Genius Toiling in Obscurity

All Things Are Never Equal

Many people have asked me what I have to say about birth hypnosis, given what my recent birth experience was like. Overall, I continue to feel good about my experience with birth hypnosis, during both pregnancies and births. Doing the visualizations freed me from all my anxieties and fears about birth, and in both of my births, I felt throughout that everything was going to turn out just fine. Also, although I have nothing for comparison, I’m sure the hypnosis helped me stay as calm as I did during Carl’s birth, helped me control my breathing, and helped me with the physical relaxation I did to get out of the way of my galloping uterus. I also have had two remarkably easy recoveries from labor and delivery; I don’t know whether the hypnosis had anything to do with that, but I’m glad of it.

I took getting ready to give birth very seriously. I learned all about the process of labor and delivery, and the medical interventions that were available, as well as practicing my birth hypnosis very regularly. All of that helped. Even though neither of my births was perfect, and I did accept medical interventions in both, I felt good about my ability to choose those interventions. I didn’t end up feeling like things were done to me, or that I was out of control, but that I had both the prior knowledge and, in the moment, the presence of mind, to make good choices.

So, I didn’t have the perfect birth hypnosis birth. I didn’t experience contractions as an abstract “pressure” or as waves that I was riding. The baby didn’t glide effortlessly down the birth canal with no special effort on my part. But I’m convinced things would have been harder and scarier without that preparation.

One of the tricky things about birth hypnosis is that, in order for it to work at all, you have to let yourself believe it completely. So when the visualization says the baby is going to be “massaged down the birth canal” by the contractions of your uterus, all on its own, you have to say to yourself, “Yep, that’s how it’s going to be, all right.” But, on the other hand, you have to prepare for other possibilities, and everyone knows this even if they won’t admit it. For instance, another thing the visualization says is that once each contraction has ended, “it is forgotten, no longer needed in memory.” The canny reader of texts will observe that something that is not unpleasant should hardly need to be specially forgotten, so there’s a tricky double message there.

One hesitation I have about recommending birth hypnosis to every pregnant woman I meet is that I am afraid it will create enormously high expectations about the birth experience, and at the same time make women feel responsible for their experience, so that if it is not the promised gossamer cloud, they’ll feel like failures. I know too many women who are disappointed by their birth experiences, or who even feel guilty about the choices they made in labor and delivery, and I do not want giving birth to be something women have to recover from emotionally in that way.

I am a big fan of birth without anaesthesia; I am very glad not to have had a spinal block even with Carl’s birth, partly because I think my amazing and speedy recoveries from giving birth are partly accounted for by not having had anaesthesia. I would like to see more women give birth without epidurals. But I want every woman to feel good about the choices she makes in labor and delivery, no matter what they are. On Sunday, I chatted with a friend at a party. She has a nine week old daughter, and had a heavily medicalized birth. She used narcotic pain relief through the early stages, and an epidural later on. She is blissed out by motherhood and had nothing but good things to say about the epidural. I was glad to hear it.

I am saddened when friends and acquaintances tell me they feel guilty for having (or asking for, even if they never got it) an epidural. I have one friend who pushed for three unproductive hours with her first son; he never moved a bit, and was born by C-section. She wanted a VBAC for her second. She pushed again, for three unproductive hours, and that baby didn’t come down so much as a millimeter. She had another C-section, and continues to wonder whether, if she had pushed longer, she might not have succeeded in delivering him vaginally. It doesn’t help that she asked her o.b. later whether he thought she could have delivered vaginally if she’d kept it up; he said he thought so. That made me mad: the right answer, of course, is that no one can know. In addition, when they did the second C-section, they were unable to do it quickly because there were so many adhesions from her previous surgery. When I heard that, I felt confident she’d made the right choice, because my mind immediately leapt to the possibility of a baby in distress needing to be delivered quickly—and the doctors getting in there and finding that “quickly” was not an option. I felt glad that she had opted for the C-section before she and the baby were completely exhausted.

Though I can’t imagine that three hours of pushing is anything but completely exhausting. Even with my first birth, which was glorious, I can remember thinking during the pushing stage, “This is great! This feels wonderful! I’m so good at this!…I hope I don’t have to do it for very long.” Pushing for three hours without even the encouragement of knowing the baby is moving down is a lot to ask of any woman.

The tricky path I want to walk is that I want women to take preparing for birth seriously and I want them to feel like they have choices in how they give birth. I’d like to see more women take the possibility of birthing without an epidural seriously, whether at home or in the hospital. And then, whatever happens, I want them to feel good about it—or at least, not to feel that they are to blame, that they have failed, or that they are somehow less than other women whose births went more according to plan.

I feel the same way about nursing. I want women to assume they’ll nurse, take it seriously, do their best to make it work—but I don’t want any woman who can’t nurse, or even any woman who chooses, for whatever reason, not to, to feel bad about that choice, or to be judged for it. The three weeks I spent pumping around the clock and finger-feeding Eric were so draining and stressful that I would not blame any woman who simply chose not to do it, not to have her first few weeks with her baby be dominated by those activities.

I can tell that I am a little sleep-deprived, because this is not coming together the way I wanted it to. But let me try to sum up my central point: There is plenty of evidence that moms and babies do better if birth occurs without an epidural. Likewise, there is plenty of evidence that breastfed babies do better than bottle-fed babies on all kinds of measures (if I had the energy, I’d link. But you’ll have to take my word for it for the moment). But the differences are small, and another way to read the evidence is that babies and moms in the developed world are, overwhelmingly, healthy and well whether there is an epidural or not. Babies and moms are, overwhelmingly,healthy and well whether the baby nurses or is fed formula. I hate to see small statistical differences turned into ideologies.

Here’s another way to put it: When my friends Adrianne and Carla had their son Noah four years ago, we developed a saying: All things being equal, it’s better to give birth without an epidural. All things being equal, it’s better to nurse than to feed formula. All things being equal, it’s better not to supplement with formula early on.

But all things are never equal.

Posted by Su Penn at April 6, 2004 04:39 PM | TrackBack