs (and Zoë certainly was), it was a pretty difficult first few months. I think the thing that saved me was having great support for breast feeding, actually. Like others, I look forward to hearing what you have to say about that.

One last thing - it might seem so, but I'm not bitter about my birth experience. It was horrible, but it gave me Zoë and that fabulous, miraculous fact overshadows everything else.

Moxie

Meg and Kelly Jeanie, I think you missed my point that having a c-section doesn't mean you didn't have a good birth, and that having things not go as you expected doesn't mean you didn't have a good birth. It sounds to me like both of you had providers you trusted who didn't leave you with lasting negative feelings about yourself from the birth. I've known two people who were told they needed c-sections because they were "too fat" (and shouldn't have gained that 30 pounds during pregnancy), and one woman who wasn't even told they were going to section her until she asked why they were wheeling her out of her room. You two are both examples of people who ended up with births that weren't at all what they expected, but who didn't end up feeling bad about themselves as a result of it.

Melanie, I think you're a better woman than I am, because I know I would still be bitter about it. I'm glad it made you so fiercely protective of your daughter instead of undermining your confidence in her.

erika

The practice we decided to use had 5 doctors who rotated on-call hours. So during the course of my pregnancy, we met with all the doctors so that we would know all of them. There were a couple we didn't like but the other 3 were great. I ended up being 10 days overdue and was scheduled to be induced on a Monday by the doctor I especially didn't like. The doctor with whom we felt a stronger connection was on call that weekend so I think I went into labor that weekend because I really wanted to birth with our favorite doctor. I decided not to have a doula and, luckily, my husband was amazing. We also had a great labor nurse who coached him wonderfully so when her shift ended, he stepped up and I can't imagine getting through the birth (no painkillers) without him. I also labored in a jacuzzi tub and, while I had no prior experience with birthing, it all happened pretty much according to how I wanted. However, I can only imagine what it would have been like with the doctor we both despised. Whether that control over the birth helped me to bond better with Sophie, I don't know, but I wasn't depressed and was very confident with my abilities to care for her.

kelly jeanie

Hi Moxie, I can appreciate that a C-section doesn't necessarily mean a "bad" birth. In my case, though, my doctor whom I trusted was out of town, and the doc who "called" my section (in his opinion because of cephalopelvic disproportion, which turned out to be crap) I had never met before. My water broke with meconium staining, so when I got to the hospital I was strapped with a monitor and told I couldn't get out of bed. Further, they decided to flush the meconium, and then the baby had some distress, so I spent 10 hours on my side in bed with contractions. I felt like a passenger. The nurses were in and out. A doula would have been wonderful, as I was terrified my baby was going to have complications. I felt like a failure as a woman that I couldn't give birth the way generations of women had, but not a failure as a mom. My point was, that I feel like my helplessness in the birth process is disconnected from my mothering. I gained confidence in mothering from being a mother, if that makes any sense. I have read birth stories like Jo's and am in awe, and am totally jealous, but I am not sure how a good experience could have made the first weeks any better, though I guess I'll never know. I think you're right, though, I don't really have any lasting negative feelings about myself, other than wishing I had that good experience, that it might improve my confidence as a woman. You're also right in that my birth probably wasn't bad, and boy, I've probably babbled on enough about something that's unrelated to the PPD topic, hey? :) Thanks for listening.

Moxie

Ah, gotcha, Kelly Jeanie. I thought you just had a regular situation with your regular doctor calling the section adn the same kind of support you would have had through a standard vaginal birth.

I wonder what it is that helped you disconnect the birth experience from your self-image as a mother.

Jo

Moxie, yes yes yes.

I want to be you when I grow up.

AmyinMotown

Moxie, I love this post. The phrase "good birth" is one of those that sets my teeth on edge because I hear it as "vaginal no-drugs birth" and the same ppeople who make that equation also make "good birth=good mother" and anyone who didn't do that is just too suspect. This post so skillfully explains what you should have going on, no matter what shape "good birth" takes for you.

It's also making me reevaluate my birth experience, though. I would call Maggie's birth more scary than anything else, and I remember feeling very angry and helpless when her heart kept slowing almost to a stop and no one would tell me anything or even say the word "c-section" out loud. The doctor on call was the one I like less in the practice, and she just kind of didn't show up when she was called in. I was too wussy to ask her for an explanation when she did show and my husband is just useless in these types of situations. The whole thing did take me quite a while to process, but I think if anything it made me feel more bonded to my daughter, knowing I was so willing to do everything up to and including getting myself sliced open to get her out fast as she was not doing too well.My first few weeks were rough, but I thik it had more to do with things you're going to be writing about down the line.

Brooklyn Girl

What Amy said. Definitely. I wound up having an emergency c-section but because I'd talked to my OB about c-sections from the get go, I knew what to expect and still consider it a good birth.

As Meg said earlier though, really I would have considered any birth that resulted in a baby a good one. Possibly I say that because I was treated with respect by the doctors and nurses and don't have any complaints in that regard.

The only people who didn't treat me with respect--and I've been loathe to post about it on my own blog because I'm still deciding how to feel about it--were the lactation consultants. Go figure.

J

Yes! I agree wholeheartedly. My daughter's birth was very different from what I had planned for, hoped for, and prepared for, but I came out of it feeling really okay with what happened, and it had everything to do with the fact that I was respected and listened to and had choices and had the information necessary to make the choices I needed to make. I did really extensive preparation for natural childbirth but then at almost 38 weeks, my baby turned footling breech. Over the next few days we did everything we could to try to get her to turn, but were unsuccessful, and then my water broke and ultimately I ended up with a c-section. But having a provider who I trusted (LOVED!), who gave me really an amazing amount of her time and support during those stressful few days before the baby was born, and being surrounded as I was by supportive people who listened to me made all the difference, I think, in my attitude after the fact.

Another woman from my Bradley class and I have remained in contact, and she also ended up with a c-section, but she feels very differently about hers. Looking back on our class discussions, she often made statements about what her OB would "allow" her to do that would have been red flags to me, had I been his patient, and that were definitely at odds with some of the things that she, herself, desired for her childbirth (ie: laboring at home after her water broke, etc.). I don't know everything about her situation, and I certainly am not second-guessing her decisions, but I do think that you are right that choosing a provider to care for you during your pregnancy who listens to you and respects you is really important for getting a "good" birth, no matter what form the birth ends up taking. That said, I also do realize that having a lot of decision-making power over who your health care provider is during your pregnancy is, quite unfortunately, a "luxury" that many women do not have.

This all sort of dawned on me in talking to my SILs, who live in another country with a health system that differs greatly from ours in its treatment of labor and delivery. From a technical standpoint, they have all had the type of labor I was hoping for (completely drug free/very low medical intervention), but none of them considered their childbirths to be empowering or "good" births, because they also had very little information as to what was happening to them throughout the labor and delivery and were not allowed to have any support system (no visitors allowed once admitted, not even the father).

kelly jeanie

Not sure what helped me disconnect the experience. Maybe because the C-section did turn out to be necessary (acynclitic position) it helped me have peace with the whole process. I guess I didn't think of it as bad, just necessary. After reading the other experiences, I see how closely the birth experience is tied to the first few weeks, and a good birth can give you those reserves you talked about, and a bad birth could (but not always) start you out in the hole. I guess I just started out at zero. :)

Jody

Ah, I'm such an outlyer here. For one thing, when did my birth experience start? At 27 weeks, when I was admitted to the hospital with PTL, and as I sobbed in the wheelchair down in perinatal, a nurse came up and rather snidely said, "you know, the doctors have to think of the babies now, dear," as if I were crying because I didn't want to be admitted to the terrible hospital and not because I might be hours away from delivering 27-week triplets? All through the following weeks, when I believed that the only way to get good care was to put on my smile and go along to get along with the constantly changing nursing staff and their different standards of care (on everything from whether to heplock IVs to how often to monitor the babies)?

And when did it end? When I was discharged, "four days" after delivery, even though that should have been 11pm on a particular day since I delivered at 11pm, but the discharge was processed at 9am, only I had to wait until 5pm for my rental pump and for everyone to line up my "necessary" prescriptions that turned out to be for crap like prenatals and BCP, and then there wasn't a single staff person to push the cart downstairs while my mom went to get the car? So I was pushing it myself, while hobbling from the c-section and 12 weeks of strict bedrest, and then I spent another half-hour at the discharge desk filling out the ADMISSIONS papers for my babies, because they hadn't been processed before that? Throughout the five weeks in the NICU, when we had to grab the attention of receptionists so they could page the nurses on our babies' ward to ask if it were an okay time for us to go see them? When different nurses had different rules about whether we had to ask to touch the babies first, and who precisely in our family was allowed to hold them, and when?

I had an emergency c-section after my water broke at 32 weeks, 4 days, and the birth itself was probably the most pleasant, relaxed, happy thing that happened in the months surrounding it. I knew all the doctors very well (5.5 weeks in the hospital will do that for a girl) and I knew it was time and there wasn't any way out but through. Everyone was kind and kept me informed and the babies came out looking as good as they could.

As for the rest of it: of course it did a number on my ability to mother, and my belief I was a mother in the first place.

I had a lot of dreams pre-pregnancy about how those months would go, and all of them were dragged away from my kicking and screaming psyche once the terms changed from good v. bad birth to live v. dead babies. And that's what's on the line in a triplet pregnancy: are you going to have live babies or dead ones? How damaged might they be if they live? (Of course those aren't the terms used, but it's the undercurrent to everything.) The mother's needs are more or less explicitly beside the point, which is only one of the many ways in which the whole schema SUCKS. Or doesn't suck, depending on how you look at it, because when everything depends on maternal compliance, how much room is there for debate?

Could it be done differently -- both the treatment of high-risk/high-responsibilty pregnancy and the attitude toward parental responsibility and invovlement in the NICU? Yes, it could. Will it be? Probably not in my lifetime.

Not that my formerly depressed and insecure mothering self who spent the first year so convinced of her inadequacy that she didn't even take one photo of herself holding all three babies at once until they were more than a year old ("I can't DO that, it's not possible") is BITTER or anything. Snort.

Yatima

I think the phrase "cephalopelvic disproportion" means "I have dinner plans".

I had my first daughter in the snooty hospital across town. My OB/GYN called CPD on me, insisting I was too little to go post dates (I'm 5'4" and on the skinny side). She booked me for an induction at 41 weeks. "Standard of care is 42 weeks!" I cried, but the hospital was all booked up and the doctor was adamant.

Luckily my water broke at 40w 5d and I had 6lb 11oz of Claire on Christmas Day, delivered after a straightforward 12-hour labour by a doctor I'd never met.

I fired that OB/GYN and had my second kid in the tiny neighborhood birth center where all the other women spoke Spanish. I went post dates, no one minded or pressured me to consider induction, and my wonderful midwife delivered 9lb 4oz of Julia after a 7-hour labour. Jules had her hand up in the baby power salute all the way down, but I didn't even need stitches.

I may be little, but my pelvis is so big inside that both girls were born with round heads, like c-section babies.

Cephalopelvic disproportion my ass.

kelly_jeanie

"I think the phrase 'cephalopelvic disproportion' means 'I have dinner plans'."

Hee!

Nopenname

That line about "doing something/something done to you"

That's what I tell people was different about my first birth and my second. The first time, the doctors they DELIVERED my baby and I felt ignored and treated poorly. The second time around I got to GIVE BIRTH and was treated like what I wanted (even if I couldn't have it due to meconium or what have you) was important.

The comments to this entry are closed.

Search Ask Moxie


Sign Up For My Email Newsletter

Blah blah blah

  • My expertise is in helping people be who they want to be, with a specialty in how being a parent fits into everything else. I like people. I like parents. I think you're doing a fantastic job. The nitty-gritty of what you do with your kids is up to you, although I'm happy to post questions here to get data points of how you could try approaching different stages, because, let's face it, this shit is hard. As for me, I have two kids who sleep through the night and can tie their own shoes. I've been a married SAHM, a married freelance WAHM, a divorcing WOHM, a divorced WOHM, and now a WAHM again. I'm not buying the Mommy Wars and I'll come sit next to you no matter how you're feeding your kid. When in doubt, follow the money trail. And don't believe the hype.
Blog powered by Typepad