Erica: Birth is transformative. We meet women every day who could describe their births from many years ago in vivid detail. And we’re all familiar with the war stories...Part of our mission here at the TMC is to transform the culture of fear surrounding birth. We encourage women to educate themselves and create a supportive environment for birth. But the truth is, we all must enter birth with open hands. The stories we would write for ourselves are not always the stories that make us the strongest mothers for our children. And friends, while birth is transformative it is truly only the beginning. This morning we hope to have an open conversation.
Panelists
Brittany Meng: Mother of four
Lucie Bautista: Mother of five grown children, (Certified Nurse Midwife)
Kirstin Magnuson: Mother of three; (Professional Counselor)
Edi Remark: Mother of two
The Experience
Erica: Tell us a briefly about your birth experiences. Did things go as you had hoped and planned for your deliveries? If not, when did you feel your “plans” slipping away?
Brittany: My twins were born as a planned c-section at 36 weeks; a 60 hour VBAC with my 3rd, and a nonmedicated natural birth with my fourth. I felt at peace with all of my deliveries at the time.
Edi: With my first I had an unplanned c-section after 20-some hours in labor. I heard that her heart rate had dropped, and I felt fear, and things from then on didn't go as planned. I had a VBAC with my second (although labor was almost as long!)
Kirstin: My first was an unplanned c-section; I remember when they gave him to me I was so exhausted I couldn't even fathom having to nurse him. I didn't want to have to do more right then. The second was a planned c-section, which was a lot less stressful, but I had a spinal headache for days that really impacted the experience. My third was a planned c-section, but they dropped the curtain and I was able to see her come out and they put her on my chest skin-to-skin and I was able to bond.
Lucie: With my first baby, I took a lot of classes where they said 'if you do this and this, you will just feel pressure.' HA! I remember during my first painful contraction I thought 'something must be wrong here! It's not supposed to go this way!' 24 hours later I gave birth; people with me told me what a good job I did, and those words were so empowering....I did it 4 more times! ;) With my fourth I had an epidural; my mother had just been diagnosed with cancer and didn't have a long time to live. I wasn't in a place to do natural childbirth at that time, and that was OK.
Erica: Birth is a major life event. When faced with disappointing/painful outcomes, what would you say to a mother struggling to acknowledge her disappointment/grief?
Kirstin: I think first I would say it's OK to feel that way. To feel frustrated and disappointed. But you can have an AND...you can feel frustrated and joyful; disappointed and excited that they're here. For me, it really helps to tell my story and share my story; it helped me heal and come to terms with my unplanned c-section. It doesn't define me, it's a part of my story.
Also, be mindful of the words you're using. Don't say things like 'it should have been this way' or 'this should have happened'. I had a professor who used to say 'quit shoulding all over yourself!' This is one dot; one point in your motherhood journey. It's a big one, but it's not everything. Keep it in perspective.
Lucie: I try to give people an opportunity to tell me about their birth during my postpartum rounds at the hospital. At our practice we share with each other; we know about every birth and are able to be involved even if we weren't the delivering midwife. We need to be open to listening to each other's stories.
If you've gotten to a place where you're really struggling, you can't just move forward, you need to start at the beginning: what were my expectations? What was I picturing? A beautiful, uncomplicated birth...no blood pressure issues, a full night of sleep beforehand, etc.?
If you had a bad birth experience with various providers, make an appointment with them and don't just blast them on Facebook! Talk to them, find out what was happening on their end and share with them why it was hard for you. Make it a growing experience. Even if you can't get them to agree, you've had your say, and then you can begin to move on. Life is about the unexpected, parenting is about the unexpected.
However, if you feel like you can't move past it, if you feel like it's destroying you, you need to get professional help to work through it.
Erica: Is there anything you wished someone had asked you post birth? Did someone offer any particularly wonderful comfort?
Audience: I wish a doctor would have come to explain "this is why things went the way they did, this is why we did what we did." I'm 10 months out and just now learning about some of the things that happened that affected my birth experience.
Audience: I wish someone would have asked me how I felt the birth went, instead of just saying 'It was so great!' Other people thought it was great, but I did not feel that way.
Brittany: After all of my births, I was content. However, my after-birth experience wasn't as great. After my last two births, when I had skin-to-skin and was able to bond with them, I realized how much I had missed with my twins. This was years later, and I was just realizing I missed that. My twins both have special needs, and when they were diagnosed, all of these questions started in my mind: "Is it because I didn't bond with them? Is it because I didn't breastfeed them?" and I was beating myself up about it. My husband helped me through this; he reminded me: "You didn't cause this. Did you know about skin to skin? Did you know about breastfeeding benefits? No. So you couldn't do anything you didn't know. When you know better, you do better."
When my fourth was born, our 2 year old was really sick and had to go to the ER. I couldn't be with him then, because I'd just had a baby. Just as with my twins, I couldn't be with them right afterwords because of the complications of the c-section, and it helped me to realize that it was OK. They were taken care of, and they still are.
Edi: I really struggled after Elena's birth, because I felt like a failure. When the doctor said it was time to do the c-section, I felt guilty because I felt relieved. I remember emailing with a friend, and she said to me, "You need to be able to grieve the expectation. Let yourself have that grief. It's OK."
I'm one of those people who have all the expectations...even at 37 I'm like 'Christmas morning, yay!!!' So my expectations for my birth were shattered and it was hard, and I needed to grieve. Tell your story until you're not crying anymore. (even though you may still cry sometimes! :) )
Initial Coping / Symptoms
Erica: Were you able to bond with your baby immediately? Do you feel your birth experiences altered this? If so, why?
Edi: With Elena being a c-section, I remember my first thought being when I pulled her hat off and saw a cone head. I thought "I had a c-section! She shouldn't have a cone head!" With my VBAC, I thought when she was put on my chest there would be all of this fanfare, but when she was put on me, my thoughts were "oh! there she is. She doesn't have a conehead. I'm hungry." I think the exhaustion really can play into your thoughts/feelings, but it didn't affect my bonding.
Brittany: I did not bond with my twins for months. They were in the NICU with all of these wires, etc. But I wasn't the professional, I don't have a medical background, so I didn't think I could really touch them a lot, etc. When they came home, I mainly just felt 'responsible'. I was 23, and it was so much responsibility. Around 8-12 weeks, I remember one of them smiling at me, and tears came to my eyes. I would say I loved them before that, but didn't feel that. After that, I actually felt more connected, and it continued to grow. I feel like it's still growing; it's very unique, and I really have to work on it daily...we have very different personalities. My 'mother's love' is always there, but we're always developing our relationship.
Erica: What were your immediate thoughts and reflections after your births?
Kirstin: After the first, I felt so wiped out. I felt like 'what more could be expected of me?!' Even nursing seemed like a monumental task. Probably the last one was different because I was able to do skin to skin, and I remember feeling how special that was.
Acceptance / Treatment
Erica: What do you think of our culture’s tendency to dismiss the importance of birth, and the disappointments that surround it?
Lucie: I had a grandmother in my office last week who had given birth 50 years ago, and needed to tell her story. We all need to tell our story.
I've had patients with very detailed birth plans where literally nothing went to plan, and the mother was OK with it. I've had mothers who had what seemed like ideal births, but the mother didn't feel that way.
I think it's this thing that we have to do to become mothers, and we can be empowered by it.
Edi: I was on vacation last week, and my sister-in-law is pregnant with her second. Our first babies were about 6 months apart. She was over 40 weeks pregnant and I was 6 months postpartum (and still dealing with my own birth experience) and the doctor was giving her options. She called me, wanting advice on what to do. Induce? Not induce? C-section? She's very natural, very 'crunchy' and I asked her: do you think it's going to bother you if you can't have a natural birth? She said no. I want to have this baby out.
Fastfoward 4 years, and we're talking again about birth; she's looking back and wondering 'if I didn't have that c-section, would I have these current complications, would I have still done it?' Sometimes you don't know how you're going to feel/how it's going to affect you until you've been through it, and it's important to note how impactful those moments are.
Erica: Sometimes, birth challenges come down to simple choices, sometimes, not. When asked, “What advice would you give pregnant women regarding giving birth confidently in the future?” Katie Rohs from PATTCh.org (Prevention and Treatment of Traumatic Birth) answered, “Empower yourself with your own knowledge, and choose a care provider that you trust deeply. Listen to your intuition – you know yourself, your baby, and your body better than any test ever will. Don’t be afraid to seek out different care if your needs aren’t being met.”
Do you agree? Did your feelings about your births differ due to different care provider choices? What else would you add?
Brittany: Yes. I was content with my births, but I did know with my fourth, I was wanting more choice. I was with OB care with the twins and the VBAC and had to see specialists, etc. I wanted to feel more choice, more in control with my fourth, so I switched to the midwife care, and I had a doula with my last two.
Audience: I moved states 7 months into my pregnancy. I had a regular OBGYN where I lived before; I didn't feel very listened to and not very personal. It very well could have been just the OB that I had. I switched to midwife care here and was so happy with it; I felt like as women we understood one another, and that I had a voice.
Audience: trusting your provider is so important. We had an impasse where we thought I may need to have an induction, but my midwife and I had worked together the whole pregnancy and were on the same page and we were both comfortable with the decision we would have to make.
Erica: PATTCh.org states that, “ Recovery from PTSE, etc. occurs with time, support, and can be facilitated by empathic discussion...” Some of the non pharmacological treatments they recommend include the following: Get adequate sleep; get exercise, do yoga; find support groups; body work, massage; psychotherapy, counseling and social work. Agree? Disagree?Anything you would add?
Kirstin: Everyone is different so your needs are going to be different. Don't compare "Well she did this, so I should do that." Take time to see "What's best for me? How can I heal? What do I need to help heal from disappointment?' Reach out and advocate for yourself. Talk to someone -whether it be a safe person or a professional, and go from there....taking care of yourself, eating well, exercising, etc.
Moving Forward / Motherhood
Erica: What does “accepting your birth” mean to you?
Lucie: I think ideally that instead of just accepting your birth, you're empowered by it. Looking back and saying 'That was hard but I did it and I made good choices.'
Being able to put it in perspective in your life story. I also have a special needs child. I felt decreased fetal movement around 37 weeks but I didn't pay as much attention to it as I could have; I let my doctors determine what to do. I'm still processing that, even though my child is now an adult, as my child has mild cerebral palsy and personality issues. But you learn to forgive yourself, and move on, and you grow. It's changed me as a person and as a provider.
Edi: We know we did what we could with the knowledge that we had. Before my second birth, I needed to make sure I was in a place of acceptance with my first birth, so that I didn't experience another potential birth that didn't meet expectations and just compound my disappointment and feelings of failure.
There will come a point where the kids aren't sleeping, where life is hard, where you're having a bad day, and those things will creep back up. You'll question your decisions, you'll wonder if you're a good mother. But those are just bad days. They don't define you as a mother.
Erica: What would you say experiences such as these teach us about life/about motherhood? What did birth teach you?
Brittany: I think acknowledging that birth is a defining moment in the life of a woman...it's important to say 'This is MY story'. Just like other big accomplishments. But it's important to remember it's the beginning of your story. With my twins, I had to learn how to love and how to grow as a mother.
With my 60 hour VBAC, I learned endurance and taking a different perspective. I didn't plan for a 3 1/2 day labor. But that happens all the time in parenthood! Your kids don't always do what you think they are going to do/should do, and you have to learn to adjust your expectations and go with it.
Erica: As you have continued in your motherhood journey has the importance of your birth diminished or grown? Why?
Edi: It's funny, I wanted the VBAC with my second, and I got it, but then I wondered: "Does that lessen my birth experience with my first?" NO. They're two different situations. My family teases me that now I'm an expert in both types of birth! When your kid starts eating rocks off the ground, does it matter how they came into this world at that time? No. You get the rocks out of their mouth. It is what it is.
Kirstin: It's part of my story and I love sharing it. It's a way to say 'this is how this child came into the world.' I feel like I'm present in where I am as a mom, and yes, the birth story starts everything off, but it's just a part of the story.
Audience: I feel like my birth experiences have shaped a lot of my life. My first was early and was in the NICU, and has opened up relationships with other NICU moms. I also lost a baby last year at 16 weeks, and am pregnant again. I've had people say 'This will be a healing birth.' But no. They're connected, yes, but they're two different experiences, two different pregnancies, two different babies. I've processed my births, and you don't have to be happy with it to be at peace with it. But each one does affect your life and your choices in your other pregnancies and birth experiences.
Erica: I think too, once you've closed the 'child-bearing' chapter of your life, it may be easier to start distancing from it more so.
Brittany: When you're pregnant again, you remember what happened. After my 60 hour labor, when I was pregnant again and nearing time to give birth, and started getting fearful about it happening again. And I started voicing those fears to my midwife, to my husband, and realizing that we would walk through it if it happened that way again, but we could do it.
We hope this cafe has left you encouraged and empowered to know that your birth story is YOUR birth story. It may not be what you planned, but it's a part of your story...one that continues to be written daily!