Even the best-laid plans can go astray, so expect the unexpected.
Just after lunch on the day of her 39-week prenatal checkup, Christine Fredette sat in her New York office, feeling what she thought were Braxton Hicks contractions (painless contractions that usually start around the fourth month of pregnancy). Later, at her scheduled appointment, Fredette's obstetrician informed her that she was in labor and was 4 centimeters dilated.
Fredette called her husband at work, they met at home to get ready, and by 4 p.m., Fredette was in the hospital, fully dilated and ready to push. "There was no time for drugs, fetal monitoring or IVs," she says. At 4:45 p.m., after three or four pushes, Fredette delivered Sean, an 8-pound, 1-ounce baby boy. The entire labor and delivery lasted a little more than four hours.
The suddenness and ease of Sean's birth caught Fredette off guard. "It was overwhelming," she says. "One minute I was at work trying to wrap things up for my maternity leave, and the next thing I knew, I was holding a newborn. It was a much different experience from what I expected, but I was delighted."
Fellow New Yorker Sue O'Brien wasn't as fortunate. A week and a half past her due date, O'Brien still was waiting for something to happen. On her 10th day post-term, she went into labor, and for 24 hours she felt contractions strong enough to keep her from sleeping but not close enough together to go to the hospital. Later, when she did go to the hospital, O'Brien received Pitocin, a drug that speeds up labor, endured two unsuccessful epidural attempts and weathered 12 more pain-wrought hours of back labor. Still the baby had not "dropped" into the birth canal and O'Brien's cervix hadn't budged — it was only 2 centimeters dilated.
O'Brien's failure to progress ultimately wore her down. "Before labor I thought, 'No way am I going to have a Cesarean. Most women deliver vaginally, and I'm going to be one of them,'" she says. "I've always believed that if you work hard at something, you can get it done." Exhausted and dispirited — and still having to get through labor — O'Brien agreed to have the C-section. The result? A beautiful, healthy baby girl named Kate. Two women, two different stories, one singular truth: Neither of their birth experiences went as expected.
Control vs. surrender
"It's a common theme, especially for first-time mothers," says Libby Colman, Ph.D., a psychologist and co-author with Elisabeth Bing of Laughter and Tears: The Emotional Life of New Mothers (Henry Holt & Co., 1997). "Women often feel they can direct the course of their labors and deliveries, whether by taking childbirth classes and drawing up birth plans, or by turning themselves over to the care of modern medicine. Each labor and delivery is unique, and like the children they produce, each has its own dynamic path."
While it's possible to use certain methods — either natural or medical — to speed labor's course and lessen the pain and discomfort it causes, ultimately it comes down to what nature hands you. Simply put, giving birth is not painless. Nor, for that matter, is it without risks. It's an intense experience that you can prepare for, to a point.
"There is this paradoxical dance that you have to do, between taking responsibility for your own experience and recognizing that you don't have control over it," Colman says. "You have to have a mindful awareness of it all, while surrendering to forces greater than yourself."
With so many books on pregnancy and childbirth available, some highly informed women may feel overly confident, even smug, about their ability to predict and control their childbirth experience. It's only natural to want to lessen discomfort and control all factors by micromanaging the process. "You think that if you buy enough self-help books, read and understand them," says Leslie Hartley Gise, M.D., a clinical professor in the department of psychiatry at the University of Hawaii, "everything will be fine."
But as well as you do, there's always someone else who does better. "Our society encourages competition in every aspect of life," says Gayle Peterson, Ph.D., M.S.W., a prenatal counselor and the author of An Easier Childbirth: A Mother's Guide for Birthing Normally (Shadow & Light Publications, 1993). "Women tend to hold themselves and each other up to a litmus test of the perfect childbirth, making their own birth experiences valid or invalid. We measure our worth according to whether we deliver naturally or with medical interventions, whether we have vaginal births or Cesareans, whether we bond immediately with the baby or half a day later, and whether we breastfeed or bottlefeed."
Gise, who spent 16 years as a psychiatrist with the obstetrics/gynecology department at Mount Sinai Hospital in New York, agrees. "We are a people preoccupied — obsessed, even — with perfect health, with counteracting aging, with having the exact right eating habits and lifestyles to ward off disease," she says. "So women think, 'If I do everything in the pregnancy and delivery right, I'll have a perfect child who'll grow into a perfect person.'"
Risks of romanticizing childbirth
The problem with romanticizing childbirth this way — and thinking that it will be a perfect experience — is that it can set women up for disappointment, or worse. "Childbirth has the potential for being a magical experience, but it doesn't always happen that way," Gise says. "In both the normal after-delivery blues and more severe cases of postpartum depression, one of the factors can be the expectation of an idyllic childbirth."
Sue O'Brien can attest to this. Her woes didn't end when she had a Cesarean delivery. The anesthesia it required caused weeks of severe headaches, which in turn interfered with her capacity to reach out to her newborn: She didn't feel bonded with Kate until her daughter was several weeks old. Reflecting back on that time, O'Brien believes that, even though it was irrational, she was actually angry with her baby daughter in the first weeks of her life for putting her through such an ordeal.
Other feelings women can experience during childbirth include those of being invaded, or even violated, and of losing control. This is very normal, according to Gise, and she recommends that new mothers openly acknowledge any negative feelings to someone they trust. However, if you're still having difficulty accepting the baby six to eight weeks postpartum or are having obsessive fears about hurting him, it's time to talk a professional.
While some negative reactions after childbirth are normal, they can be minimized with foresight. "Preparing for childbirth is not a question of more, but better," Peterson says. "Your preparations should be oriented toward normal delivery, but you should also plan for help in case you need it."
The most crucial aspects of readying yourself for childbirth, experts say, is learning how you'd like the event to happen; knowing your levels for pain tolerance, strength and endurance; and having a trusting relationship with someone who can be an advocate for you in the delivery room, such as your partner, a friend, a doula or a midwife. Also important is finding a compatible caregiver, obstetrician/ gynecologist or midwife who is willing to work with you to form a birth plan you are comfortable with. Such a plan can be as simple as saying to the doctor, "Please give me drugs when I ask for them," or it can spell out, step by step, how you would like the birth to go, if possible. "You want to be able to forge a relationship of teamwork," Peterson says. "If the caregiver is not interested, find another one."
Regardless of the means, a good birthing experience brings with it a sense of satisfaction, pride, joy and power that will give you confidence in your abilities and your body. It will help you to discover inner resources and coping mechanisms that will be valuable throughout your life. And it will enable you to appreciate the wonder and beauty of bringing a child into the world.
Such a birth is entirely possible — once you accept that you have to expect the unexpected.