Choosing a Method
When I became pregnant, I was your average 28-year-old, just as nervous about giving birth as the next mom-to-be. I didn't stand firmly in either the natural-birth or the epidural camp. I didn't know what I was up against, so how could I commit to one way or the other?
As I thought about it, I realized that my highest priority was to have the safest birth possible. It seemed so illogical to avoid drugs (even over-the-counter ones) during pregnancy but to use them (even strong narcotics) during the birth. And frankly, I didn't trust a stranger, no matter how educated, to stick a long needle into my spine. But if the pain was as unbearable as everyone said, how could I make it through labor without drugs?
Before I'd thought about it much more, my husband, Lou, came home with news of friends who'd had two babies using the Bradley method. This completely natural method of childbirth has been around since the 1970s, but I'd never heard of it. When I looked into it, I discovered that the Bradley method's education and relaxation techniques and its emphasis on the dad as coach suited Lou and me perfectly. An intensive 12-week class gives couples information, such as how the body works to give birth and what routinely happens in a labor and delivery room, so that they can make informed decisions. While using relaxation as a way of handling and reducing pain is the goal of most natural birthing methods, Bradley instructors teach expectant moms to surrender control of their bodies using normal breathing and by focusing inward. (In contrast, Lamaze uses altered breathing patterns and outside focal points as means of distraction.)
What Technique Worked for Us
At 19 weeks, I went online to find a local instructor. There was only one person in our county who offered the class, but luckily she had room in her next session. A few weeks later, we gathered with five other couples for our two-hour class. There was a lot of ground to cover, and with our first quiz, I discovered how little I knew about biology and childbirth. I didn't know what exercises would tone my perineum, never mind where my perineum was (it's the skin and muscles between the vulva and the anus). I didn't know about the natural alignment plateau (a normal point during labor when contractions may continue but dilation stops or slows) or transition (the last stage of labor before pushing).
Through class discussion and our Bradley workbook, we learned these terms as well as every detail about what to expect during labor. It truly amazed me how so many body parts worked instinctively and in unison to deliver the baby. With each new thing I learned, I gained confidence that I could deliver our baby naturally. For example, once I knew that each contraction was simply uterine muscles working to open up the cervix and push the baby down, they were less scary.
At the same time, Lou grew more comfortable in his role as coach. He studied our workbook on his train ride to work each day. The two pages he valued the most included a chart listing the emotional and physical signs of each stage of labor; he photocopied them so he'd have them during labor.
We also learned specific exercises that help condition the birthing muscles. I did Kegels at red lights, sat Indian (tailor sitting) style to watch TV, did pelvic rocks during commercials, and squatted to reach pots and pans.
Practicing our relaxation techniques, the key to the Bradley method, was not as easy. Our assignment: to spend at least 20 minutes every day until the birth training my body and mind to relax. It sounded good, but there were often nights when we had no energy for practicing. When we did, I wasn't sure I was reaching that completely relaxed mental state, and I wasn't convinced I'd be able to do it during labor. Sure, I can relax when I'm getting a massage or lying in bed listening to waves washing ashore. But I'd never felt a contraction -- how could I simulate my reaction to one?
Writing a Birth Plan
Toward the end of our class, we worked on our birth plan. We knew we could not control every aspect of the birth, but we wanted to make sure our birth team understood what was most important to us. Assuming we would have a normal birth, we outlined our priorities: We wanted to be together during labor and delivery; we wanted freedom to move around; we did not want Pitocin used to induce or augment labor; we did not want routine internal exams; and we did not want electronic fetal monitoring, an IV, or an episiotomy.
Since we didn't want any surprises in the birthing room, we made an extra appointment specifically to go over the birth plan with Kristin, the midwife we'd chosen, who was affiliated with our local hospital. For the most part, she was in sync with us, but there were a few points of contention. Due to hospital policies, I discovered that I had to have an initial 20-minute electronic fetal monitor check and then a recheck every two hours. Although they would not automatically induce me if my water broke or my due date passed, they did have their time limits. And of course, if complications arose, we would have to reevaluate everything. Though we were disappointed about the fetal monitoring, we were confident that our midwife would help us have our natural birth.
Others in the class were not so lucky. Two couples switched doctors just a month before giving birth. While going over their birth plans, these couples realized their doctors were resistant to a completely natural birth. They decided to search out a birth center that would help them reach their goals.
We'd done everything we could to prepare; now we had to wait and see what nature had in store for us. As my due date got closer, my prelabor jitters got worse. I even read up on some drug options and their side effects, just in case I needed them. But Lou assured me I could handle labor pains and that he would be there for me.
Having the Baby
My due date finally arrived, and despite all our preparation, I was still nervous. But the baby didn't want to wait. Around 10 a.m. I felt a little pressure in my pelvis but figured it wasn't a contraction -- a contraction would be more painful. It wasn't until a few hours later (seated in church!) that we timed the sessions and realized I was in labor. Shortly, there was no mistaking that fact -- the contractions were growing steadily. We called our midwife to alert her and settled in to labor in the comfort of our home. By 2 p.m. I was still walking around a lot. My baby was positioned posterior (sunny-side up), which made it very uncomfortable for me to lie down or sit back in a chair. During contractions, I would squat or sit on a big rubber ball to get comfortable. I closed my eyes, focused on relaxing, and took deep, normal breaths. Lou talked me through each contraction, reminding me not to fight them but to let myself go. By 7 p.m. my contractions were really tough and coming one on top of another. I found it increasingly difficult to relax. Lou knew these were signs that I was in late first stage labor, so we decided it was time to head to the hospital.
I was immediately wheeled from the emergency room up to our birthing room. We got off to a poor start with the nurse. At the door, she told Lou he would have to go back down to registration to do some paperwork. Lou politely refused to be separated from me. We're not sure if the nurse read the birth plan in my chart; if she did, it didn't seem to matter to her. For example, she kept asking me questions while I was trying to relax through a contraction. Lou would answer, but she'd ignore him and ask me again. Still, we stayed focused on what we had to do.
Next, I had to lie in bed (very uncomfortable!) for a fetal monitor check. In between contractions, I drank cup after cup of ginger ale to hydrate myself so I wouldn't be put on an IV. Then I had an exam to determine that I was fully effaced and nearly 7 centimeters dilated -- finally, good news! I would have been crushed if 10 hours of labor hadn't gotten me that far.
Labor progressed normally, which is to say the contractions got harder and even closer together. For two more hours, I labored standing up or kneeling in bed. I really had to focus on remaining calm. Lou was a true Bradley coach: During each contraction he rubbed my back with tennis balls to help ease the pain. When I didn't like that any longer, he held my hand and talked to me. He reminded me of what we had learned in class: to breathe deeply, to visualize my muscles working to help push the baby down the birth canal. He assured me that we were almost there. In other words, he kept me focused on our end goal -- the baby -- instead of the pain.
Having the Baby Continued
But even with Lou's efforts, I have to admit that things did not go the way I had envisioned. I had pictured myself lying quietly in bed, focusing on the baby. Instead, I moaned and groaned through the final contractions. While knowing what was going on physiologically made me less fearful, visualizing muscles being stretched and pulled didn't make the contractions less painful. We had said that we didn't want internal exams, but toward the end of labor I had two. I needed assurance that I was almost there. Even focusing on deep breathing didn't work in the end. When I had trouble catching my breath, Kristin suggested some patterned breathing techniques.
Despite these realities of labor, I did not ask for drugs. In fact, the harder labor got, the closer we knew we were to having the baby. We took one contraction at a time and slowly got through it.
At about 9:40 p.m., shortly after my water broke, I was ready to push. And what a relief that was -- I could finally work with the contractions. And since I chose to push sitting up in bed, I could lean back and relax in between them. I pushed as long and as hard as was comfortable (Lou reminded me to ignore our nurse counting to 10). As the baby's head crowned, Kristin massaged my perineum with oil and coached me through the final pushes. At 10:21 p.m., our baby slipped out squawking and squirming and was placed on my belly. With tears in his eyes, Lou announced we had a baby girl, Emma Katherine. She was beautiful -- pink, wide-eyed, and gurgling.
Even though I'd heard dozens of labor stories, I was still surprised at how tough it had been. But Emma and I were both healthy and alert. Though it took me a few days to say there would be a next time, I now look forward to it. I hope we can make the relaxation techniques work even better for us. If not, odds are good that labor will be easier and faster the second time around. For now, I can focus on my new labor of love -- motherhood.
Katherine Eastman Seeley lives in Norwalk, Connecticut.
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