Women's Bodies, Women's Wisdom
by Christiane Northrup
From Chapter 12: Pregnancy and Birthing
My Personal Story
As a mother and a women's doctor, I have experienced childbirth from both sides of the bed. Every mother has moments that she cherishes from the birth experience and insights and feelings she'd like to share with other women. I'd like to tell you my story and also some remarkable stories of other women.
The due date for my first child was December 7, 1980. I continued my work supervising the residency clinic at a Boston hospital, and I flew or drove to Maine every other week to keep my practice going there. I had watched far too many pregnant women stop work early and then mope around the house eating, waiting for the baby to come, sometimes begging their obstetrician to induce labor. I didn't want to fall into that category. I had also seen dozens of women go overdue. I certainly wasn't going to get excited about labor--at least, not until my due date.
On Thanksgiving we went to dinner at a friend's house. Later that evening, back home in bed, I started to experience very mild but regular contractions that didn't hurt. Like the good controlled doctor that I was, I went into the bathroom and decided to examine my cervix to see if I was dilating. When I did this, my water broke. I thought, "Damn, now I know this really is it." Shortly thereafter, without the natural "padding" that the amniotic fluid provides, my contractions began coming every two minutes and were much more uncomfortable than initially.
I called my mother, who was planning to help me after the birth and said, "I'm not going to like this." She said that she understood (after six children, she knew) but that it wouldn't last forever. In the 1940s, Mom had always had to labor alone, strapped down in bed with no pain relief or personal support. For each delivery, she had been knocked unconscious by drugs and was handed the baby later by the obstetrician, as though it were a gift from him and not the fruit of her own labor. Thousands of women like her were never given a choice and didn't even know there were other ways to deliver.
The pain of labor was far greater than I thought it would be. (It's always worse after the membranes are ruptured, a point that doesn't seem to stop some obstetricians from doing it prematurely even when there's no need to.) I had seen hundreds of women in labor after five years of OB training. I had always focused on the women who didn't appear to have any discomfort, and I was so sure I would be one of them. But here I was--stuck. I felt as though I were in a box, and there was no way out except through. My intellect could not get me out of this--and I was determined to go through the process naturally. I already trusted the natural world more than the artificial man-made one. What I didn't appreciate then was the depth of my own programming into and cooperation with that same man-made world.
We called my obstetrician, a sensitive man with whom I had worked in the hospital for several years. He suggested that my husband and I go into the hospital. The only problem was that all I wanted to do was stay on the floor on my hands and knees. Moving anywhere seemed to me the most unnatural thing I could think of. It went against every instinct in my body.
I didn't have a bag packed for the hospital, so my husband ran around and put some underwear, a nightgown, and a toothbrush in a bag. Then he tried to get me dressed, out the door, and into the car. He nearly had to carry me. Left to my own instincts, I would never have left my position on my hands and knees on the floor.
When we got to the hospital, a place where I had worked for half a decade, I had to go through the admitting office as a patient. Admissions had lost the correct papers and would not let me go upstairs to the labor and delivery floor, where my nurse friends and my doctor were waiting. This was my introduction to the bureaucracy of hospitals, something I'd been shielded from for years. (Laboring in a hospital hallway alone is inhumane; but for thousands of women, it is their experience.) I simply walked out of that room, went to the back hall elevator, got in, and went up to labor and delivery by myself.
When my doctor examined me, I was four centimeters dilated. (You have to get to ten to be ready to push.) For the next three hours my contractions came frequently. But I failed to dilate beyond six centimeters, where I remained "stuck" for those three hours. The contraction pattern on the monitor was "dysfunctional." Though the contractions hurt a lot, and I never got much of a break between them, they simply were not getting the job done. I had what is known as hypertonic uterine inertia, which means that the contractions, though present, are not efficient--they are erratic, originating all over the uterus at the same time, like the heart when it goes into atrial fibrillation. (The high heart--in the chest--does the same sort of thing as the low heart--the uterus in the pelvis--sometimes.) Instead of beginning at the top and moving in a wave to the bottom of the uterus, the contractions originated in many places at the same time. Labor didn't progress well. It was like trying to get toothpaste out of a tube by squeezing it in fifteen places at the same time with a little bit of pressure, instead of squeezing firmly only at the back end of the tube so that the paste comes out uniformly.
When my doctor told me that I had made no progress in three hours, I knew what was next. (Remember, my intellect thought it was in control of my labor.) "Okay," I said, "start the IV, plug in the fetal electrode, and hang the Pit." Pitocin (oxytocin) is a drug that artificially contracts the uterus. After the Pitocin was started, the contractions became almost unbearable, going to full intensity almost as soon as they started.
No amount of Lamaze breathing distracted me from the intensity of the feeling that the lower part of my body was in the grip of a vise. At one point, I looked at the clock and saw that it was 11:15 A.M. What I recall thinking was, "If this goes on for another fifteen minutes, I'm going to need an epidural anesthetic." I didn't know that I was in transition--the part of labor that is most intense, just before the cervix becomes fully dilated. Within the next twelve minutes I suddenly felt the urge to push. It was the most powerful bodily sensation I've ever felt, and I was powerless to resist it. The thought flashed through my mind, "If I ever tell another woman not to push when every fiber in her body tells her to push, may God strike me with lightning!"
In two pushes, Ann almost flew out of my body. My obstetrician quite literally caught her. Though I was laboring in the "birthing room," I wasn't laboring in the "correct" delivery bed, and I barely made it to the delivery bed in time. (Birthing rooms now are equipped with beds that adjust for delivery of the baby, so that moving from one bed to another isn't necessary.)
Ann cried and cried, and though I put her to my breast almost immediately, it still took quite a while to calm her down. I believe this was because the Pitocin made for a far too rapid second stage of labor. It was too intense both for Ann and for me. Neither she nor I had much chance to recover between contractions.
A primiparous patient--one having her first baby--usually takes an hour or more to push the baby out. From the time the cervix is fully dilated to delivery--the second stage of labor--I went from six centimeters to delivery in less than one hour; my uterus was being pushed by a powerful drug, a very intense and distinctly unnatural experience.
To this day, my daughter is not particularly "at home" in her body and is afraid to take physical risks, for instance in skiing or hiking. Though there are various reasons for this, I know deep within me that being propelled into the world with so little time to accommodate herself to the process of labor was a terrifying experience for her.
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