Becoming Mother

A book and a blog for first-time mothers

Tag: labor

Why are American Women Dying in Childbirth?

 

American women are more likely to die from complications in pregnancy and childbirth compared to women in any other developed country.

It’s true.

But why?

***

At 1:27 p.m. on February 2, 2017, I gave birth to an 8 lb. 10 oz. boy.

Because there was meconium in my amniotic fluid, a NICU team was paged to be present at the birth to make sure that the baby’s lungs were clear.

Those first minutes after birth were very blurry. There was just too much going on to fully appreciate everything that was happening. From my perspective as the birthing mother, I remember my son turning his head upward and looking me in the eyes (that really happened). I remember seeing that he was a boy. (A boy!?! Really!?! What?!?!)

I remember dropping my head back against the bed and crying in relief that it was over. I remember thinking, “Well, that’s the last time I’m doing that.”

I was euphoric and so, so grateful. We had made it. We had survived that. Both of us. That was what I was thinking.

I did not know that I was hemorrhaging. 

This is the thing about hemorrhaging: It happens so fast.

It happens while mothers are crying from happiness that their baby is alive and breathing. It happens while they’re trying to get a good look at their baby’s face. It happens silently as the room’s atmosphere turns from the intensity and suspense of the pushing phase into joy and excitement of the delivery phase.

No woman wants to believe that it’s going to happen to her. I had none of the risk factors associated with postpartum hemorrhage.

But it still happened to me.

While we were celebrating and crying and basking in the joy of the birth, my midwife was tracking my blood loss. I remember looking down and seeing her furrowed brow every time more blood poured out of me. But I didn’t think anything terrible was happening. I was flooded with joy and gratitude that labor was over.

But in the first ten minutes after birth, more and more nurses entered the room and the treatments started. My midwife told me each treatment that she was doing to stop the bleeding. By this time, I had lost about 1200 mL of blood, about 2.5 pints of blood. In other words, I had lost about 25% of the blood in my entire pregnant body.

Surviving postpartum hemorrhage requires a medical professional who quickly realizes what is happening and starts treatment immediately.

In my case, the midwife tried a shot of Pitocin. When that didn’t work, she gave me Cytotec. When that didn’t work, she gave me IV Pitocin. She kept massaging my uterus. She was on her last treatment before starting a blood transfusion: a shot of methergine.

That’s how close we were to a true emergency.

screenshot_20170207-165547

My heart rate during labor. You can see exactly when the hemorrhage begins and how my body responded.

 

Hemorrhage is one of the leading causes of death in childbirth.

Causes of Death in Childbirth

Still.

Let me be clear: postpartum hemorrhage isn’t caused by a lack of care. This would probably have happened to me if I had given birth anywhere else.

But women die from hemorrhage when doctors and nurses don’t quickly recognize the amount of blood loss and begin treatment. Some states, like California, have codified and implemented standardized procedures and training for nurses and doctors so that teams can quickly and efficiently follow protocol to prevent postpartum hemorrhages from killing mothers. Instead of “eye-balling” how much blood a mother loses during delivery, nurses were taught how to collect and measure postpartum blood loss to help them quickly identify hemorrhage.

“Hospitals that adopted the toolkit saw a 21 percent decrease in near deaths from maternal bleeding in the first year; hospitals that didn’t use the protocol had a 1.2 percent reduction.”

But not all states have such standardized protocol.

***

A joint investigation by NPR and ProPublica found that more women are dying of complications related to pregnancy and childbirth compared to any other developed country.

In every 100,000 births in the United States, 26 women die. In other developed countries, the numbers range between 5 and 9 births. And those numbers have climbed from 17 to 26 deaths from 2000-2015.

Seriously.

Seriously.

It seems unimaginable. Really? In the United States? But we have so much technology. We have some of the best hospitals in the world.

Maternal Mortality

What the hell is going on?!?

There were several major findings from this investigation.

  1. The U.S. is spending more money on research, equipment, and training for improving infant outcomes. Think of how much progress we have made in helping premature babies and treating newborns born with previously fatal deformities and diseases.
  2. Decreased education and training about caring for birthing mothers, for both doctors and nurses. This leads to a lack of knowledge that is passed on to the mother when she is discharged from the hospital.
  3. Lack of standardized best practices for caring for birthing mothers among the states. Unlike other developed countries, there is no nationwide effort for reducing the maternal death rate in the United States. Responsibility has been left to individual states to decide if and how they investigate maternal deaths.

America has not conquered maternal mortality. We like to think that because we have advanced technology and highly trained medical professionals that tragedies like a woman dying in childbirth just simply don’t happen anymore.

At least not nearly as much as it used to.

It’s a kind of hubris, really. To think that we have mastered childbirth. We have tamed it and told it who’s boss. In fact, we’re so good at childbirth that we should just focus most of our attention on the infants. They’re the ones that are the most vulnerable, right?

But the truth is…

“In recent decades, under the assumption that it had conquered maternal mortality, the American medical system has focused more on fetal and infant safety and survival than on the mother’s health and well-being.”

~Nina Martin & Renee Montagne, “The Last Person You’d Expect to Die in Childbirth”

***

If there was one major takeaway from this report that I want to share with everyone it’s this:

Women still die in childbirth. 

Giving birth in the United States does not guarantee that both mother and baby make it out alive.

I completely agree with the report’s observations that labor and birth put women in the most vulnerable position in their entire lives. They don’t know what’s going on. They’re immersed in the pain and process of labor. Birthing women depend on everyone around them, doctors and nurses alike, to notice the signs that an emergency is unfolding.

If you or someone you know will be giving birth in the United States in the near future, I strongly encourage you to read ProPublica’s full investigative report on this topic.

This is not a political issue. ProPublica is an independent organization that is not funded by political donations.

This is a human issue.

American women are not immune to maternal mortality.

For the women who die every year from pregnancy and childbirth from preventable or treatable conditions, let’s raise our awareness of this problem and insist that we study this at the national level, not just the state level.

We can do better than this.

The death of a new mother is not like any other sudden death. It blasts a hole in the universe.

~Nina Martin and Renee Montagne, “The Last Person You’d Expect to Die in Childbirth

A Birth Story in Songs

When the right music finds the right moments, what we see and feel is carved even more deeply into our memory.

Cognitive psychologists have studied this. In long-term memory, what we tend to remember with the most clarity in the long run are the most unusual and emotional moments of our lives. Because of its ability to mirror or even amplify those emotions, music can be an anchor that fastens those memories in place for the duration of our lives.

As I labored this past February during the birth of our second child, the right music found the right moments over and over again.

I don’t think it was coincidence.

To be honest, I made music playlists for each of my births and loaded them with songs that I would like to hear.

But as anyone who has experienced labor will tell you, ain’t no one DJing your birth when the shit hits the fan. In my first birth, we barely touched the playlist once I was in active labor. It just played on. And whatever order I had chosen when I was willy-nilly loading the songs was the order that they played.

I honestly only remember one song from one moment of my first labor. It was the song playing when our daughter was born, “I Will Be Here,” by Steven Curtis Chapman. It was a sentimental Christian ballad that I added to the playlist on a whim, and one that I didn’t even particularly like anymore. Sure, it was a sweet song. It reminded me of those first vows that we said at our wedding eight years earlier.

But it wasn’t really a birth song. And it certainly wasn’t the one that I would have chosen.

So it was surprising to me just how many times the right music found the right moments in this birth. For me, the music felt like another birth attendant.

The songs held my hand.

The songs urged me one.

And sometimes, the songs were the screams from my own heart.

Someday, I’ll share with you a written version of this birth story. I’m thinking about releasing it as a free Kindle Single, if I can make the time this summer to do that.

But for now, let’s go on a ride.

Let’s give birth.

With songs.

February 2, 2017

 

Early Labor: 3-4 centimeters

3:00 a.m.

Contractions every 3-4 minutes. Standing, hips swaying. Eyes closed.

I Can’t Make You Love Me If You Don’t” Bonnie Raitt

Here in the dark, in these final hours
I will lay down my heart and I’ll feel the power

5:00 a.m.

Contractions every 2-3 minutes. Lying on my side on the bed. Leg, dangling off the side to help the baby turn into position.

Landslide” Fleetwood Mac

Can the child within my heart rise above?
Can I sail through the changing ocean tides?
Can I handle the seasons of my life?

7:00 a.m.

Contractions every 2-3 minutes and requiring controlled breathing to cope. Lying on my left side, gripping the headboard of the bed. Eyes sometimes open, sometimes closed.

Society” Eddie Vedder

Society, have mercy on me
I hope you’re not angry if I disagree
Society, crazy and deep
I hope you’re not lonely without me

Active Labor: 5-7 centimeters

9:00 a.m.

Contractions every 1-2 minutes. In the birthing tub. Blue light in the water. Legs floating. Head leaning back on the edge of the tub. Holding Doug’s hands as he sits behind me next to the tub.

Hypnotic, oscillating moments of weightlessness and heaviness. Baby pushing between pelvic bones, twisting in each contraction.

A lot of groaning.

“Teardrop” Massive Attack

Love, love is a verb
Love is a doing word
Fearless on my breath
Gentle impulsion
Shakes me, makes me lighter
Fearless on my breath
Teardrop on the fire
Fearless on my breath

Transition

A.K.A Climbing the Ladder and Wrestling with God:

7-10 centimeters

10:25 – 10:55 a.m.

Forty-five second, double-peaked contractions every other minute.

This part… Oh, this part. I will write about this in detail later. It was thirty minutes of my life that I will never forget because it is the second time in my life that I encountered God.

“God Moving Over the Face of the Waters” Moby

Stalled: 10 centimeters

11:30 a.m.

Contractions every 1-2 minutes, but no urge to push. Although completely dilated, my water still hadn’t broken. Back in the tub for pain relief. I pressed my face into the edge of the tub and cried.

Doubt. Such deep, deep doubt.

“Last Man” Clint Mansell

12:00 p.m.

Contractions every 2-3 minutes. When my midwife checked me, she told me that the baby still needed to come down farther. I tried a number of different positions but nothing helped. I asked her (okay, screamed for her) to break my water.

That worked.

“Redeemer” Paul Cardall

Pushing

12:55 p.m.

This is another part that I will write about in much greater detail. For right now, just know there was a lot of screaming.

I mean… Yeah. A lot of screaming.

“Press On” Robinella

Life is filled with bitter music
Breeze that whistles like a song
Death gets swept down like an eagle
Snatches with our shoes still on

Press on

“Welcome Home” Radical Face

All my nightmares escaped my head
Bar the door, please don’t let them in
You were never supposed to leave
Now my head’s splitting at the seams
And I don’t know if I can

“Holocene” Bon Iver

And at once I knew I was not magnificent
Huddled far from the highway aisle
Jagged vacance, thick with ice
And I could see for miles, miles, miles

“The Wound” Gospel Whiskey Runners

The road is long and dusty and alone
I’ve got not place to rest, no place to call my own
My eyes have seen the glory of your love
And I won’t turn back this time
No, I won’t turn back this time

“Work Song” Hozier

When my times comes around
Lay me gently in the cold, dark earth
No grave can hold my body down
I’ll crawl home to her

Birth

1:27 p.m.

henry_glass_february_2_2

“You’re All I Need to Get By” Marvin Gaye and Tammi Terrell

Like the sweet morning dew, I took one look at you,
And it was plain to see, you were my destiny.
With my arms open wide,
I threw away my pride
I’ll sacrifice for you
Dedicate my life for you

“I’ll Have to Say I Love You in a Song” Jim Croce

Every time I tried to tell you
The words just came out wrong
So I’ll have to say I love you in a song

Postpartum Hemmorhage

1:35 p.m.

“Do You Realize” Flaming Lips

Do you realize that you have the most beautiful face
Do you realize we’re floating in space,
Do you realize that happiness makes you cry
Do you realize that everyone you know someday will die

And instead of saying all of your goodbyes, let them know
You realize that life goes fast
It’s hard to make the good things last
You realize the sun doesn’t go down
It’s just an illusion caused by the world spinning round

2:10 p.m.

I asked Doug to take a picture of Henry’s face so I could see him up close.

When I saw the picture, what I thought was,

Yes.

That’s exactly right.

wp-1486067795806.jpg

I Wore a FitBit During Pregnancy and Childbirth: Here’s What I Learned

Disclosure: I’m a bit of a data nerd.

Not in the sense that I like to design studies and collect data. Just in the sense that I like to look at charts and graphs and timelines and other visuals.

Call it “data-nerd-light.”

I began wearing a FitBit Charge HR last February, shortly after I started running as a regular form of exercise.

At first, it was useful for keeping track of my exercise. Having information about my sleep patterns and steps was just fun information to use to challenge myself.

Then, in early May 2016, I got pregnant.

Over the course of my pregnancy, I regularly wore my FitBit and amassed loads of interesting data about how my body changed and responded differently to exercise over the course of my pregnancy.

The FitBit Charge HR will monitor your heart rate and calories burned, as well as your number of steps, floors climbed, and miles traveled. Then, it spits out all of this data into usable and easy-to-read charts. (UPDATE: My Charge HR started separating around the display and I had to replace it after 16 months of use. I recently upgraded to the Charge HR 2. It’s just $20 more and much more durable. The bands are replaceable too, so the same problem can’t happen on this model.)

fitbit

I started this pregnancy at 147 pounds (at 5′ 7.5″) and my ending weight was 192 pounds, which is a 45-pound weight gain. My pre-pregnancy condition was quite good. I was running about two miles in the morning every day and lifting weights once or twice per week. I was maintaining my weight. I had good energy. I could climb several flights of stairs without getting winded.

So what does pregnancy do to a healthy body? Let’s take a look.

Resting Heart Rate

screenshot_20170213-064729

My pre-pregnancy resting heart rate was about 56 beats per minute, a sign of a fairly athletic lifestyle. You can see my heart rate climb steeply in the second trimester when I have my first major growth spurt, and then again in the last trimester during the last month of growth. Both time periods correspond to an increase in blood volume in my body.

Fun fact: at the end of pregnancy, a woman’s blood volume increases 40-50% throughout pregnancy.

Weight Gained

screenshot_20170213-064412

I put on most of my weight during the second and third trimester growth spurts, and just a few pounds gained in the first trimester. This is a healthy weight gain curve, although, I assure you, it didn’t feel healthy at the time. I remember that I kept thinking, No! Four pounds in a week! This baby is going to be twelve pounds by the end of this!

Daily Calories Burned: Pre-Pregnancy

On the left is a typical day of exercise on a pre-pregnancy day, which includes a two-mile run in the morning and regular movement at work.

On the right is a day that I’m proud of: the day that I ran six miles around the National Mall in Washington D.C. Included in this number are the other calories that I burned throughout the day, just by existing. See the number of calories burned? Keep that in mind as I show you how many calories during the late third trimester.

Daily Calories Burned: First Trimester

screenshot_20170213-065329

In my first trimester, I continued to run whenever I felt well enough. (Weeks 7-11 were Nausea City, so I limited my exercise to walks during this time.) But I took it easy. I didn’t exercise in the peak heart rate zone if I could help it. I monitored my run pretty closely so I stayed in the lower heart rate zones.

Daily Calories Burned: Second Trimester

screenshot_20170215-165950

I continued to run in the second trimester. In the early second trimester, I incorporated more indoor aerobic exercise because it was so damn hot outside in late July to August. In this screenshot, you see the end of October, when I was 24 weeks pregnant, right at the end of my second trimester growth spurt.

The important difference is my resting heart rate, which has jumped to 70 beats per minute. Because of that elevated resting heart rate at this point, I was more likely to reach a fat-burning heart rate for daily activities, beyond the time when I was intentionally exercising.

Daily Calories Burned: Early Third Trimester

screenshot_20170213-065100

I continued to incorporate running in my exercise all the way to 32 weeks of pregnancy, but over time, I slowly decreased my running in favor of walking. By 33 weeks of pregnancy, I was done running. This screenshot is from Week 30. It’s not terribly different from my second trimester stats. Notice that my resting heart rate continues to rise.

Daily Calories Burned: Mid-Third Trimester

screenshot_20170213-064949

This is when pregnancy becomes an outright test of endurance. This screenshot is from Week 36 (which, for my 41.5-week pregnancy, was mid-third trimester). On this day, I walked for 30 minutes. And I existed. End of story.

I mean, it’s the day after Christmas, for goodness sake. What could I possibly have done? I’m sure I was doing things like eating my fifth sugar cookie and picking up bits of wrapping paper and rogue pine needles. Along with a rousing game of “Ketchup or Mustard?” with our three-year-old. (What? You’ve never heard of that game? You just ask the person if they want ketchup or mustard over and over and over again. That’s it. Fun, huh?)

So that’s why pregnant women say, “God, I’m so tired” at the end of the day. Not only are they carrying around a lot of extra weight, but their resting heart rates are elevated, causing them to be burning loads of calories for hours.

But wait. It gets harder.

Daily Calories Burned: Late-Third Trimester

screenshot_20170213-064859

Okay. So here I was at five days past my due date. At this point, I was desperate to get this kid out of me. So I decided to go for two thirty-minute walks, which you can clearly see on the graph. My pace was much, much slower than normal because my hips were so gelatinous and my gait was off. But pace isn’t important. It’s getting the heart rate up there that counts.

With just two thirty-minute walks and existing for 24 hours, I burned as many calories as I did when I ran six miles and existed for 24 hours. Courtesy of an elevated resting heart rate and additional body weight.

In addition, my body’s center of gravity was off, it was difficult to move, and I had an assortment of new aches and pains to deal with just to get through the day (and night).

What were your calories burned on the day you gave birth?

screenshot_20170207-165547

So glad you asked.

Now, I know what you’re thinking. That peak heart rate must have happened during my pushing phase.

Nope.

That was when I started hemorrhaging after the birth. Obviously, this wasn’t part of the plan and it isn’t a typical part of the birthing process for most women (thank God). Only about 4% of women will experience a postpartum hemorrhage. (The most likely cause of my PPH was an “overdistended uterus” due to my baby being over 8.8 pounds.)

As a result, my heart rate soared in the peak heart rate zone for close to an hour. As blood poured out of me, my heart pumped loads of fresh blood to the affected tissues and organs. All of this put my body into metabolic overload and it was the main reason I ate like a crazy person for the first five days post-birth.

Most of my labor raised my heart rate into a low fat-burning zone rate, so it was still important that I ate and drank during labor. This is what I will never understand about typical hospital policies regarding labor. Is it really worth it to deny women the right to eat during labor simply because of the minuscule possibility that 1) she’ll have a C-section and 2) during that C-section she aspirates?

Labor burns a lot of calories. And if you’re restricted to clear fluids, you’re pretty much relying on the sugar in Sierra Mist to pull you through. I think that if you have the urge to eat, you should be allowed to eat. The risk of eating harming a woman in labor is just far too small.

I mean, really… When you are awake for days and laboring for hours and hours, you burn a lot of calories.

screenshot_20170213-073429

 

So there you have it. An inside look at one slice of what a woman goes through when she carries a child and gives birth. It is a test of strength and endurance simply to carry a child to term and give birth.

The fact that women give birth so often might make the process seem ordinary, but it is truly an extraordinary feat for both mother and child to come out on the other side, whole and alive.

UPDATE: Just wanted to thank you for stopping by this post, which has been gaining a lot of traffic lately (probably because this post shows up in Google searches that include “pregnancy” and “FitBit.” Ha!) If you’re a new reader, please check out my book, Becoming Mother, available in print ($12.99) or Kindle ($2.99) editions.

Peace.

Book-Cover-Becoming-Mother-Kindle

Finally, We’ve Had the Baby

I was supposed to have a January baby. Thought there was no way I would end up giving birth in February.

Ha.

Ha.

Just like last time, my expectations for what would happen during this birth didn’t quite pan out.

Like just about everything else in parenthood.

I’ll write about the details later. Not today.

Today, I simply say that life is unpredictable and messy. No matter how much we like to pretend that we have things under control, we very much do not. We don’t like the storms that plow through our neatly plotted lives. They uproot what we’ve planned. They can undo our hard work and make it irrelevant and meaningless.

But a lot of beautiful things can emerge from the storms of our lives.

Like rainbows.

Years ago, my husband worked in a lasers lab. One day, he told me something interesting about rainbows. The shape of a rainbow is actually a circle, not a semi-circle. If you were to be flying above a rainbow and looking down at it, you would see a circle.

It’s your perspective on land that limits your ability to see the full circle.

When you’re too close to the storm, it’s hard to see the full beauty of the rainbow. It’s hard to see that is has no end. That, like many truths in nature, it goes around and around. Forever.

But the more distance that you gain from a turbulent time, the more you realize that even hope and goodness still abound.

In fact, maybe they exist because of the storm.

For these reasons, I especially like the term “rainbow baby.” A “rainbow baby” is a baby who is born after a miscarriage, stillbirth, or infant loss.

Today, we had our own rainbow baby.

Henry Glass

February 2, 2017

1:27 PM

8 pounds 10 ounces

It’s a funny thing though.

Even though this is the deepest part of winter

Even though the storm of labor has just now passed

And I’m sitting here, holding this flawless face in my arms,

I feel like I’m seeing the whole rainbow.

Not just half of it.

“Do You Realize” by the Flaming Lips

Do you realize that you have the most beautiful face
Do you realize we’re floating in space,
Do you realize that happiness makes you cry
Do you realize that everyone you know someday will die

And instead of saying all of your goodbyes, let them know
You realize that life goes fast
It’s hard to make the good things last
You realize the sun doesn’t go down
It’s just an illusion caused by the world spinning round

41 weeks, 3 days: Ranting and Raving

Forget anxiety and fear of the imminent pain of childbirth.

I’m so beyond being nervous or afraid of what comes next.

Now, I’m just pissed. I’m downright angry.

If I want to give birth in the birthing center that I’ve chosen, I have to give birth by 41 weeks, 6 days. That gives me until Saturday. After that, I’ll have to go to the regular maternity ward and play by their rules.

Just like last time.

Which is what I was trying to avoid.

I will literally take whatever contractions come my way if it means this is the last day that I’m pregnant. 

F— this pregnancy! I’m so over it!

I will die pregnant. I know it. Labor will never start. Ever. And I’ll be that one crazy case where the pregnant woman just dies because her body splits open because the baby keeps growing. 

I simply cannot believe this has not happened yet. What is wrong with me? Why? WHY?

The most frustrating thing? I’ve had four times when contractions have started and then just stopped.

And I’m not talking Braxton-Hicks contractions. I’m talking full-on, labor contractions. Sometimes 4 to 8 minutes apart for several hours. They last long enough for me to get excited, to gather my things, to think about plans for the rest of the day that include going to the hospital.

And then? Nothing.

They just stop.

WHYYYYYY??????

And then, I get this email from Babycenter.com.

1-week-old

Just shoot me now.

Are you kidding me, Babycenter? I never told you my baby was born. So you just automatically send these emails? Are you trying to piss me off? And what if my baby were stillborn?

This is the worst. I despise living in this constant state of suspension. I don’t tend to be a control freak. My job as a teacher requires me to constantly practice the art of flexibility.

But this is too much.

You think it feels like a long time since Trump became president on January 20th? Tired of processing bullet after bullet that he’s shooting into American democracy?

Now, imagine adding the additional mental burden of realizing at the end of every day that you will, once again, have to find a way to sleep with an enormous pregnant belly, tossing and turning every 45 minutes until the sun rises.

And being pumped full with as much estrogen as a non-pregnant woman has in three years of her life.

February 2nd is Groundhog Day. And how perfectly appropriate. I feel like I’ve been living my own personal Groundhog Day since January 22nd.

So, I’m at the end of my rope. If the point of me waiting this long to have a baby was to teach me a lesson in patience, I’m beyond that lesson. I’m not learning anything anymore.

Now, I’m just pissed.

40 Weeks, 4 days: Mountain Climbing

Baby,

I think we’re close.

It feels like we’ve been climbing together for so long.

At first, it was a gradual slope, one that I could walk without much of a problem (although–who am I kidding–the nausea was tough). I brought provisions along for the both of us. Assurances that we would make it through this journey together, whole.

But that slope became a hill. My heart picked up speed, so did yours. The further we climbed, the more of my supplies I left behind. I held on to things that I thought you might need. Because I knew you were fragile, so tiny and dependent. I knew I was tough and I could go without.

But now that hill is a mountain, so steep and imperceptibly tall in front of us. When does it end? I’ve let go of even more, hoping it will make us just a little lighter. My hands can’t find any holds in the rock. I feel like I’m climbing blind, hoping that my fingers will feel what my eyes cannot.

mountain

But now, our companions will stay behind as we go forward. They will cheer for us from a safe distance, while we trudge on.

Alone. Together.

What comes next is the hardest part.

Now that the oxygen is thin,

Now that we’re at our heaviest,

our achiest,

our tiredest,

Now that we’ve given up all that we can,

I will have to reach down and pull out that last bit of strength and will

For the both of us

Because you are depending on me

I will lower my head, reach my hands up into the darkness, and feel for the ledge

For you

I will pull, pull, pull

Even though my body tells me that it will break

And my mind tells me that I will fall

My spirit will say, Yes.

Yes.

Now.

You’re ready.

Open your eyes.

Week 39: What We Learn From Pain

I’ve been thinking a lot about pain this week.

Probably because I know that, very soon, I’ll be in the presence of the Mother of all Pains.

Labor.

I bow in its presence.

What’s that saying? Better the devil you know than the devil you don’t know?

In that sense, labor is a devil that I know. But let’s be honest. It’s been three years since we’ve spent any time together. And having known labor, I’m left speechless.

I know its power.

I know that it will require every last piece of my strength and my will.

And I know that won’t be enough. I’ll have to go deeper into myself, into my reserves that I haven’t had to use for years, just to hold on to the belief that I’ll make it through.

Because that’s the only way that I can transform from a doubtful, anxious human being to a powerful vehicle that brings new life into this world.

That’s what labor does. It transforms you.

***

This weekend, I was reminded of just how transformative pain can be.

In Glennon Doyle Melton’s memoir, Love Warrior, she says this about pain:

What if in skipping the pain, I was missing my lessons?

Instead of running away from my pain, was I supposed to run toward it? …

Maybe instead of slamming the door on pain, I need to throw open the door wide and say, “Come in. Sit down. And don’t leave until you’ve taught me what I need to know.”

love-warrior

Glennon spends most of her life running from and numbing pain through bulimia and binge-drinking. When her husband confesses that he has been cheating on her for years, she is thrown into a crisis that she feels she cannot solve on her own. She finally enters therapy so she can figure out how to pull herself and her family through their quagmire.

In the most poignant moment of her memoir, she finds herself in a hot yoga class. While other women express that their intentions for their yoga practice are to “embrace loving-kindness” or to “radiate sunlight to all creation,” Glennon says that her intention is to “stay on this mat and make it through whatever is about to happen without running out of here.”

As she lies on her mat, she allows the pain of her life to overwhelm her. She sees memories of all the things that have hurt her and she imagines all the terrible things that might still happen. While everyone else participates in the yoga session, she lies on her mat, weeping. She allows herself to feel all the pain that she has been running from and numbing herself from feeling.

At the end of the session, her yoga teacher tells her,

That–what you just did? That is the Journey of the Warrior.

***

I cried when I read that. Because it is exactly how I felt after I gave birth the first time.

I felt that I had just confronted all of my weaknesses and flaws, all of my fears and failures, all of my doubts.

And I had come out on the other side.

Alive. Whole. Transformed.

Before giving birth, I feared that I wasn’t strong. That I was too weak. Too inexperienced. That I wouldn’t know my own body more than my doctors. That when push came to shove, I would get out of the way and let someone better handle the hard stuff.

I feared that that’s how it would probably be when I became a mother. That I would smile in deference and listen to everyone else who knew better than me about what was best for my child.

That I wouldn’t cause problems by raising my concerns.

That I would continue to be “the good little girl.”

That when my time would come, I would numb the pain so I could listen to the doctors respectfully, follow directions like a rational person, and push on command.

Even though I so desperately wanted to be that woman who wouldn’t be squashed and silenced by norms…

I suspected in my heart that that’s exactly who I was.

Another woman who would believe the limitations that everyone else had decided for her.

***

In her memoir, Glennon echoes similar thoughts.

I realize that I have allowed myself to see it all and feel it all and I have survived…

I’d been fully human for an hour and a half and it had hurt like hell. It had almost killed me, but not quite. That “not quite” part seems incredibly important.

Accepting pain rather than running from pain is not a mainstream sentiment in our culture. We’ve built an entire culture around numbing pain. Not just through medication, but through addiction. To drugs. To alcohol. To possessions.

And addiction to distractions.

Smartphones and constant Internet access have helped to create these personal mini-universes, free from empty moments in which we might otherwise feel boredom or pain or discomfort.

But what is the human experience when we don’t allow ourselves to feel pain, whether it’s physical or emotional?

When we don’t allow ourselves to feel the pain, we rob ourselves of a rich understanding of who we are and what we can overcome.

As Glennon Doyle Melton puts it,

Don’t avoid the pain. You need it. It’s meant for you.

Be still with it, let it come, let it go, let it leave you with the fuel you’ll burn to get your work done on this earth.

Bring it on.

I’m ready.

Week 38: Paradoxes

Are you ready?!

This is the most likely comment that people will say to me in the next few weeks.

How do I honestly answer this?

Yes. I don’t want to be pregnant anymore.

No. I’m not ready for labor again.

Yes. I’m tired of all the fluid retention.

No. I’m not ready to breastfeed again.

Yes. I want to finally see this baby.

No. I don’t want to do all the night feedings.

Yes. I can’t stand carrying all this weight anymore.

No. The room still isn’t ready yet.

Yes. We’ll never be fully prepared anyway.

***

When I sleep at night on these bitterly cold days, I sweat. I throw the sheets off until I freeze. Then I pull them back over me. Repeat.

I have crazy dreams. Last night, I successfully managed to outsmart, outrun, and hide from a serial killer who had me trapped in an office building, much like the one in Mad Men (which, of course, I’ve been binge-watching lately).

At full term, a woman’s placenta generates as much estrogen as a non-pregnant woman will produce in three years.

Yeah.

Thus the sweating and crazy dreams.

In the weeks to come, the loss of these same hormones will cause me to shake with hot flashes and chills, to weep at the drop of a hat, and to constantly check to make sure the baby is sleeping.

Basically, their loss will make me feel completely undone.

This is the beginning of the ride down into powerlessness. This is when my individual will and desires start to bow their heads to my body’s processes and the needs of this tiny person, now coming forth.

This is when I become a passenger in my own body.

***

Dr. Robbie Davis-Floyd, a cultural anthropologist who specializes in the rituals of birth, points out that pregnancy is both “a state and a becoming.” If you translate the word “pregnancy” from Latin, it would literally read, “the state of being before being born.”

It is a kind of limbo. To be pregnant is to experience the world in flux. To see the world turned upside down and inside out. In her book, Birth as an American Rite of Passage, Davis-Floyd writes that,

“the near-constant inner and outer flux of pregnancy keeps the category systems of pregnant women in a continuous state of upheaval as old ways of thinking change to include new life” (p. 24).

So fluid is this state of being that I oscillate back and forth between wanting to be free of this pregnancy and not wanting it to end.

***

Labor also brings its own set of paradoxes.

In labor, the fastest way to progress is completely counter-intuitive.

You need to relax through the pain.

Try it the next time you burn your hand or stub you foot so hard you scream. Your first instinct is to clench and bear down. Not to breathe calmly through it.

Labor takes you out of the boat and throws you to the mercy of a series of invisible, crashing waves. At first, you might hold your breath through the pain and gasp for air in the breaks. But in time, the waves come at you harder and faster, leaving little to no time to breathe.

And that is when you realize that what you really need to do is stop fighting.

Let the water hold you down, down, down. Until you are still.

Because the more you resist, the longer labor is.

So surrender becomes your savior.

Surrendering to pain. Accepting it. Even though you don’t know when it will end.

That is the smoothest path through labor.

***

As a human being, I loathe this truth, that surrender is necessary in labor. I hate uncertainty and I cling to control. I avoid pain if I can.

But allow me to get spiritual for a moment.

As a Christian, I understand this truth.

Of all the symbols that Christians could have used to represent their most ardent belief, they chose a symbol of execution. Of Death.

Instead of choosing a symbol of humility (the manger) or peace (the dove) or bounty (the fish), Christians chose a symbol of intense pain and sacrifice. A sacrifice so crushing that it would obliterate body and mind, leaving behind only spirit.

They chose a symbol of death because they believed that it was only by dying to their previous lives that they would be able to embrace new life. They believed that before experiencing true humility and peace and bounty, they first needed to give it all up.

Because you can’t truly receive until your hands are empty.

Emptiness first. Then Plenty.

Death first. Then Life.

As a Christian, this is how I understand labor. I see labor as the most authentic expression of what I worship.

I follow a belief that Death comes first. Then Life.

Death to Self. Then, New Life.

***

As I’ve said before, January doesn’t seem like a month that goes well with birth. It stands in contrast to so many other months when we see evidence of life at work. In the United States, nature lovers will tell you that we are currently in Deep Winter, a period of seven weeks before Early Spring begins. In these weeks, we see nature as barren, perhaps even conquered.

But below the surface, the world is shifting and preparing for spring.

light-shining

I think about this as I walk in the mornings now, bundled beneath layers. Even though the winter air bites and stings, the winter light still warms me when the clouds break.

I went to church last Sunday and I was reminded that we are in the season of Epiphany, the time of year when Christians remember that God’s light doesn’t just shine on us. It comes down to light our way. Even though the darkness consumes so many hours of these winter days, the light is still there.

Even though darkness, light.

Even though Death, Life.

Even though pain, progress.

Even though two, one.

Even though being, becoming.

Even though ready, not ready.

On natural childbirth: An honest confession to first-time moms

If you try to give birth without medication for approval or respect from others, you probably won’t make it. You will reach a point when you don’t give a shit anymore what anyone thinks of you.

In the hardest hour of labor, my husband said to me, “I’m so proud of you.”

Do you know what I said?

Fuck pride. I don’t care about pride anymore.”

About an hour before the transition stage (or "when the shit really hit the fan")

About an hour before the transition stage (or “when the shit really hit the fan”)

And I so did not.

So what kept me from getting the epidural?

It wasn’t because I had read enough books and blog posts about the benefits of natural childbirth.

It wasn’t because I didn’t ask for one.

Oh, I did.

I got to my point when I begged my husband and my doula. I was in full transition mode, complete with 45-second double-peaked contractions, with only 30-second breaks between them.

I was in agony.

But my doula said, “The worst part is over! You’ve only got another 45 minutes before you can push. Let’s get you in the shower.” (She was right, but I didn’t know it at the moment.)

So why did I listen to her?

Time.

When you only have 30 to 45 seconds of pain-free moments at a time, the last way that you want to spend them is on making decisions. You spend the first 15 seconds in complete gratitude that the pain is gone. Then, the next 15 seconds trying to enjoy the sensation of nothingness. And only in the last 15 seconds do you think, Oh no… It’s coming back.

Pain unleashes the animal in you—and animals don’t really make decisions based on higher order thinking.

So don’t admire me.

Or if you want to admire me, admire me for the ability to cope with pain until it became unbearable. Because I don’t deserve any admiration for being able to cope with unbearable pain. I didn’t cope with it. I was just completely incapable of doing anything besides letting the pain come.

This isn’t to say that I regret having an unmedicated childbirth.

Because as a result of this unbearable pain, I encountered a truly transcendent experience in which I felt connected to God. I won’t go into detail here—I’ve already done that in my book. (Help a mom out and buy a copy here!)

But I want to clarify that I didn’t decide during my pregnancy, “You know what? I want a spiritual awakening. Yeah. I want to experience a spiritual rebirth while I’m giving birth to another human being.”

Give me a break. Who does that? Not this one, I assure you.

The initial reason that I wanted to give birth without medication was because I had read a lot of books about the phenomenon of “cascading interventions” in childbirth. Oh yeah, Business of Being Born and Ina May Gaskin and Dick Grantly-Read. All of them. And after that 20-week ultrasound, my maternal instincts started kicking into high gear. I wanted to do whatever I could to protect this child. But that rationale only survived as long as my ability to reason. And once pain pushed me into a mental space where I couldn’t rationalize anymore, anything was possible.

Perhaps this is why a 1999 study of mostly white, highly educated women in their early 30s (i.e., me) found that 43% of the women who said they would “definitely not” get an epidural—indeed got one.

I am not shocked at all by this. Neither do I judge. Because, ladies, the only thing that stood in my way from an epidural was time and my birth attendants. My husband and doula knew what rational Sharon had previously decided and they had promised to give me support as long as I was willing to accept it. It wasn’t my incredible willpower or my amazing capacity to be a “good mother.”

Good grief. Don’t let anyone tell you that you’re a good mother because you of something that you did.

Hear me out on this one. You’re not a good mother because you had a natural childbirth, or breastfed your baby, or never let your baby cry, or never felt ungrateful in the face of new motherhood challenges.

You are a good mother because of who you are. Not because of what you do. Or don’t do.

As Rachel Martin repeats over and over again on her blog, Finding Joy—You are enough. What you are—all of that—is what makes you a good mother.

Please don’t fall into the trap—as I did early in new motherhood—of deriving your value as a mother based on what you do.

Because you will fall short.

Over and over again.

You will forget the diapers at home when you go out. Or feed your baby—God forbid!—formula when the breastfeeding struggles are more than you can bear. Or maybe you’ll be the only mother at the playgroup who doesn’t know that many kinds of rice contain arsenic. (Oh my God! I’ve been feeding my baby arsenic!)

If you value your worth as a mother based on what you do and not on who you are, then you will constantly be beaten down by all those messy and imperfect moments of motherhood. They will beat you to a pulp and drive you into an incessant loop of I’m a terrible mother. I’m no good at this. This baby deserves better than me. It’s my job to protect this child so they will get through life perfectly, and I’m failing!

Don’t give in to this self-destructive script.

You are a good mother because of who you are.

Not because of anything that you do.

Don’t reduce the experience of motherhood into a checklist rather than seeing it as it really is–meaningful and contextualized interactions with your children. That’s where the nurturing happens. That’s what kids remember later on–not all the other stuff that we waste our time obsessing over.

Wholehearted motherhood is so not a competition—and that is actually what the experience of laboring without medication taught me.

Because when you are in the hardest hour of labor, you can no longer compare yourself to anyone else. You can’t see anyone else vying for first place. You can’t even see yourself. And all you care about is the present moment.

But if you insist on treating motherhood as a competition, you will lose every single time. You may not show it to others, but you will feel the sting of failure, over and over again. And then you will plan how to make everyone else believe that you are still a winner.

Oh, so exhausting.

Why not save your mental and emotional energy for something more important?  Why not learn this lesson now before you become that too-perfect mom that no one relates to? It’s so much better to hang out here down in the masses of messy motherhood than it is to be floating high above everyone, dangling from a thin string, just waiting for the helium to run out.

Come on down.

Join the crowd.

***

Like this post? You’ll love “Becoming Mother.” 

Book-Cover-Becoming-Mother-Kindle

A down-to-earth journey into new motherhood and a great gift for first-time moms.

Goodreads Giveaway: “Becoming Mother: A Journey of Identity”

Want a free copy of “Becoming Mother?” I’m giving away 15 printed copies via Goodreads this month. Enter by September 1st and you might be one of them! (Pssst… This is a great baby shower gift for a first-time mom!)

Goodreads Book Giveaway

Becoming Mother by Sharon Tjaden-Glass

Becoming Mother

by Sharon Tjaden-Glass

Giveaway ends September 01, 2015.

See the giveaway details
at Goodreads.

Enter Giveaway

%d bloggers like this: