I am sitting butt naked on a birth ball, attached to a breast pump, and I’m bouncing up and down as fast as I can. David and Steve Gordon’s album Drum Medicine (best birthing music ever) is making the walls vibrate. It’s 10 p.m. the day before my baby’s due date. Wait a minute… how did I end up here? This is not how I envisioned myself giving birth… and why the heck am I using a breast pump? Doesn’t that come much later, like after the baby is born? Do I actually think that this bizarre method is going to help me fulfill my drug-free birth fantasy? I imagine you’re dying to know why I would put myself in such a compromising situation. Well, it’s because I want to have an unmedicated birth. I more than want it; I need it. And I’m willing to do whatever it takes to accomplish that. In my case, it will mean using a breast pump to stimulate labor.
I’ve always looked forward to birth as an empowering female rite of passage, one I want to play an active role in. My fears regarding birth are not about pain; having had a 12-week miscarriage and an ovarian cyst that burst, I know I can handle intensity. Instead, I am afraid of feeling disempowered, and like my journey is being hijacked by medical personnel. It is this fear, combined with a deep-seated longing to experience birth for myself in its rawest form, which makes me crave a drug-free birth.
Fifteen hours earlier...
I wake up to pee at dawn and it’s just really wet. Like everywhere. My husband, sister, doula and I head to the small birth center at the certified baby-friendly hospital I have chosen. I’m not having contractions, only mild cramping. I’m bawling in the car. After having read every “natural birth” book I could lay my chubby pregnant fingers on for the last nine months (my favorite being Ina May’s Guide to Childbirth by Ina May Gaskin), I know this is not looking great. Broken water bag and no contractions means I’m on a time limit. According to obstetric tradition, the baby should be out within 24 hours of the water breaking, or else: c-section. I have a feeling my womb does not like to perform under pressure. I have dreamt of having a “natural,” unmedicated childbirth my whole life, and my chances are now looking slimmer by the minute.
I am 'failing to progress.' What should I do?
I check in at the hospital and thankfully, my wishes are heeded: I just want to be with my peeps, staff please stay out. My contractions are beginning to pick up somewhat, so they leave me to do my thing. I dance, I bounce on the ball, I walk around the room, all because I have read in the Ina May book that movement can increase contractions. I also have my acupuncturist come and do an acupuncture labor induction. I give myself an enema. All these things help build up my contractions to a steady rhythm. I feel empowered, I can do this! I’m going to have my drug-free birth! My birth attendants are all cheerful, although I notice quite a frown on my doula’s face when I exclaim:
“This is so manageable! I don’t know why anyone would want an epidural!”
Later I found out that this is when she knew things were not progressing well. Apparently, very few women in un-medicated, heavy labor would exclaim, “This is so manageable!”
It’s around 10 p.m. at night when the midwife comes to check me. I’ll never forget her face when she looks up at me after the exam. It’s a face of pity, of how-should-I-break-it-to-her.
“I’m sorry, but you’re not making progress. I really think we need to start you on Pitocin.”
It feels like I’ve just had a death sentence put on my dream birth. Pitocin is the last thing that I want! Why? Because I have read in the Ina May book about how Pitocin can be the start of a spiral of medical interventions, which could land you with a c-section. Pitocin can cause contractions that are unnaturally strong, which potentially puts a strain on the baby. Therefore, babies whose moms are on Pitocin need to be constantly monitored. The need for constant monitoring demands the mother to be unnaturally still. Anyone who’s been in un-medicated labor knows that sitting or lying down, being still in general, is the worst. To me (and Ina May Gaskin), the natural state of a laboring woman is rocking, swaying, bouncing, squatting. With Pitocin, it is much harder for the mother to have this freedom as the monitor restricts her movements. Limited to the immediate bed area, and sometimes to the very bed itself, the pain can be unendurable. Women who receive Pitocin therefore may end up with an epidural. As epidurals tend to slow down labor, the risk for interventions (such as a c-section) can be increased (a variety of studies and meta-analyses have found mixed results on the impact of epidurals on c-sections, but the College of Family Physicians of Canada concluded that “it appeared that increasing use of EA (epidural analgesia) was transforming birth,” with much higher rates of c-sections). This domino effect is the reason why so called “stalled labor” or “failure to progress” is amongst the top causes for c-sections in the country, according to Obstetric Gynecology.
It has just been confirmed. I am “failing to progress.” What should I do? Accept Pitocin knowing that I might be headed toward an epidural and a c-section? (The well-studied risks to mom and baby from epidurals had me almost equally freaked out about that one — a Cochrane review has found higher risks of vacuum and forceps delivery with epidurals in older data, as well as low maternal blood pressure and oxygen levels in baby, though not lower Apgar scores). Or should I decline and hope for a miracle?
All my hopes are now invested in a little machine known as a breast pump.
The midwife leaves us to confer amongst ourselves. I feel heavy and let down. Is it time to let go of my “natural birth” fantasy? This dream is something I’ve been carrying around ever since I as a little girl realized I could give life. Do I really need to give that up? My doula and I look at each other. What should we do? I see an idea dawning on her face. There is one last thing we haven’t tried. We have this one idea, a last, slim chance to save my drug-free labor. Will it work? We don’t know. Is it a bit bizarre and well, ridiculous looking? Yes. Is it worth a shot? Definitely!
We plead to the midwife to give us a chance with this last method. She reluctantly gives us two hours, then she really wants me to get on Pitocin. The clock is ticking. My 24 hours feel like quicksand.
All my hopes are now invested in a little machine known as a breast pump. We have read in the Ina May book that nipple stimulation can cause the uterus to contract. The science behind it is that nature needs a way to prevent moms from bleeding to death — when the baby is out and starts suckling the nipple, it signals to the uterus to cramp up and stop the flow of blood.
The nurse wheels in a hospital grade breast pump (superior to the ones we have at home) for me to try. I’ve never used a breast pump before or even seen anyone else use one, so it’s a whole new experience. It takes a little while to find the right fit for the funnel part that connects to the breast, but once that is in place we turn the dials up to max and start pumping.
I’m riding this birth ball, pulled by the breast pump, right into heavy labor land.
This is when I find myself naked, pushing those breast pump funnels into my engorged breasts, bouncing up and down as fast as I can manage. Somewhere in the back of my mind I realize this must look completely ridiculous, but everyone is respectful enough not to laugh (and not snap pics!). Anyway, I don’t care. I would do literally anything to save my drug-free birth.
I’m giving it my all pumping, bouncing, and sweating. Crazy drum music spurring me along. It simply has to work.
My contractions get heavier, deeper and closer together after just about 10 minutes on the ball. Soon I realize why no one exclaims “This is so manageable!” when they’re about to give birth. I’m riding this birth ball, pulled by the breast pump, right into heavy labor land. I become completely drawn into myself and my sensations, everything disappearing from my mind except the surging rhythm of pain and release. The timing of what follows is what my doula told me afterwards.
After about 40 minutes on the ball my contractions are only a couple minutes apart. My doula convinces me that it’s safe to give my breasts a break. I’m reluctant at first – what if my contractions slow down again? She assures me that I can always get back at it if I need to. I get off the ball and stand holding onto a table, rocking side to side between contractions and hanging from my elbows during them. Another hour and a half passes that way, my contractions coming as strong and fast as with the pump. It’s like I got jump started by the pump and now things are just moving, and they’re moving fast.
'Now lie back and catch your baby,' she says.
Around midnight my doula urges me to lie down and take a rest. She says I’ve done well and that I should conserve my energies. I lie down on my side for a very painful half hour, during which I manage to relax completely, allowing those strong breast pumped contractions to do their job of opening. Suddenly I have a startling sensation: Hey everyone, I think I need to push!
There is a big bustle in the room as I push squatting, hanging onto that squat bar for dear life. An hour and 20 minutes later my son glides out of me and into the midwife’s hands. "Now lie back and catch your baby,” she says. Just four hours after having been told I need to get on Pitocin, I am birthing my baby drug-free, thanks to the miracle of nipple stimulation via breast pump.
Eleven months later I am grateful I got to start my journey of motherhood feeling strong, empowered and content. I took charge of my birthing situation and birthed in the way that was important to me. I could not have done it without Ina May Gaskin’s wise teachings, the help of my doula, the open-mindedness of my husband and the pure love of my sister.
To all you pregnant ladies out there to whom, like me, a drug-free birth is deeply important: It’s possible! Sometimes it’s the crazy drum music that does it, sometimes the breast pump, but whatever it is, don’t be afraid to be unconventional as you forge your own path to an unmedicated childbirth.